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March 2016
Zika: Working Together as Specialists and a Society to End an Outbreak
In the last issue of IDSA News, we published a concise summary of current information about the outbreak of Zika virus in South America and the Caribbean, with several links to resources providing up-to-date information available from the Centers for Disease Control and Prevention. Through a feature box on the homepage of IDSA’s website, we continue to provide timely updates and alerts. As infectious diseases specialists, we must be prepared to answer questions from our patients and the public about what is known about the virus, but also be aware of what is being done domestically and globally to prevent its spread.
As a clinician I am fascinated, as I’m sure many of you are, to learn about the progression of knowledge about Zika virus as it spreads. There are many issues that have yet to be understood and are being clarified daily: How long does the period of Zika viremia last? In blood? In semen? Is Aedes aegypti (and related Aedes species) the only capable mosquito vector for Zika virus, or can other commonly occurring virus genera (such as Culex, which is a prevalent genus in most of the US) also become carriers? 
I am watching closely as more information comes about regarding the correlation between microcephaly and Zika during pregnancy in Brazil, and the total lack of such association in Colombia. The critical question is whether Zika virus disease alone can cause sever neurological disease (microcephaly consequent to in utero infections, Guillain Barre syndrome in infected nonpregnant persons) or whether cofactors are needed. 
Infectious diseases specialists around the world are working day and night to find answers to many critical questions surrounding this disease while at the same time working on the development of a vaccine. Meanwhile, IDSA is also working to address the necessary public health policy response to the outbreak.
IDSA’s Public Health Committee, with input from the Center for Global Health Policy, has developed policy recommendations on how best to address the outbreak both within the US and globally. The focus of these recommendations is to ensure adequate federal support to strengthen our public health prevention and control readiness, diagnostic development, medical countermeasures research and development, and global health activities. 
These recommendations were shared in a letter to the Senate Health, Education, Labor, and Pensions (HELP) Committee, which held a hearing in late February on the Zika virus outbreak. The letter also highlights the key role of ID physicians in responding to the outbreak. These recommendations will also be shared with the House Energy and Commerce Committee, which plans to hold a Zika virus hearing early this month. IDSA’s funding recommendations will also be shared with relevant appropriations subcommittees in Congress. 
The Obama Administration has requested a $1.8 billion emergency supplemental budget request to respond to the outbreak. In addition to resources needed to ramp up domestic preparedness and research and development, the request proposes $335 million for USAID to support mosquito control, public education and maternal health programs in affected countries. 
As with any outbreak of this kind, whether it be Ebola, West Nile, Dengue or Chikungunya virus, there is much we don’t yet know, and the unknown can be the source of a great deal of anxiety and fear among the public. I am heartened, and proud, to know that infectious diseases specialists—some of the brightest medical minds in the world—are working around the clock to find answers. 

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