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One Year After Outbreak, U.S. Still Has No Ability to Contain Zika Virus

Every U.S. state, except Alaska, has reported Zika case

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May 26, 2017

The U.S. government still lacks the capability needed to combat an ongoing outbreak of the Zika virus more than a year after the disease spread across the United States, according to a government oversight report highlighting the inability of federal agencies surveil, track, and treat the virus.

At least 5,197 new Zika virus cases have been reported as of April 5, according to investigators from the Government Accountability Office, which recently published an in-depth investigation into the United States's ongoing issues with combatting the disease.

"While much has been learned about the epidemiology of the Zika virus, many unknowns remain, including the actual number of infections and the full spectrum of outcomes," according to the report, which found that government agencies tasked with combatting the outbreak are unable to fully track the spread of the virus across America.

There still remains no viable drug to treat and combat the Zika virus, according to the report, which disclosed that every contiguous U.S. state has reported at least one case of the disease. U.S. doctors and scientists are still not certain how the disease spreads.

The lack of information on the virus has complicated efforts to stem the outbreak. These efforts also have been hindered by problems communicating information and disseminating it the public in a timely fashion, according to the report.

"While much has been learned about the epidemiology of Zika virus, many unknowns remain, including, the total number of infections; the biological mechanisms, risks, reasons for geographic differences, and full spectrum of outcomes associated with maternal-fetal transmission; the presence and duration of the virus in different bodily fluids," according to the report.

The Center for Disease Control and Prevention, or CDC, "has not been able to predict how much the Zika virus will spread in the continental United States," according to the report. "CDC officials told us that there was no epidemiologic model that looked at both types of transmission together  sexual and mosquito borne."

Between Jan. 1, 2015 and April 5, 2017, 5,197 cases of Zika were reported in the United States, with the highest concentration in New York, Florida, California, and Texas.

Aside from Alaska, "every state and three territories reported at least one Zika virus disease case by April 5, 2017," according to the report. "Ten states reported more than 100 cases each. Ninety-four percent of all cases in U.S. states and the District of Columbia were travel-associated."

U.S. territories were found to have about seven times the number of cases as U.S. states, with reported cases standing at 36,504, according to the report.

Efforts to prevent the spread of Zika have been difficult due to the disease's complicated nature, as well as inabilities by the U.S. government to adequately communicate with the public, the report found.

While the U.S. government has made many strides in its efforts to respond to Zika outbreaks, there remain issues.

GAO investigators "identified some challenges regarding the communication of guidance from CDC early in Zika virus surveillance implementation," according to the report.

Entities within the CDC have failed to communicate with one another about the disease and guidance on how to deal with it has not been consistent. Due to the rapidly evolving nature of the disease, some CDC branches were not informed of updated and altered information.

"Challenges resulted from officials from different CDC units needing to establish communication channels that had not existed before the Zika virus outbreak," according to the report. "Officials from one selected site told us about difficulty in communication and the importance of agency-wide communication and partnerships, and relationships that can make things happen faster."

Surveillance of the disease also continues to present challenges.

"State and local public health agencies faced several challenges in implementing surveillance for Zika virus and its associated health outcomes," according to the report. "These challenges involved establishing early case definitions, timely communication of critical information, and interoperability between surveillance databases.'

Reporting to the CDC still remains voluntary and outside health agencies are responsible for reporting the disease of their own accord, an issue that may hamper surveillance efforts, according the report.