This post has been updated.
The Obama administration will ask Congress for $1.8 billion to respond to the Zika virus abroad and prepare for it at home, officials said Monday.
"We must work aggressively to investigate these outbreaks, and mitigate, to the best extent possible, the spread of the virus," the administration said in a statement. It said it has not yet seen a case of Zika transmitted directly within the continental United States, but with the approach of spring and summer mosquito seasons, it wants to be prepared to fight the disease.
Hours later, the Centers for Disease Control and Prevention announced that its emergency operations center in Atlanta was on its highest level of alert. More than 300 CDC staff are working in the command center to monitor and coordinate the Zika response.
Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said he did not expect a major outbreak in the United States, noting that similar viruses such as dengue fever have been controlled in certain regions of the country such as Texas and Florida. But he said: "We never assume the least. We always assume the worst."
The CDC money would be used to reduce transmission in the most vulnerable parts of the United States, including Puerto Rico, Hawaii and southern states such as Florida and Texas. Officials are also focusing on pregnant women and their babies, the groups at highest risk.
The mosquito-borne virus is suspected of being linked to a rare congenital condition known as microcephaly, in which babies are born with head and brain abnormalities.
In Brazil, the epicenter of the outbreak in the Americas, Zika has been linked to a surge of such cases. CDC Director Tom Frieden said last week that the association between the virus and microcephaly has become stronger. So, too, has a link between Zika and Guillain-Barré syndrome, which can lead to paralysis in adults. Several South American countries have identified cases of that rare condition.
“Reducing the risk from Zika isn’t going to be quick and it isn’t going to be easy,” Frieden said in an interview Monday. “Mosquitoes are very hard to control.” The link to the potentially devastating birth outcomes is a “completely unprecedented phenomenon,” he said. “Our key priority is reducing the risk to pregnant women and their infants.”
Puerto Rico, the U.S. Virgin Islands and American Samoa are likely to have widespread transmission of Zika because they are home to large populations of the mosquito species considered the primary “vector” for spreading the virus.
“The risk to Puerto Rico is significant,” Frieden said. The territory, already in the grip of a debt crisis, has at least 20 cases in which individuals have been infected without leaving the United States. Puerto Rico also has had widespread outbreaks of dengue fever, another virus transmitted by the same type of mosquito. Health experts say the pattern of dengue’s spread is a likely indicator for Zika.
The bulk of the money the administration is requesting, $828 million, would go to the Centers for Disease Control and Prevention. The request also includes $250 million for a one-year increase in Medicaid funds for Puerto Rico. The administration would pump $200 million into accelerated vaccine and testing techniques for Zika through the National Institutes of Health and the Food and Drug Administration. And $210 million would go to a new fund to respond to new outbreaks if they appear in the United States.
The rest of the money would go to help other countries respond to the virus. It would include $335 million for the U.S. Agency for International Development and $41 million for the State Department to respond across South America, Central America and the Caribbean.
Fauci said the NIH was already diverting researchers' attention away from projects aimed at similar viruses to draw up ideas on the Zika virus. And he said that if Congress did not appropriate the money, the NIH would be forced to divert money from other projects.
But Fauci and White House spokesman Josh Earnest did not, when asked, offer travel advice to Olympic athletes planning to compete in the games in Brazil this summer. "It’s very difficult to give advice to people who’ve devoted the last number of years training for that," he said. Earnest later added, "Ask your doctor, not the White House press secretary."
Some Republicans are opposed to that much funding. Rep. Chris Stewart (R-Utah) last week introduced legislation that would let federal agencies use unused funds allocated to fight the Ebola virus. He said that as of September 2015, there was approximately $1.4 billion in remaining funds.
But White House spokesman Josh Earnest said “over the last couple of years we have seen flare-ups of Ebola and we want to make sure that we have learned lessons from a couple of years ago that we sort of follow through on the necessary steps. So the point is, we don't want to take money that is currently being used to make sure we follow through on our Ebola response and have it be diverted to this latest effort.”
The administration said the money it has requested would go to expanding mosquito-control programs; accelerating vaccine research and diagnostic development; enabling the testing and procurement of vaccines and diagnostics; educating health care providers, pregnant women and their partners; improving epidemiology and expanding laboratory and diagnostic testing capacity; improving health services and supports for low-income pregnant women; and enhancing the ability of Zika-affected countries to better combat mosquitoes and control transmission.
The World Health Organization has declared Zika a global health emergency.