‘Nobody’s looking’: why US Zika outbreak could be bigger than we know (Source theguardian.com)

If you were bitten by a mosquito, and within two weeks had a fever, bloodshot eyes, a rash and felt generally achy, you would have four classic symptoms of Zika. But if you or your sexual partner didn’t travel to Latin America, you might also have a hard time getting tested.

That’s because Zika tests are complicated, time-consuming, sometimes inaccurate and expensive. These obstacles have led some scientists to believe that several states at risk for spread of the disease may already have Zika outbreaks, without even knowing it.

“There is not active surveillance going on in the at-risk states in the United States,” said Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine in Texas.

“I think there’s not just Zika transmission going on in Miami, it’s going on all up and down the Gulf Coast and in Arizona, it’s just that nobody’s looking.” The only confirmed cases of Zika caused by local mosquitoes in the continental US are in Miami, Florida. Federal officials have since issued a travel warning for the area, asking pregnant women or those hoping to become pregnant to avoid the Wynwood neighborhood. There, local mosquitoes infected 15 people with the virus.

Other Gulf coast states are also considered to to be at high risk for local transmission of Zika virus. That is because Aedes aegypti mosquitoes are endemic, and multiple travelers have returned with the infection. Louisiana, long known to be a haven for mosquitoes, is considered a state at-risk of Zika transmission. There, 22 cases of travel-related Zika has been confirmed by the Centers for Disease Control and Prevention (CDC). “The big fear, of course, is we’ll figure this out seven, eight, nine months from now, in the spring of 2017, when we start seeing babies show up with microcephaly,” said Hotez.

Meanwhile, for community health centers in another Gulf Coast state, Texas, the virus recalls an earlier epidemic that left public health officials flat-footed. “We’ve never faced something like Zika before. We faced, what was it? H1N1,” said José Camacho, executive director of the Texas Association of Community Health Centers. Member clinics serve about 1.3 million low-income Texans. “Overnight we were overwhelmed, and I guess nobody was ready for that either. And we’re fearful that some of the same things are playing out here.”