South Florida's battle plan for Zika, expected to rebound with the rainy season, includes more boots on the ground to inspect and fumigate for mosquitoes, more lab resources to speed up test turnaround times and the promise of a more collegial collaboration between the federal and state governments.
“As you know, I have a good relationship with the White House,” said Florida Gov. Rick Scott, who visited the health department in Miami on Monday for a roundtable with local leaders on Zika preparedness.
Scott was a frequent critic of the federal government as a partner in the fight against Zika last year. But he expects a better relationship with the Trump administration, specifically because of Health and Human Services Secretary Tom Price, whom Scott said he has known since 1993.
“I think they’ll be very responsive to the things I ask for,” Scott said.
But despite significant funding from the Centers for Disease Control and Prevention, the fight against Zika is largely a local effort.
Scott and Miami-Dade Mayor Carlos Gimenez promised more resources for mosquito control, for public health labs and for coordinating medical care for infants and families impacted by the virus.
“We’re going to continue to be very aggressive in our mosquito control efforts,” Gimenez said.
Miami-Dade spent about $20 million fighting Zika in 2016, Gimenez said, and he thanked Scott for the state’s reimbursement of about $18 million so far.
The disease cropped up in Florida first as travel-related cases and then, in June, local cases began surging. Three areas in Miami-Dade were identified as transmission zones -- Wynwood, Miami Beach and Little River.
This year, Gimenez said, he expects to spend even more fighting Zika. He also wants to introduce local legislation that would compel builders to develop mosquito control plans for their construction sites, which are common breeding grounds for mosquitoes.
“Nothing onerous,” Gimenez said, adding that county attorneys are working on sample legislation.
County officials also plan to hire an additional 42 workers for mosquito control, boosting the department’s size to about 60 full-time inspectors, technicians, biologists and other employees.
“We’re going to spend a lot of money,” said Alina Hudak, a deputy mayor who oversees the county’s mosquito control department. She estimated efforts in 2017 will cost an additional $10 million over the prior year.
Though Zika has been nearly dormant in Miami-Dade so far in 2017, with two locally acquired cases confirmed and no zones of active transmission identified, Hudak said the county has remained vigilant — monitoring mosquito populations every week through a system of 130 traps located throughout the county. An additional 90 traps are expected by the summer, she said.
Gimenez added that public crews were already fumigating for mosquito larvae to get a jump start on the spring and summer, when mosquito numbers are highest. He said a recent outbreak of yellow fever in Brazil added another reason to prepare early against the Aedes aegypti species of mosquito, which also spreads Zika.
And in the battle to win over “hearts and minds” in the fight against Zika, Miami-Dade will boost advertising, using a newly launched public awareness campaign called “Fight the Bite” to spread the word at department stores, movie theaters and other places about the need to drain standing water and eliminate mosquito breeding sites.
On the state level, Florida Surgeon General Celeste Philip and Scott also promised more resources.
Following up on Scott’s budget proposal, which calls for new funding for the health department to hire more scientists and conduct more research to combat the spread of Zika, Philip said the bureau of public labs has “increased capacity greatly” for testing.
She said by mid-April, the state will begin conducting a complex test for distinguishing Zika from related viruses, such as dengue and chikungunya, that previously only the CDC could perform. Philip said having the state conduct the test, known as a plaque reduction neutralization test, will cut wait times from two to three months down to several weeks.
Last year, a backlog in the delivery of Zika test results led to patients, most of them pregnant women, waiting months to receive their results. Philip said the state still has Zika test results pending, and that “the majority” are from 2016. She wouldn’t say how many tests are pending.
Philip said the health department also will launch a program to coordinate care for infants born to mothers infected with Zika while pregnant. She said local hospitals, such as Jackson Health System, have established Zika-specific care plans, and that the state agency would help ensure that patients follow CDC guidelines for evaluating infants impacted by the virus.
Zika poses the greatest threat to pregnant women and their unborn children because, the CDC has concluded, the virus can cause microcephaly and other severe fetal brain defects. Zika also can lead to eye, ear and neurological problems, including Guillain-Barré syndrome.