By Ron Klain
When I was coordinating the U.S. response to Ebola in the fall of 2014,
one frequent problem was false reports of Ebola cases in this country.
Early symptoms of Ebola resemble flu. Even when we screened out the 99%
of flu patients who had not been to Liberia, Sierra Leone, and Guinea
(and therefore did not have Ebola), there were still many more suspected
or feared cases than actual instances of Ebola in the U.S. Many
sleepless nights in the winter of 2014-2015 ended, fortunately, with
negative Ebola tests.
But among the many reasons policy makers and citizens are not taking seriously enough the potential threat and consequences of Zika is that just the opposite is true for this virus.
About 80% of people who contract the Zika virus experience no symptoms. And health-care professionals are generally not testing asymptomatic people in the U.S., even if they have been to Zika-affected countries or areas in this country where Zika is spreading. This means that most people in the U.S. and its territories who have Zika do not know that they have the virus.
This is particularly stunning when we consider how many cases of Zika have been laboratory-confirmed: more than 2,500 in the 50 states and over 9,000 others in U.S. territories (largely in Puerto Rico). Given that four out of five people with Zika don’t have symptoms and that some people who have symptoms might not get tested, the number of Zika cases in the U.S. and its territories is probably in the tens of thousands already.
We might presume that pregnant women are aware of the dangers to their unborn babies and so are more likely to get tested if they sense symptoms. But most women who have Zika do not have symptoms and so may not think about being tested; others become pregnant after being exposed and likewise may not focus on the need for testing. This means a high percentage of pregnant women exposed to Zika have not been tested, making the current confirmed case counts–600 pregnant women with Zika in the States and 800 in Puerto Rico–almost certainly undercounts. Fortunately, most pregnant women who have Zika, even those exhibiting symptoms, will not give birth to babies with microcephaly–but some unknown, if small, percentage of them will. If the number of women with Zika is higher than the published case count, the number of babies at risk of being born with microcephaly is also higher than the number of confirmed cases suggests.
The Zika undercount also means that the risk of local transmission is far higher than many appreciate...
About 80% of people who contract the Zika virus experience no symptoms. And health-care professionals are generally not testing asymptomatic people in the U.S., even if they have been to Zika-affected countries or areas in this country where Zika is spreading. This means that most people in the U.S. and its territories who have Zika do not know that they have the virus.
This is particularly stunning when we consider how many cases of Zika have been laboratory-confirmed: more than 2,500 in the 50 states and over 9,000 others in U.S. territories (largely in Puerto Rico). Given that four out of five people with Zika don’t have symptoms and that some people who have symptoms might not get tested, the number of Zika cases in the U.S. and its territories is probably in the tens of thousands already.
We might presume that pregnant women are aware of the dangers to their unborn babies and so are more likely to get tested if they sense symptoms. But most women who have Zika do not have symptoms and so may not think about being tested; others become pregnant after being exposed and likewise may not focus on the need for testing. This means a high percentage of pregnant women exposed to Zika have not been tested, making the current confirmed case counts–600 pregnant women with Zika in the States and 800 in Puerto Rico–almost certainly undercounts. Fortunately, most pregnant women who have Zika, even those exhibiting symptoms, will not give birth to babies with microcephaly–but some unknown, if small, percentage of them will. If the number of women with Zika is higher than the published case count, the number of babies at risk of being born with microcephaly is also higher than the number of confirmed cases suggests.
The Zika undercount also means that the risk of local transmission is far higher than many appreciate...
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