tv White House Briefing on Zika Virus CSPAN February 9, 2016 3:36am-4:23am EST
sure we're taking the necessary steps to help the american people. so with the frequency we have discussed this issue over the last couple of weeks, joining me today at the podium are two of the u.s. government's foremost experts on this issue. and they can describe to you both some of the risks associated with this public health issue, but also describe to you the steps that the u.s. government is taking to protect the american people. so to my immediate right is dr. ann shuket from the centers of disease control, and to her right is dr. tony foauci from te national institute of health. dr. schuchat, do you want to go first? >> brazil recognized the virus
the first time in the americas even though we've known about the virus sings 1947. it causes a mild illness in most people. in fact, 4 out of 5 people have no symptoms a the all, but last fall, brazil noticed an increase in an unusual birth defect and we began to be concerned that this virus could potentially be associated with serious comply cases of pregnancy. since that time, the virus has spread to a number of countries in the americas. it's also spread to u.s. territories including puerto rico, the u.s. virgin islands and american samoa. and we have had cases in travelers here in the united states. cdc, the health and human services and the entire u.s. government is taking this very seriously. for the average american, this is not something that will change your day to day life, but if you are pregnant, we have taken the unusual step of recommending that you avoid travel to areas where zika is spreading, or if you live in area such as that, or must
travel, that you be very vigilant with applying mosquito relel pant and taking steps to avoid mosquito bites. we are working 24/7 to understand this virus, to detect it where it is occurring, and to prevent its spread. this will not be easy because the mosquito that spreads zika virus is aggressive day-time biter. it lives outside and inside the home and it can be pretty hard to control it. you know in the backyard how hard it can be to control miskit toes, this is one of those mosquitos that's quite difficult to control. that said, we're working very aggressively with areas where the virus is spreading and areas where it may spread to make sure they're prepared and to help prevent serious complications of pregnancy. at the same time, while we learn more about the risk in pregnancy and the best ways to reduce that risk. we ear working with all of the states and local areas on surveillance reporting.
we've made this disease nationally notifiable. we've shipped out laboratory diagnostic tests so that states can recognize this, and we've issued a number of guidances, not just for travel, but guidances for health care workers so they know how to take care of women who may have been exposed to the virus and how to counsel them about things like sex during pregnancy. so i think that we are working very hard to get the information that americans want and to work with our partners around the world to understand this virus, but also to control its spread and mitigate the harm that it may do. i'm going to turn things over to dr. fauci. >> thank you, anne. as part of the zboft response to the zika issue is the fundamental and clinical biomedical research response to answer some of the questions that we don't know about ebola -- excuse me, about zika and to get that thing on the line so that we could just develop what we call
countermeasures. so let me just briefly describe five issues that we're doing and a lot of this is in collaboration with the cdc. but not much of it is done with our contractors. the first is natural history, understanding the natural history of this infection, not only in people who are infected without being pregnant, but also the natural history of pregnancy and the possible relationship to microcephaly. that's an important part to the especially deem logical approach. the second one is a basic science and understanding about this virus, what we have learned over many years in studying other viruses. viruses like ebola, viruses like hiv. there's viral biology, understanding, is there anything different between these virus, which seems to have originated and worked its way across the pacific into south america. if you look at the molecular fingerprints of that virus, is it any different? and does that relate at all to the disease we're seeing and to what we are seeing as a possible
connection with microcephaly. the other is vector control and this is done in close collaboration with the cdc and there are classic ways in which you control vectors. there are also some relatively novel approaches, genetic manipulation of mosquitos infecting mosquitos with certain bacteria, which prevent them to be able to transmit this virus. if someone is actively affected, you can tell within the period of seven, eight, nine ten days because you can isolate and detect the virus by molecular means. once they clear the virus, to determine had they been affected with zika or one of the other viruses that's very similar to zika. we need to get a very specific diagnostic to tell a woman
particularly who's pregnant, have you been infected with zika or not? that's going to be very important. and we're working very closely on that. and finally, there's the issue with the vaccine. vaccines are very important. the good news is that zika is what we call a certain class of virus ps and we have successfully developed vaccines against flavi viruses like yellow fever. we're studying that right now. we have already started to develop a vaccine and we can predict that we would likely be in phase one trial just to determine if it's safe and in it produces a good response, probably by the end of the summer and get that going by the end of this year, and if it looks like it's safe, we'll go to the next stage. unlikely to have a vaccine that's widely available for a few years. but we certainly can get the initial steps. again, happy to answer any questions.
>> you said once we clear the virus, we're not able to tell if someone has been affected? >> once you clear the virus, the way you determine is by the antibody that you've made against the virus. there's an antibody test that is done by the cdc and a couple of specialized centers that can tell you if you've been affected. you can only tell because of the similarity between zika and dandan dangi. if it's possible, you have to go to the next level of tests that can tell you is it zika or something else. all of that takes time and highly specialized tests. what we're trying to get is a test that will tell you immediately, were you infected and was it zika versus anything else. >> is that a more precise
antibody measurement? >> yes. it recognizes only that aspect of zika that isn't shared with dengi. >> since we won't have a widely available vaks teen for possibly year, what do you think is going to be the most effective method for stopping the spread? we are learning ant routes. the sexual transmission is one way right now our focus is on protecting pregnant women and on trying to control the moss kit toe.
before when hiv was found in tears and saliva, the question was can it be transmitted that way. we can't tell for sure, just because it's in the urine and saliva should not be presumed that is going to be a significant or any way of it being transmitted. we're not going to blow it off. we're going to follow it carefully, but wre make sure that we make the presumption that it can be transmitted by saliva or urine. >> what we can do, the cdc and nih is just give them the facts
and evidence-based information. and dr. schuckat already mentioned that. zika is a relatively mild, in fact, inconsequential infection, but the possibility that a very, very rare event, but as an infei infectioi infecti infection, it isn't serious, the issue is with pregnant women. even under that, if you follow the guidelines that are already out by the cdc about pregnant women traveling and making sure that if, in fact, they're pregnant and want to get pregnant they seriously consider putting it off. and men who go there and might come back to the united states and might have a wife or a sexual partner who's pregnant to be very careful they don't transmit it. those guidelines sfa the way they are, those are the kind of things people should consider when they're going to make their decision.
>> can you give us an idea of when this could be approved? >> well, obviously the request that we have put forth is a request that we made of congress for the of resources that would be beneficial in advancing the efforts that the doctors have been talking about here. we can used a decisional resources. there's been discussion of a development of a vaccine.
her hopeful that have congress can recognize the urgency of this request and act quickly on it. this falls in the category of things that break along party lines. resourc resources to confront a public health challenge like this is something that merits a serious response from the u.s. government. the congress has an important role to play. we hope they'll act quickly. >> yes, last week authorities in dallas investigated and reported on the likely sexual spread of the virus. one person traveled to a zika affected area, developed symptoms of zika came back and after a sexual encounter the partner also developed clinical symptoms and was confirmed to have zika virus.
>> could this go to support abortions those fetuses have been diagnosed? and for the doctors, i'm wondering, you laid out a time line kind of on how long it might be until a vaccine. i'm wondering about the time line for the questions that still exist, especially tying it to these long-term birth defects. and also if you could talk about el salvador's advice for women not to get pregnant until 2018.
>> as it relates to the funding request, i'm not aware of any specific requests like that that will be included. obviously congress will have to consider the kinds of policy questions that would go along with that funding. obviously, there is a ban on the use of fed funds for abortion without the exceptions that are commonly discussed. but ultimately, there will be some policy implications of a lot of these questions. hopefully resolving questions like that. will not impede congress' ability to act quickly in a way that will ensure that we have the resources that we need to protect the american people. >> i'll answer the question about vaccine and ask the doctor to answer the question. with regard to the vaccine, one of the positive things that we have is that we've developed vaccines against flavy virus before. we have a vaccine technology that we developed for west nile, which is also a flavy virus.
the trouble is we didn't have a pharmaceutical company that wanted to take it to the next step of advanced development. we're not going to have that trouble with zika, because they're a pharmaceutical company that's involved. right now we're making a construct for the zika vaccine. that would take us months to get through the tox studies, the fda. we would probably start with humans sometime in the summer, do a phase one trial. that would take about three months. i anticipate we'll be finished before 2016. then you go into an advanced 2 a and 2b, which means that if the epidemic is still at the point where it is now, where there's a lot of cases, you can determine whether a vaccine is safe and effective within a relatively short period of time, measured in six months or more six, seven eight. not five years or so. people say a vaccine is not available.
if you're talking about dotting all the i even and crossing all the t's. when you're in an emergency situation, i think we can move much more quickly than that and get an accelerated approval. about the time line going forward to understand the birth defects and also the other serious complications that may be linked with zika, i think we can dppt substantial information in the weeks ahead, but a lot of the definitive information is going to take many months. the brazil investigators working internationally are looking backwards at people who probably got zika virus last spring and delivered babies this fall or winter. but what we're also keen to do is prospectively follow pregnancies because the microcephaly may be just one of multiple problems that a pregnant woman can face.
>> do you feel the recommendations go far enough. would you like to see him make a similar recommendation? >> every circumstance is different. going home for a funeral, maybe a very special event, we think the most important thing we can do at cdc. the circumstances around travel are going to be very individual. i do think it's important that the world health organization
called attention to this event as a public health emergency of international concern and really has put every country on notice to say take this seriously. we really don't know exactly what to expect and we all want to work aggressively to limit the harm that occurs. >> april? >> as you're talking about this, you're saying it's an epidemic. do you think this could be a pandemic before you have all the vaccines in place. >> a large amount of zika virus have been spreading in americas,
in warmer temperatures and in different zone. we see an infection in people who travel and who are moment. we aren't affecting large scale zika infections. the recommendations for pregnant women were so that we could reduce the chances that pregnant women would unknowingly step into harm's way. even though we do expect the virus to come to the u.s. in travelers, we weren't expecting large outbreaks here with we do think it's likely that we'll have limited local transmission in some of the southern states. and that's one of the reasons for the interest in additional resources so that we can be prepared to aggressively respond with s.w.a.t. teams, local rapid response teams, and also to try to mitigate that or prevent it with effective mas kit toe control inned a vns of the time when those mosquitos may be circulatin circulating.
>> historically, the reason why we're saying about we don't expect the massive outbreak, even though we will be prepared if it is, is that historically, we have faced this over the last few years, both with denghi and with chikagunya. denghi is the same mosquito that transmits zia. although we've had many little local transmitability, particularly along the gulf coast, florida and the keys, dade county and in texas, we were able to relatively easy control it by a very aggressive vector controlled capability.
and that's the reason why even though for years we've had the threat of denghi exploding as a big outbreak, it hasn't happened. we've had the threat since 2013 of chikanugya spreading and it hasn't happened. that's historical that we have with denghi. >> we're talking about public health control of an outbreak without even having a vaccine.
>> is it prudent to defer pregnancy as el salvador has recommended. >> the southern part of the country that have experienced denghi include the southern parts of florida and texas and hawaii has also had denghi. one of the things going for us here in the continental united states is that most people have screens on their windows. most people have air conditioning. we don't have as dense urbanization in the areas where
the virus containing mosquitos could thrive. so we live in a quite different circumstance than in some of the regions in brazil, for instance, where we've seen large zika outbreaks. so i think in that context, we're optimistic that we won't have large scale transmission. we don't want to talk about people planning and circumstances that make it the right time.
one of things we're really keen to do is to follow lots of pregnant women to understand whether the risk is throughout the pregnancy or only in potentially the first couple of months of the pregnancy, also to understand what's going on with the epidemiology, has the wave passed or is it getting worse. we're looking now at altitude. maybe it's just at highle altitudes you're unlikely to be infected by a mosquito. we are trying to alert women that if you're traveling to one
of these areas, there may be a risk. >> as they hone in on babies that actually meet the strakt case definition, it may be a smaller number than the 4,000 or so that were initially reported. those studies will be very important in telling us about the risk and about potential co-factors. but we don't have that information yet.
>> can you talk a bit about this response to zika. can you compare it to the response to ebola? and could you talk about, are we better prepared now because of the actions we took earlier with ebola. >> we responded very, very rapidly to this. we had the president of the united states involved in a very thorough briefing and briefings of this very early on. the first case was in december
2013, and then by march, when there were a lot of cases, people started to realize that. so that's the first thing. there's an outbreak and i don't b see right now any need for yet again having another czar. but if the situation evolves that it would require that, i'm sure that the president would be very open to making that decision. >> they didn't offer specific medical advice, but actually coordinate a variety of government agencies instrumental to the response. you recall there was a
significant employment of d.o.d. assets to west africa. they're monitoring travelers as they enter the country. there was obviously a need for significant dhs involvement in that response. those kinds of things are not yet determined to be necessary. the response to ebola, those muscles have been exercised, so to speak. if this does become something that requires an even greater commitment of resources from a variety of government agencies then the be the would be in position to consider something like that.
>> can you see a scenario when quarantining travelers will be necessary? >> the most important thing here is that this is a mosquito-born virus and with eneed to focus on mosquito control in the area where is it's spreading and really good information for people who may be traveling to such areas. of so i think that would be the public health strategy that would be our focus right now. >> kevin? >> thanks. >> a question about spring break, which is right around the corner. you're talking about tens of thousands of young americans who will be traveling to areas that may have already been impacted by the virus. have we gotten to a point where
already perhaps we should refeign to traveling to these areas in such large numbers? we're not cancelling spring break. we're telling people who are pregnant, you know, you may not want to go. >> soo the numbers, there are 30 million travelers back and forth. that really relates to the issue that was asked about quarantine and things like that. that's an astounding number, you know? >> we have time for two more. roberta? in certain areas that you
described, how concerned are you that this issue is going to become politicized given the political season. >> believe it or not, i can't tell you. the reason i can't tell you, we have a program, at least at nih, which is a virus protein program. we had grantee se studying the other viruses made proposals to go right ahead and now take a look at zika. we're going to take a look at
how well we can spend the money that can be allocated to us for that. >> i just wnted to add, i don't have dollars to tell you, but in 2007, there was the first recognized jut break of zika virus on the pacific island yap. and cdc responded to local authorities. >> nature has a way of coming up with surprises. we really need to take a broader systematic approach. i know that's part of the government response here, to know -- you know, we're very keenly interested in zika virus, but we want to improve vector control. we want to improve diagnostics, we want to have the local and state support be stronger than it is right now.
>> i'm confident that just about everything will be subjected to some politics over the course of this year. but hopefully when something is important as the health of pregnant women in the united states, we can keep most of our attention focused where it should be. know should be taken to keep people safe. okay? steve? >> how much money is left over from the ebola effort and can be used for this now? >> well, there are some -- there is work that is ongoing, to make sure that we follow through on our ebola response. there have been designations made by international organizations that indicate that there's no ebola -- active ebola
virus in some of the countries where we saw that a couple of years ago. but we continue to be quite vigilant about continuing to build the kind of infrastructure that will be critical to fighting this disease in west africa. but also continuing to do the work here in the united states, so that if there is another outbreak, we can expect the american people. the -- over the last couple of years, we have seen flare-ups of ebola and we want to make sure we've learned the lessons of a couple of years ago and follow on the necessary steps. we don't want to take money that is currently being used to make sure we follow through on the ebola response and have it be diverted to this latest effort. we believe the most effective way to move forward is to get congress to appropriate and provide the resources that our experts need to keep the american people safe. i think the bottom line is, you know, there may be a point in
time in which we feel like there are some resources from our ebola efforts that could be used for other things, without impacting our critical efforts against ebola. but right now, the request that we have made of congress reflects the need for the kinds of resources that are necessary to pursue the kinds of remedies that we've been discussing here. okay? pam? >> both doctors mentioned -- and it sounds like you haven't ruled out there might be some other potential significant health risks associated with zika, is that correct? >> yes, that's right. and in particular, with pregnant, microcephaly has been recognized, but we know with other viruses that can cause pregnancy complications there's a whole spectrum of conditions and so we're keen to be looking broader than just what has been
recognized so far. i don't have information today about another syndrome that's not in pregnant women that we're alert to. gee yonl bar resbaz syndrome is seen with diarrheal infections and we're in the midst of studying that in brazil with our colleagues there to understand better what the risk is. but i think with this kind of large-scale spread of a virus that hasn't been in that many people before we have to keep our eyes open. so far what we know is that the people we're most concerned about are pregnant women, and in the general public, 4 out of 5 people have no symptoms. 1 out of 5 has very mild illness without us expecting have to lots of deaths. >> jared, i'll give you the last one and let our experts go. >> thank you. doctor, you said prepare for the worse. if the 1.8 billion of emergency
funds is delayed, diminished or denied in any way by congress, how does that affect the outlook of what you're looking at in terms of the response? >> well, obviously in order to do the full gamut of what we need, we're going to need more resources. so if we don't get the resources, we're not going to be able to do as much as we would have. if it turns out that it's delayed or what have you, at least in my institution, i would have to move money away from other things to do this, but we're hoping for the best. and the reaction of the american public to this, i would hope we would have smooth sailing with getting this through. >> and i just want to say, we are working 24/7 to protect americans right now against the threat of zika and to support the areas that have already seen spread. we expect with the warmer months to come, that more risk will be present. and so this is really a time when we need to scale up the
diagnostics that are getting shipped out and we need to be working on better diagnostics so that problem that a pregnant woman has about, you might have this, but we're not sure. time is precious for this emerging infection. >> given the pro portion that's going to diagnostics ais $1.8 billion enough, or should that be a bigger pot to divide into the different -- >> you know, my sense is that diagnostics are not the only thing that's important here. clearly there's a family of issues that we need to attend to, including the vector control, which is going to be difficult, the support for pregnant women, the issue of surveillance of birth defects. the studies that will help us get better information to the people who need it. so i think the diagnostics and vaccines are important, but they're one piece of a very comprehensive plan. >> so we put in a proposal for
what we thought was necessary to do what we need to do. if it turns out that we get further into it and there's a lot more, then i think there will be another request. but right now for what has been asked for by the president, that would allow us to do the job we need to do right now. >> thank you very much for your time. >> thank you, good to see you. >> on our next washington journal, we preview the new hampshire primary vote with political reporter dan tuohy of the new hampshire union leader. after that we'll take to william o'brien, who is co--chair of the pet cruz presidential campaign. and later a conversation about the youth vote in the 2016 campaign. washington journal live on c-span at 7:00 eastern, join by phone, facebook or twitter. >> new hampshire graphics, a sign-making company and we're learning about how political yard signs are made with the
owner shane millie. how are you today? >> fine, thank you. >> let's talk about your business before we head to the press. what kind of uptick have you seen this year? >> we've seen a nice jump in business. we have the primaries in town. this time of year, political wise, we get quite a few orders coming in. talk about the campaigns you've worked for. who have you worked for and what kind of orders are you seeing? >> we've done some ben carson, some rand paul signs. we do a lot of state and local political players as well. >> so when a campaign comes to you, what do they have to give you in order to get your business done? >> they'll give us their art work or kind of an idea of what they're looking to do. they'll tell us what they're looking for, quantities, and and we'll tailor our products to fit them best. >> so when a campaign comes to you, how many pieces are they looking at from you? >> it depends on the size of their campaign, if it's statewide, local, anywhere from 25 up to 5,000. >> so when you start making these signs, what's the process
like? can you walk us through it? >> sure thing. it's a standard screen-printing process. this machine here i'll load a sign piece and we'll turn it on and what happens is, the machine will spread the ink on the screen and we have a squeegee to give us the final product. >> and there's the one color that we're seeing. what happens with multiple colors? >> we'll run there through the dryer so the ink will dry and send it back through with a second color on. >> so if it's a single side, you get one -- >> if we have double side, we'll run the same process, flip it around and do the other side. >> as far as the workload for you, how many hours a day do you spend doing this? >> that depends. eight hours is a short day for us this time of year. depending on the orders, we can be eight, 12, 15-hour days quite easily. >> and you're standing, you're
putting pieces in. >> oh, yeah. we got people running around fairly crazy this time of year. >> now, tell us about the machine. >> the machine is old. it's a 1967 model and it's your standard, they call it a flat bed clam shell machine. this is your basic flat sign printing platform. when we see yard signs, is it all done on machines like this, or are there other types of machine? >> there are other types. this is the most common. it's a very basic machine, just very reliable. >> especially this time of year, what do you like about the work that you do? >> the variety. i enjoy it. these signs today are red. tomorrow they'll be blue. all different types, all different sizes. never the same thing twice. >> shane millie, the owner of new hampshire graphic advantage. he's talking to us about how political yard signs are made. thank you. >> thank you very much.
>> the citizens of the granite state -- in village, town and city, voters brave bitter cold and sleet to cast their vote. >> thanks to the people of new hampshire. >> good to be black here in new hampshire. >> first in the nation primary. >> new hampshire. >> new hampshire. >> new hampshire. >> new hampshire. >> hey, he's from new hampshire. >> it's great to be back in new hampshire. >> one reporter has called new hampshire's primary, the most cherished of american political tribal life. ♪ >> governor, thank you very much for coming to new hampshire. >> this is a place where you can observe a candidate in the heat
of a dialogue, in the heat of getting tough questions about their positions on the issues. it's not just a place where there's a scripted speech. new hampshire takes its first in the nation primary status really seriously. >> this is one of a whole series of town hall meetings we'll be having. >> this is my 20th town hall meeting. >> welcome to our 115th town hall meeting here in new hampshire. [ cheers and applause ] >> next a house homeland security hearing on the visa process for refugees trying to enter the u.s. witnesses from the immigration department, state department and dhs. this is it two and a half hours.
>> committee on homeland security will come to order. committee is meeting today to receive testimony regarding the threat posed from the exploitation of our nation's refugee and visa programs by violent islamic extremist groups such as isis. i now recognize myself for an opening statement. today we're in the highest threat environment since 9/11 yet there's a crisis of confidence. in washington's ability to do what it takes to protect our country. over the past few weeks i've traveled around the country to discuss the terror threats we face and how to thwart them. the american people are concerned and rightfully so. the president believes terrorist groups like isis are on the run but the truth is that they are on the march. gaining ground across the world. make no mistake they want to