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tv   Hearing on the Global Zika Virus Outbreak  CSPAN  February 27, 2016 4:27am-5:56am EST

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the effo the house oversight subcommittee is an hour and 25 minutes.
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>> good afternoon. i would like to call the subcommittee on transportation and public assets to order. this hearing, and this is a subcommitt subcommittee, a committee on oversight and government reform. today we're conducting a hearing on the zika virus. we're looking at the coordination of multiagency response to that virus. very pleased to have everyone join us today. the order of business will be as follows. we'll have opening statements.
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we will then hear from our witnesses. from the witnesses, we will hear your testimony, and then we'll go into questions. that will be the order of business. so without objection, the chair is authorized to declare a recess at anytime and i'll start with my opening statement and then i'll yield to ms. duckworth. again, i want to thanks everyone for attending. there are probably some that didn't want us to hold this hearing, but i think it's very necessary that we do conduct it. i think that zika virus is probably one of the more difficult health challenges that the nation and the world have faced probably since the ebola crises. and unlike that particular crises, there's some very good news to report in this hearing,
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and then the purpose of the hearing is also to hear from some of those voof involved in making certain that the public health and welfare and safety is preserved while we face this possible epidemic. and i might say this isn't something just facing the united states, it's facing the world. so it spread, again, now across many continents. and we have international events like the olympics this summer in brazil. we want to make certain that american travelers there are protected. i might also say we have person personnel throughout the infected area and the world who are responsible to make sure they're safe and secure. many of them are abroad serving the united states in diplomatic posts with the military and others. and we want to make certain that
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those individuals that were we're responsible for are also protected. i'm pleased, too, with the world health organization will hear from this daez that they did not alert the public and declare a seriousness of ebola at the time. that is not the case here. they have acted. they have been proactive. i'm also pleased that we have a very good response both from the federal level and the state level and other agent i ises in governme government. we need to keep it that way and we need to keep going forward. today the purpose of this hearing is to see where we are and what we have done and where we need to go and how we can keep this under control.
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we have a represent from my state which has taken the lead. we have the surgeon general from florida with us and we'll hear again from nih. they've done a great job, the center of disease control is here. and we'll get an opportunity to get an update on a great world event which we're looking at in brazil later this year. right now, and i want to say this and make this very clear, there has been no detected zika infection from an insect or moss k mossquito in the united states of america, no transmission that i'm afraid of. most of what we found so far are individuals who have traveled somewhere else or come into the
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united states. this isn't a south united states problem. in fact, right now -- we have a chart we could show later. i think as far as wisconsin in the united states and what is a 23 states have now had cases where they have determined that someone was infected with zika virus. and we don't have infection from mosquitos in the united states. we have people coming in from outside who have been infected with that disease. so we still have a long way to go in the detection process. we don't know all the connections and we'll have questions and some directions about where we're going to look at how we can go after the disease, either for vaccinations
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or for treatment. it was again somewhat limited in the united states and once again getting a head start on it in a single case. i just had lunch with a local health director. i thought that was very informative because i wanted to hear from him how things that we're doing here have filtered down to the local level. they do face challenges. i want to make sure that they have the test kits available. some of that has been provided and the state of florida acted
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in early february. the governor and others, and they have been in close contact with the local officials which i think is extremely important. there's some simple things that can be done and we note they are using insecticides and using mosquito repellant, staying in air conditioned locations. and that again is where people are getting the infection. but if we do have the problem in the united states, we want to make certain that people are aware of the risk that they face and the simple solutions. just like mosquitos that we have from coast to coast and from border to border. while the cdc remains hesitant to confirm some of the links, we'll hear more about that. experts are confident that zika is causing some outcomes that
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we've seen and we'll talk about them. the most notable are women and pregnant women. they seem to have -- or seem to be fairly certain of a link there. we'll find out more about that and other possible links to individuals that may cause them serious health damage. the administration woke up at 3:00 in the morning. i have this folder, i fell asleep reading it. but i finished it last night, and i did read that the administration, last week, the president sent a communication to the members of congress and asking dpr $1. billion request for emergency action. i also read where mr. rogers, our chairman of appropriations said we have almost the exact
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amount left over from ebola and the possibility of using that. i want to make certain that the funds are available, particularly for the research for finding out anything that can stop this. that also needs funding asap. and we want to make certain that those funds are available. we have questions about the money. money usually solves most of our problems. the situation is rapidly developing and changing and americans have concerns. but they need to know that their government on each level, federal, state and local are making certain that the challenge is being met. and we want to ensure the public
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were all receiving the latest information and coordinating in good fashion so that we could do the best. the united states is fortunate. we have the world's most advanced health care system in the united states. it's impressive. we want to keep it that way and make certain that we're well coordinated. we use common sense that we'll be able to contain the spread of this virus and be well equipped for any future threats it may pose. so i look forward to hearing from the panel. i welcome our witnesses. i would like to turn to our ranking member, the young lady from illinois, ms. duckworth for her opening comment. >> thank you, mr. chairman. and thank you to our expert witnesses for being here today. today's hearing is an important opportunity to examine the effectiveness of our current efforts to combat the zika virus and to ensure the interagency
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response is sufficiently coordinated. there have been 82 reported cases of zika virus. this have been limited to people traveling to the united states from affected countries. as a new mother i understand the public's concern. the recent outbreak of this outbreak in broo sil shed a light on a disease which most americans are not aware. and as the head of the disease centers control and prevention, even the scientific community, there is an astounding lack of literature examining the zika virus. fortunately our public health community is working hard to change this. since the last major zika outbreak in 2007, the cdc produced a test to detect zika in a sample taken from an infected child. more recently, the cdc activated its emergency operations center last month in response to this latest outbreak and on february
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1, the world health organization designated the outbreak a public health emergency of international concern. our public health system has acted quickly to increase its surveillance and diagnosis capabilities in infected areas and to ramp up what had been very limited scientific research on this virus. i want to thank the cdc and nih for their very hard work and rapid response in this case. however, much work remains to be done so that we can better understand the zika virus and develop proven strategies to treat infected individuals. to contain the virus' spread and ultimately to develop effective therapies and vaccines that will neutralize the threat entirely. further, we must work diligently to assess every available control measure and adopt the most effective policies to prevent the virus from entering the mosquito population in the continental united states. equally important in light of what appears to be the zika virus' capacity to cause severe birth defects, we must also
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provide safe, effective and affordable contraception to individuals living in areas of risk for zika transmission. this includes taking action to strengthen healthcare services in areas where mosquito populations are already carrying zika, such as puerto rico and the virgin islands. zika, like the pandemics before it knows no boundaries. our contributions to public health efforts in central and south america are first and foremost the right thing to do. but they are also critical to controlling the spread of this disease. that's why i support the president's proposal for $1.9 billion in emergency funding for domestic and international response for zika. i also emphasize that continued consistent investment in public health remains critical in periods of crisis, as well as in periods of calm. our public health agencies are able to mobilize with agility today because they have built on decades of knowledge, capacity and lessons learned to respond
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to emergency threats some of which we never imagined. the emergence of zika should serve as a warning that we must invest in infrastructure, to defend us both against this threat and the viruses that will surely appear in the future. until we have more answers, we all must remain vigilant against zika. we must all take reasonable precautions so we give the next generation the best chance at full, healthy lives. this requires cooperation of both men and women to prevent transmissions to other humans or to mosquitos in the continental united states. the urge everyone to proceed with caution to protect themselves, their partners, their families and their communities. thank you, mr. chairman for holding this hearing today. i yield back. >> if other members have opening statements, what we'll do is we will do is hold the record open for five legislative days. did you have an opening statement? okay. but we'll hold the record open
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for five legislative days for members who would like to submit a written statement. and we may be asking our witnesses questions in addition to what's done in this formal setting. and they'll also be made part of the record without objection. so ordered. i'm pleased to welcome dr. ann schucket, dr. anthony fauci. he is the director of the national institute of allergy and infectious dzs at the national institute of health. welcome back, doctor. and dr. john armstrong, and he is the surgeon general and
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secondary of health for the state of florida. and then we have dr. bill moreau. he's the managing director for sports medicine for the united states states olympic committee. i want to welcome all of you. and pursuant to the committee rules,s this an investigation and oversight subcommittee and committee of conference. i'll ask you to stand and be sworn. please raise your right hand. do you solemnly swear or affirm that the testimony you're about to give before this subcommittee of congress is the whole truth and nothing but the truth? let the record reflect that the witnesses answered in the affirmative. and while dr. fauci has been here before, maybe others, it's customary to give a five minute statement and if you have
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additional information or data you would like to be made part of the official record of these proceed seed proceedi proceedings, we ask the chair to be included and we will do that. we will start right out. we want to welcome again the deputy director of the center of disease control, dr. ann schucat. welcome and you're recognized. >> thank you so much, chairman. cdc and partners here and overseas are working around the clock to find out as much as we can as quickly as we can, and we are learning more every single day. to accomplish this, cdc is coordinating here at home with others across the department of health and human services including my colleague dr. fauci, and we're working with partners across the u.s. government as well as with other parts of the society to make sure that we communicate with travelers and health care providers, update travel alerts
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and clinical guidance, develop improved mosquito control methods and we're coordinating internationally with the world health organization and pan-american world health organization on the zika response. we're working directly with brazil and other nations, and we're all trying to learn more about zika and help prevent its spread. i want to begin with three key points. this is a dynamic situation. it's changing very frequently. we are committed to share what we know when we know it, and to revise and adapt to the new information. secondly, emerging infections come from nature and they can be challenging. a new syndrome like this can be scary, particularly for vulnerable pregnant women. but we can and should do more to detect, respond, and prevent these new infectious threats. thirdly, cdc has a unique decades long experience in core
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public health functions that are critical for this kind of response. we work on emerging pathogens like zika. we work on disease detection, lab capacity, especially deemolodee -- epidemiology with states and local governments and other countries. what are the facts? we've known about this virus for a long time. but only in 2007 was the first outbreak recognized. we think the virus usually causes a mild syndrome, but we've recently learned that it appears to be associated with serious birth defects, microcephaly and possibly others. there may also be links with a neurological problem. it's principally spread by a mosquito, a very difficult mosquito to control, and that is one of our challenges. there are more cases in brazil, a number of countries in latin
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america are seeing sharp increases in zika virus infections. we expect many travelers returning to the united states to have zika virus infection. at this time, avoiding the virus and the mosquitos that spread it is the best way to protect a pregnancy. there may be local transmission in the united states. the mosquito is resident in those communities. we need to be ready for it. one of the reasons the governor did detect that emergency. we think that other countries are the place where critical information can be learned and
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that's why we're working side by side with our colleagues in brazil and columbia to learn as much as we can as quickly as we can. cdc has been very busy. as you've heard, we've activated our emergency operation scepter to the highest level. we've actually got more than 500 people working on this response. not just our infectious disease experts and our insect experts, but also our experts in birth defects in communication, in travel health. we have developed and distributed kits for laboratory detection and are working with state and local health departments so they can deploy those tests. we're work on the ground in brazil and columbia trying to uncover the mysteries of those links that we're talking about. while we're doing much already, zika requires a robust all-of-government response. as put forward in the emergency zika funding request.
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cdc cdc's part of that request was to provide support for support rico and other areas in the united states, the territories where the virus is already spreading. secondly, for the rest of the u.s., where the travelers may be returning and where laboratory capacity and communication is going to be vital, as well as insect monitoring. and thirdly, for our international partners, where we have a chance to learn as much as we can and to protect americans in that way. this funding would support cdc's work in prevention, detection, and response. to conclude, we must act swiftly to address the challenge of zika virus. we're learning more every day, but there's much more to learn and much more to do. and cdc will continue to work collaboratively and with other departments across congress, to ensure an effective response. thank you. >> thank you for your testimony. we'll turn to dr. fauci,
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representing nih, welcome, sir, and you're recognized. >> thank you very much, chairman micah. members of the committee, first i want to thank you for the opportunity to discuss with you and the committee the role of the national institutes of ik feckious diseases and the broader approach toward addressing the zika virus threat. the institute that i direct has a dual mandate. first, we maintain and grow a robust and basic research propos portfolio. however, despite that long-term commitment, we are also prepared and are part of our mandate to rapidly respond to new and emerges disease threats. this has been something that we have been doing essentially from the beginning. in fact, if one takes a look at this slide, it is the title of a
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prospective that i wrote last month for the new england journal of medicine, and you see from the title, it says zika virus in the americas, yet another arbow virus threat. what i was referring to, over the last couple of decades, we've seen new diseases of this type that we've not seen before, west nile, gengy from decades going, chicken gunia and most recently zika. when one looks at the role of what we do, if we can go back one, the nih's mandate is to do basic and clinical research to provide the research resources for industry and academia with the ultimate mandate to develop vaccines, therapeutics and diagnostics. so let me take a couple of minutes to just describe some of these. when you look at things like the epidemiology and natural history, we're focusing on
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looking at symptomatic versus asymptomatic disease. what about the role of virus and how long it lasts in an individual following infection? a question extraordinarily important to pregnant women and women who want to become pregnant. what about cohort studies to nail down the causative relationship or not between infection and pregnancy and the development of congenital abnormalities such as microcephaly, as well as understanding the pathogen sis of disease. the research is very similar to the research we've done with other viruses, ranging from hiv 30 years ago, to most recently ebola. to look at viral structure, medical biology. the pathogen sis of disease, looking at the immune response, which gives us great insight into the development of vaccines
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in addition, the cdc takes the lead role as disease detectives in trying to determine the diagnosis of the disease. nih grantees and contractors are also working on a more sensitive and specific to anybody test to determine if, in fact, someone has been infected. because we know now the current tests that are available have a degree of cross reactivity. one of the most important things we do is to develop vaccines, as we've done for so many of these emerging threats. the candidates you see on the slide are the two that are most advanced and are essentially ready to go into early trials. we're partnering with our industry colleagues and right now, let me give you an example of why it's important to have done decades of research in other diseases that gives us a head start. years ago, we developed a vaccine for west nile virus.
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we went into phase one when it was shown to be safe. we didn't have any industrial partners, so we never made it to the advanced development, but we used that platform to develop now a zika vaccine that is essentially ready to go in the development of the early preclinical studies. and it's really a very interesting phenomenon. we took a dna piece and take that same platform, take out the west nile gene and stick in the zika gene. so right now, we're making this vaccine and we predict it will be ready to go into phase one trial by the summer of this year and hopefully by the end of 2016, we'll have enough information to decide if we could even go further to an advanced trial. and i'll be happy to discuss that during the question period. finally, when one looks at
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therapy, we're doing screening of drugs of known activity against certain of these viruses, as well as new drugs that have potential activity. this is a very important issue and we are now partnering with many of our industrial and biotech partners to do this. finally, on this last slide, i just want to recapitulate what i said from the very beginning. emerges infections have been with us all along, they're with us now, and they will always be with us. i call it the perpetual challenge, as i did in this review from a few years ago. i would like to thank this committee and others for the extraordinary support that you've given us over the years to allow us to fulfill this mandate. thank you. >> thank you, dr. fauci. now we'll recognize our florida surgeon general, dr. armstrong, welcome, and you're recognized sir. >> thank you, chair, micah, ranking member duckworth, members of the subcommittee.
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florida has a long tradition of eradicating mosquito-born diseases. the florida department of health was created from an epidemic of yellow fever in 1889. our outbreaks have been local and of short duration. consistently the approach is three-fold. first, mosquito control, next public information, and third, professional education. we've seen success with containment of west nile, chikungunya -- to date, we have had no transmission of the zika virus in the state of florida. our department has reported 29 travel-related zika cases to the cdc, most recently from seminole
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county. a travel related case is one that was contracted outside the state prior to arrival. none of our confirmed cases of active zika virus involve pregnant women. we have, however, identified three pregnant women, who traveled to countries affected by zika and who likely had zika virus in those countries, and who have returned without any symptoms. they have evidence of remote infection with zika, and we are applying cdc guidelines to ensure that these women receive care through their health professionals consistent with those guidelines. we currently have the laboratory capacity to conduct over 4,800 viral tests for active zika and over 1200 antibody tests to it detect past zika infections. we've been conducting 300 tests
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per week and reporting positive results to our partners and the public daily. recognizing the increase of travel-related cases of zika in florida, governor rick scott requested a briefing with the cdc on the zika virus. we confirmed that the mosquito, the carrier, is common in florida and that there are potential links between zika and newborn microcephaly as well as adult disorders including gill an barr syndrome. -- and about the impacts of zika after an individual becomes infected. guidance from the krk should account for this uncertainty, while providing actionable recommendations based on what is known. based on that meeting and the tripling of cases, governor rick scott issued an executive order directing me to declare public
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health emergencies in the counties with diagnosed travel cases. on that day, i declared and add counties to the declaration as i've shared. the public health emergency included three key directives. one, notification of florida's commission of agriculture, who overs oversees the office which connects with florida's mosquito control boards. next, coordination of local leaders and public outreach to vulnerable populations with action plans reported back to the dwmt of health, and outreach to medical professionals of up-to-date guidelines and access to diagnostic tools. we instituted a command teaj for comprehensive readiness activities. florida is one of the premiere state labs in the country. one in jacksonville, and branch laboratories in miami and tampa. when the public health emergency was issues, governor scott recognized that with over 20
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million and 100 million tourists annually, florida must stay ahead of the zika virus. he called for the florida health department to have on hand 4,000 tests, which were commercially available and ordered the next day. so we can test pregnant women and new mothers with symptoms of zika. the antibody test allows individuals to see if they ever had the zika virus. at the time, we had a capacity for only 475 tests. on february 9th, the cdc provided florida with 950 test says, bringing our total to 1,425. with our struinfrastructure and resources, we're equipped to test patients with zika virus and associated travel history to an impacted country based on cdc
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guidance. the florida department of health licenses all medical professionals and has existing communication channels and we've used the channels to share treatment and testing protocols, as well as recent fda recommendations regarding blood donations with individuals who have been to areas with active zika virus transmission. it's always been paramount importance that universal precautions provide the appropriate level of protection. the cdc hosted a conference call for florida medical professionals to provide information on the symptoms, treatment and proper precautions for zika. nearly 600 medical professionals and health care facilities dialed into the call to hear directly from the cdc on the issue ms they need to take to help patients. strengthening the connection twb health care professionals and the public is essential for tracking disease and we remain in frequent contact with the cdc
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and tda on how best to prepare communities in florida. finally, public outreach. we work to keep the public informed as one of the best ways to calm fears and educate for action. we established a hotline for florida residents and visitors, as well as anyone planning on visiting florida in the near future. we want them to have access to communication, to have the latest updates, get their questions answered. we issue a daily press release with up to date diagnosis counts and tips on how to protect yourself. we've established a website with public information on community meetings. we've developed info graphics to explain what the virus is and the best practices for mosquito protection. these materials have been requested for branding by other states. we've made these available to our 67 county health officers as
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an integrated department of health. we're sharing three key messages about zika virus. one, anyone who's pregnant, intends to become pregnant, or might become pregnant, should not travel to a country with active zika virus transmission, as determined by the cdc. two, travelers from zika-infected countries should have protected sex for at least a month upon returning to the united states due to the lingering presence of the virus in various bodily fluids. and three, the best way to prevent zika and other mosquito-born viruses, eliminate any standing water, to use mosquito repellant and cover with proper clothing and to ensure that window and door skrens are in place and intact. our residents play an important role in preventing the spread and we want them to have all the information they need to join the effort. in florida, we've developed a
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pruch, seamless model to take cdc guidance and get it to our residents, visitors, health professionals and partner organizations to protect them from emerging mosquito-born diseases. in the past we've had success in containing other mosquito-born viruses with systems that mirror the level of preparedness that we currently maintain. we've made it a priority to stay ahead of the virus in florida and we'll continue to do all we can to keep floridians safe. thank you. >> thank you, dr. armstrong, and we'll now hear from the representative from the u.s. olympic committee, dr. moreau, welcome, and you're recognized. >> thank you, chairman micah, ranking member duckworth, and the other members of the subcommitt subcommittee, for holding this hearing on zika and u.s. governmental preparedness. the usoc recognizes that zika is
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a serious global health concern and an issue we are proactively addressing with team usa. u.s. olympic as a sports organization, our mission is to support athletes in achieving sustained competitive excellence while demonstrating the values of the olympic movement, thereby inspiring americans. every two years, we bring team usa to the olympic and paralympic games. we work with 47 governing bodies of sport to build team usa. the safety of our athletes and staff is our number one priority. as the managing director of sports medicine for the u.s. olympic committee, my mission is to build and coordinate a complex network of medical doctors, health care services and academic experts across numerous medical fields. the u.s. olympic committee is not an organization with a focus on the specialty of infectious
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disease. we rely on the expertise of the centers for disease control and prevent and other public and private infectious disease experts to address and help us to understand the threats that viruses such as zika pose to our athletes. we've been in contact with the cdc and other experts for months. they continue to provide us sound recommendations, based on the information available to date. we have supported these recommendations, developed a protocol to mitigate risks and provided this information to all potential team usa athletes and support staff, likely to travel to rio before and during the summer olympic and paralympic games. i've -- working with the cdc and other experts, we've developed a protocol to mitigate the risks posed by zika. let me walk you through that right now. we're continuously communicating
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the latest information to our athletes, staff, and other stakeholders. we are steadily communicating with partners, such as the international olympic committee, the world health organization, the cdc, department of defense, and infectious disease specialists. we're monitoring evidence-based sources for information regarding viral pathogens. we're following the mosquito bite precautions provided by the cdc. we are following insect repellant as recommended die by dod. we are training our medical team regarding the early recognition and prevention for viral infections such as zika. we are stocking our form larry with the best supportive, medical intervention. we are providing deep containing insect repellant for personnel. with additional supplies on hand
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in rio, we are considering pretreatment for all usoc personal clothing. we are also considering providing bed nets for all personnel, and we are identifying brazilian location for additional support regarding viral pathogens. in conclusion, knowledge about zika virus is growing on an almost well daily basis. we are following all the development. we are incredibly pleased with the support and collaboration we received from the cdc, the dod and others and are indeed indebted to them. we're sharing this information so that we can provide the best, most accurate information to our athletes and staff, who most directly serve and support our athletes. we will continue to work closely with the cdc, the dod, and other infectious disease experts throughout the rio games and we'll continue to follow the cdc recommendations. thank you again for the opportunity to address this
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important issue. >> thank you to each of our witnesses for their testimony and we'll turn to questions and i'll begin. dr. schuchat, can the cdc confirm what i said earlier, that we have not had a case of zika infection from a mosquito in the united states? everything is coming in so far from another source, is that correct? >> for the 50 states and the district of columbia, that's right. we do have cases in puerto rico and the territories? >> so virgin islands -- >> virgin islands and american samoa at this point. continental u.s., 50 states, not yet. >> now the next thing, and i just became more concerned as i heard dr. armstrong reveal the
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issue with pregnant women and we think there's a link, a pretty good link to some birth defects. and this is a transportation oversight committee along with other things, but these people are coming in mostly from latin and south america, by air. are there warnings now to people coming in -- is everyone getting a warning who comes in, particularly women i'd be concerned. when i read all the testimony, seems like the women are the most at risk, we don't know. but are they getting a warning. >> we've been working very closely with the air travel industry and other travel partners, so there's signage -- >> again, i think that, again, it would be good to send out something that -- and the airlines that cooperate -- they always cooperate.
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we've had bird flu, we've had other -- ebola -- others. but i think we need to get a warning in. it's not that many coming in. we know where they're coming in from. but the infected areas, that there be some kibnd of warning o the passengers. i get there's long-term incubation or whatever you call it, the period of vulnerability, from 21 to 30 days, that's pretty much agreed on, dr. fauci? you said stop having sex for 30 days or something like that? >> you will clear the virus within seven days usually. and therefore, for the rest of the time, generally, except if you're a male, and it could be in the semen, which has been demonstrated in a number of individuals. >> we don't know how long that? >> we don't know. it's been in some, as far out as 62 days. >> as far as what?
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>> one was 62 days, but that may be an outlier. >> well, again, i think the first thing is getting the warning out. these are people coming into the united states from infected areas. so that would be my concern and we need to work with the aviation industry to get these warnings out there, particularly among women and then advise them of the risks that we know so far. >> i have from the governor's office a couple minutes ago, asking for the center for disease control for another 250 kits to test for zika virus. are you able -- now that you've already cooperated and you guys have been there, dr. armstrong, the requests have gone in. everything's been done in a timely fashion. are we able to meet this request
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and where are we in the stockpile of making certain we have the test kit? >> you know, we have been working round the clock to produce kits and to develop even better tests. and we -- one of the reasons for the emergency request is the volume. we contaminaestimate half a mil pregnant women will be traveling back and forth to affected areas this year. 35,000 pregnant women in puerto rico alone. so keeping up with that volume for the state support is one of the reasons for the emergency request. >> but do we have the test kits now, or ordered? you just said there may be a big need. your job is to stay ahead of the curve, and your job. do we have the test kits? here's one small additional order, and can we meet additional -- >> where we are right now --
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>> the order's in. >> we've produced about 30,000, and we'll have about 90,000 shortly. so we're working round the clock. and working with private partners, so they can help us. >> so we're going to -- if we haven't, we're going to alert people coming in, going to work with you on that. want the test kit, want to make sure we have test kits available and the supply. the thing that startled me was the blood supply, because this is in the blood. we should also have a warning about -- there ought to be 60 days, 90 days' warning that people should not donate blood or identify they've been to a country where they've been exposed when they're coming back. >> the fda has -- actually, voluntarily the blood bank did that, and the fda instituted it formally. there's effort now in puerto rico to import blood because the
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virus -- because they can't assure that local blood will be okay. >> and is the fda giving proper warning? >> absolutely. >> god bless the people of puerto rico, they should have some transparency in the blood supply, truth and -- >> and there's accelerated effort to the develop screening tests so blood can be assured to be safe in endemic locations. >> okay. now, you guys have been great in identifying the course forward, but i've got a couple of quick questions. the testing and you're trying to get more advanced tests and a lot of that evolves around the president's request. it was a good request, i just read it, where's my president's request here guys? here it is. from the white house, the speaker and all the members. he asked for about $1.8 billion.
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coincidentally and i didn't know this, i have a letter back from mr. rogers, the chairman of appropriations, there's about $1.8 billion available with leftover money from ebola. do you have the ability to move that money in to where we need it? i'll ask both of you, cdc, nih. >> a couple key points about ebola. the outbreak is out of the headlines, but there is still substantial effort left -- >> but you still have a balance of about $1.8 billion? >> the cdc doesn't have that large a balance for ebola. our resources are either committed or -- >> but the administration does have, again, from mr. rogers, the chairman of appropriations is saying that that's unexpended
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dollars. my whole question is, is there some money available, do you have money to address this now? >> we -- >> are you short? >> the resources for ebola are committed. they're global health security recourses which are -- >> do you have resources now? we do a lot of things around here by executive order, we ship money in a nano second. you can see the president or the administration shifting money to some cause. >> right. >> do you have the ability to get the test kits -- i want to ask dr. fauci. because you got a whole bunch of things in research. you're on -- it was fantastic news to hear the summer trials -- by this summer, you're moving ahead and you showed us how you're doing that. but i want to assure these members that you feel you have the resources and support from the administration to move forward.
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do you, dr. fauci? >> our proportion of the ebola money -- >> well, you have ebola and you have other money -- >> well, i'll explain to you what we're doing. our pro portion of the ebola money, we spent all of it, except for maybe $8, $9 million. >> are sources right now, without the supplement asked for by the president, is moving money out of other things. let me tell you what we've done. we have money we've been investing in contractors and grantees who do virus research in the united states and brazil. we've directed them to switch over and add on -- >> they're under contract to address -- >> right. but they're going to have to not do other things in order to do that. >> and do you have people under contract? >> we've -- the global money commitments have been made to 17 high-risk countries in africa
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where we -- and asia, which are very vulnerable for exactly what happened with ebola. >> you're directing some of those funds now to zika in that 17 countries you're talking about? >> no. those resources are for african countries. >> but for what? ebola, or other diseases? all of the above? >> to prevent, detect and respond to threats, including -- >> so it should be zika? >> in those countries, they're not having zika. >> well, it is in different -- >> the geography -- [ all speak at once ] >> and do you spend to redirect some of that money now that we have this? >> we think that would be dangerous in terms of the outbreaks that are ongoing. >> again, what i'm trying to get, to make certain you have the resources. if you don't have them, we need to know. we need to know that also, the things that need to get under contract or under contract for the test kits, for the research
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for the vaccine, for moving this little protocol forward, dr. fauci. >> mr. chairman, just so i can clarify, in order to get a jump-start, we took money that we had allocated for things like dengy and moved it over. i will not be able to proceed with the trial that i described to you without additional money. >> okay. >> which is one of the reasons why -- >> see, that's what we need to know. tell our colleagues, the request is in, the president gave it to us last week. and we'll have to work with our leadership. but we want you to have the funds available. we don't want to neglect important research. and one of the reasons i voted for the omnibus so we have additional money in research, alzheimer's, and some other diseases. you can't rob peter to pay paul. >> some of our plans are dependent on the supplement. >> okay. again, i have other questions
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like notifying -- you notifying our dod and overseas personnel through state and dod. have they -- are there official notices going out on the risks and the warnings and all of that? >> yes. we've been working closely with the other departments for the americans overseas. >> we have families and everybody out all around the globe. i've gone over my time. we'll come back, as we've got plenty of time, as you can see with the members that are here. miss duckworth, i'll yield to you, and thank you. >> thank you, mr. chairman. dr. schuchat, i want to speak about notifying travelers coming back into the united states. i'm wondering about the travelers in the united states who might be on their way out. what information is being provided? what guidance has the cdc provided to the obstetric community in the continental united states regarding zina? >> we've been working closely with the community including
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obstetricians. joint guidance and the website has distributed our guidance to the 65,000 obstetricians in america, and we've held calls and sessions for question and answers. we've are very keen to be letting women know before they travel and the signage and the outreach is through direct health clinicians, chnls and consumer groups as well. i did a scary mommy blog, and we've been working all the social media, as well as the professional groups, so that women know and that their families know what to expect. we know that women's most trusted source is their own doctor, and so we want their own doctor to know the answers to the questions. with a breaking syndrome like this, information is updated frequently. so it's not just a one-time guidance, but ongoing updates. >> is that a similar effort with family physicians or groups? i'm thinking if i were traveling
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to these countries, i would need to get immunized for other diseases as well. if i were planning a trip, i would be getting those immunizations also. is zika being added as part of the conversation? >> yes, that's right. our travel site is the most popular on cdc's website. we work close with the community and the special travel industry to make sure that people know who to expect where they're going. what to eat and drink or not and what shots they might need before they travel. so zika has been added to those messages. >> i'm a big fan of nih, and we should be funding you at far higher levels, because it's a savings, it's an investment. do you know if there's a specific stage in pregnancy when exposure to zika is more likely to cause microcephaly. >> we don't know for sure, but if it acts like all viruses, the
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first trimester is the most vulnerable. whether or not individuals who might get infected later in pregnancy, have a degree of adverse event with the pregnancy, it's not entirely clear. i wouldn't be surprised if there are some outliers in which you can have late effects of infection later on. but when you think about this, almost always the first trimester is the most vulnerable. >> and i understand that the severity of the birth defects with zika do vary. >> very much so. >> do we have any idea what causes it? or is it just in the learning process? >> it's part of the learning process, but you use other models like rubella and others. and there isn't just one size fits all. you have a great degree and you might have severe microcephaly, to the point of the fetus not even surviving, or you might
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have birth with some abnormalities of vision, or perhaps mental issues. it goes from one end of the spectrum to the other. >> do those also include schizophrenia or bipolar disorder? >> there have been reports in the past, not with stwreeka yet, of infections that mothers have during early parts of pregnancy, and what is currently an increase in the incidence of certain types of disorder. there's controversy about that, but there's enough to suggest that there would be an impact on some aspect of brain function, which might also include things like psychiatric issues. >> you might be the organization that works with the dod perhaps. what about military women that are being deployed, especially?
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i served in operation new horizon multiple times and various missions in latin america. what are we doing with dod -- with military men and women who are going over? >> we've been working closely with the military and the department of state so that our guidance for americans traveling abroad can be consistent for the military that are serving abroad, as well as for the state department employees and their families. so we do think that in places where there's active circulation of zika virus right now, particularly latin america, that the ability to -- that it's not good for pregnant women to be there, and if they're interested in redeploying elsewhere, i think the departments are working with them on that. >> is there any plans to do any type of universal testing and monitoring of troops who are assigned there? most are going to be reserve and national guard troops, they're going and planning to do their three weeks or one month and
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they come back. but it's a nice population that you can track, who will go and come back. >> yeah. one of the aspects of coordination across the government and the intergovernmental leadership calls that we have, and the dod is very actively participating in that. they do enormous amounts of research. so i'm not personally aware of whether there's deployment tracking in terms of cohort studies going on, but that's the kind of thing that they're able to do. >> okay. i yield back to the chairman. >> thank the gentle lady. mr. desaulnier? >> thank you, mr. chairman. first off, congratulations to all of you, i'm always very proud of our robust public health system in the united states. worked in local government, state government, it works best, but nobody notices. but in this global economy, with
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pandemics, always something we have to be cautious about. my questions are two lines really of questioning. dr. fauci, first of all, how would you characterize the american role in global pandemic preparedness? we are looked at both because americans travel a lot, but because of our infrastructure as a leader in this. how do we interact with the global community and make sure that we're using our resources in an effective and efficient way given our position? >> i think we interact quite well and it's getting better and better. every time we have a challenge, there are really lessons learned that i think are important. everything from responding to a pandemic influenza, or the threat of a pandemic influenza, to the global response to ebola, in which there were several lessons learned and even now, all of us are experiencing like dr. schuchat and i were very much involved in the issue with ebola. and as people who are now involved very deeply, the issue
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with zika, we already see the differences in how the global community has responded in a much more robust way than we did before. so the answer to your question is, i think we've done well all along, but we're really doing better now because of experience. so the global preparedness is going up exponentially. >> i believe so. and we have a global health security agenda that we're part of, that the united states is part of, which is also part of that preparedness issue. >> doctor, the cdc's perspective? >> yes. i think people are taking the issue of preparedness very serious and the importance of being able to detect, prevent and respond is vital. the u.s. is a leader, but we have many countries joining from the process. and the w.h.o. did jump on this a lot quicker than previously. >> my other line of questioning, dr. fauci, i'm told you were
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involved in the aids epidemic, and being from the bay area, and being old enough to remember that, as we were dealing with that, and researchers at places like usf were dealing with it, many of whom are still practicing, the miscommunication was a huge struggle. the things that people say, both politically and in terms of our effectiveness. but now, all these years later, you still have that, but then you have social media. just curious. you spend a lot of your time, i imagine, correcting misinformation, and how much, if you'd like to talk about that, about what you're learning about how we communicate vis-a-vis social media and what time you have to expand maybe correcting what's out there, and has that changed over time? >> well, part of the administration and in this case, the department of health and human services which are the predominant agency involved, is that we try very hard, all of us, to get out there publicly, with the media, both the classic media and the social media. myself and tom freedman, and ann
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schuchat, we're on the media all the time, tv, radio, et cetera, trying to get the information out. what we've learned all the way back from the years of hiv-aids that we want to get correct information out. when we don't know the answer to something, we say we don't know the answer. and that's the reason why you're hearing us be very cautious, for example, of saying, we believe and think that there is a direct causal relationship between infection of a pregnant woman and microcephaly. but we haven't yet done the definitive studies. and the reason we don't want to stay anything definitive unless we do the study, because there may be other co-factors that are involved that we don't know about. if we come out confidently saying something and then it turns out not to be the case, we lose credibility. so we're very careful to only talk on evidence based, as opposed to guessing what we think the answer is. >> from the cdc's perspective?
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>> yeah, we think that the changes in communication have both benefitted and harmed. it's easier to reach a lot of people. but that means it's easier for everyone to reach a lot of people. so the credibility of the public health folks doing the talking is critical and we want to protect that. >> i think we're all aware of the benefits and curses of social media. mr. chairman, i'll yield back the balance of my time. thank you very much. >> i have a few more follow-up questions. okay, there are people in the united states who are infected. they were infected outside. right now, it's winter across the united states and we're getting into more of the mosquito season. do we know if the disease can be
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transmitted from a mosquito biting an infected person? dr. fauci, do you know? so we're gaining in the number of infected people in the united states. it's in their blood and a mosquito bites them, then we infect the mosquito population right here. >> that certainly can happen and -- >> i'm not a scientist. >> no. well, certainly that's the way it is spread now in the areas where there is local transmission, in south america and the caribbean. we have those mosquitos in the united states, particularly a region in the southeastern part along the gulf coast. one of the things that we're preparing for, we have, as you heard from dr. schuchat and others, a considerable number of imported cases that got infected elsewhere and come home. we're going to see more of those. what would not be surprising is at some time in the future, we will see local transmission,
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where just what you're saying happens. where someone comes back, they get bit by a mosquito -- >> the way you stop that, you stop the mosquito. like we've gone after west nile. we had west nile right here. >> right, mosquito control. and that's what the people have started. >> that's mostly a state and local issue. i don't know if we are helping any of the local entities, if they can use their funds, if we have cdc funds. -- not cdc funds. we have community block -- >> quite a bit of the emergency request is to be able to support state and local mosquito control. mosquito control is very patchy right now. and there aren't -- >> we're damn good at it. >> and we're all grateful. >> we've had mosquitos in most of the gulf coast region from -- i've worked in louisiana, along
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the gulf coast, to texas, and they're pretty good at it. but again, there are places that are not as good at it. and the reaction that florida has taken. florida set a model already for the united states. but what we want to do, what we want to do is make certain we're covering the rest of the south. sounds like we already had some damage in puerto rico, the virgin islands and the caribbean region? >> yes. the living conditions and the climate in puerto rico and the caribbean are such that mosquitos are very intense, circulating year-round. in areas that have good mosquito control in the u.s., the type of mosquito that we're dealing with here is a bit difficult. there are a variety of species, but it's a daytime biter, inside and outside -- >> again, public information for folks in the continental united states, you've got to use insect
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repellant. the local authorities and state have to do more spraying. i've seen some of the recommendations already, even small amounts of standing water are breeding grounds for the coming spring and summer. >> and it just may need to be more intensive mosquito control, because this one is quite difficult. particularly as i mentioned in puerto rico. >> now, you didn't mention this, dr. moreau, but i read about it. did you mention that the games are being held in brazil in their winter? did you mention that? it might have been in your written testimony. >> folks don't know that, which means you've got the best chance of not getting infected in brazil where the olympics are being held? is it july or august? i forget the dates. >> august for the olympic games and september for the paralympic games. >> and that's some of your coldest months, so you have your
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least likely time of being infected, for folks that want to go. we want our u.s. team to participate, to be protected and we want our visitors also to have that. every time you get a chance, you need to tell folks that you got the least chance of being bitten or infected during that period of time. because it's the opposite of of the northern hemisphere. okay, dod has already done a lot of work. how do we -- how have we been coordinating with dod, department of defense for anyone not -- can you tell us? >> maybe i can begin and then he can continue. there's been intergovernmental coordination across the leadership, to do the planning both for protection -- there's also a lot of research that dod does. >> yes. >> and they're part of our
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countermeasures. >> but we're not duplicating? >> no. and same with ebola research. one of the promising vaccines was developed originally through military work, so i would say the coordination is good. >> what would you say, doctor? >> i totally agree. we've worked with the dod on a number of issues, the most recent was ebola. we have very good coordination, and it comes centrally, and we coordinate among all the agencies. >> well, at this point in the record, then, with your permission, miss duckworth, i'll enter into the record and trying to get everybody's who's involved here, their testimony. and we ask dod, who is not a witness, if testimony from the department of defense, testimony from u.s. agency for international development, and testimony from the american mosquito control association, and the gentle lady moves that
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this be made part of the record without objection. so ordered. so we'll put that in the record at this point. again, i've got three -- well, two federal agencies here, and we've got the state witness association here for our olympic committee and we need to know that we have a coordinated and seamless connect with all of our agencies. did you want to comment any more on dod? okay. i just saw here that there's research outside the united states, a british technology company. i don't know the name. it's currently testing genetically modified mosquito named ox 513-a in brazil. are you aware of this? are we doing anything with these
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folks? >> yes, we are. the idea of genetically modified mosquitos, which would make a male sterile and release it into the environment -- >> and they've released some of these? >> yes, they have. the release of genetically modified mosquitos in order to prevent the procreation of other mosquitos is something that has been tried in the local ways, where you would go into a relatively restricted geographic area and it seems to be rather effective at a local level. the challenge with genetically modified mosquitos in addition to somewhat of the society cal pushback about anything genetically modified being released into the environment, is that it's difficult to scale it up on a country-wide basis. that's one of the problems we have with that. >> so, again, i'm just trying to find out if we're covering all of our bases here. then you've got -- i'm learning
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more as we go along. you recommended, cdc, some of the insect repellant and i just found out, i didn't know they had this, this is insect repellant for clothing and gear, and our all knowledgeable ranking member, who knows about dod said, yes, they have this, but they've also found it causes cancer. this seems like a good product. and i go down to like puerto rico all the time. one of my favorite places to visit. just came back after the holidays. but is this stuff good to use and are you guys recommending that? cdc, tell us if the cure is worse than the disease? >> we work really closely with the epa, who registers insecticides and repellants and so forth. and so our website has a link to what is okayed and what is not. and so there are many repellants and treatment for the clothing.
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which some of the products are fine and i can't see that far -- >> the staff said this is okay. i'm also being conscious of warning of my knowledge of -- she said they used to soak their uniforms in it. but again, getting information out to people, how they can protect themselves is so important. so we've covered some of that. i was kinda shocked the first time i've heard your 62 days, at least for the males to possibly be infected and have a -- pose some risk. because i've not seen that before. is that the first time you've announced it today that -- >> that report has been out for a few weeks now. >> but i've not heard it
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publicly. i've heard 21 to 30 days advisory. >> no. >> which is a different situation, but i think we need to be aware of that. i appreciate your making it known publicly. dr. armstrong, you haven't been neglected and we appreciate you coming here. you're at the other end of the spectrum. got good report from our local health officials and the quick response from the governor, the quick response from you, the state level. tell us, again, i know it's awkward having cdc and nih here, is there something we're missing? is there something you could recommend that we should pay attention to from the state level and local, you're on the front line. >> well, thank you for your question. we have to manage this situation in the state and locally with what we know. and what we have appreciated is
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guidance from the cdc now that is acknowledging uncertainty in what we don't know and helping us to really provide insights for people out of an abundance of caution, so that we keep them safe. and i think that's been a key change from ebola to zika, that there is acknowledgement by the cdc that just because they don't have a definitive answer to something, doesn't mean something doesn't need to be said. we still need a guideline. and we again are leveraging all the cdc guidelines to protect the people of florida and our visitors. >> question, a follow-up to my question to dr. fauci about the genetically modified organisms. i guess there was some efforts in florida to curtail some mosqui mosquito-born threats using that approach. are you aware of that? >> yes, i am aware of that, in
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the past. and i think that -- >> is it a route we should take? what did we use that on? i don't recall. >> i'll have to get you the specific virus against which we were using the mosquito approach. but i would echo what dr. fauci says. i think there needs to be a great deal of public awareness and education before doing that. and we need to be aware of unintended consequences from introducing genetically modified mosquitos. you're at the state level, you're at the federal level. when i spoke with our local, one of our local health directors, he said, we get these cases, he says, and we're also responsible for monitoring the individuals who are infected. he says, well, we have very limited staff, and i need people then to be the monitors. and as you get multiple people, you need multiple staff checking
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up on them. so some of the resources to the local entities, to actually monitor these folks, it appears it might be putting a strain on them. do you have a way of dealing with that? do we have some emergency funds at the state level to make certain that folks who are infected are monitored? >> well, at this point, we're applying what we learned through monitoring for ebola virus. we had a very aggressive program. >> they told me actually -- listen to this. he said one way we would go when they thought someone was infected with ebola. he said they would come with a sign, what's your temperature. he says, because you didn't want to come in contact with them. that was a different situation, but you have to modify your approach to the risk even for the worker. but my concern was the funds to make certain you have the workers who can go out and
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monitor these folks. right now, these are very limited numbers. but we'll have to make certain at the state level or on an emergency basis if we see where we've got to have additional personnel, that that need is met. so i think those are the major questions. again, we have some serious issues here. we've done -- or you all have -- we've done nothing, but you've done a great job in staying ahead of it. usually this committee is very harsh on folks. and we had some tough time with the start of ebola and some other issues but i'm very pleased with where we are right now. we just want to keep it under control and go forward. did you have anything else, miss duckworth? well, again, we'll keep the record open for additional questions for our witnesses.
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make any responses part of the record today. want to thank each of you for your good work, for testing today, and look forward to working with you and we'll try to pledge ourselves to get the resources that are necessary in a timely fashion. there being no further business before the subcommittee, this hearing is adjourned. thank you. [ hearing adjourned ]
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it's a whole different campaign now. we have basically moved beyond the early primary and caucus states. now we're in super tuesday. so if you think about it, 12 states. voters in each of these 12 states will have a defining impact on who the democrats and republicans nominate. it's a very different phase in the campaign, because we've moved from retail campaigning, that one-on-one that we saw in iowa, new hampshire, even in south carolina. now we're campaigning in 12 states where the candidates are literally going from airport to airport, trying to appeal to as many voters as possible and make their last-minute pitches.
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advertising is key, organization is key, but it really has moved to a very different level in this campaign, where the candidates hope that voters know who they are. in most cases, the name idea is out there. so what the candidates have to do is convince those voters, including the undecided, that that's the person they should vote for. since this network began in the late 1970s, one of the abilities has been for people calming in, ask questions, provide their opinions. lot of polls out there, especially if you talk to states from primaries were held, what were the lines like, why were you supporting candidate x, how solid is your support? you really get a sense that you don't get anywhere else. the other networks will have pundits and the ability to question leading reporters on super tuesday. but the best pundits are viewers, listeners, who are tuning in on c-span radio, or watching on c-span television.
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>> our road to the white house coverage continues this weekend with ohio governor john kasich. who addressed voters at a campaign rally in nashville, a
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congressional pig book sometimes around april or may. >> tonight at 8:00 eastern on c-span's q & a. >> next, a hearing on u.s. military strategy in the asia pacific region. topics included north korea's recent missile


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