Toomey Urges Action on Zika Virus Research

February 8, 2016

Today, U.S. Senator Pat Toomey (R-Pa.) sent a letter to the Director of the Centers for Disease Control and Prevention, Dr. Thomas Frieden and to the Director of the National Institutes of Health, Dr. Anthony Fauci regarding the growing number of reports linking the rapidly-spreading Zika virus and severe birth defects in newborn babies.

In the letter, Sen. Toomey encourages urgent research by the two federal agencies to help public health experts and medical providers treat and counsel patients.

"The anecdotal reports of the Zika virus causing birth defects and other abnormalities in newborn babies are absolutely heartbreaking," said Sen. Toomey. "Additional research into the linkage between the Zika virus and these adverse outcomes is urgently needed so physicians can provide soon-to-be mothers with clear and accurate information about risk factors and possible medical interventions."

The text of the letter is below.

Thomas Frieden, M.D.
Director
Centers for Disease Control and Prevention
1600 Clifton Road
Atlanta, GA 30333

Anthony Fauci, M.D.
Director
National Institute of Allergy and Infectious Diseases
National Intitutes of Health
Bethesda, MD 20892

Dear Drs. Frieden and Fauci,

There are a growing number of reports linking the rapidly-spreading Zika virus with severe birth defects, microcephaly, and Guillain Barré Syndrome (GBS). Unfortunately, expectant mothers and their physicians do not have clear, accurate information about the risks of the Zika virus, which in turn sows legitimate fears and worries. As lawmakers work with you on developing a federal response, I write today to encourage urgent research by your agencies that will help public health experts and medical providers treat and counsel patients.
To date, much of the information about Zika virus risks in pregnancy are anecdotal. There are no evidence-based guidelines or protocols for physicians who are treating or counseling expectant mothers, as well as infants, who may have been exposed to the Zika virus. Furthermore, the outcomes for infants whose mothers contracted Zika virus during pregnancy are unknown. Many questions remain including:
1. Does the Zika virus cause microcephaly? If so, are there other factors (such as co-infection with another virus, nutritional deficiencies, etc.) that affect the likelihood of microcephaly?

2. What are the long-term physical and neurologic outcomes for infants whose mothers were infected with the Zika virus?

3. Once a person has contracted the Zika virus, are they immune, or can they become infected once again during the next pregnancy?

4. Is there any chance for reactivation of the Zika virus in a pregnancy once a mother has had it in the past? If yes, are there any consequences for the developing fetus?

5. Are there any short or long-term adverse outcomes for a developing fetus that occur when the mother is infected with the Zika virus, but the baby does not have microcephaly? For example, are there possible developmental delays even though the head size is within the normal range? Is there a head size other than the size meeting the definition of microcephaly where an infant is still at risk for long-term problems?

6. Are there any predictors during pregnancy that could be used to counsel women about the eventual risk for adverse outcomes (e.g. trimester of exposure, severity of illness, viral levels in maternal blood, etc.)
7. What efforts are there to study interventions, such as a vaccine, to prevent microcephaly and associated morbidity possibly caused by the Zika virus?

8. If newborns or young children contract the Zika virus, do they have any risk for long-term problems, such as neurodevelopmental delay?
On February 16, 2016, the National Academy of Medicine (NAM) will sponsor a workshop on "Research Priorities to Inform Public Health and Medical Practice for Domestic Zika Virus." At that workshop, I urge federal attendees and participants to encourage research that addresses this public health concern so that expectant mothers and physicians have accurate information about the Zika virus.
I thank you in advance for considering this request. I commend your efforts to quickly respond to the Zika virus, especially your work to inform the public about possible risks and treatment protocols of an emerging threat. Please keep my office updated on these matters. If you have any questions, please do not hesitate to contact me.
Sincerely,

Pat Toomey
U.S. Senator

Cc: Victor J. Dzau, M.D., President, National Academy of Medicine