What's being done to fight the Zika virus?

The following is a script from “The Zika Virus,” which aired on Nov. 6, 2016. Dr. Jon LaPook is the correspondent. Denise Cetta, producer. Matthew Danowski, editor.

The presidential election may have pushed the Zika virus off the front page, but Zika is not going away. It’s spreading.  Dr. Jon LaPook, on assignment for 60 Minutes, has been tracking the Zika virus and the American government’s efforts to control it.

The first time most Americans heard about the Zika virus was when it was breaking out in Brazil last winter. Hundreds of babies were born with catastrophic brain damage called microcephaly. The question for Americans has been when, not if, it would break out here. Well, now it has. Already, there are more than 30,000 diagnosed Zika cases, most of those in the U.S. territory of Puerto Rico, but also in every state but Alaska. And because it is now known Zika can be transmitted through mosquitoes, blood and sex, that number is expected to rise.

 
In September, after eight months of political deadlock, Congress finally approved $1.1 billion to fight the virus. Dr. Anthony Fauci, head of infectious diseases at the National Institutes of Health, says the delay is an example of what worries him most about Zika.

Anthony Fauci: People don’t take it seriously.

Jon LaPook: How do you not take it seriously when you see the babies with microcephaly?

Anthony Fauci: But people don’t--People don’t.

Jon LaPook: How do you explain that?

Anthony Fauci: They tend to say, “Well, I’m not seeing anything. So it must not be happening.”

Jon LaPook: It’s invisible, so it’s not real?

Anthony Fauci: Or you don’t know somebody who’s had a microcephalic baby yet. Yet.

Dr. Anthony Fauci has been on the frontlines fighting every virus to threaten Americans since the 1980s. That includes HIV, SARS, H1N1, and Ebola. He says not in 30 years has a virus emerged so unexpectedly and viciously. 

When Zika infects a pregnant woman the toll it takes can be horrifying. The virus can attack a fetus’s brain and start eating it away -- leaving newborns with small, malformed heads.

Jon LaPook: When you first saw those  photographs of the babies with microcephaly, what went through your head?

Anthony Fauci: You realize the suffering that’s associated with that. The suffering that that baby, if the baby does survive, what that baby has to look forward to for the rest of their life. And the impact on the family.

“The mosquito didn’t fly from Rio de Janeiro to Florida. The mosquito flies 500 feet in a lifetime. It’s the people who travel.” Dr. Anthony Fauci

The Zika virus was discovered in the heart of Africa in 1947 and infected small clusters of people over the next 60 years. But then, in 2007, it began popping up on some islands in the Pacific. People infected there started traveling…triggering, Dr. Fauci says, a global pandemic.

Anthony Fauci: All of a sudden, the Yap Islands, French Polynesia, Easter Island, Brazil, South America, Central America, Puerto Rico, Gulf Coast. I mean, that is such an example of how, when you have a transmissible agent and people travel. And that’s exactly how the infection got to Florida. The mosquito didn’t fly from Rio de Janeiro to Florida. The mosquito flies 500 feet in a lifetime. It’s the people who travel.

Travelers with Zika have the virus in their bloodstream for about a week. When they arrive in a place without Zika, a local, uninfected mosquito can bite them, become infected, and then go on to bite other people, spreading the virus.

That’s what happened in Puerto Rico -- where, in just over six months, Zika engulfed the island, and infected thousands of pregnant women. In September we were at the university hospital in San Juan when one of them, Rocio Hernandez, went into labor.

Zika infection during any trimester can cause birth defects, but research suggests early infection, in the first three months, poses the greatest risk to the fetus. Rocio was diagnosed late in her pregnancy.

For more on Zika’s impact visit RSNA’s “Congenital Brain Abnormalities and Zika Virus: What the Radiologist Can Expect to See Prenatally and Postnatally”

After 21 hours of labor, an emergency C-section.

The nurses are meticulous...looking for any sign the Zika virus has infiltrated the newborn’s body. They take the usual height and weight, and collect samples of urine and blood for testing. Head circumference is crucial. Any deviation from the norm could indicate the virus has attacked the baby’s brain.

Baby boy Derek’s head size looks good. But obstetrician Dr. Alberto De la Vega is alarmed by what he’s been seeing in other pregnancies. He’s done prenatal sonograms on over 450 Zika-positive pregnant women in the last nine months.

Alberto De la Vega: You see these lines over here? This is a skull. It looks like it’s collapsing and it’s not growing adequately. You see?

Jon LaPook: So it should be something more like this?

Alberto De la Vega:  It should be as having a round view. But what you’re seeing is that this parts of the skull are going inward like that.

Jon LaPook:  And they’re going inward because?

Alberto De la Vega: The brain is not only is not growing, but it’s dying.

Jon LaPook: How many weeks is this along?

Alberto De la Vega: This is a 20-week pregnancy.

Jon LaPook:  So what did you say to the mother here, or what did she do?

Alberto De la Vega: Well in this particular case, the patient decided to terminate the pregnancy after we counseled her and told her about what we were finding. And it was very difficult for her to make that decision.  

Alberto De la Vega: This is the head.

The day we met Dr. De la Vega he was performing a sonogram on Raquel Morales. She got Zika early in her pregnancy -- and is 24 weeks along.

Alberto De la Vega: Your baby’s growing normally. Your baby’s brain is growing proportionately and normally. These are great news.

But when it comes to Zika, Dr. De la Vega says, every conversation includes a question mark.

Alberto De la Vega: There may be things we cannot detect. There’s a lot about the Zika virus we don’t know. And we hope for the best obviously. 

Jon LaPook: Right now, Raquel and her baby are not out of the woods?

Alberto De la Vega: Definitely not. No one is. No one is. We only know about the more severe consequences. How about all the other problems that could arise? Is this baby gonna have autism? Is this baby gonna have learning disabilities? Is he gonna have cerebral palsy? We don’t know.

Jon LaPook: There’s probably gonna be a spectrum of disease?

Alberto De la Vega: Which we are far from describing.

Doctors are finding that in addition to microcephaly, babies can suffer other developmental problems -- inability to swallow, seizures, hearing loss and damage to the retina, which can lead to blindness.

Jon LaPook: Would you recommend that women not get pregnant?

Alberto De la Vega: Definitely. Until we have a vaccine, or until we have control over this epidemic, you should avoid it. This is not the time to get pregnant in Puerto Rico or any place where the infection is occurring.

According to the Centers for Disease Control, there are now more than 1,000 pregnant women on the United States mainland who’ve been infected with Zika, most through travel. Twenty-five babies have been born with microcephaly or other birth defects. Five pregnancies have ended with the loss of the fetus.

The United States government is not recommending that women delay pregnancy. It has largely focused on killing the mosquitoes that carry the virus. But that may not be enough: Zika has stunned scientists by becoming the first mosquito-borne virus ever known to be transmitted through sex.

Jon LaPook: Is it possible that a lot of the infections, that we were ascribing to mosquitos, were really sexual transmission?

Anthony Fauci: Well, I think that’s an open question that we need to address and find out. Just how frequently is sexual transmission occurring? How much of it are we missing? How long does it remain in the semen? ‘Cause that’s a real complicating issue, particularly since 80 percent of infections are without symptoms, someone could be infected and have absolutely no idea that they’re infected.

For those people who do get symptoms, Zika usually resembles a mild flu -- fever, muscle aches and a rash, often subtle. But in some adults the virus can cause severe neurological problems. In Puerto Rico we met this man, who after being bitten by a Zika-infected mosquito, suffered inflammation of the spinal cord, leaving him barely able to walk. His doctor is not certain he will recover.

Last winter when the epidemic hit, Dr. Fauci knew the best way to stop Zika was to develop a vaccine.

Anthony Fauci: We had an, “OK, all hands on deck” type of meeting. “Let’s do it. We’ve gotta do it.”

Dr. Fauci and his team had a head start. He showed us how a vaccine they’d already created for West Nile virus was reconfigured for Zika.

Anthony Fauci: This is what’s called a DNA platform. And a DNA platform is made up of a plasmid, which is merely a circular piece of DNA. And what it has in it is an area where you can actually insert the gene of whatever virus you want to make a vaccine against. So we just stick in this gene from Zika. And now you have a Zika vaccine, merely by replacing this little segment.

Jon LaPook: Kind of like a prefabricated scaffolding, right?

Anthony Fauci: The foundation stays the same. You put in the part. If the part is West Nile, you stick the West Nile in. You wanna do Zika? You take the West Nile out. You put Zika in.

The DNA in vaccines like this can be quickly mass-produced. This new approach means future vaccines could take months, not years, to reach clinical trials.

Last August, we watched with Dr. Fauci as volunteer Catherine Paquette received the very first dose. This experimental vaccine does not contain live virus, so it cannot give her Zika.

A month later Catherine’s blood was collected to see if the vaccine was generating the expected immune response.

Jon LaPook: It’s turning blue.

Anthony Fauci: How about that? That’s what’s called instant gratification.

The blue color indicates the presence of antibodies programmed to fight Zika.

Anthony Fauci: We know that this kind of antibody protects an animal. So you can make a reasonable extrapolation that if you make the same kind of response in a human, that you will ultimately protect the human. And that’s exactly what this is showing.

Jon LaPook: That’s a big moment. If that had not turned color...

Anthony Fauci: If that had not turned color?

Jon LaPook; Then what?

Anthony Fauci: I would of fainted in front of you.

They plan to soon test the vaccine in thousands of volunteers living in Zika-infected areas like Puerto Rico. If it protects people there, it could be ready for distribution by early 2018. By that time, millions of people around the world will already have been infected.

Jon LaPook: One of the big questions I’ve been hearing is, say, for example, “My 10-year-old daughter, if she gets infected now, will she have a problem 10 years from now, when she gets pregnant?”

Anthony Fauci: There is no indication that there is going to be a problem at all. However, you always keep your eye out to see if there’s something that we haven’t noticed.

Staying alert, Dr. Fauci says, is key with all infectious diseases. Back in the 1980s, when HIV emerged, he started keeping a map to track the threats. 

Anthony Fauci: So this was the first one that I did in 1984 and this is the last one.

Jon LaPook: Oh my gosh.

Anthony Fauci: So these are all things that have emerged, you know? Everything from Lyme disease, through Anthrax, through Chikungunya. Now we got Zika, was the most recent one that was added. We have Ebola right here in West Africa.

Jon LaPook:  If one of these broke loose, really broke loose, it could kill how many?

Anthony Fauci: God forbid if you ever had a flu that transmitted very easily and had a high degree of mortality, you could have a really serious situation.

Jon LaPook:  Like tens of millions of people?

Anthony Fauci: More than that, yeah.

Dr. Tom Frieden is responsible for making sure that doesn’t happen. He’s director of the Centers for Disease Control.

Jon LaPook:  How many warehouses like this are there?

Tom Frieden: I can’t tell you that. But we have them distributed such that we can reach any part of the U.S. within 12 hours or less.

They are called strategic national stockpiles and our 60 Minutes cameras were given a rare look inside one of the secret facilities.

Tom Frieden: If there were a big outbreak, we have medical supplies, vaccines, antibiotics, intravenous fluids. Things that would be needed to keep people alive and protect them.

Dr. Frieden is eager for a Zika vaccine to add to the arsenal. Until then, the CDC is deploying hundreds of scientists and public health workers to promote mosquito control, raise awareness about prevention, and develop new ways of testing for the virus.

Jon LaPook: You recently wrote that Zika presents an unprecedented threat to our nation.

Tom Frieden: Zika really is unprecedented. Never before have we seen a mosquito-borne virus that can cause birth defects.

Jon LaPook:  What happens at the end of this mosquito season?

Tom Frieden: Mosquitoes usually quiet down around the end of October, longer in Puerto Rico and other places, but next season isn’t far away. And we anticipate that Zika is likely to be with us for years to come.

Radiology scan of malformed baby courtesy of Radiological Society of North America
Mosquito footage courtesy of Sanofi Pasteur