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As if a crumbling economy and crippling debt weren’t enough to handle, Puerto Rico is also in the throes of a new looming crisis: the mosquito-borne Zika virus is gaining ground. The U.S. Centers for Disease Control predicts an astounding 20 percent of the island’s 3.5 million people will likely contract Zika this year alone. Jeffrey Brown goes to the front line of the battle against the virus.
Now the second in our two-part series about Puerto Rico's major troubles.
The Zika outbreak is hitting the island sharply this spring. And it's expected to get worse, a source of major concern for women living and visiting there.
Jeffrey Brown recently went to Puerto Rico to see how officials are grappling with Zika.
At the emergency operations center in San Juan last week, it was day 90 in the island's battle with Zika.
HECTOR COLON, Puerto Rico Department of Health: There is in red has 26 to 50 cases.
This center is used to dealing with hurricanes and other emergencies. But priority number one now is the mosquito-borne virus that's been spreading here since last December, with some 785 cases so far.
Deputy Director Hector Colon showed us how teams stay in touch with hospitals, and call individuals to offer counseling and information on how to protect their families. The most urgent focus is on pregnant women.
We monitor especially the pregnant women that test positive to Zika. We offer them to do a test. And the ones that test positive, we monitor them very closely once they give birth.
The fear is that Puerto Ricans will experience what was first seen in Brazil: babies born with abnormally small heads and brain damage, a condition known as microcephaly.
Mysteries abound with Zika, including why birth defects occur and who is most susceptible. Most adults who get the virus have few or no symptoms.
Puerto Rico, with its warm and wet climate, its economy in a shambles, is a prime breeding ground for mosquitoes and the virus they bring. No cases of microcephaly have been reported here so far, but there has been one death associated with the virus, and the Centers for Disease Control predicts that an astounding 20 percent of the island's 3.5 million people will likely contract Zika this year, all this while the government is defaulting on its debt and cutting back on services.
In San Juan, we found a range of reactions.
I'm not afraid of Zika.
Why not? Why not?
I guess because it hasn't been near by me. I have never met anyone who has been sick of Zika or any kind of danger about the mosquitoes.
Yes? Are you afraid?
Yes, I'm a little, because the women are pregnant have a lot of consequences because of the mosquito that bites and it has the virus, the Zika.
Mosquito-borne diseases are nothing new here. But Zika presents major new challenges, to understand it, prevent it, to educate people about it, while avoiding fear and panic.
At a women, infant and children, or WIC, center, we watched a counseling session for two pregnant women.
Neither Katherine Merced nor Nicole Ramirez has contracted Zika, but they told us they had plenty of questions.
NICOLE RAMIREZ, Expecting Mother (through interpreter):
In the first three months of pregnancy, I heard that Off had a chemical that could lead to complications, so I didn't put it on.
KATHERINE MERCED, Expecting Mother (through interpreter):
I'm terrified, worried more than anybody, because it could be sexually transmitted to me.
In fact, says nutritionist Amarilys Alvarez Sanchez, repellents such as Off are safe, but Zika can still be transmitted sexually.
AMARILYS ALVAREZ SANCHEZ, WIC Puerto Rico (through interpreter):
There is a lack of understanding in sexual relations, and that the virus can be transmitted from the father to the mother. Women will laugh and say they're already pregnant, but they don't realize the need for condoms.
Condoms must be used, that is, even after a woman is pregnant.
In a nearby room, CDC behavioral scientist Melissa Mercado conducted a focus group to learn what women know about Zika, what questions they have, and where public education efforts might reach them.
MELISSA MERCADO, Centers for Disease Control and Prevention: We are trying to reach to the women, so we also need to know what types of media they are using, so that the message actually gets to her and to them in a way that it's most accessible and clear. We want information to be clear in what they need to know to protect themselves and their babies.
In the meantime, research goes on at CDC labs on the outskirts of San Juan.
Roberto Barrera heads a team in the entomology and ecology section that's studying Zika-transmitting yellow-fever mosquitoes to better understand how to eradicate them.
DR. ROBERTO BARRERA, Centers for Disease Control and Prevention: You're looking at thousands of eggs.
It's a big problem, since they have built up resistance to permethrin, the most commonly used insecticide.
Dr. Barrera showed us a strain raised in the lab.
DR. ROBERTO BARRERA:
So, you compare the response of a local mosquito and with this mosquito that has been in a lab for so long. And you compare, and you can evaluate the degree of resistance to the insecticide that you're testing.
Field workers set traps like these around the island to gather mosquito eggs, which are then raised in the lab.
So, this is where you bring the live mosquitoes to test the insecticides?
In a separate trailer, Barrera and other researchers try out different insecticides and use timers to measure the effect.
The idea is to raise the survival or the mortality.
Higher-tech equipment was being used in the diagnostic laboratory next door, where scientists study samples of the virus to distinguish it from other mosquito-borne illnesses, such as dengue, that are also endemic to the island.
Dr. Jorge Munoz heads this one.
DR. JORGE MUNOZ, Centers for Disease Control and Prevention: What made me worry was the diagnostic of the disease. We knew that separating Zika from dengue is difficult in the laboratory. We need a specific test to be able to separate them, to tell them apart.
Munoz says his team has developed a test that's being tried out in labs around the Caribbean region. But it's just a beginning,, with much still to learn about the disease, its impact, and how to treat it.
As of now, there is no vaccine.
Do you worry, as a scientist? You see what happens in the public, right? There gets a sense of panic.
DR. JORGE MUNOZ:
And that could overrun the science, right, or the pace of the science.
Yes, it put us a test. We need to react and provide solutions very quickly.
Puerto Rico Governor Alejandro Garcia Padilla expressed his concerns to me about fears he said were overblown and based on ignorance.
GOV. ALEJANDRO GARCIA PADILLA, Puerto Rico:
Anyone can travel to Puerto Rico. The U.S. Olympic team will go to Rio in a couple of months. And that's the mecca of Zika. So it's safe to travel here. But if the woman is pregnant or trying to, then they should avoid to come to Puerto Rico or to go to Central Florida.
It was a not-so-subtle reminder that concerns such as the ones these pregnant mothers have may soon become more common on the mainland.
From San Juan, Puerto Rico, I'm Jeffrey Brown for the "PBS NewsHour."
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