While Congress dithers over the advancing Zika virus, another smoldering epidemic keeps threatening to burst back into flame.

Ebola.


Emergency funds to fight that deadly virus may run out in October because they were poached to fight Zika until Congress agreed on a plan to battle the new, mosquito-borne epidemic.

And that’s a major problem because while Ebola has subsided as a threat, it hasn’t ended. It could burst into alarming bloom as it did in mid-2014 unless there are forces and resources on the ground to fight it, say senior federal health officials.

That’s been overlooked in the fight over Zika, where the idea that Ebola is “over” has colored the increasingly partisan stalemate on how much to spend on Zika and where the money should come from. Right now, the odds are that Congress will leave town until early September without setting aside more Zika money — forcing health authorities to keep drawing on Ebola funds.

It took more than a year to end the Ebola epidemic in Guinea, Sierra Leone and Liberia that took 11,000 lives. Since mid-2015, six additional, small outbreaks have been brought under control — with great difficulty.

“You can’t just say, ‘Ebola’s not a problem today,’” said Jonathan Fielding, a UCLA professor of health policy who led a panel that reviewed the performance of the Health and Human Services Department during the Ebola crisis. “You have to think in a broader context. We want to avoid another terrible episode where 11,000 people die.”

Fielding’s commission recommended the creation of an emergency response fund for infectious disease outbreaks, precisely to keep them from becoming political footballs in a divided Congress. The current House appropriations bill contains $300 million to set up such a fund. That bill is unlikely to become law, but the idea of the fund could still get incorporated into the health spending that Congress ultimately enacts.

Ebola, scientists now know, can survive in the semen of survivors for at least 18 months without symptoms, then spread through sex.

Just this past March, a flareup in Guinea and Liberia brought 13 cases. To douse the outbreak, health workers had to track down 1,200 people potentially infected by those patients. At five command centers and 50 health care facilities, they deployed rapid tests for the virus and administered 1,750 experimental vaccinations.

“It took swabbing thousands of people to recognize a single case of Ebola,” said Anne Schuchat, deputy director of the CDC, which still has 75 staff in the region — down from nearly 2,000 during the epidemic. “The disease can look like other things, and it can be spread from the patient to others without recognition.”

While the National Institutes of Health spent its $238 million in emergency Ebola funds to sponsor vaccine, drug and other research, the CDC and U.S. Agency for International Development are still using their Ebola funds to build and sustain health systems and fight outbreaks in Africa.

“They didn’t spend it all right away. That doesn’t mean they don’t need it or won’t spend it,” said Anthony Fauci, director of the National Institute for Allergy and Infectious Diseases. “They’re making investments in the future, which were intended.”

“We cannot risk allowing the disease to again threaten the health and safety of Americans,” said USAID spokesman Ben Edwards. And yet there’s no word about whether Congress will replenish the $5.4 billion emergency fund for Ebola, which it set up in 2014.

USAID, which got $2.5 billion of that fund, continues to track and monitor new cases, help to contain flare ups, and strengthen the response of vulnerable countries to Ebola and other emerging threats.

The CDC, among other things, is studying the vaccine’s safety and efficacy, examining how long the virus can remain viable in the human body, and learning what kinds of animals serve as a reservoir for it in the wild. The vaccine seems effective, but years more of research — and funding — may be required to know if it works well enough to license.

But in October, unless new funding comes through as part of the Zika package, CDC’s funding for emergency work on Ebola will run out, because more than $500 million was transferred to fight Zika while the administrator waited for Congress to fund work on the mosquito-borne disease, which has spread through Latin America and the Caribbean.

Because of the titanic risks of another deadly Ebola epidemic in Africa, CDC’s doctors and scientists there aren’t going to fold their tents and leave the field. But if the borrowed Zika money doesn’t come back, the agency will have to find the money from somewhere else, Schuchat said.

“By robbing Peter to pay Paul,” she said.

Thousands of Zika cases, meanwhile, have swept through the Virgin Islands and Puerto Rico, where about 50 pregnant women are being infected with Zika each day. More than 1,130 cases linked to travel have been reported in the continental U.S., where local outbreaks of the disease are viewed as inevitable. The first Zika-related death in the continental United States — that of an elderly Utah woman — was reported Friday.

The lesson of the Ebola crisis — one that public health officials hope policymakers will follow in fighting Zika — is that we live in an interconnected world and need to act quickly to fight outbreaks, she said.

Diseases like malaria, measles, Lassa fever and even polio made comebacks in the Ebola-plagued countries. Like Ebola, these diseases don’t recognize borders and are targets of international campaigns involving billions of dollars.

The Ebola shortfall reflects the country’s general problems with preparedness, said Bruce Ribner, an infectious disease specialist at Emory University who leads a consortium of hospitals prepared to treat Ebola and other emerging diseases like avian flu, Lassa fever or MERS.

Last spring an outbreak in South Korea infected 180 people before anyone realized that the illness was caused by the MERS virus, which originated in the Saudi peninsula and arrived with a traveler who visited four hospitals with a respiratory infection.

“That could just as easily happen in Indianapolis,” said Ribner.