WASHINGTON - The Zika virus has hit Puerto Rico as the U.S. commonwealth reels from an economic crisis that has led to thousands of layoffs at its hospitals.
The virus' impact and how the federal government should respond has been an issue in the 2016 Democratic primary and one that the next president — Democrat or Republican — could very well have to tackle.
To what scale Zika will be an issue in the mainland U.S. may depend on how this Congress responds to the virus in Puerto Rico. The U.S. territory, whose native born residents are American citizens, has been called "ground zero" for the Zika outbreak in the U.S. by CDC director Tom Frieden.
Top U.S. health officials are calling the Zika virus threat an emergency and the White House has asked for $1.9 billion to pay for a package of preparations, medical treatments and education about the virus. There is particular concern for pregnant women who can pass it on and whose children can be born with microcephaly, a neurological condition where the baby's head and brain are underdeveloped.
Amanda Rentería, national political adviser to Hillary Clinton and a former Senate chief of staff, visited the island last weekend to learn how Puerto Rico is responding and to bring that information back to Congress.
Like Clinton, Bernie Sanders has urged Congress to fully fund the emergency spending bill the White House requested to combat the Zika virus and to oppose using Ebola funding to pay for it as some Republicans have suggested.
Rentería, who said she covered herself in DEET and took other precautions, spoke to NBC Latino on Monday upon returning from her trip. Below is an abbreviated and edited transcript of the discussion:
What are your takeaways about the Zika virus from your visit to Puerto Rico?
One is that we met with people who have dealt with two other mosquito-borne diseases across the country (dengue and Chikungunya). This is very early in the Zika virus life.
Everything you read about the virus in Brazil, they are in earlier stages in Puerto Rico and they have a really, really fantastic surveillance system there. They are catching and finding out about these (cases) early. They are monitoring it incredibly well, part of that is because the Centers for Disease Control (CDC) is actually in Puerto Rico.
Pregnant women are the No. 1 target (of the monitoring and prevention). It can be passed on and a (infected) pregnant woman is 50 times more likely to have microcephaly babies. You can prevent yourself from getting it, you can wear long clothing, but it's harder in Puerto Rico.
A thing like this affects poor communities in a real way — they have bad infrastructure, standing water, they don't have air conditioning so they leave windows open, they don't have a great sewage system.
What effect is the financial crisis in Puerto Rico having on preparing for and combating the Zika virus?
You can use surveillance, but if your health care system is laying off doctors it's hard to convene the meetings, to call in the mothers —we also need to make sure we have doctors who can take care of these women should they have microcephaly babies come October, November. That's when the first cases would come out.
Do you consider this a women's issue?
When you think about this, it really does affect the entire community. When we were talking to the (Puerto Rico) secretary of health, she was actually trying to use (public service announcements) of, "This is how we have to care for our community."
How costly will it be to deal with the Zika virus and what is Hillary Clinton's plan to make sure it doesn't hit the U.S. or if it does, to control it?
The most important thing we can do is make sure there is funding in Congress. It did help that we went there, but even thinking about going down there, I had to get DEET, I had to make sure I had long pants — it makes it real for folks in Congress.
Anything we can do to educate women on the island, especially in poorer communities —they are putting these packages together that have nets, they have (information), go buy the green (can) of DEET, not the orange (green has more DEET).
They are giving out mosquito rings that you dump in standing water and it kills the larvae … (Women Infants and Children) is playing a major role, they come in, they have a demonstration (on Zika) and they are able to get a package. What they've found is they have done a couple PSAs and the secretary of health has been on the air and since that has happened, more are coming in [for information].
With other mosquito diseases, you feel it. You know you have it. With this, you don't know and could potentially be spreading it through sex. You might not know. You can take precautions.
When I think about where we are vulnerable on the mainland, you think about poor communities —no AC, poor streets and potholes, [stagnant] water —that's where communities are more likely to be harmed by the disease.
Any more key takeaways?
The mosquitos don't just stay in Puerto Rico during the summer, all along the border they are more susceptible to it. There is some work done on vector control, on the flight of the mosquitos, but you don't need a lot of mosquitos —it can be sexually transmitted.