Hundreds of millions of dollars approved by Congress last month to fight Zika won't go anywhere until the beginning of next year — almost a full year after it was first requested, federal officials said Tuesday.
That's because it's entered the slow, bureaucratic world of the federal funding process. Cities, states and counties have to bid on the money, and federal agencies then decide who to give it to.
In the meantime, Florida reported three more home-grown cases of Zika Tuesday and said another batch of infected mosquitoes had been found in Miami Beach -- a finding that suggests infected people are still actively passing the virus to the insects.
Florida has been demanding quicker help from the federal government in controlling mosquitoes and getting people tested for the virus.
But Congress did not award the full $1.9 billion the Obama administration had been asking for, and sometimes allocated it in specific ways, said Caitlyn Miller, director of discretionary programs at the Health and Human Services Department.
"We had to make tradeoffs," Miller told reporters in a telephone briefing.
HHS took a first step towards getting the money going, at any rate, announcing that the process was open.
A big chunk, $394 million, will go to the Centers for Disease Control and Prevention, which will then parcel the money out under various programs to state and local governments, officials told reporters.
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A little more than $44 million of that will go to pay back general public health preparedness funds that were raided to cover the Zika emergency response while Congress fought over funding, officials said.
States and cities can apply for a piece of a $10 million fund to study the effects that Zika has on babies infected in the womb, and up to $120 million will be available to help build out and supply labs to test people, especially pregnant women, for Zika infection.
"Although we may see a decline in Zika virus transmission in some areas, it is also critically important that we continue to follow pregnant women who have any evidence of Zika virus infection," said the CDC's Dr. Denise Jamieson.
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The CDC knows of 878 women in U.S. states who are or were pregnant and had Zika. So far, 23 babies have been born with birth defects caused by Zika and five were miscarried or aborted because of severe birth defects, the CDC says.
Another 1,806 women in U.S. territories, mostly Puerto Rico, have been pregnant and infected with Zika. The CDC knows of nearly 4,000 Zika cases in the U.S., almost all of them related to travel although Florida has 183 home-grown cases of Zika. Florida health officials refuse to say how many of the 109 Zika-infected pregnant women there caught the virus locally.
Zika is known to cause catastrophic birth defects that are immediately obvious, such as the small head and other abnormalities seen in microcephaly.
But increasingly, doctors say they are seeing subtler birth defects and damage that may not become obvious for years. The U.S. has launched programs to follow pregnant women to see just what the risk is of a birth defect if they catch Zika and what happens to affected babies as they grow up.
U.S. labs are also working on vaccines to prevent Zika infection, drugs to treat Zika infections and better tests so people, especially pregnant women, can know sooner if they are infected with Zika.