February 04, 2017

Zika remains a concern, say public health experts; several legal issues surface following Fla. outbreak

The Zika virus is no longer a public health emergency, the World Health Organization has declared, but scientists and public health officials in the South Florida area say that the mosquito-borne virus is likely to remain as long as the region entertains visitors from areas where the virus is endemic. And while there have been no reported cases of Zika this year in the Miami-Dade area, Ground Zero for the virus in the continental U.S. last year, locally acquired cases of the virus are expected to reappear with the warm weather and rain.

And with each diagnosed case of the virus, municipalities and public health officials face potential legal ramifications associated with their battle to combat the disease. To discuss the implications and impact of public health emergencies such as Zika on communities, the ABA Young Lawyers Division hosted a panel, “The Zika Virus: The Legal Implications of a Public Health Emergency” on Feb. 3, during the Midyear Meeting in Miami.

Panelists included Bob Eadie, who has served as the administrator and health officer for the Florida Department of Health in Monroe County in the Florida Keys since 2007; Dr. Phillips K. Stoddard, professor of biology at Florida International University since 1992; Dr. Anna M. Likos, state epidemiologist and interim deputy secretary for Health for the Florida Department of Health; and moderator Melodie Arian, associate in the Southern California office of Thakur Law Firm.

Likos gave a history of the disease, its African origin in Uganda in 1947, its evolution and emergence in the Americas, infection rates, symptoms, treatment and prevention. The current status of the Zika virus as of December 14, 2016:

  • 1,046 imported cases from outside the U.S.
  • 262 locally acquired (0 in 2017)
  • 21 with Florida and non-Florida exposures
  • 187 pregnant women
  • 3 sexual transmission cases
  • Top 4 countries for imported cases: Puerto Rico, Dominican Republic, Nicaragua, and Jamaica
  • At least 50 percent of cases were visiting friends/relatives

Lessons learned from the fight against the disease last year were the difficulty of killing the mosquitoes because of their resistance to the various insecticides, lack of vaccines, and the need to educate the public about the virus and prevention methods. Earlier this year, Florida Gov. Rick Scott awarded 34 grants totaling $25 million to 10 state universities and research institutions to speed up the development of a Zika vaccine, devise new testing methods and to study the long-term impacts of the virus.

It’s a step in the right direction, said Stoddard the scientist who was very critical of how the state handled the Zika crisis last year. While he said the state did a good job of initially knocking out the virus when it was restricted to the Wynwood area of Miami, he said they allowed it to spread because of an insistence on using insecticides that proved ineffective against the mosquitoes.

“For 28 days they used the same insecticides which had not worked and during those 28 days the virus spread unabated and nobody lost their job over it or nothing was done. Finally, after 28 days they began using the insecticides that the Florida Keys Mosquito Control District had found were effective. But it took them a month before they did that,” Stoddard said.

He was also critical of the state’s reluctance to rely on scientists in helping to devise strategies to fight the virus. “The CDC has 11 epidemiologists for the entire United States, including Puerto Rico. Miami-Dade County has zero scientists,” said Stoddard. “We have expertise around Florida but not here in Miami-Dade County. I can’t explain that except that there is a basic disrespect for science and scientist at a time when scientists are going to be directing how these things are done.”

Stoddard said there are at least three legal issues he thinks needs addressing going forward. They are:

  1. Private property rights. “Unless there is a declared emergency, our staff can’t go onto a resident’s property to inspect for mosquito breeding sites,” he explained. “So we need a change in our laws because this is a serious public health issue. And unless my staff can get in there to do something we can’t protect our residents.

  2. Notification. “Should there be notification of people who are susceptible? If you are coming off chemotherapy, you should know about the exposure to insecticides,” he said. “But there are no laws requiring advance notification.”

  3.  Vaccines. Stoddard noted how the vaccine to treat lime disease was taken off the market by the manufacturer because it wasn’t a required vaccine and the manufacturers couldn’t make money on it. “They were still exposed to the liability issues but they had no profit in it so they withdrew it,” he said of the vaccine manufacturers. “So even if you make vaccines, how do you protect the manufactures so that they can do the work for public good?

As a public health officer, Eadie said there is a delicate balance in throwing the full weight of the law behind an issue and doing what is in the public’s interest during a public health emergency. “As a public health officer have a lot of ex parte powers to put people away or to enter their property or to do a whole of things that you wouldn’t think we could do,” he said. But you have to be very careful to save those huge powers for when you really need it.”

He said there are times when lawyers need to step in but to combat a disease like the Zika virus takes a collaborate effort of public health officials, mosquito disease control and city leaders working together to eliminate breeding sites and educating the public. “That sounds very simple but to make that message understandable to all people is difficult because they go on about their life,” Eadie said.