HOUSTON (CN) - The Zika virus is on a collision course with the U.S. Gulf Coast, where it could cause a major public health crisis of birth defects and stillbirths, a tropical disease expert warned the World Affairs Council of Greater Houston.
Dr. Peter Hotez is founder of the National School of Tropical Medicine, director of Texas Children Hospital's Center for Vaccine Development and a molecular biology and pediatrics professor at Baylor College of Medicine.
Hotez, who testified last week to two congressional committees, said he does not believe the lawmakers understand the potential for a full-blown crisis from what they called "small outbreaks" of Zika.
"What's a small outbreak of mothers delivering babies with microcephaly at obstetrical wards in Houston? There's no such thing as a small outbreak," Hotez said.
"The minute we start seeing microcephaly cases people will treat it in the same way as Hurricane Katrina on the Gulf Coast or the BP oil spill."
Texas has confirmed 18 cases of Zika virus, all but one of whom were infected outside the United States. One Dallas County resident got Zika from having sex with a man who contracted the virus in Venezuela, according to the Texas Department of Health Services.
Florida health officials said on Feb. 24 that three pregnant women there tested positive for the virus, one week after the state declared a public health emergency .
Though Brazilian scientists have found evidence that the Zika virus is responsible for 4,000 recent cases of microcephaly in the country, where 1.5 million people have been infected with Zika, the World Health Organization said in February that definitive proof of a connection was still several months away.
Babies with the defect are born with small heads and developmental problems.
"The link is confirmed in my opinion," Hotez told an audience of more than 150 on Thursday at an event sponsored by the World Affairs Council of Greater Houston.
"So one of the things I said out of frustration to a reporter, and of course they printed it, is, 'We have to stop asking if this virus is associated with microcephaly.' It's so well-established right now I don't think there's any question. And we have to act accordingly."
Hotez said there is evidence that Zika is causing stillbirths and congenital defects more serious than microcephaly. He showed an X-ray of a baby missing part of its brain and attributed it to Zika.
Hotez acknowledged he is using a "shrill" tone talking about Zika to the public and to Congress. He's doing so, he said, because he does not believe the United States with its "726 mosquito-control authorities each doing their own thing" is prepared for the virus that will arrive on the Gulf Coast in late spring or early summer.
Brazil reported its first cases of Zika, which can cause fever, rash and pain behind the eyes, in March 2015. The virus has been reported in more than two dozen Latin American countries and Hotez predicts it will be in every Caribbean island by the end of March.
Hotez said the virus is moving so fast, and there's so little published about it in biomedical journals, that scientists are trying to connect the dots based on discussions with colleagues and alerts issued by the WHO and the Centers for Disease Control and Prevention.
One common statement about Zika in the media is that 80 percent of people who are infected do not show symptoms.
"Where does that information come from?" Hotez asked. "I have no idea.
"Maybe somebody just said it once. So that's one of the things we have to be careful about pinning down," he said at the World Affairs Council event, held in a Houston ballroom under six huge crystal chandeliers.
Scientists first identified the virus in 1947 in a jungle in Uganda.
"It came out of the Zika Forest and Zika in the local language means 'overgrowth,'" Hotez said. "The first human case was in Nigeria in 1954 and there's been about a couple of dozen cases reported in Africa ever since."
Then something "extraordinary happened," Hotez said. The virus showed up on the Island of Yap in Micronesia in 2007, where it infected three-quarters of the population.
"And then it kind of marched across the Pacific, going to New Caledonia, the Cook Islands, French Polynesia, where a massive outbreak of 28,000 cases occurred. Then it went to Easter Island off the coast of Chile."
Hotez said scientists suspect that Zika underwent a mutation to adapt to humans, and that the change is responsible for its spread from Africa to Latin America.
"It looks as though the strain that was in Asia, that was in French Polynesia, is pretty much identical to the one that's in Latin America," he said.
Hotez predicted that Haiti, where the virus just made landfall, will be hit hard by Zika because of its lack of a public health system.
"We have 264,000 pregnant women at any given time in Haiti, a high percentage of whom, maybe half or more, are going to get Zika. We could be looking at tens of thousands of [microcephaly] cases in Haiti and a human catastrophe of epic proportions," he said.
Hotez frames Zika as a crisis of poverty. He said the epicenter of Brazil's microcephaly cases is in northeastern Pernambuco State, a poverty-stricken area where people live in homes built on stilts with no window screens or air-conditioning, surrounded by standing water and trash.
Discarded debris is prime real estate for the Aedes Aegypti mosquito, which feeds on human blood and transmits the virus after picking it up from an infected human.
Hotez showed a picture of a rundown home in Houston's Fifth Ward, two miles northeast of downtown, with a pile of old tires in the yard.
"No window screens, standing water, discarded tires along the roadside, plastic containers filled with water: that, again, with the Aedes Aegypti, means I think we have the perfect storm for the possibility of Zika outbreaks in Houston," Hotez said.
Despite what he sees as imminent peril, Hotez said, governments can eradicate the Aedes Aegypti mosquito, and have done so with a tried-and-true approach.
"Between 1947 and 1962, 18 countries in Latin America eradicated the Aedes Aegypti mosquito. They used this aggressive program of insecticides and they drained water so, we know the old-fashioned methods can work," he said.
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