History buffs and infectious-disease experts have already drawn links between the rubella outbreak in the 1960s and the current spread of Zika.
But drugmakers today face greater regulatory hurdles, and the federal government has yet to dedicate funding to address the Zika epidemic. That means a vaccine and successful methods to stop transmission of the virus may be a long time coming.
Nearly 75 years ago, an Australian ophthalmologist noticed he was treating cataracts in a significant number of newborns whose mothers were infected with rubella early in their pregnancies.
It was the first time researchers understood the long-term impact of the disease, which, for adults, was virally spread and caused relatively mild symptoms—mostly a rash. Doctors in other countries began to link rubella-infected mothers with babies born with deafness, heart problems, developmental disabilities, liver damage and bone and joint deformities. And then, between 1964 and 1965, more than 12.5 million people in the U.S. became infected. About 20,000 children were born with congenital rubella syndrome.
That was the last time the nation experienced a scare with the long-term health and financial impact now posed to populations vulnerable to the Zika virus, which until recently was believed to be spread only by mosquitoes.
According to the Centers for Disease Control and Prevention, the one-year rubella epidemic cost the country an estimated $840 million, which is equivalent to about $6.5 billion today. But Congress broke for the summer this month without debating a $1.1 billion bill to fight the Zika virus.
Last week the CDC announced $60 million in state grants to support epidemiologic surveillance and investigation, mosquito control and monitoring, and laboratory capacity. But CDC Director Dr. Thomas Frieden noted in the announcement that Congress had failed to “provide the additional resources we need to fully support the Zika response.”
The World Bank has estimated the disease will cost the world $3.5 billion in 2016, mostly because of people avoiding travel to areas where the virus is being actively transmitted. It does not attempt to include the costs of children growing up with microcephaly or the cost of developing a vaccine.
Regulatory and safety requirements will likely add years and many millions of dollars to the effort. In the 1960s, consent to participate in drug clinical trials was given on a relatively small, simple form and testing could be done on a larger population. Today, the Food and Drug Administration's vaccine guidance alone is 13 pages long. The process of developing, testing and winning approval for a vaccine often takes more than 10 years.