Dozens of travelers in Washington and thousands more across the nation at risk for Zika virus infection have waited weeks for test results because of a federal backlog. That includes pregnant women whose fetuses may face devastating birth defects.
When Stephanie Billmayer flew back to Seattle from Brazil on March 1, the first thing she did was schedule a test for the Zika virus. Eight weeks pregnant, the English teacher wanted only to know her unborn baby was safe from the devastating epidemic exploding across Latin America and the Caribbean.
But it was more than a month before she got any answers.
Her blood test was among dozens from Washington state and thousands across the U.S. backlogged at a Centers for Disease Control and Prevention (CDC) lab in Fort Collins, Colo.
Not until April 5 did Billmayer, 33, learn the test was negative, news that capped weeks of anxiety and uncertainty, she said.
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“I was very worried,” said Billmayer, a longtime Seattle resident who spent the past year teaching in Rio de Janeiro, where she met her soon-to-be husband. “Any first-time mother panics about everything. You have terrible dreams and visions of all kinds of disease. And this on top of it.”
That worry has become more common as growing numbers of travelers have sought testing after visiting or living in Zika-affected countries. Health experts and scientists increasingly believe the Zika virus is responsible for devastating damage to fetal brains if mothers become infected during pregnancy.
In February, CDC officials urged U.S. pregnant women with possible exposure to Zika — through travel or through potentially affected sex partners — to get tested, even if they had no symptoms of disease.
“The response to that was pretty substantial,” said Dr. Paul Mead, a medical officer with the CDC’s division of vector-borne diseases. “There’s no question it’s taking longer to turn around the samples than we’d like.”
At one point, the agency faced a backlog of several thousand tests, Mead said. That’s been whittled down to about 500.
At least 74 people in Washington state are waiting now for Zika test results, out of some 256 specimens submitted since January, said Dr. Scott Lindquist, the state’s epidemiologist for communicable disease.
So far, two residents, one in Clallam County and one in Mason County, have tested positive for Zika after traveling to areas where the virus is spreading. Two international travelers also were diagnosed in Washington: a man from Guatemala tested in King County and a woman from an unidentified Zika-affected country tested in Spokane after giving birth. Her baby was apparently healthy.
Nationwide, nearly 350 people in the U.S. have been diagnosed with travel-associated Zika virus infections, including 32 pregnant women, according to the CDC. Seven of those cases were transmitted sexually by men who had traveled to areas where Zika is spreading.
Local mosquitoes have been spreading Zika virus in U.S. territories, where more than 350 cases have been diagnosed in Puerto Rico, the U.S. Virgin Islands and American Samoa.
No local transmission has been reported on the U.S. mainland, but CDC officials say such spread could occur by late spring and summer, though it could be limited due to good mosquito control in most areas. Still, some health experts are warning pregnant women to avoid or limit travel to areas at risk.
Zika tests are ordered only for the most worrisome cases: people who show symptoms of infection with the virus or pregnant women whose fetuses are believed to be at highest risk from the infection.
Some Washington travelers have received answers in as few as nine days, Lindquist said. But others have waited 53 days, or nearly eight weeks. The average so far is a little more than three weeks, Lindquist said.
“Until we can speed this up, everyone’s just sitting there waiting to make decisions about their lives,” Lindquist said. “In Washington state, we need faster lab results. Or we need a rapid test that we can use here.”
The U.S. Food and Drug Administration this year authorized emergency use of two new tests to detect Zika virus in blood, cerebrospinal fluid or tissue, a move that helped speed results.
Now, public-health labs in a growing number of states are able to test for Zika, too, taking away some of the burden from the CDC’s primary lab for such testing in Colorado, Mead said.
“We anticipate we’ll be all caught up as of next week,” he said.
Washington state hasn’t received the diagnostic tests yet because the state doesn’t harbor the Aedes aegypti and Aedes albopictus mosquitoes that spread Zika virus, and the risk is considered low.
Still, health officials here applauded efforts to speed up local results.
“We definitely welcome that,” Lindquist said. “We want these families to know these results.”
For Stephanie Billmayer, who is staying with family in Montana, learning she wasn’t infected with Zika was a profound relief. But other questions remain before the birth of the baby, due Oct. 16.
Her fiancé, Andre Silva, 39, is an oil-rig worker in Brazil whose family — including his parents, nephew and 7-year-old son — all tested positive for the virus in March.
The couple plan to get married this weekend in Las Vegas, Billmayer said. They’ll have a lot to talk about, including CDC warnings that couples at risk for Zika infection use condoms or abstain from sex during pregnancy.
Billmayer said she’d like to return to Brazil, perhaps early next year, after the baby comes, and that she hopes international attention will result in help for families affected by Zika.
“I don’t think of it as an international health crisis,” Billmayer said. “Because when it hits you directly, you think of it as your own personal worry.”