[Congressional Record Volume 148, Number 133 (Thursday, October 10, 2002)]
[Senate]
[Pages S10383-S10385]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. FRIST (for himself, Mr. Dodd, Mr. Santorum, Mr. Bayh, Mr. 
        Cochran, and Mr. Dewine):
  S. 3105. A bill to amend the Public Health Service Act to provide 
grants for the operation of enhanced mosquito control programs to 
prevent and control mosquito-borne diseases; to the Committee on 
Health, Education, Labor, and Pensions.

[[Page S10384]]

  Mr. FRIST. Mr. President, I rise today to introduce the ``West Nile 
Virus and Arboviral Disease Act''--a bill to help strengthen our public 
health system and improved research so that we can better respond to 
West Nile virus and other arboviruses. I want to thank Senators Dodd, 
Santorum, Bayh, Cochran, and DeWine for their work in helping craft 
this important legislation.
  This year, nearly 3000 Americans have been diagnosed with West Nile 
Virus, WNV. At least 146 have died. While this virus is transmitted to 
humans primarily through migratory birds and mosquitoes, recent 
evidence strongly suggests that WNV can be transmitted through blood 
transfusions, organ donations, and possibly even breast milk. Further, 
the latest studies indicate that some patients may experience polio-
like symptoms as a result of WNV infection.
  WNV first appeared in North America in 1999 with reports of 
encephalitis in birds, humans and horses. Prior to this summer, there 
had been only 149 cases and 18 deaths from this virus. Now, WNV has 
spread as far south as Florida and as far west as California, 
encompassing areas with warmer climates that will allow a year-round 
transmission cycle. In three years, we have lost the opportunity to 
contain the disease to the northeastern region of the United States, 
where mosquitos do not breed year-round. As a result, many more people 
will die and become ill.
  Clearly, the increasing spread of the disease and these new findings 
require an enhanced response at the Federal level. We must do more to 
support State and local public health efforts to combat the spread of 
West Nile. And we must also intensify research at the federal level to 
better understand the etiology of the virus, develop improved abatement 
tools, and prevent the spread of the illness.
  The Centers for Disease Control and Prevention, CDC, has published 
national guidelines for surveillance, prevention and control of WNV. 
CDC also developed a national electronic surveillance system, ArboNET, 
to track West Nile in humans, birds, mosquitoes, horses, and other 
animals. However, the data available to the ArboNET system likely 
underestimates actual geographic distribution of WNV transmission in 
the United States because the data are provided by up to 54 ArboNet by 
local health unit surveillance efforts which vary according to capacity 
and ability. We need to do more to strengthen the capacity of those 
surveillance efforts. One only needs to examine the map of the spread 
of WNV to determine that there may be gaps in our surveillance when 
some States, like Kansas and West Virginia, are surrounded by other 
states with similar arbovirus patterns but still not indicating the 
presence of human disease. One of the peculiarities of great 
surveillance systems is the increased incidence of disease, simply 
because better information is being collected.

  Although strengthening our surveillance and response capabilities 
will help, we must also do more to increase the number of appropriately 
trained entomologists. There is clearly a need for more individuals who 
can understand the disease vectors, identify their breeding areas, and 
take action to eliminate the mosquito population before WNV season.
  In response to these obvious deficiencies, this legislation 
establishes a temporary program for the containment of WNV and related 
arboviral diseases. Through this grant program, which is authorized for 
two years, but can be extended by the Secretary of Health and Human 
Services for an additional year, the CDC is authorized to make grants 
to states. States can use the funds to develop, implement, and evaluate 
comprehensive, community-based mosquito control plans. Additionally, 
states can work with local communities to develop and implement 
programs to support longer term prevention and control efforts, 
including training to develop a competent public health workforce. 
Finally, States are encouraged to work with local health entities to 
develop prevention and control programs.
  As part of the requirement under the grant program, the CDC is 
charged with developing, in consultation with public and private health 
and mosquito control organizations, guidelines for State and local 
communities for a sustainable, locally managed, integrated mosquito 
control programs, as well as otherwise increasing CDC's capacity to 
provide technical assistance.
  We also need to learn more about this virus and how it is spread. To 
combat WNV, we must develop: 1. improved insecticides; 2. rapid tests 
for the presence of WNV in human blood products; 3. pathogen 
inactivation technologies; and 4. additional methodologies to contain 
the spread of WNV or other related arboviruses, including the 
development of an appropriate WNV vaccine for humans and other mammals 
and better antiviral treatments.
  In 1972, the FDA banned the general use of the pesticide DDT, ending 
nearly three decades of application. During which time, the once-
popular chemical was used to control insect pests on crop and forest 
lands, around homes and gardens, and for industrial and commercial 
purposes. DDT was developed as the first of the modern insecticides 
early in World War II. It was initially used with great effect to 
combat malaria, typhus, and the other insect-borne human diseases among 
both military and civilian populations. A persistent, broad-spectrum 
compound often termed the ``miracle'' pesticide, DDT came into wide 
agricultural and commercial usage in this country in the late 1940s, 
but was banned by the FDA when the Director at that time determined 
that the continued massive use of DDT posed unacceptable risks of the 
environment and potential harm to human health. Since that time, we 
have not developed a replacement for DDT. We have become complacent, 
assuming that there would be no need to continue to reducing the insect 
population. We can no longer be complacent.
  We have not yet developed a rapid diagnostic WNV test for blood 
products. There are two types of tests available, a serologic test or a 
polymerase chain reaction, PCR, test, but only the PCR test would be 
feasible for screening purposes. Experts have suggested that a new PCR 
test could be available within 18 months if the appropriate market 
incentives were in place. We need to determine the best way to expedite 
the development of this test.
  Pathogen inactivation techniques could be used to purify blood 
samples by removing all DNA and RNA particles from the blood. However, 
we have not yet performed a larger assessment to determine the overall 
health benefit of this technique. Because the process relies on adding 
additional chemicals to the blood product, those chemicals, or 
derivatives thereof, may have a particular health effect. Therefore, 
given that there will be other emerging infectious diseases in our 
future, we need to develop a proactive, not reactive, mode to dealing 
with those infections.
  Currently, scientists have developed an equine vaccine for WNV, but 
there is no human vaccine. Given the limited vaccine options, many 
veterinarians are even using the equine vaccine for avians and other 
mammals. Therefore, we need to focus efforts on developing vaccines for 
a host of susceptible mammals.
  In conducting that research, given the nature of all arboviruses and 
the fact that WNV also infects a host of mammals, we need to build more 
bridges between veterinary health and public health. Already, avian 
experts are asked to assist our public health experts to help identify 
how bird migration would affect the spread of WNV. Additionally, any 
new vaccine or diagnostic test for WNV may have broader applicability 
to the host of other mammals affected by the virus.
  Given the multitude of federal agencies that should be involved with 
relevant research, the legislation charges the President with 
expanding, intensifying, and enhancing research related to the 
identification or the development of insecticides, the development of a 
screening tools for WNV in both blood and organs, the development of 
pathogen inactivation technologies, technologies that safety and cost-
effectively remove RNA and DNA from blood, and the development of 
additional methodologies for containing the spread of West Nile Virus 
and other related arboviruses. This research program is authorized for 
five years.
  More should be done to continuously support the development of a 
capable public health infrastructure and increased response 
coordination at all levels. At the Federal level, we have

[[Page S10385]]

significantly increased our resources for these purpose by providing 
nearly $1 billion for bioterrorism-related activities, activities which 
should focus on ``dual use'' capabilities to strengthen our ability to 
respond to all infectious diseases. However, we need to ensure a 
continued investment if we are to stabilize our public health 
infrastructure and continue to focus on means by which to increase 
coordination.
  Again, I want to commend Senators Dodd, Santorum, Bayh, Cochran, and 
DeWine for their contributions to the development of this legislation. 
It has been an honor and a pleasure to work with my distinguished 
colleagues on this bill, and I look forward to continuing to working 
with them and others to find better solutions to combating WNV.
                                 ______