Congressional inaction on Zika funds has hampered efforts on the local level to stop the spread of the disease. That was more or less proven Friday when Florida Department of Health officials said it's highly likely that four new cases in Miami were the first to be contracted by infected mosquitoes in the U.S.
To date, there have been 1,658 cases of Zika in the continental United States. But so far, they've all involved someone who had traveled to a foreign country or had sex with someone who had recently been to a Zika-affected country.
President Obama in May proposed $1.9 billion to help combat the spread of the virus. Congress, however, was unable to agree on that number and left for recess without allocating any extra money for state and local governments.
Even if Congress does allocate Zika funding, local officials say they may already have missed an important window for combatting the virus.
“The real tragedy is that now is the time when you need the extra money and resources: July and August is mosquito control time all across the U.S.,” said Peter Hotez, dean of the National School of Tropical Medicine at the Baylor College of Medicine. “Everything from here on out is just going to be damage control.”
In the absence of federal funding, localities have been left to fend for themselves.
“The Centers for Disease Control is not going to fight this disease. This is going to be a fight almost exclusively at the local level,” said Hotez.
Beyond mosquito control, which is hardest in the summer months, Hotez says local health centers must start being constantly on the lookout for possible cases.
“If people come in with a rash or a fever, they need to get tested for Zika. It’s very labor intensive to test everyone with Zika symptoms," he said, "but it just has to get done.”
There's one problem: resources.
"We need more money, and we need it now," said Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, adding that he's "almost certain we’re going to see more locally transmitted cases."
Staffing and supplies at both mosquito control units and health departments vary widely county-to-county, so the fight to prevent Zika could look quite different from one ZIP code to the next.
“There are such disparities on the state and local level," said Fauci, "and that’s what is going to get us in trouble."
Many localities have engaged in public awareness campaigns about the virus. Houston has been aggressive about teaming up with local media, and there are informational signs on all of the buses and trains. The city has also been clearing out empty lots since the spring -- where heavy trash like tires are often disposed -- which is a perfect breeding ground for mosquitoes.
“I don’t know how the mayor found the money to keep that effort going, but he has,” said David Persse, medical director for the city of Houston.
In a handful of counties, mosquito control officials have been going door-to-door offering information on mosquito abatement -- and offering to spray residents' properties.
But that approach isn't foolproof: One of the counties engaged in door-to-door outreach is Miami-Dade, the site of the most recent cases.