After being tested, Abrams waited. The clinic told her the county health department would be in touch within a couple of days. Early the next week, someone called to say Abrams' blood had tested negative for dengue fever. Then a second call disclosed she had tested negative for Lyme disease. For several more days, there was no word. The wait became excruciating. "So I started calling every day -- 'What about the chikungunya?'"
Finally, on July 26, Abrams was told she had tested positive, and on July 30, after the sample had been sent to another lab for confirmation, the St. Lucie County Health Department announced the results. Abrams had officially become the third locally acquired chikungunya case in the United States.
By then, the pain had come back, and it was worse than ever. Abrams' fingers and wrists hurt too much to pick up a plate. Her back throbbed to the point where she dreaded the thought of even turning over in bed. Her knees and feet hurt so much that she sometimes lay flat for hours just to avoid touching the ground. "The only way I can describe it to you is if you could take your feet, have somebody crush all the bones in them, and then ask you to walk constantly."
The pain had become overwhelming. Consuming. Surreal.
"I thought I was going to die," she says. "I was terrified it was never going to go away."
Dr. Scott Weaver is struck by chikungunya's beauty. A virologist at the University of Texas Medical Branch in Galveston, he has spent more time with it than anyone in America. He has stared through a microscope for hours at its millions of intricate, prickly edges, mesmerized by its bright colors.
For more than a decade, inside a Biosafety Level 4 lab 50 miles from Houston -- the same place where scientists pore over Ebola -- Weaver has been dedicated to creating a chikungunya vaccine. "I've spent my entire career working on this virus," he says. "Someone should benefit."
Weaver is tall and lanky, with graying hair and a thick salt-and-pepper beard that extends high on his cheekbones. He often wears plaid shirts, even in the lab, which gives him the look of a 1970s computer geek or a misplaced lumberjack. Weaver, who is now in his 50s, first became fascinated by mosquitoes and the diseases they spread more than 30 years ago, when he cataloged insects around the swamps of his native Maryland during the summer after his freshman year of college.
He has tracked chikungunya through Africa, Southeast Asia, and, recently, the Caribbean, though he typically spends most of his time in his spacious office in Galveston, surrounded by heavy wooden furniture and various mosquito paraphernalia, including a mosquito hand puppet.
When he first started at the university in the 1990s, Weaver worked mostly with chikungunya epidemiological data, tracing the origins and cycle of chikungunya and other alphaviruses. But then came September 11, 2001. After the terror attacks, the National Institutes of Health (NIH) in Bethesda, Maryland, suddenly began pouring millions into research funds and biodefense, including for emerging infectious diseases like chikungunya.
"We developed our first vaccine within a matter of months," says the researcher. Weaver's team had used a living sample of the virus, just as doctors did for the polio and other vaccines. But live vaccines require an incredibly delicate balancing act -- they must be strong enough to be effective at inducing antibodies yet weak enough to not make humans sick or to spread the virus to other mosquitoes if the vaccine recipient is bitten.
It finished creating the first version of the vaccine in 2007, but Weaver's team was concerned this vaccine could be transmitted to mosquitoes from its recipients. The researchers had to start again. In 2011, they developed another version that has proven effective and safe in preclinical trials. But Weaver can't move on to clinical trials -- tests on real people -- because large pharmaceutical companies aren't yet willing to risk the millions of dollars that would likely be needed, he says. And human trials, of course, are critical for approval by the Food and Drug Administration. "The FDA is extremely conservative," he says. "And in this country, a lot of these infectious diseases aren't causing enough life-threatening infections to make the public worry whether there's a product available or why it takes years to get one approved."
The NIH is also developing a chikun-gunya vaccine, as are numerous other research centers. And last month, the institutes reported a successful human trial: Twenty-five volunteers who received the vaccine developed an effective antibody response. The NIH vaccine isn't live, which means it's considered safer, but it's also less efficient and has to be administered via three shots over the course of a month. "If you want to stop an epidemic, you can't take a month to vaccinate," Weaver says. "You can't even get people to come back for all of their doses of the vaccine most of the time."
Moreover, the NIH vaccine still needs a second trial, and after losing its previous pharmaceutical support, the institutes are searching for funding. Merck, the New Jersey-based company that had supported the project, pulled out after deciding against a large-scale trial it was considering in India. "The take-home message was no one knew how much disease they had in India, so there was no way of knowing how many they'd have to vaccinate to show efficacy," Weaver says. "And to get that information, they'd have to pay for it." (Researchers from the NIH declined to speak with New Times.)
Weaver's vaccine technically has a backer, Tokyo-based Takeda Pharmaceutical, but so far the company hasn't invested much, despite the vaccine's promise. "Now the vaccine is less of a scientific problem and more of a financial and logistical problem," Weaver says.