Zika

Local transmission of Zika virus has been confirmed in 67 countries worldwide and in 46 countries or territories in the Americas. On February 1, 2016 the World Health Organization declared a Public Health Emergency of International Concern due to the increase in microcephaly cases and other neurological disorders reported in Brazil. Several countries issued travel warnings for pregnant women travelling to Zika-affected countries with Brazil, Colombia, Ecuador, and El Salvador advising against pregnancy. The risk of local transmission in unaffected regions is unknown but potentially significant where competent Zika vectors are present and also given the additional complexities of sexual transmission and population mobility. Despite the rapid spread of Zika virus across the Americas and global concerns regarding its effects on fetuses, little is known about the pattern of spread. Knowledge of the direction and the speed of movement of disease is invaluable for public health response planning, including the timing and placement of interventions.

Objective

To estimate the velocity of Zika virus disease spread in Brazil using data on confirmed Zika virus disease cases at the municipal-level.

Zika virus disease and Zika virus congenital infection are nationally notifiable conditions that became prominent recently as a growing number of travel-associated infections have been identified in the United States. The Centers for Disease Control and Prevention (CDC) have dedicated significant time and effort on determining and addressing the risks and impact of Zika on pregnant women and their babies who are most vulnerable to the disease. CDC relies on two sources of information, reported voluntarily by healthcare providers, to monitor Zika virus disease: ArboNET and the newly established U.S. Zika Pregnancy Registry. A study by IMS Health compared U.S.trends of the Zika virus disease in general and pregnant women with Zika virus disease in particular observed in an IMS healthcare claims database and the CDC ArboNET and the newly established U.S. ZikaPregnancy Registry.

Objective

Demonstrate the value of consolidated claims data from community healthcare providers in Zika Virus Disease surveillance at local level.

The first travel-associated cases of Zika virus infection in New York City (NYC) were identified in January 2016. Local transmission of Zika virus from imported cases is possible due to presence of Aedes albopictus mosquitos. Timely detection of local Zika virus transmission could inform public health interventions and mitigate additional spread of illness. Daily emergency department (ED) visit surveillance to detect individual cases and spatio-temporal clusters of locally-acquired Zika virus disease was initiated in June 2016. 

Objective

Case and cluster identification of emergency department visits related to local transmission of Zika virus. 

Zika, chikungunya, and dengue have surged in the Americas over the past several years and pose serious health threats in regions of the U.S. where Ae. aegypti and Ae. albopictus mosquito vectors occur. Ae. aegypti have been detected up to 6 months of the year or longer in parts of Arizona, Florida, and Texas where mosquito surveillance is regularly conducted. However, many areas in the U.S. lack basic data on vector presence or absence. The Zika, dengue, and chikungunya viruses range in pathogenicity, but all include asymptomatic or mild presentations for which individuals may not seek care. Traditional passive surveillance systems rely on confirmatory laboratory testing and may not detect emergent disease until there is high morbidity in a community or severe disease presentation. Participatory surveillance is an approach to disease detection that allows the public to directly report symptoms electronically and provides rapid visualization of aggregated data to the user and public health agencies. Several such systems have been shown to be sensitive, accurate, and timelier than traditional surveillance. We developed Kidenga, a mobile phone app and participatory surveillance system, to address some of the challenges in early detection of day-biting mosquitoes and Aedes-borne arboviruses and to enhance dissemination of information to at-risk communities. 

Objective

(1) Early detection of Aedes-borne arboviral disease;

(2) improved data on Ae. aegypti and Ae. albopictus distribution in the United States (U.S.); and

(3) education of clinicians and the public. 

Zika virus spread quickly through South and Central America in 2015. The City of Houston saw its first travel-related Zika cases in December of 2015. On January 29th, the City held the first planning meeting with regional partners from healthcare, blood banks, petrochemical companies, mosquito control, and others. Additionally the City activated Incident Command Structure (ICS) and designated the Public Health Authority as the Incident Commander.

Initial steps taken by HHD included expanding the capability and capacity of the public health laboratory to test for Zika virus; expand surveillance efforts; created an educational campaign around the “3Ds” of Zika defense (Drain, Dress, DEET) which were then disseminated through several means, including a mass mailing with water bills; and provided DEET to mothers through the WIC program.

The Houston Health Department took the lead in authoring the City’s Zika Action Plan. In this 3 goals and 6 strategies were identified. Goals included 1) Keep Houstonians and visitors aware of the threat of Zika; 2) minimize the spread of the virus; and 3) protect pregnant women from the virus. The 6 strategies employed were to A) develop preparedness plans; B) implement ICS within the City; C) ensure situational awareness through surveillance; D) Increase community awareness; E) reduce opportunities for Zika mosquito breeding grounds; and F) provide direct intervention to reduce the threat of Zika.

HHD was responsible for many of the action items within the plan. We conducted several community outreach events, where we disseminated educational materials, t-shirts, DEET, and other give- aways. These events allowed frequent engagement with the public for bidrectional communication on how to approach the threat. 

Objective

This session will explore the role of the Houston Health Department (HHD) in the City of Houston’s response to the threat of Zika. The panelists will provide perspective from the roles of Bureau Chief, informatician, and epidemiologist and provide insight into lessons learned and strategic successes. 

Zika virus was declared an international public health emergency by the World Health Organization on February 1, 2016. With Georgia hosting the world’s busiest international airport and a sub- tropical climate that can support the primary Zika virus vector, Aedes aegypti, and secondary vector, Aedes albopictus, the CDC designated Georgia as a high risk state for vector transmission. Faced with a lack of mosquito surveillance data to evaluate risk of autochthonous transmission and a few counties statewide that provide comprehensive mosquito control, the DPH rapidly scaled up a response. DPH updated existing mosquito surveillance and response plans targeted for West Nile Virus (WNV) and expanded capacity to areas that lacked previous surveillance targeting the Zika virus vector. 

Objective

To describe the Georgia Department of Public Health’s (DPH) mosquito surveillance capacity before and after Zika virus was declared a public health emergency, review and compare mosquito surveillance results from 2015 to 2016, and evaluate the risk of autochthonous vector transmission of Zika virus based on 2016 surveillance data of Aedes aegypti and Aedes albopictus mosquitoes. 

In 2016, the World Health Organization declared Zika virus a global public health emergency. Zika infection during pregnancy can cause microcephaly and other fetal brain defects. To facilitate clinicians’ ability to detect Zika, various syndrome definitions have been developed. 

Objective

To develop and validate a Zika virus disease syndrome definition within the GUARDIAN (Geographic Utilization of Artificial Intelligence in Real-Time for Disease Identification and Alert Notification) surveillance system.