2. History of Zika
• Zika was originally isolated in 1947 in Uganda by scientists who were
doing a routine surveillance of yellow fever
• In 1952 the first human cases were detected in Uganda and the
United Republic ofTanzania
• From its’ discovery to 2007, there were very few confirmed cases of
the disease but an initial epidemic occurred in 2007 in Micronesia.
• The current outbreak, which has been named a “public health
emergency of international concern” by the World Health
Organization began in May 2015 in Brazil and has since spread to 22
other countries in North and South America.
3. What is Zika?
• A mosquito borne virus
• Can be transmitted sexually or by infected mosquitos
• Symptoms include; mild fever, rash, conjunctivitis, muscle/joint pain,
headache
• In adults, the symptoms are mild and last for 2-7 days
• Guillain Barre
• In babies, PROVEN link to microcephaly
• Also can result in miscarriages & still births
• Can also cause absent or poorly developed brain structures, defects of the
eye, hearing deficits, and impaired growth
4. Are Americans at risk?
• Residents ofTexas, Florida, Puerto Rico and Hawaii
predicted to be at highest risk of
transmission by mosquito
• Pregnant woman= highly vulnerable
• Blood supply
• Patients who live in poor housing conditions, lack window screens, and
have family members/travel back forth to Mexico/Central America,
work in jobs that put them at risk for mosquito infestation
5. Estimated range maps show CDC’s best estimate of the potential range of Aedes aegypti
and Aedes albopictus in the United States.Where mosquitoes are or have been
previously found.
6. Puerto Rico
• “America’s ZikaVirus Epicenter”
• Perfect storm! Infested mosquitos abundant in Puerto Rico, warm/tropical
climate, less than ideal infrastructure, and mass amounts of standing water
• Estimated that 1 million of the 3.55 million inhabitants of PR will get Zika in
the next year.Already Puerto Rico already has 448 cases of Zika
• US citizens can travel freely between mainland US and the island
• Public health system= verge of collapse
• Huge debt
• Degraded quality of life
• ½ of citizens below poverty line
• Cuts to health services! brain drain
7. What is being done in Puerto Rico?
• HHS Secretary Sylvia Burwell
• $5 billion to 20 CHCs
• HHS distributed nearly 13,000 Zika prevention kits on the island.
• CDC sprayed to control mosquitoes at the homes of 100 pregnant
women and more than 400 additional residences are scheduled to get
treatment
8. CDC Recommendations
• Preparation, if vector is present/possible in the state! Senior rep to
coordinate response, secure surveillance, review programs/plans,
communication campaign
• Mosquito season! follow up on suspected cases, increase communication
to public & rep, counsel people whose sexual partners are affected,
encourage reporting
• Confirmed local transmission! state incident management structure,
CDC field team, issue press release, intensify surveillance, rapid insecticide
resistance study, communications towards pregnant population, and notify
local blood collection agencies
• Widespread Local Transmission by Mosquitos! incident manager
provide regular updates, intensify outreach, intensify/expand vector control
options, intervention plans for high risk populations
• Local Transmission by Mosquitos in Multiple Countries! further
expansion of regional/state wide response
9. What are policymakers doing?
• Adding ZikaVirus to the FDA Priority ReviewVoucher
Program Act
• Obama administration
11. Health Centers
• Legacy Community Health Center; Houston,Texas
• One of the nations largest FQHC
• Offering screening for pregnant patients
• Increased patient communications; individual letters & radio ad
• Client Newark Community Health Center; Newark, New Jersey
• Growing population of Latin Americans
• Asking pregnant patients about travel history
• Held educational briefing partnering withThe New Jersey Department of
Health
• Community Health Centers of Sarasota County; Florida
• Set up a Zika information hotline
• Community Health Centers in NewYork City
• Travel advisory posters
• Free insect repellent to pregnant women
12. What else can CHCs & FQHCs be doing?
• Increased screening in at risk areas (Florida, Puerto Rico,Texas but also large
cities that people travel in and out of! DC)
• Community education
• Birth control options
• Risks/information about Zika
• On the ground work with rural populations (especially in Puerto Rico)
• Increase access to birth control
• Distribute “Zika Prevention Kits” to at risk populations
• A bed net
• Insect repellent
• Standing water treatment tabs
• Condom
13. What NACHC can do
• Provide educational materials for health centers across the country,
especially those in high risk areas (Texas, Florida, Hawaii, Puerto Rico)
• Lobby for voucher program to increase incentive for vaccine creation
• Increase awareness among clinical workers on signs of the disease
