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Top 10 Zika Response Planning Tips: Brief Information for State, Tribal, Local, and Territorial Health Officials

Background

In December 2015, Puerto Rico, a U.S. territory, reported its first confirmed case of Zika virus disease.

Currently, outbreaks are occurring in many countries and territories. To date, Zika has not been spread by mosquitoes in the continental United States, but travel-associated cases have been reported. CDC continues to evaluate cases of Zika transmission in the United States and U.S. territories and updates guidance as new information becomes available. For more information, visit CDC’s Zika website.

In May 2015, the Pan American Health Organization (PAHO) issued an alert regarding the first confirmed case of Zika virus infection in Brazil. The outbreak in Brazil coincided with increased reports of Guillain-Barré syndrome (GBS) and pregnant women giving birth to babies with birth defects. Recently, CDC scientists announced that there is now enough evidence to conclude that Zika virus infection during pregnancy is a cause of microcephaly and other severe fetal brain defects.

Purpose

This summary of key Zika virus resources is a ready reference and aid for response planning for state, local, and territorial public health officials.

Zika Readiness Planning Resources

Local, state, and territorial responses to Zika cases or an outbreak will differ in jurisdictions where Aedes species mosquitoes (A. aegypti and A. albopictus) are endemic, and, therefore, local mosquito populations could become infected with Zika virus. All locations will likely have travel-associated cases, and there is priority need for laboratory testing capabilities, enhanced epidemiology, and surveillance systems, and support for pregnant women and families with a child born with microcephaly or other birth defects linked to Zika virus infection. Following are resources CDC has developed to help state, local, and territorial public health officials prepare for potential Zika virus cases.

  1. Vector Control and Surveillance
    (Applicable in all locations where Aedes aegypti or Aedes albopictus mosquitoes are endemic)

    Goal
    To target vector control programs in priority areas/at-risk populations to suppress Zika virus transmission if local cases or an outbreak is detected.

    Action Steps
  1. Public Health Surveillance and Epidemiological Investigation

    Goals
    To ensure adequate diagnosis and reporting of Zika virus cases; to monitor epidemiologic trends in distribution, transmission, and severity; to direct prevention and control efforts; and to identify cases that require follow up or intervention.

    Action Steps
  • Determine if systems and procedures are in place to identify potential or confirmed Zika cases:
    • through symptomatic infections
    • in pregnant women
    • associated with reproductive or congenital outcomes, including microcephaly
    • associated with Guillain-Barré syndrome
    • associated with blood transfusions
    • associated with sexual transmission
  • Ensure investigating officials and clinicians have the latest case definitions developed with the assistance of the Council of State and Territorial Epidemiologists.
  • Ensure clinicians are aware that, as an arboviral disease, Zika is a nationally notifiable condition in the National Notifiable Disease Surveillance System.

    Resources
  • Current case definitions [PDF - 11 pages]
  1. Laboratory Testing and Support Services

    Goal
    To ensure state and territorial health departments have the support needed to adequately test specimens from suspect Zika cases.

    Action Steps
  1. Prevention of Sexually Transmitted Zika Virus Infections

    Goal
    To reduce the risk of sexually transmitted Zika virus by providing guidance to the public regarding the risks and to clinicians so they may counsel their patients.

    Action Steps
  1. Prevention of Blood Transfusion–transmitted Zika Virus Infections

    Goal
    To reduce the risk of transfusion-transmitted Zika virus during a local or more widespread outbreak in areas with active transmission.

    Action Steps
  1. Maternal and Child Health Surveillance and Response

    Goal
    To prevent Zika virus infection during pregnancy, monitor pregnant women with suspected or confirmed Zika virus infection, and follow up to track adverse pregnancy and infant outcomes.

    Action Steps
  1. Rapid Birth Defects Monitoring and Follow-up

    Goal
    To ensure rapid detection of microcephaly, other major birth defects, and other disabilities that might be associated with Zika virus infection and to plan for adequate services for these children and their families

    Action Steps
  • For those states/territories with a state birth defects surveillance program, ensure healthcare providers have information regarding reporting requirements and infrastructure.
  • Ensure training and educational materials from CDC are appropriately augmented with state/territorial requirements and distributed to pediatric providers so that they can evaluate infants with possible congenital Zika virus infection.
  • Determine if projected needs (medical and support) for families with a child with microcephaly or another major birth defect have been assessed and planned for and if there is a  system in place with the capacity to adequately address those needs.

    Resources
  • Guillain-Barré Syndrome Q & A
  • MMWR Zika Reports
  • Facts about Microcephaly
  • National Birth Defects Prevention Network  
  1. Travel Health News

    Goal
    To ensure travelers to areas with locally transmitted Zika virus receive appropriate information regarding risks and protection measures.

    Action Steps
  • Disseminate travel notices designed to inform travelers and clinicians about the risks for contracting Zika infection related to specific destinations and provide prevention recommendations.

    Resources
  • CDC Zika Travel Notices
  1. Clinician Outreach and Communication

    Goal
    To inform healthcare providers on the risks, recognition, diagnosis, reporting, clinical management, outcomes, and prevention of Zika virus infections.

    Action Steps
  1. Risk Communication/Community Education

    Goal
    To inform the public about Zika virus and related birth defects or illnesses, especially microcephaly and other harmful effects to pregnant women and their fetuses.

    Action Steps
  • Develop communication messages, products, and programs with key partners and stakeholders to harmonize response for people traveling to or living in areas of higher risk of Zika transmission.  
    • Identify primary communication outlets for areas of high risk populations (e.g., radio, television) and potential for using those channels to communicate messaging. 
    • Use the CDC Joint Information Center (JIC) key messages document, CDC Zika website, and other CDC resources, along with local resources, as needed, to prepare messaging materials. 
    • Work with CDC’s JIC on development of printed, radio, and visual materials as needed.
  • Identify local vendors for translation (as necessary), printing, signage, audiovisual/public service announcement development and determine what is required (funding, contract approval) to use these resources for message and product dissemination.

    Resources
  • CDC Zika Website
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