Zika Virus & Community Health Centers
- 1. ZikaVirus & Community Health Centers Rashel Rabinovich
- 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
- 10. “ ” Nonprofit community health centers are becoming the first line of defense Texas Tribune
- 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
- 14. Sources • http://www.theatlantic.com/health/archive/2016/02/the-past-present-and-future- of-zika/459585/ • http://www.who.int/emergencies/zika-virus/timeline/en/ • http://www.who.int/mediacentre/factsheets/zika/en/ • http://www.cdc.gov/zika/public-health-partners/tips.html • http://www.nytimes.com/2016/03/31/us/mapping-a-genetic-strategy-to-fight- the-zika-virus.html?_r=0 • http://www.aframnews.com/legacy-community-health-to-screen-pregnant- women-for-zika-virus/ • http://www.politico.com/story/2016/03/zika-virus-america-threat-220983 http://www.salon.com/2016/02/16/ americas_most_dangerous_zika_challenge_puerto_ricos_health_system_is_coll apsing_and_nobody_wants_to_help/