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Zika Virus: An Emerging Infectious Disease in the Western Hemisphere and an Emerging CSTE Response

Posted By Paul Etkind, CSTE Consultant, Saturday, June 30, 2018
Updated: Friday, June 29, 2018

The Zika Virus Preparedness Resources Toolkit is now available on CSTE’s website, with sections devoted to General Information, Epidemiology, Data Management, Laboratory Guidance, Maternal and Child Health, and more.

Zika virus was initially identified in Uganda in 1947. It made surprise appearances in the Pacific Island of Yap (Micronesia) in 2007, and then in other island groups in the Pacific in 2013. Reports of cases in Brazil began accumulating in March 2015. This was Zika’s first appearance in the Western Hemisphere. By May 2015, Brazil was reporting locally acquired cases. The Zika outbreak in the Western Hemisphere presented some surprising challenges as the case counts rose rapidly and the number of affected countries also increased at an alarming rate. An association with microcephaly among infants exposed in utero represented one of the initial surprises. The second was the suggestion, since confirmed, that this arthropod-borne virus could also be transmitted sexually. This second surprise, not seen before, was a potential game changer. Prevention and control was no longer limited to traditional adult and larval mosquito spraying, eliminating mosquito breeding habitats, and the use of repellants by residents. By February 2016, the World Health Organization (WHO) declared Zika virus disease to be a Public Health Emergency of International Concern.

Many U.S. territories reported local Zika transmission, then in July 2016, locally acquired cases of Zika were identified in Florida. Zika virus prevention and control was a national public health priority. The Council of State and Territorial Epidemiologists (CSTE) supported Zika preparedness and response activities for local, state, and federal public health partners. Activities included: placing three Zika fellows in health departments, supporting six deployments to Puerto Rico for Zika response, and coordinating response efforts between CSTE members and the Centers for Disease Control and Prevention (CDC). Supplemental funding from CDC through CSTE supported development of a toolkit of Zika-related tools that can be used to accelerate state and local public health preparedness planning and operational readiness.

The Zika Virus Preparedness Resources Toolkit, which is now publicly available on CSTE’s website, has sections devoted to the following topics: General Information, Epidemiology, Data Management, Laboratory Guidance, Maternal and Child Health, Vector Research and Management, Policy Statements, and an Appendix with definitions and explanations of acronyms used in the toolkit. Each section contains reference and educational materials along with forms and letters that can be adapted and used by other jurisdictions. CDC’s supplemental funding also supported five national “Zika: Notes from the Field” webinars, which focused on Case Surveillance, Mosquito Surveillance, Diagnostics, Strategies for Expanding Surveillance, and Control and Prevention Strategies. The recordings of these webinars are also available in CSTE’s Webinar Library.

This toolkit is intended to be a content resource for applied epidemiologists and their colleagues to save time and effort looking for sources or materials that they can use in developing their own prevention and control policies and strategies. The primary vector species, Aedes aegypti and Aedes albopictus, are already distributed across much of the United States. Viral spread is of greater concern. As we move forward, we hope applied epidemiologists and other public health professionals will find this toolkit useful in strengthening their jurisdiction’s vector-borne disease surveillance and control programs to not only prevent Zika virus disease, but also other mosquito-borne diseases as well.

For more information on CSTE’s Vector-Borne Diseases and Public Health Emergency Preparedness Subcommittee activities, contact Jordan Peart at jpeart@cste.org.

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