1. Zika Virus Update April 5, 2016 Presented by: Vinny Taneja, MBBS;MPH Director Tarrant County Public Health “A Nationally Accredited Health Department”

2. What is Zika? Zika is a viral illness caused by Zika Virus and spread by the bite of infected Aedes Mosquitoes.

3. Where did this come from? Originally found in 1947 in the Zika forest of Uganda. Prior to 2015, Zika virus outbreaks have occurred in areas of Africa, Southeast Asia, and the Pacific Islands. In May 2015, the Pan American Health Organization (PAHO) issued an alert regarding the first confirmed Zika virus infections in Brazil.

4. Current Situation Spread to over 40 countries worldwide 312 confirmed cases in US –27 Pregnant Women –6 Sexually transmitted –1 Guillain-Barre syndrome –0 Locally transmitted, ALL Imported cases

5. Signs and Symptoms Zika is usually a mild illness with a fever, rash, joint pain and occasionally conjunctivitis. The illness usually lasts about 1 week. Hospitalization is usually not necessary. Deaths with Zika are not common but have been reported. Only about 1 in 5 will develop any symptoms.

6. Emerging Science There have been several reports out of Brazil with children born with Microcephaly (Small Head) while there was a large Zika outbreak there. The causation is not confirmed but still coincidental enough to cause concern about gaps in understanding of the disease. WHO believes there is a strong correlation. There have also been reports of Guillain-Barre Syndrome and other neurologic disorders out of French Polynesia and some other countries

7. Emerging Science…. Primarily spread by mosquitoes Emerging: Reports of sexual transmission! Possible spread from infected blood. Possible spread from mother to baby.

8. Is there a test? Yes, CDC provided a test for humans –TCPH is currently able to provide Zika Testing Right now there is no available test for mosquitoes

9. Treatment There is no treatment Generally rest, fluids and acetaminophen Do not take other NSAID’s like ibuprofen, aspirin, naproxen etc. Hospitalization is usually not needed

10. Prevention

11. Personal Protection –Avoid mosquito bites –Use DEET or another EPA approved repellant –Avoid travel to Zika affected countries, especially if pregnant Emerging: –Encourage condom use especially if returning from Zika affected countries –http://www.cdc.gov/zika/hc-providers/qa- sexual-transmission.htmlhttp://www.cdc.gov/zika/hc-providers/qa- sexual-transmission.html

12. What is TCPH doing? Educating the public and medical community –Health Alerts –Website, Social Media, Printed Materials –Grand Rounds with OB/GYN –Zika Home Care Kit Opened a Zika Virus Hotline: –817-248-6299 Meeting with City and other jurisdiction partners 1 on 1 to discuss mosquito control plans –Source Reduction –Larviciding –Adulticiding –Surveillance education (Mosquito traps) Mosquito season kick off meeting on March 21, 2016 Discussed plan with City of Fort Worth staff and also level JEOC meetings

13. Educational Resources

14. Elimination Mosquito Breeding Sites video –https://youtu.be/G_ekfQ-F4F4https://youtu.be/G_ekfQ-F4F4 Website: –http://health.tarrantcounty.comhttp://health.tarrantcounty.com Social Media: –www.facebook.com/tarrantcountypublichealthwww.facebook.com/tarrantcountypublichealth –https://twitter.com/@tcphtweetshttps://twitter.com/@tcphtweets

15. Is this a threat in Tarrant County? Right now primarily through imported cases Aedes mosquito usually hibernates in winter giving us time to prepare for the upcoming mosquito season, Culex is active as an adult but not a common vector for Zika. Need cooperation from our community to fight off the mosquito threat

16. What is our imported case response plan? Response will be determined on a case by case basis –Consider travel history –Is the patient in the viremic time frame? –If so educate about disease spread and bite prevention, Tool: Zika Home Care Kit –Assess property for appropriate vector mosquitoes –Determine appropriate measures Source elimination Spraying/ fogging/ larviciding Setting up BG Sentinel traps for surveillance

17. Where to spend our resources? Source Reduction! –Single biggest weapon in fighting mosquito borne illness –Sources AROUND THE HOUSE! –Open drains, blocked drains –Overgrown grass, weeds –Trash pick up –Junk and abandoned tires

18. Source Reduction!

19. Questions