Transcript Paola Lichtenberger MD

Solutions for Unified Critical Communications
The Zika Virus: An Emergency Management Panel
#Zika
Agenda
#Zika
• Logistics
• Panel Introductions
• Zika Medical Information
• Panel Discussion
• Audience Q&A
2
Housekeeping
Use the Q&A
function to
submit your
questions.
@everbridge
#zika
We’ll send out a
recording after
the event
3
#Zika
Panel Introductions
4
Introducing Panelists
Ranya Habash MD (Moderator)
• Chief Medical Officer at Everbridge
• Board Certified Ophthalmologist
• Founder of Eye Physicians of Florida
• Official Eye Surgeon of the UFC
Paola Lichtenberger MD
• Infectious Disease Specialist at the
University of Miami Miller School of
Medicine
• Director of the University of Miami
Tropical Medicine Program
• Associate Program Director of the
Infectious Diseases Fellowship program
Jackson Memorial Hospital/University of
Miami Program
• Travel Medicine and tropical Medicine
certified
#Zika
Tom Crane
• Senior Solutions Consultant/Technical
Account Manager at Everbridge
• Commissioner for local emergency
preparedness advisory committee
• Team coordinator for Community
Emergency Response Team
• Previously worked for the Federal
Emergency Management Agency and
as a consultant for the U.S. Department
of Homeland Security
Andrew Woods
• Member of the Business Continuity
Institute
• Worked in the Business Continuity field
since 2004
• Built ISO/BCI aligned Resiliency program
from the ground up including: BIA, BCP,
DRP and CMP
• Managed Everbridge for 150,000
contacts in 100s lines of business in over
67 countries
5
#Zika
Zika Medical Information
6
Paola Lichtenberger M.D.
UM Tropical Medicine Program
Infectious Diseases
University of Miami Miller School of Medicine
[email protected]
Zika virus
• Belongs to Genus Flavivirus, family
Flaviviridae
• Enveloped icosahedral Single
stranded RNA virus
• Two lineages:
• African and Asian
Tick-borne encephalitis
virus
West Nile Virus
Murray Valley Encephalitis Virus
Japanese Encephalitis Virus
St. Louis Encephalitis Virus
DENV 1
DENV 3
DENV 2
DENV 4
Yellow Fever Virus
Zika Virus
History of Zika virus
• 1947: Uganda
Zika Virus Transmission
• Mosquito bites
• Aedes species (A. Aegypti, A. albopictus)
• Mother to Child
• Around time of birth
• During pregnancy
• No reports of cases through breastfeeding
• Infected blood or sexual contact
• Three cases of sexual contact reported
• Cases of blood transfusion
http://www.cdc.gov/zika/transmission/index.html
Ongoing Zika virus outbreak
Zika virus Infection In the United States
February 10, 2016.
US States
•Travel-associated: 84
•Locally acquired vector-borne: 0
US Territories
•Travel-associated cases reported: 1
•Locally acquired cases reported: 9
9 cases. Travel related
http://www.cdc.gov/zika/geo/active-countries.html
Clinical presentation
• Infection rate: 73% (95% CI 68-77)
• Symptomatic attack rate among
infected 18% (CI 10-27)
• All age groups affected
• Adults more likely to present for for
medical care
• Symptoms typically resolve in 5-7 days
• Mortality is rare
• Laboratory findings:
• Lymphopenia, Thrombocytopenia,
Elevated creatinine, Elevated
transaminases
Duffy M. N Engl J Med 2009. serosurvey on Yap Island, 2007
Courtesy of Drs. G. Baracco M.D. and Paola Lichtenberger M.D.
Miami Veteran’s Affairs HealthCare System. February 2016.
Differential diagnosis of Zika virus
Bacterial
Viral
Parasites/Non Infectious
•
•
•
•
Influenza
Enterovirus
Measles
Rubella
•
Dengue
•
West Nile Virus
• Leptospirosis
•
Acute Retroviral Syndrome (HIV)
• Rickettsial diseases
•
Chikungunya
•
Other alphaviruses
•
Epstein-Barr virus
•
Parvovirus
•
Roseola virus
• Scarlet fever (Group A
Strep)
• Meningococcemia
• Typhoid fever
• Other bacterial septicemia
• Malaria
• Post infectious arthritis
• Rheumatologic diseases
Zika Virus
Neurological Complications
Neurological Complications
• Guillain-Barre Syndrome (not confirmed)
• French Polynesia (2013-2014): 42 reported cases of GBS.
• Bahia, Brazil ( July 2015): 42 cases of GBS, 25 (62%) had a
history of symptoms consistent with Zika virus infection.
• Meningitis, Meningoencephalitis, myelitis
Ophtalmological Complications
• Conjunctivitis, retinal atrophy
Epidemiological Update, Neurological Syndrome, congenital abnormalities and Zica virus
January 17, 2016. Pan American Health Organization • www.paho.org • © PAHO/WHO, 2016
Zika Virus
Pregnancy related Complications
Zika Virus
Testing/Diagnosis
• Culture for virus
• Acute phase (≤7 days after onset) –
• Zika specific polymerase chain reaction for viral RNA (PCR) in
blood saliva or urine OR
• IgM anti-Zika (ELISA)
• Chronic phase (>day 4, lasts for months) –
• IgM anti-ZikaV (ELISA)
Primary prevention measures
• There is no commercially available vaccine to
prevent Zika virus (but several in clinical trials)
• Focus on prevention of mosquito exposure.
• Consider advising people at risk for severe disease
to avoid travel to areas with ongoing outbreaks
• Those with active infection should be advised to
avoid exposure to mosquitos to avoid further
spread
http://wwwnc.cdc.gov/travel/yellowbook/2010/chapter-2/protection-against-mosquitoes-ticks-insects-arthropods.aspx
Primary prevention measures
• Avoid being bitten (mostly daytime feeder)
•
•
•
•
Use repellent on skin (sunscreen first, then repellent)
Wear long-sleeved shirt and long pants
Spray permethrin or DEET repellents on clothing (DEET >20%)
Stay in places with screens or air conditioning
• Empty fluid-filled containers on a weekly basis
* Breeding sites: plants, pools, water-filled buckets, used tires, empty oil drums, water storage containers See website
http://wwwnc.cdc.gov/travel/yellowbook/2010/chapter-2/protection-against-mosquitoes-ticks-insects-arthropods.aspx
Primary prevention measures
• Avoid sexual contact with patients with acute symptoms for about 7 days:
Condom use
Abstinence
• Abstain to donate blood while acute sickness
UHEALTH/UMMG: Clinical Algorithm for Diagnosis and management of Zika Virus Infection. Curry C.
Lichtenberger P. February 2016
Summary
• Zika virus remains a threat for the US, especially South Florida
• Prevention includes avoiding mosquito bites and controlling
their breeding sites
• Presents with fever and skin rash in patients in areas with
known local transmission or returning travelers
• Report laboratory confirmed cases to state health
departments
• Pregnant population is the highest risk population
#Zika
Panel Q&A
22
#Zika
Question #1
What info should you try to share with employees around Zika? What
should the goal be?
23
#Zika
Question #2
What resources do you use for planning and communication strategies
around Zika?
24
#Zika
Question #3
How can residents access/acquire information from public health
organizations?
25
#Zika
Question #4
What message topics should government agencies be prepared to
address as mosquito season approaches?
26
#Zika
Question #5
What should companies communicate to workers who are being sent
to the Olympics in Rio de Janeiro or other high risk areas?
27
#Zika
Question #6
What are effective strategies for private, public, and healthcare
organizations working together? For example, how can private
organizations be made aware of what public organizations are doing
and what resources there are?
28
#Zika
Q&AQ&A
@everbridge
#Zika
Contact Us:
Everbridge
[email protected]
818-230-9700
Use the Q&A
function to
submit your
questions.
29
Thank you for joining us!Q&A
#Zika
You May Also Be Interested In:
Crisis Communication for the Next Pandemic (Kit)
• White Paper: Crisis Communication for the Next Pandemic
• Everbridge's Pandemic Readiness Self-Audit Worksheet
• Message Maps Document
http://goo.gl/NZTqJE
Charmeck Alerts: Cross Departmental Coordination
http://goo.gl/j1vOYd
Everbridge Panel
•
•
•
•
Ranya Habash MD
Paola Lichtenberger MD
Tom Crane, Emergency Management
Andrew Woods, Business Continuity
http://goo.gl/r0DsGD
Follow us:
www.everbridge.com/blog
@everbridge
Linkedin
30