Transcript Presentation - Texas Medical Center

HCPHES Responding to Zika:
Planned Response Activities
Mac McClendon
Director Office of Public Health Preparedness & Response/EMC
Harris County Public Health & Environmental Services
March 23, 2016
The HCPHES Priority Public Health Issues for 2013-2018
Chronic
Disease
Food
Safety
Emergency
Preparedness
Environmental
Health
Infectious
Disease
Injury
Social, Mental,
and Emotional
Wellbeing
HCPHES & HARRIS COUNTY
 HCPHES serves as the county health
department for Harris County (TX) with
over 700 public health professionals
 Third most populous county in nation with
estimated population of 4.34 million
 Spread over 1,778 square miles (larger than
the state of Rhode Island)
 Geographically, politically, and sociodemographically diverse and growing
 Home to world’s largest medical center
The HCPHES Priority Public Health Issues for 2013-2018
Chronic
Disease
Food
Safety
Emergency
Preparedness
Environmental
Health
Infectious
Disease
Injury
Social, Mental,
and Emotional
Wellbeing
Zika Virus in the Continental United States
• Local transmission of Zika virus by mosquitoes has not been
reported in the continental United States
• With current outbreaks in the Americas, cases among U.S.
travelers will most likely increase
• Imported cases may result in virus introduction and local
spread in some areas of U.S. with appropriate vectors and
environmental conditions
• Aedes aegypti and Aedes albopictus
The HCPHES Priority Public Health Issues for 2013-2018
Chronic
Disease
Food
Safety
Emergency
Preparedness
Environmental
Health
Infectious
Disease
Injury
Social, Mental,
and Emotional
Wellbeing
Modes of Transmission
Aedes albopictus
• Bite of infected mosquito
• Mother to child
• Sexual contact
• Blood transfusion
• Laboratory exposure
• Theoretical
• Organ or tissue transplant
• Breast milk: Zika virus RNA detected
The HCPHES Priority Public Health Issues for 2013-2018
Chronic
Disease
Food
Safety
Emergency
Preparedness
Environmental
Health
Aedes aegypti
Infectious
Disease
Injury
Social, Mental,
and Emotional
Wellbeing
Zika Virus Rates
• 1 in 5 people infected with Zika virus become ill
• All age groups can be affected
• Transmitted by same mosquito species that carry Dengue
and Chikungunya viruses
• No severe disease, hospitalizations, or deaths
The HCPHES Priority Public Health Issues for 2013-2018
Chronic
Disease
Food
Safety
Emergency
Preparedness
Environmental
Health
Infectious
Disease
Injury
Social, Mental,
and Emotional
Wellbeing
HCPHES APPROACH TO FIGHTING AEDES
 Understand Aedes vector predominance in Texas (85) & Harris County (56)
 Recognize need to shift from primarily Culex-based program to
incorporation of Aedes mosquito as a targeted vector
 Appreciate importance of public education, personal protection, and source
reduction as major tenets in fight against Aedes
 Assure “One Health” and health equity lens are applied to evolving
multidisciplinary response
Aedes
albopictus
Aedes
aegypti
The HCPHES Priority Public Health Issues for 2013-2018
Chronic
Disease
Food
Safety
Emergency
Preparedness
Environmental
Health
Infectious
Disease
Injury
Social, Mental,
and Emotional
Wellbeing
Role of Health Equity, One Health, & MDT
Multi-Disciplinary Teams (MDT)
An internal team whose purpose is to conduct targeted mosquito, epidemiological, environmental
assessments of household perimeters & proximate areas to determine need for interventions
Health Equity
The HCPHES Priority Public Health Issues for 2013-2018
One Health
Chronic
Disease
Food
Safety
Emergency
Preparedness
MDT
Environmental
Health
Infectious
Disease
Injury
Social, Mental,
and Emotional
Wellbeing
HCPHES PLANNED ZIKA RESPONSE ACTIVITIES
Level 4 - Normal Conditions: No cases of locally acquired Zika in Harris County
Level 3 - Increased Readiness: One case of locally acquired Zika in Harris County
Level 2 - High Readiness: A few or cluster of cases of locally acquired Zika within Harris County
Level 1 - Maximum Readiness: Widespread cases of locally acquired Zika throughout Harris County

Vector Surveillance and Control
 Utilize mosquito surveillance using (limited) historical data on Aedes combined with (expanded) surveillance
including incorporation of predictive modeling within the 268 operational areas
 Generate GIS maps indicating key metrics such as mosquito population density levels of Aedes, Zika confirmed
mosquito samples, local cases of human infections, and sources of breeding, etc.
 Conduct necessary staff trainings for inspectors, larvicide applicators, and other MC support personnel
 Acquire testing materials and laboratory equipment for mosquito virology laboratory for Zika
 Work with partners and community members on key issues around reducing mosquito habitats
The HCPHES Priority Public Health Issues for 2013-2018
Chronic
Disease
Food
Safety
Emergency
Preparedness
Environmental
Health
Infectious
Disease
Injury
Social, Mental,
and Emotional
Wellbeing
HCPHES PLANNED ZIKA RESPONSE ACTIVITIES

Communications, Education and Engagement



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Conduct disease prevention education, personal protection, and source reduction campaigns
Utilize media and other community partners to provide credible information to the public
Distribute insect repellent and other prevention modalities to local communities when feasible and appropriate
Create messaging in languages most appropriate for affected communities, working with area consulates, etc.
Conduct door to door education and outreach in targeted communities
Engage federal, state, and local stakeholders to coordinate efforts
The HCPHES Priority Public Health Issues for 2013-2018
Chronic
Disease
Food
Safety
Emergency
Preparedness
Environmental
Health
Infectious
Disease
Injury
Social, Mental,
and Emotional
Wellbeing
HCPHES PLANNED ZIKA RESPONSE ACTIVITIES

Epidemiology Surveillance & Testing

Health Care Provider/Clinician Outreach

Environmental Health

Veterinary Public Health

Legal Review and Authority

Preparedness and Response
The HCPHES Priority Public Health Issues for 2013-2018
Chronic
Disease
Food
Safety
Emergency
Preparedness
Environmental
Health
Infectious
Disease
Injury
Social, Mental,
and Emotional
Wellbeing
HCPHES Operations/Response:
• Multi-Disciplinary Team (MDT) activated with one
symptomatic, confirmed Zika case
• Provides education on Zika virus and prevention/protection measures
• Conducts assessments of the case, contacts and environment within a 200
meter radius of the case’s residence
• 3-5 people on each team
• Team Lead: Epidemiology
The HCPHES Priority Public Health Issues for 2013-2018
Chronic
Disease
Food
Safety
Emergency
Preparedness
Environmental
Health
Infectious
Disease
Injury
Social, Mental,
and Emotional
Wellbeing
HCPHES Operations/Response: MDT
assessments
• Epidemiological assessment
• Active surveillance for symptoms
• Contact investigations
• Serologic testing
• Environmental assessment
• Search for mosquito breeding sources (e.g. standing water in tires,
flowerpots, gutters, fountains, unmaintained pools)
• Address nuisance issues
• Mosquito assessment
• Adult mosquito sampling within and around affected area
• Samples submitted for viral diagnostic testing
The HCPHES Priority Public Health Issues for 2013-2018
Chronic
Disease
Food
Safety
Emergency
Preparedness
Environmental
Health
Infectious
Disease
Injury
Social, Mental,
and Emotional
Wellbeing
Communication, Education, and Outreach
Strategies and Tactics
• Media
• Social Media
• Website
• Advertising of Campaign Message
• Community Engagement
The HCPHES Priority Public Health Issues for 2013-2018
Chronic
Disease
Food
Safety
Emergency
Preparedness
Environmental
Health
Infectious
Disease
Injury
Social, Mental,
and Emotional
Wellbeing
Communicating to the Public
• Stay on message
• Be sensitive to their circumstances – financial, cultural,
environmental – and listen to their concerns
• Use plain language – not scientific terms or acronyms
• Use interpreters when needed
• Be engaging – do demonstrations to ensure they understand
• Provide resources, educational materials
• Make sure to follow-up
• Media inquiries? Contact OCEE
The HCPHES Priority Public Health Issues for 2013-2018
Chronic
Disease
Food
Safety
Emergency
Preparedness
Environmental
Health
Infectious
Disease
Injury
Social, Mental,
and Emotional
Wellbeing
Prevent the Bite…Day & Night
Personal Protection
• Wear an EPA-registered insect repellent that
contains one of the following:
• DEET, picaridin, IR3535, oil of lemon eucalyptus;
use according to the label
• Cover up. Wear long-sleeved shirts, long pants, and socks
• Place mosquito netting over infant carriers, cribs, and
strollers
The HCPHES Priority Public Health Issues for 2013-2018
Chronic
Disease
Food
Safety
Emergency
Preparedness
Environmental
Health
Infectious
Disease
Injury
Social, Mental,
and Emotional
Wellbeing
Prevent the Bite…Day & Night
Mosquito-Proof your Property
• Remove/empty containers that can hold water
such as tires, flower pots, birdbaths, and toys;
Keep rain gutters free of debris
• Install or repair screens on windows and doors
• Sweep up lawn clippings and leaves; Don’t feed
the storm drain
• Eliminate mosquito breeding sources inside your
home, too
The HCPHES Priority Public Health Issues for 2013-2018
Chronic
Disease
Food
Safety
Emergency
Preparedness
Environmental
Health
Infectious
Disease
Injury
Social, Mental,
and Emotional
Wellbeing
Questions?
For the latest on Zika Virus and Mosquito Control in Harris County,
visit:www.hcphes.org/zika
The HCPHES Priority Public Health Issues for 2013-2018
Chronic
Disease
Food
Safety
Emergency
Preparedness
Environmental
Health
Infectious
Disease
Injury
Social, Mental,
and Emotional
Wellbeing