Transcript of Get Ready Report podcast, episode 47: What Americans need to know about Zika

Welcome to APHA’s Get Ready podcast. Today, we speak with Dr. Ben Beard, branch chief for the Bacterial Diseases Branch in the Division of Vector-Borne Disease at the National Center for Emerging and Zoonotic Infectious Diseases. Dr. Beard also currently serves as a deputy incident manager for the Centers for Disease Control and Prevention’s Zika response.

How are you doing, Dr. Beard?

I’m doing great, thank you. How are you today, Daniel?

Excellent, excellent. Thanks so much for carving out some time to speak with us. So, our first question today is, now that Zika has reached Level 1 activity at CDC, in which you called a global crisis, what are the most important things for Americans to know about Zika and how to protect themselves from it?

OK, sure. Well, first of all, thanks for the opportunity to be here today and to discuss the Zika virus outbreak. I’d like to begin by elaborating quickly on what we mean by Level 1 activity for those who might not know.

This means basically CDC has activated our emergency operation center and we’re working at our highest level response to address this outbreak. We’re learning more about Zika literally every day and we’re doing everything we can to rapidly share information and adjust our guidelines for permission and our recommendations for specific audiences, including pregnant women, travellers and those who are living in areas where Zika risk occurs for local transmission.

So basically, and answering your question, there are three ways that we know, currently, that Zika spreads. The first of those is that Zika is spread to people primarily through the bite of an infected mosquito. The mosquitoes that spread Zika virus are the same mosquitoes that spread dengue and chikungunya viruses. These mosquitoes become infected when they bite a person who’s already been infected by Zika virus. Once infected, those mosquitoes can then spread the virus to other people that they bite.

Secondly, Zika can be passed through sexual contact from a person who has Zika to his or her partners. This is even if the infected person doesn’t have symptoms at the time. Thirdly, a pregnant woman can pass Zika virus to the fetuses during pregnancy or at delivery. So, consequently, it’s very important if you’re pregnant, don’t travel to a place where Zika is actively being transmitted, and if you’re pregnant and travelling to or living in a place with Zika, you should do everything you can to limit yourself from mosquito bites.

If you’re pregnant and have a partner who lives in or has travelled to an area with Zika, you should either use a condom or other barrier method every time you have sex, or not have sex during pregnancy at all. Pregnant women should talk to their health care provider about any recent travel that they or the sex partner has in areas with Zika.

Many people who have become infected with Zika virus don’t know or they don’t have symptoms. Or most of those symptoms may be mild symptoms, such as fever, rash, joint pain or red eyes that last a few days to a week. If you do have these symptoms, especially if you have recently travelled, you should see your doctor or other health care provider. If you are living in an area or travelling to an area with Zika, take steps to protect yourself, your family and your community from Zika.

Using things like preventing mosquito bites, and you can do this by wearing clothes that cover your arms and legs, using Environmental Protection Agency, EPA-registered repellents that contain active ingredients like DEET, Picaridin or IR3535.

Control mosquitoes around your home. You can do this through making sure your screens are intact on your windows and doors and once a week empty, scrub out, turn over, cover or throw out any items around your house that hold water. These are things like old tires, buckets, planters, toys, pools, bird baths, flower pots or trash containers.

Plans for travel, keeping in mind what I said earlier about travel and pregnancy and the concerns about that. And one great way to do this is to check CDC’s travel notices before you travel. You can find these at the following web address: www.CDC.gov/zika. Click on the link for travellers.

Protect yourself during sex. Use condoms or other barrier methods correctly from start to finish any time you have sex to reduce the chance of getting Zika.

Finally, if you have Zika, you can prevent further spread of Zika by taking these same prevention measures. Does that make sense?

Oh, absolutely. Thank you so much for the detailed description and information, Dr. Beard. What we know about Zika seems to change every day. We’ve heard, as you’ve described, the risks that Zika poses for pregnant women and babies and for people travelling, especially this summer for the Olympics in Rio. Should any other groups of people take precaution?

That’s actually a great question. In addition to the groups that you’ve mentioned, OSHA and NIOSH have developed specific guidance for those who live in or work in areas where Zika is found and for health care workers who may come into contact with Zika virus. This is sort of guidance related to worksite safety and protection.

One of the groups of workers that we think about are outdoor workers and those whose work takes them to areas with active Zika transmission. This could be people who work on cruise ships or airline crew workers, for example. These groups of people may be at the greatest risk for exposure to Zika virus.

So some of the actions that employers can take to prevent the spread of Zika at the workplace are to inform workers about their risks of exposure to Zika virus through mosquito bites and train them how to protect themselves. They can provide insect repellent and encourage their use according to CDC and EPA guidance.

They can provide workers with and encourage them to wear clothing that covering their hands, arms, legs and other exposed areas of skin, workers performing these tasks related to mosquito control may need additional protection as well, depending on what their job-specific activities are.

In warm weather, encourage workers to wear lightweight, loose-fitting clothing. This type of clothing protects workers against the sun’s harmful rays and provides a barrier to mosquitoes. Always provide workers with adequate water, rest and shade and monitor workers for signs and symptoms of heat illness as well.

And then, as mentioned before, get rid of sources of standing water that could be places where mosquito larvae are actually breeding near these worksites.

Basically, outside workers should use insect repellant, they should wear long-sleeved clothing and long pants and protect themselves from mosquito bites. If they or their partner are pregnant or are planning to become pregnant, then they should follow the precautions that I mentioned earlier for pregnancy.

And of course, they should seek immediate medical attention if they develop symptoms of Zika virus infection.

For health care workers and laboratory workers, CDC continues to underscore the importance of following good infection control and biosafety practices to prevent and minimize the risk of transmission. This includes the use of what we call universal precautions for potential blood-borne pathogen, BBP, exposure, as described in OSHA’s BBP standards.

Standard precautions such as hand hygiene and appropriate personal protective equipment to avoid direct contact with blood or other infectious materials. And there’s specific guidance for this that can be found at the following web address: http://www.cdc.gov/niosh/topics/outdoor/mosquito-borne/pdfs/osha-niosh_fs-3855_zika_virus_04-2016.pdf. As we learn more about the virus and its early transmission, CDC will continue to update this guidance and you can find this at CDC’s Zika website: www.CDC.gov/zika.

This website is frequently updated so it’s got all the most up-to-date information on prevention and has links to these other sites I mentioned as well.

Well, again, thank you so much. We will be sure to check that out and make sure that our members do as well. And I guess, finally, you kind of touched on some things that health care workers can do to protect themselves and patients from Zika, but what about us, as public health professionals, you know our 50,000 members here at APHA, and the public health community nationwide? What can we do to protect communities for Zika?

That’s a great question, as public health professionals play an incredibly important role. The actions of local, state and territorial public health professionals are really critical to our Zika prevention efforts.

From the first day to the response, CDC has been working with our public health partners to provide real-time updates to share guidance and develop plans in preparation for local mosquito-borne transmission of Zika. Public health partners are working to rapidly implement these plans to prevent ongoing transmission.

On April 1, 2016, for example, CDC hosted the Zika Action Plan Summit for local state and territorial health officials. The summit accelerated readiness for local Zika transmission by offering public health officials up-to-date information and tools to improve Zika preparedness within those state jurisdictions including best communication practices, based on crisis and risk communication principles.

And basically the Zika CDC Interim Response Plan has recently been updated and is posted at our website at the site that I already mentioned. Public health professionals can use these tools to educate communities, clinicians and other health care professionals about how to protect people from Zika virus infection, how to effectively manage cases and prevent local transmission.

Public health professionals are on the front lines in their communities promoting key prevention messages and supporting mosquito control efforts. They are the trusted voices that the public and providers can rely upon for up-to-date information and technical assistance.

As we move toward the beginning of the school year, I think there is a really unique opportunity for public health authorities, as school seasons start, to work with schools to make sure that risk of Zika transmission can be minimized. Public health authorities in school districts can proactively and collaboratively establish direct communication channels and clearly define each partner’s roles and responsibilities.

Finally, public health professionals can support response plan exercises as well and these are carried out at state and local levels to make sure that readiness within communities are achieved. So those are a few things I would suggest.

Well, Dr. Beard, this has been very educational, not only for myself, but it will be for our readers and our members. So, thank you so much for speaking with APHA.

Thanks a lot, have a great day.

Posted Aug. 5, 2016. Listen to this podcast on our main podcast page.