Caribbean Still Hotspot for Zika Virus as NYC Bolsters Its Preparedness & Response Action Plan

Complications associated with the Zika virus are still a significant consideration for many regions of the Caribbean as the winter tourism season approaches.

An analysis conducted by Public Health England has found that 37 of the UK’s travel-related cases of the mosquito-borne virus originated from bites sustained in Jamaica, making the island nation the number one source for such cases. In addition, 33 and 36 cases, respectively, have resulted from travel to South America or Barbados, while 32 cases have been linked with travel to Central America. An additional 20 cases are believed to have originated from travel to St. Lucia. The figures come from a report on the study published by St. Lucia News Online.

Although the United Kingdom has reported no locally-transmitted cases of Zika virus infections to date, due to the absence of native virus-carrying Aedes aegypti mosquitoes, the aforementioned numbers are a bit troubling. Many UK residents have emigrated from both Jamaica and Barbados; as a result, there is a significant amount of travel between the UK and the two Caribbean nations.

For similar reasons, estimates regarding the future incidence of Zika-related Guillain-Barré syndrome in Puerto Rico, a US commonwealth and popular tourist destination (at least historically), have public health officials stateside on alert. According to a study authored by researchers from the Centers for Disease Control and Prevention (CDC) and scheduled for publication in the January 2017 issue of Emerging Infectious Diseases, Puerto Rico may see 3.2 to 5.1 times more cases of Guillain-Barré in 2016, due to Zika, than it would in a typical year. The incidence of the neurological condition in those with Zika virus infection has, in other countries, ranged from 1.1 to 2.3 per 10,000 cases. Furthermore, using data from outbreaks in French Polynesia, Brazil, and elsewhere, the CDC authors suggest that as many as 70% of island residents could be infected with the Zika virus this year alone.

Perhaps in response to these numbers, officials in New York City, which has a significant population of Puerto Rican immigrants, and thus, significant travel to and from the island, have bolstered the Zika Preparedness and Response Action Plan, according to an article published October 21 in the CDC’s Mortality and Morbidity Weekly Reports (MMWR). The article notes that, New York State has reported the “highest number of Zika virus disease cases in the continental United States” to date—715; all of these cases are travel-related forms, meaning that they did not result from local virus-carrying mosquitoes.

The Action Plan was drafted by NYC Health + Hospitals, a city agency that oversees all public hospitals in the five boroughs, and was built off its original Ebola preparedness plan that had been drafted in 2014. The plan includes “universal screening for travel-associated Zika virus exposure, signage and maps depicting areas with active Zika virus transmission, laboratory services, and timely linking of infected patients to appropriate care,” according to the MMWR article.

Speaking on the plan, the authors, from NYC Health + Hospitals, wrote, “A robust emergency preparedness and response program can help health care systems limit the effects of Zika virus and ensure appropriate screening, diagnosis, and care. Potentially effective strategies include modification of established and tested protocols, offering ongoing health care provider education, and close collaboration with state and local health departments for Zika guidance and support.”

Brian P. Dunleavy is a medical writer and editor based in New York. His work has appeared in numerous healthcare-related publications. He is the former editor of Infectious Disease Special Edition.