0. Pre-incident Preparedness
1. Mosquito Season
- State DOHs are expected to assess the situation, educate the public as well as healthcare providers, and establish lab testing capacity. According to Dr. Fischer, all states should have already completed this phase.
2. Limited Local Transmission in One Geographic Area
- DOHs are asked to investigate possible Zika infection cases by first testing them and then assessing the mode of infection (local, travel-related, through sexual intercourse, or through blood transfusion).
- The CDC recommends testing those individuals who are symptomatic during or within two weeks of travel to areas with local transmission, specifically pregnant women, as well as those who have epidemiological risks.
- Once Zika or related congenital infections have been lab confirmed, healthcare providers must notify their local or state health departments, who will then report the cases to the CDC.
- All lab-confirmed cases must be investigated to identify areas where local transmission is most likely to occur.
- Household members and neighbors of patients (within a 150-yard radius) are to be surveyed. Individuals who present with Zika-related signs and symptoms are to be tested for Zika or other diseases which can be mistaken for the virus, specifically those with increased febrile or rash illnesses.
- Local healthcare providers and laboratories are to be notified of the case.
- The CDC suggests conducting community outreach to increase Zika awareness and prevention methods.
- All blood donors are to be screened, and mosquito surveillance measures are to be taken.
3. Widespread Local Transmission in One Geographic Area
4. Widespread Local Transmission in Multiple Areas
- Case investigations are to be conducted to identify focus areas and target infection control.
- Additional cases should be investigated to determine whether they are incidences of local transmission or are related to previous cases.
- Surveillance efforts should be expanded to encompass all areas with cases.
- All pregnant women should be screened and those testing positive for the virus or are suspected of being infected, should be monitored.
- All blood donors are to be screened.
- The CDC recommends that all previously implemented surveillance efforts be intensified for intensity and the geographical extent of transmission.
- Those who are at highest risk for Zika-related complications should be tested.
- Areas experiencing local transmission should be identified. Prevention and control efforts should be intensified in these areas.
- State and local departments of health should collaborate with mosquito control districts, commercial laboratories, blood collection agencies, and the CDC, as well as other federal agencies.
Timely reporting and assessment of all cases is key to reducing the risk of local transmission, according to Dr. Fischer. State and local health departments are encouraged to email firstname.lastname@example.org
with any questions regarding Zika epidemiology, or any other concerns regarding preparedness and response.
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