Zika Preparation: The Public Health View
Mosquito Control at the State and Local Levels
State and local governments will use an integrated mosquito management approach to control the mosquito population. This approach includes surveillance and control of adult mosquitoes as well as their eggs and larvae. Removing standing water helps to eliminate places where mosquitoes can lay eggs and where mosquito larvae can grow. Spraying from backpack sprayers, trucks, and airplanes may be used to kill adult mosquitoes, further preventing the spread of Zika virus.
At this time, there is no vaccine against Zika virus. The World Health Organization (WHO) has declared Zika a public health emergency and has deemed the development of a safe and effective vaccine as a global health priority. In August 2016, the National Institutes of Health (NIH) launched a clinical trial of a vaccine candidate to test the vaccine’s safety and ability to generate an immune response in participants. Additionally, Inovio Pharmaceuticals, Inc. and GeneOne Life Science, Inc. received FDA approval to begin an early-stage clinical trial to evaluate safety, tolerability, and immunogenicity of another vaccine candidate. If results from these clinical trials are encouraging, further studies could begin early in 2017 in countries with ongoing Zika outbreaks.
Public Health Funding
There is currently legislation under consideration in Congress that would provide $1.1 billion in supplemental funding to help respond to the Zika outbreak. Key provisions in the bill include:
- $476 million to the Centers for Disease Control and Prevention (CDC) for a variety of activities, including mosquito control initiatives, disease surveillance, public education efforts, and grants to state, local, and territorial health departments
- $230 million to the NIH to support vaccine research and the development of diagnostic tests for Zika virus
- $85 million for the Biomedical Advanced Research and Development Authority (BARDA) at the U.S. Department of Health and Human Services (HHS) for research and development activities related to Zika
- $175 million for the State Department and the U.S. Agency for International Development (USAID) for efforts relating to mosquito control efforts, diagnostic testing, and vaccine development
International organizations also designated to receive funding are the World Health Organization (WHO), the Pan American Health Organization (PAHO), the United Nations Children's Fund (UNICEF), and the Food and Agriculture Organization of the United States (FAO). The remaining funding would be distributed among several additional programs such as funding for community health centers, the National Health Service Corps, and Social Services Block Grants.
A vote to pass the legislation narrowly failed on June 28, 2016. Congressional leaders from both parties have expressed desire to bring the legislation up for another vote when legislators return from August recess. It remains to be seen, however, whether the legislation will survive in its current form given ongoing political disagreements among Republican and Democratic officials regarding several controversial provisions in the bill.
Protection: What Can You Do?
As shown below, people can protect themselves from mosquito bites by using insect repellent, wearing long-sleeved clothing, closing windows, and using a mosquito net. The CDC recommends the use of Environmental Protection Agency (EPA)-registered insect repellents, as these repellents are proven safe and effective, even for pregnant and breastfeeding women. The product label instructions should always be followed, and users should reapply insect repellent as directed. Do not use products containing oil of lemon eucalyptus (OLE) or para-methane-diol (PMD) on children under 3 years of age, and do not apply any insect repellent on babies younger than 2 months old. Additionally, take steps to remove standing water around your house to prevent mosquitoes from laying eggs in the water.
Women who are pregnant are recommended to avoid travel to areas with Zika. Women who are trying to get pregnant should talk with their doctor or other healthcare provider about their travel plans to make an informed decision. While traveling, follow the methods shown above to protect from mosquito bites. After returning home, it is advised to continue using insect repellent for 3 weeks, even if there are no signs of illness. Taking these steps helps to prevent the potential spread of Zika virus to local mosquitoes that could, in turn, spread the virus to other people.
Protect Yourself During Sex
If your partner has traveled to an area with Zika or if you are pregnant, use barrier protection (condoms) to prevent the spread of Zika virus. Men should consider using condoms or refraining from sex for at least 6 months after Zika symptoms, as the virus has been detected in semen up to 6 months after the initial infection.
Zika Screening for Pregnant Women
The CDC recommends that pregnant women do not travel to areas with active Zika transmission. Pregnant women who develop symptoms with possible exposure to Zika should take a blood and urine test to detect Zika up to 2 weeks after they have developed symptoms. Pregnant women who do not have symptoms but who may have been exposed to Zika may request testing within 2-12 weeks after the last possible exposure. Pregnant women who are concerned about Zika virus infection should consult with their healthcare provider.