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Solutions for Unified Critical Communications The Zika Virus: An Emergency Management Panel #Zika Agenda #Zika • Logistics • Panel Introductions • Zika Medical Information • Panel Discussion • Audience Q&A 2 Housekeeping Use the Q&A function to submit your questions. @everbridge #zika We’ll send out a recording after the event 3 #Zika Panel Introductions 4 Introducing Panelists Ranya Habash MD (Moderator) • Chief Medical Officer at Everbridge • Board Certified Ophthalmologist • Founder of Eye Physicians of Florida • Official Eye Surgeon of the UFC Paola Lichtenberger MD • Infectious Disease Specialist at the University of Miami Miller School of Medicine • Director of the University of Miami Tropical Medicine Program • Associate Program Director of the Infectious Diseases Fellowship program Jackson Memorial Hospital/University of Miami Program • Travel Medicine and tropical Medicine certified #Zika Tom Crane • Senior Solutions Consultant/Technical Account Manager at Everbridge • Commissioner for local emergency preparedness advisory committee • Team coordinator for Community Emergency Response Team • Previously worked for the Federal Emergency Management Agency and as a consultant for the U.S. Department of Homeland Security Andrew Woods • Member of the Business Continuity Institute • Worked in the Business Continuity field since 2004 • Built ISO/BCI aligned Resiliency program from the ground up including: BIA, BCP, DRP and CMP • Managed Everbridge for 150,000 contacts in 100s lines of business in over 67 countries 5 #Zika Zika Medical Information 6 Paola Lichtenberger M.D. UM Tropical Medicine Program Infectious Diseases University of Miami Miller School of Medicine [email protected] Zika virus • Belongs to Genus Flavivirus, family Flaviviridae • Enveloped icosahedral Single stranded RNA virus • Two lineages: • African and Asian Tick-borne encephalitis virus West Nile Virus Murray Valley Encephalitis Virus Japanese Encephalitis Virus St. Louis Encephalitis Virus DENV 1 DENV 3 DENV 2 DENV 4 Yellow Fever Virus Zika Virus History of Zika virus • 1947: Uganda Zika Virus Transmission • Mosquito bites • Aedes species (A. Aegypti, A. albopictus) • Mother to Child • Around time of birth • During pregnancy • No reports of cases through breastfeeding • Infected blood or sexual contact • Three cases of sexual contact reported • Cases of blood transfusion http://www.cdc.gov/zika/transmission/index.html Ongoing Zika virus outbreak Zika virus Infection In the United States February 10, 2016. US States •Travel-associated: 84 •Locally acquired vector-borne: 0 US Territories •Travel-associated cases reported: 1 •Locally acquired cases reported: 9 9 cases. Travel related http://www.cdc.gov/zika/geo/active-countries.html Clinical presentation • Infection rate: 73% (95% CI 68-77) • Symptomatic attack rate among infected 18% (CI 10-27) • All age groups affected • Adults more likely to present for for medical care • Symptoms typically resolve in 5-7 days • Mortality is rare • Laboratory findings: • Lymphopenia, Thrombocytopenia, Elevated creatinine, Elevated transaminases Duffy M. N Engl J Med 2009. serosurvey on Yap Island, 2007 Courtesy of Drs. G. Baracco M.D. and Paola Lichtenberger M.D. Miami Veteran’s Affairs HealthCare System. February 2016. Differential diagnosis of Zika virus Bacterial Viral Parasites/Non Infectious • • • • Influenza Enterovirus Measles Rubella • Dengue • West Nile Virus • Leptospirosis • Acute Retroviral Syndrome (HIV) • Rickettsial diseases • Chikungunya • Other alphaviruses • Epstein-Barr virus • Parvovirus • Roseola virus • Scarlet fever (Group A Strep) • Meningococcemia • Typhoid fever • Other bacterial septicemia • Malaria • Post infectious arthritis • Rheumatologic diseases Zika Virus Neurological Complications Neurological Complications • Guillain-Barre Syndrome (not confirmed) • French Polynesia (2013-2014): 42 reported cases of GBS. • Bahia, Brazil ( July 2015): 42 cases of GBS, 25 (62%) had a history of symptoms consistent with Zika virus infection. • Meningitis, Meningoencephalitis, myelitis Ophtalmological Complications • Conjunctivitis, retinal atrophy Epidemiological Update, Neurological Syndrome, congenital abnormalities and Zica virus January 17, 2016. Pan American Health Organization • www.paho.org • © PAHO/WHO, 2016 Zika Virus Pregnancy related Complications Zika Virus Testing/Diagnosis • Culture for virus • Acute phase (≤7 days after onset) – • Zika specific polymerase chain reaction for viral RNA (PCR) in blood saliva or urine OR • IgM anti-Zika (ELISA) • Chronic phase (>day 4, lasts for months) – • IgM anti-ZikaV (ELISA) Primary prevention measures • There is no commercially available vaccine to prevent Zika virus (but several in clinical trials) • Focus on prevention of mosquito exposure. • Consider advising people at risk for severe disease to avoid travel to areas with ongoing outbreaks • Those with active infection should be advised to avoid exposure to mosquitos to avoid further spread http://wwwnc.cdc.gov/travel/yellowbook/2010/chapter-2/protection-against-mosquitoes-ticks-insects-arthropods.aspx Primary prevention measures • Avoid being bitten (mostly daytime feeder) • • • • Use repellent on skin (sunscreen first, then repellent) Wear long-sleeved shirt and long pants Spray permethrin or DEET repellents on clothing (DEET >20%) Stay in places with screens or air conditioning • Empty fluid-filled containers on a weekly basis * Breeding sites: plants, pools, water-filled buckets, used tires, empty oil drums, water storage containers See website http://wwwnc.cdc.gov/travel/yellowbook/2010/chapter-2/protection-against-mosquitoes-ticks-insects-arthropods.aspx Primary prevention measures • Avoid sexual contact with patients with acute symptoms for about 7 days: Condom use Abstinence • Abstain to donate blood while acute sickness UHEALTH/UMMG: Clinical Algorithm for Diagnosis and management of Zika Virus Infection. Curry C. Lichtenberger P. February 2016 Summary • Zika virus remains a threat for the US, especially South Florida • Prevention includes avoiding mosquito bites and controlling their breeding sites • Presents with fever and skin rash in patients in areas with known local transmission or returning travelers • Report laboratory confirmed cases to state health departments • Pregnant population is the highest risk population #Zika Panel Q&A 22 #Zika Question #1 What info should you try to share with employees around Zika? What should the goal be? 23 #Zika Question #2 What resources do you use for planning and communication strategies around Zika? 24 #Zika Question #3 How can residents access/acquire information from public health organizations? 25 #Zika Question #4 What message topics should government agencies be prepared to address as mosquito season approaches? 26 #Zika Question #5 What should companies communicate to workers who are being sent to the Olympics in Rio de Janeiro or other high risk areas? 27 #Zika Question #6 What are effective strategies for private, public, and healthcare organizations working together? For example, how can private organizations be made aware of what public organizations are doing and what resources there are? 28 #Zika Q&AQ&A @everbridge #Zika Contact Us: Everbridge [email protected] 818-230-9700 Use the Q&A function to submit your questions. 29 Thank you for joining us!Q&A #Zika You May Also Be Interested In: Crisis Communication for the Next Pandemic (Kit) • White Paper: Crisis Communication for the Next Pandemic • Everbridge's Pandemic Readiness Self-Audit Worksheet • Message Maps Document http://goo.gl/NZTqJE Charmeck Alerts: Cross Departmental Coordination http://goo.gl/j1vOYd Everbridge Panel • • • • Ranya Habash MD Paola Lichtenberger MD Tom Crane, Emergency Management Andrew Woods, Business Continuity http://goo.gl/r0DsGD Follow us: www.everbridge.com/blog @everbridge Linkedin 30