scholarly journals Detecting local Zika virus transmission in the continental United States: a comparison of surveillance strategies

2017 ◽  
Author(s):  
Steven P Russell ◽  
Kyle R Ryff ◽  
Carolyn V Gould ◽  
Stacey W Martin ◽  
Michael A Johansson
Keyword(s):  
Public Health ◽  
Pregnant Women ◽  
Zika Virus ◽  
Blood Donors ◽  
Virus Disease ◽  
Case Definition ◽  
False Positives ◽  
Probability Of Detection ◽  
Surveillance Systems ◽  
Surveillance Strategy

AbstractIntroductionThe 2015-2017 Zika virus (ZIKV) epidemic in the Americas has driven efforts to strengthen surveillance systems and to develop interventions, testing, and travel recommendations. In the continental U.S. and Hawaii, where limited transmission has been observed, detecting local transmission is a key public health objective. We assessed the effectiveness of three general surveillance strategies for this situation: testing all pregnant women twice during pregnancy, testing blood donations, and testing symptomatic people who seek medical care in an emergency department (ED).MethodsWe developed a simulation model for each surveillance strategy and simulated different transmission scenarios with varying population sizes and infection rates. We then calculated the probability of detecting transmission, the number of tests needed, and the number of false positive test results.ResultsThe probability of detecting ZIKV transmission was highest for testing ED patients with Zika symptoms, followed by pregnant women and blood donors, in that order. The magnitude of the difference in probability of detection between strategies depended on the incidence of infection. Testing ED patients required fewer tests and resulted in fewer false positives than surveillance among pregnant women. The optimal strategy identified was to test ED patients with at least two Zika virus disease symptoms. This case definition resulted in a high probability of detection with relatively few tests and false positives.DiscussionIn the continental U.S. and Hawaii, where local ZIKV transmission is rare, optimizing the probability of detecting infections while minimizing resource usage is particularly important. Local surveillance strategies will be influenced by existing public health system infrastructure, but should also consider the effectiveness of different approaches. This analysis demonstrated differences across strategies and indicated that testing symptomatic ED patients is generally a more efficient strategy for detecting transmission than routine testing of pregnant women or blood donors.

scholarly journals Dual burden of Zika and COVID-19 in India: challenges, opportunities and recommendations

2021 ◽  
Vol 49 (1) ◽  
Author(s):  
Mainak Bardhan ◽  
Debolina Pramanik ◽  
Rizana Riyaz ◽  
Mohammad Mehedi Hasan ◽  
Mohammad Yasir Essar
Keyword(s):  
Public Health ◽  
Early Diagnosis ◽  
Zika Virus ◽  
Virus Disease ◽  
Healthcare Resources ◽  
Health Measures ◽  
The World ◽  
Significant Public Health ◽  
Congenital Zika Syndrome ◽  
Dual Burden

AbstractThe COVID-19 pandemic has wreaked havoc in the world from last year, and any further insults like Zika virus will surely bring the apocalypse unto us. In July 2021, Zika began spreading in India, mainly in the state of Kerala. Zika infection resembles closely COVID-19 and other arboviral infections, which might lead to delayed and misdiagnosis, further leading to underreporting of cases. Some of the feared complications of Zika include Guillain–Barré syndrome and congenital Zika syndrome leading to microcephaly. Thus, Zika virus disease (ZVD) has significant public health and social impacts. Since the trifecta of infectious diseases (host, agent and environment) are all conducive to the spread of Zika in India, there is a huge risk that ZVD might become endemic in India, which is especially dangerous in the backdrop of this pandemic. This has to be stopped at all costs: the main aspects of which are public health measures, vector control and early diagnosis, especially in case of pregnant women. The diversion of healthcare resources for this pandemic has albeit made this difficult, but we must do our bit if we have to overcome this situation.

scholarly journals Accuracy of Zika virus disease case definition during simultaneous Dengue and Chikungunya epidemics

PLoS ONE ◽  
2017 ◽  
Vol 12 (6) ◽  
pp. e0179725 ◽  
Author(s):  
José Ueleres Braga ◽  
Clarisse Bressan ◽  
Ana Paula Razal Dalvi ◽  
Guilherme Amaral Calvet ◽  
Regina Paiva Daumas ◽  
...  
Keyword(s):  
Zika Virus ◽  
Virus Disease ◽  
Case Definition ◽  
Disease Case

scholarly journals Postnatally Acquired Zika Virus Disease Among Children, United States, 2016–2017

2019 ◽  
Vol 70 (2) ◽  
pp. 227-231 ◽  
Author(s):  
Nicole P Lindsey ◽  
Charsey C Porse ◽  
Emily Potts ◽  
Judie Hyun ◽  
Kayleigh Sandhu ◽  
...  
Keyword(s):  
Zika Virus ◽  
Virus Disease ◽  
Healthcare Providers ◽  
Clinical Signs ◽  
Virus Transmission ◽  
Signs And Symptoms ◽  
Clinical Findings ◽  
Case Definition ◽  
Illness Onset ◽  
Clinical Signs And Symptoms

Abstract Background The clinical findings among children with postnatally acquired Zika virus disease are not well characterized. We describe and compare clinical signs and symptoms for children aged <18 years. Methods Zika virus disease cases were included if they met the national surveillance case definition, had illness onset in 2016 or 2017, resided in a participating state, and were reported to the Centers for Disease Control and Prevention. Pediatric cases were aged <18 years; congenital and perinatal infections were excluded. Pediatric cases were matched to adult cases (18‒49 years). Clinical information was compared between younger and older pediatric cases and between children and adults. Results A total of 141 pediatric Zika virus disease cases were identified; none experienced neurologic disease. Overall, 28 (20%) were treated in an emergency department, 1 (<1%) was hospitalized; none died. Of the 4 primary clinical signs and symptoms associated with Zika virus disease, 133 (94%) children had rash, 104 (74%) fever, 67 (48%) arthralgia, and 51 (36%) conjunctivitis. Fever, arthralgia, and myalgia were more common in older children (12‒17 years) than younger children (1‒11 years). Arthralgia, arthritis, edema, and myalgia were more common in adults compared to children. Conclusions This report supports previous findings that Zika virus disease is generally mild in children. The most common symptoms are similar to other childhood infections, and clinical findings and outcomes are similar to those in adults. Healthcare providers should consider a diagnosis of Zika virus infection in children with fever, rash, arthralgia, or conjunctivitis, who reside in or have traveled to an area where Zika virus transmission is occurring.

scholarly journals Zika virus infection in pregnancy: Establishing a case definition for clinical research on pregnant women with rash in an active transmission setting

2019 ◽  
Vol 13 (10) ◽  
pp. e0007763 ◽  
Author(s):  
Ricardo Arraes de Alencar Ximenes ◽  
Demócrito de Barros Miranda-Filho ◽  
Elizabeth B. Brickley ◽  
Ulisses Ramos Montarroyos ◽  
Celina Maria Turchi Martelli ◽  
...  
Keyword(s):  
Virus Infection ◽  
Clinical Research ◽  
Pregnant Women ◽  
Zika Virus ◽  
Case Definition ◽  
Transmission Setting ◽  
Zika Virus Infection ◽  
In Pregnancy

Zika and travel: Public health implications and communications for blood donors, sperm donors and pregnant women

2018 ◽  
Vol 21 ◽  
pp. 77
Author(s):  
Andrin Aschwanden ◽  
Can Demir ◽  
Rosa Hinselmann ◽  
Sabrina Kasser ◽  
Andreas Rohrer
Keyword(s):  
Public Health ◽  
Pregnant Women ◽  
Blood Donors ◽  
Health Implications ◽  
Sperm Donors

scholarly journals Quarantine for Zika Virus? Where is the Science?

2016 ◽  
Vol 10 (5) ◽  
pp. 704-706 ◽  
Author(s):  
Kristi L. Koenig
Keyword(s):  
Public Health ◽  
Zika Virus ◽  
Ebola Virus ◽  
Virus Disease ◽  
Rapid Test ◽  
Signs And Symptoms ◽  
World Health ◽  
Virus Infections ◽  
Health Organization ◽  
Spread Of Infection

AbstractIn January 2016, the World Health Organization warned that Zika virus is “spreading explosively” in the Americas and that up to 4 million infections could be present worldwide within a year. Soon thereafter, some politicians and authors publicly advocated for quarantine of travelers returning from regions where mosquitoes carrying Zika virus are prevalent. The public health tool of quarantine can be used to prevent the spread of infection by restricting the movement of persons who have been exposed to a deadly disease that can be transmitted from person to person before symptom onset. With 80% of Zika virus infections being asymptomatic, no rapid test being available to detect the virus, and primary transmission being via the bites of certain mosquitoes, application of quarantine in this setting is not scientifically sound or practically feasible. Rather, public health interventions should focus on preventing bites from infected mosquitoes, counseling pregnant women on the risks of fetal microcephaly and other birth defects, and identifying patients with signs and symptoms of Guillain-Barré syndrome. As was seen in the Ebola virus disease outbreak of 2014, non-evidence-based factors can influence policy decisions. Public health experts must ensure that policy makers are informed that quarantine is not a scientifically sound approach for the control of Zika virus. (Disaster Med Public Health Preparedness. 2016;0:1–3)

scholarly journals Avian Flu, Ebola, MERS, and Other Emerging Challenges for Influenza Surveillance Practitioners

2016 ◽  
Vol 8 (1) ◽  
Author(s):  
Alan Siniscalchi ◽  
Brooke Evans
Keyword(s):  
Public Health ◽  
Disease Surveillance ◽  
Ebola Virus ◽  
Virus Disease ◽  
Cost Effective ◽  
Emerging Diseases ◽  
Influenza Surveillance ◽  
Surveillance Systems ◽  
Public Health Agencies ◽  
Public Health Practitioners

Public health agencies strive to develop and maintain cost-effective disease surveillance systems to better understand the burden of disease within their jurisdiction. The emergence of novel avian influenza and other respiratory viruses such as MERS-CoV along with other emerging diseases including Ebola virus disease offer new challenges to public health practitioners. The authors conducted a series of surveys of influenza surveillance coordinators to identify and define these challenges. The results emphasize the importance of maintaining sufficient infrastructure and the trained personnel needed to operate these surveillance systems for optimal disease detection and public health preparedness and response readiness.

scholarly journals Ebola, Enterovirus, MERS, Novel Flu, and other Challenges for Public Health Surveillance Practitioners

2015 ◽  
Vol 7 (1) ◽  
Author(s):  
Alan Siniscalchi ◽  
Brooke Evans
Keyword(s):  
Public Health ◽  
Disease Surveillance ◽  
Ebola Virus ◽  
Virus Disease ◽  
Cost Effective ◽  
Emerging Diseases ◽  
Influenza Surveillance ◽  
Surveillance Systems ◽  
Public Health Agencies ◽  
Public Health Practitioners

Public health agencies strive to develop and maintain cost-effective disease surveillance systems to better understand the burden of disease within their jurisdiction. The emergence of novel influenza and other respiratory viruses such as MERS-CoV along with other emerging diseases including Ebola virus disease offer new challenges to public health practitioners. The authors conducted a series of surveys of influenza surveillance coordinators to identify and define these challenges. The results emphasize the importance of maintaining sufficient infrastructure and the trained personnel needed to operate these surveillance systems for optimal disease detection and public health preparedness and response readiness.

scholarly journals Pregnant women with suspected Zika virus infection: A claims data analysis

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Silvia Valkova
Keyword(s):  
United States ◽  
New York ◽  
Virus Infection ◽  
Pregnant Women ◽  
Zika Virus ◽  
Claims Data ◽  
Virus Disease ◽  
Healthcare Providers ◽  
Zika Virus Infection ◽  
Icd 10

ObjectiveDemonstrate the value of consolidated claims data from communityhealthcare providers in Zika Virus Disease surveillance at local level.IntroductionZika virus disease and Zika virus congenital infection arenationally notifiable conditions that became prominent recently as agrowing number of travel-associated infections have been identifiedin the United States. The Centers for Disease Control and Prevention(CDC) have dedicated significant time and effort on determining andaddressing the risks and impact of Zika on pregnant women and theirbabies who are most vulnerable to the disease. CDC relies on twosources of information, reported voluntarily by healthcare providers,to monitor Zika virus disease: ArboNET and the newly establishedU.S. Zika Pregnancy Registry. A study by IMS Health compared U.S.trends of the Zika virus disease in general and pregnant women withZika virus disease in particular observed in an IMS healthcare claimsdatabase and the CDC ArboNET and the newly established U.S. ZikaPregnancy Registry.MethodsIMS used for this analysis claims for reimbursement from office-based healthcare providers, which are widely accepted standardbusiness practice records throughout the healthcare industry. IMSclaims data is collected daily from office-based providers throughoutthe U.S. and processed, stored and analyzed in a centralized database.The information is available at the patient and visit level, with theability to characterize deidentified patients by age, gender andZIP3 location and to trace a patient’s history of visits, diagnoses,procedures, drugs prescribed and tests performed or ordered.The general IMS study sample captured all patients throughout thecontinental United States covered in claims between October 1, 2016and May 24, 2016 with ICD 10 diagnosis code A92.8, Other SpecifiedMosquito-Borne Viral Fevers. This sample was compared to thesample of laboratory-confirmed Zika virus disease cases reportedto ArboNET by state or territory from the CDC Arboviral DiseaseBranch from January 1, 2015 through May 18, 2016. In addition,IMS compared the subset of patients with both a Zika virus diseasediagnosis and any ICD 10 pregnancy diagnosis to the CDC sampleof patients captured by the U.S. Zika Pregnancy Registry with anylaboratory evidence of possible Zika virus infection in the UnitedStates and territories.ResultsThroughout the continental United States, the IMS claims-basedsample captured 875 patients with a Zika virus disease diagnosiscompared to 548 travel-associated cases reported by CDC. At thestate level, especially in New York, New Jersey, Illinois and Texas,the IMS data captured a much larger number of cases that the CDCreported cases. Most of these possible Zika cases are concentratedin the large metropolitan areas around New York City, Chicagoand Houston. Many of them are diagnosed and treated by the samehealthcare providers.The IMS sample captured 577 pregnant women with a possibleZika virus infection compared to the 168 pregnant women with apossible Zika virus infection reported in the U.S. Zika PregnancyRegistry as of May 24, 2016. Many of the pregnant women in the IMSsample had multiple visits, often in consecutive months, associatedwith the Zika virus disease diagnosis. Pregnant women are morelikely to be tested and diagnosed with a Zika virus infection due tothe risk of fetal malformations from the disease. As many as 250 ofthe 577 pregnant women with a possible Zika virus infection also hada diagnosis of suspected fetal damage due to a viral disease. Of allwomen with a possible Zika virus infection in the IMS sample, 120were in New Jersey, 111 in New York, 93 in Illinois and 74 in Texas,and most were concentrated in the large metropolitan areas aroundNew York City, Chicago and Houston.ConclusionsThese findings suggest that all-payer claims data can be usedsuccesfully to monitor Zika transmission trends at local and statelevel, especially with a focus on pregnant women. Healthcare claimsdata is fast, granular, relevant at local level and can be used tosupplement CDC ArboNET data for local and state level surveillanceand response to the evolving Zika virus infection outbreak. Thisstudy is an example of a novel approach to surveillance for Zika virusdisease and potentially many other infectious diseases.

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