1. Zika Virus: Control, Monitoring, and Prevention The National Press Club Thursday, August 11, 2016

2. Kelly Murphy Program Director, Health Division National Governors Association Center for Best Practices August 11, 2016 States’ Roles and Efforts to Control Zika Virus

3. Road Map of Presentation  Brief overview of the National Governors Association  States’ Role in Public Health Preparedness  Public Health Implications of Zika Virus  NGA Response to Zika Virus and Summary of State Actions 3

4. About the National Governors Association 4 Nation’s oldest organization serving the needs of governors and their staff (founded in 1908) A consensus organization with bipartisan leadership: Chair Gov. McAuliffe (D- VA) and Vice Chair Gov. Sandoval (R-NV) Through NGA, governors share best practices, speak with a collective voice on national policy and develop innovative solutions that improve state government and support the principles of federalism. NGA Center for Best Practices: a hybrid think thank/consultancy that works to surface evidence-based practices and works directly with governors on specific policy projects. The NGA Center divisions are: Health Education Energy, Environment, and Transportation Economic, Human Services and Workforce Homeland Security and Public Safety

5. Governors’ Role in Public Health Preparedness 5 Federal, state and local governments all play important roles in public health preparedness Governors’ Roles: Coordinate among key partners Federal government Within state government Local government Private sector Communicate accurate, timely and targeted information Both internally and externally Use executive authorities Governors’ executive authorities include issuing executive orders and emergency declarations, and leveraging budgetary authority

6. Public Health Implications of Zika Virus 6 Zika virus is transmitted to humans primarily via bite of infected Aedes species mosquito Zika virus can cause microcephaly, a severe birth defect in infants, when pregnant women are exposed to Zika Zika also is associated with neurological problems and other adverse pregnancy outcomes 7,373 Zika cases have been confirmed across 46 states, 3 territories, and the District of Columbia * (as of August 3) 1,825 Zika cases reported in continental United States: 1,818 travel-associated; 1 laboratory acquired; 6 locally acquired (FL) 5,548 in U.S. Territories, 5,525 of which were locally acquired 972 pregnant women with laboratory evidence of possible Zika infection and 23 confirmed cases of Guillain-Barré Syndrome There have been several Zika-associated deaths reported including in Puerto Rico, Texas, and Utah *Source: Based on CDC data and discussions with CDC experts, please reference http://www.cdc.gov/zika/geo/united-states.html for additional informationhttp://www.cdc.gov/zika/geo/united-states.html

7. Public Health Implications of Zika Virus 7 According to CDC, widespread transmission of Zika virus appears to be unlikely in continental United States, particularly with adequate prevention efforts in place However, CDC predicts the number of Zika cases will continue to increase, and that local transmission remains a risk in some southern states, especially those with past outbreaks of chikungunya and dengue

8. Public Health Implications of Zika Virus 8 Most Zika infections in the continental U.S. are travel-related and currently affect 46 states, 3 territories and the District of Columbia There is active local transmission in Florida and CDC considers southern states – especially those with a history of chikungunya and dengue outbreaks -- at risk for local transmission

9. Public Health Implications of Zika Virus 9 Increased infection rates can reach a “tipping point” that quickly accelerates viral transmission Prevention and control efforts to avoid local transmission and escalation to “tipping point” is critical to prevent outbreaks Zika Virus Infection Curve, Salvador, Colombia, June 2015-March 2016, showing “tipping point” at Week 51-52

10. Key NGA Responses to Zika Virus 10 DateAction February 2016NGA develops bulletin for governors on the emerging issue of Zika April 1, 2016NGA co-hosts Zika Action Plan Summit 1 with CDC and the White House with 39 states and jurisdictions participating April 22, 2016NGA launches Zika webpage 2 for states with a custom map made for states to track Zika cases May 9, 2016NGA works with governors to issue a statement 3 asking for swift and adequate funding for states May 10, 2016NGA and CDC host Zika Emergency Risk Communications Webinar for governors’ communications directors Anticipated: Summer 2016 NGA Public Safety Division Issue Brief: Improving State Efforts to Prepare and Respond to Public Health Emergencies OngoingNGA actively involved in CDC’s Zika Action Partnership Network with other organizations to increase coordination and collaboration OngoingGovernors’ office briefings as requested 1 http://www.cdc.gov/zap/ 2 http://www.nga.org/cms/zika-in-the-states-what-you-need-to-know 3 http://www.nga.org/cms/home/news-room/news-releases/2016--news-releases/col2-content/governors-ask-for-swift-action.html

11. Summary of State Actions on Zika Virus 11 Governors have been at the forefront of Zika response and preparedness. Broadly, they have focused on implementing phased, jurisdictional, risk-based Zika plans that include strategies around communication, surveillance, laboratory testing, mosquito control, outreach to pregnant women, and blood safety. These efforts have included: Creating and implementing state action and response plans Coordinating state agencies and departments Targeting resources and deploying rapid response efforts Increasing surveillance and vector control efforts Increasing tracking and testing of affected pregnancies and births Mapping and tracking mosquito populations Implementing adult and larval mosquito control including ground applications and aerial spraying, and community interventions Launching efforts for health care providers and at-risk individuals Training local health departments and health care providers Providing educational materials to pregnant women Launching public awareness campaigns Disseminating Zika prevention kits

12. Contact Information NGA Center for Best Practices Kelly Murphy, Program Director Health Division kmurphy@nga.org NGA Office of Federal Relations Anna Holmquist Davis, Director adavis@nga.org 12