1. Zika Virus Disease: Virginia’s Planning Activities
July 27, 2016
Marissa J. Levine MD MPH
State Health Commissioner

2. Zika Virus Disease – Basics
Spread to people primarily through bite of infected Aedes mosquitoes
Other modes of transmission: sexual, maternal-fetal
Common symptoms: Fever, rash, joint pain and conjunctivitis
Usually a mild illness, lasting several days to 1 week
Most infected persons do not get sick
Infection during pregnancy can cause a serious birth defect called microcephaly, and other severe fetal brain defects which have life-long impact.
Zika virus infection is primarily spread through the bite of an infected mosquito (Aedes species). Of those that are infected with the virus, 1 out of every 5 will become sick. The most commonly reported symptoms are fever, rash, joint pain and conjunctivitis. The illness is typically mild, lasting approximately 1 week. There are some reports of more lengthy or more serious illness, but those are much less common. 80% of those who are infected will NOT become ill.
The treatment for Zika virus infection is what is known as “supportive care”, that is, there are no specific medications to treat the infection. The illness is treated by managing the symptoms, which can include fluids, rest, and medications such as tylenol to reduce fever. There is currently no vaccine to prevent zika virus infection. 2

3. Estimated range of Aedes albopictus and Aedes aegypti in the US, 20163

4. Virginia’s Preparedness Efforts
Virginia Zika Task Force established
Human disease surveillance initiated
Laboratory testing available
Mosquito surveillance initiated
Ongoing education and guidance to Virginians
Guidance to clinicians - regularly updated 4

5. Virginia Zika Task Force Input from all Task Groups
Office of the Governor
Commissioner VDH
Virginia Zika Task Force
VDEM
VDH OEP
Governor’s Office Representative
Lt. Governor’s Office Representative
Clinician Outreach Task Group
Communications Task Group
Human Surveillance Task Group
Maternity Health Task Group
Mosquito Control Task Group
Blood/Tissue Safety Task Group
Others
DVS
Lead: VDH ORCE
Lead: VDH OEPI
Lead: VDH OEPI
Lead: Virginia Mosquito Control Association
Lead: American Red Cross
DBHDS
Input from all Task Groups
DGS DCLS
VDH Office of Family Health Services
Virginia Blood Services
DOE
LEGEND:
BHDS: Virginia Department of Behavioral Health and Developmental Services
DCLS: Division of Consolidated Laboratory Services
DCR: Virginia Department of Conservation and Recreation
DGS: Virginia Department of General Services
DOE: Virginia Department of Education
DVS: Virginia Department of Veterans Services
OEP: Office of Emergency Preparedness
OEPI: Office of Epidemiology
ORCE: Office of Risk Communications and Education
SCHEV: State Council of Higher Education for Virginia
VACO: Virginia Association of Counties
VCU Health: Virginia Commonwealth University Medical Center
VDEM: Virginia Department of Emergency Management
VDH: Virginia Department of Health
VDOF: Virginia Department of Forestry
VDGIF: Virginia Department of Games and Inland Fisheries
VHHA: Virginia Hospital and Healthcare Association
VML: Virginia Municipal League
SCHEV
VDACS
VDH OEPI
DGS
VDGIF
VHHA
VDOF
DCR
MSV
VACO
State agency
Private Sector
VML
Non-governmental organization 5

6. Testing Virginia Residents for Zika Virus
950
Virginia Residents Approved for Zika Testing between 1/29/2016 and 7/20/2016
Virginia Residents Approved for Testing by Region
Case Status
Num %
Confirmed/Probable case 43 5
Not a case
757 80
Test results pending
128 13
Test declined 22 2
This slide shows the 950 Virginia residents approved for testing as of July 20, 2016.
The Northern Region has the majority (59%) of residents, followed (distantly) by Central (17%), Eastern (11%), Northwest (9%), Southwest (4%).
Among these 950 Virginia residents, 43 (or 4.5% (rounded to 5% in table)) were classified as confirmed or probable cases based on lab and epi criteria, 757 were classified as not a case, and test results are pending for 128 people.
It’s important to mention that case classification is based on lab and clinical criteria (or symptoms).
NOT A CASE – majority are asymptomatic! 6

7. Virginia Jurisdictions and Military Installations having Mosquito Control Capabilities
Fort Myers & the Pentagon, Arlington County
Fort Belvoir, Fairfax County
Langley AFB, Hampton
Fort Eustis, Newport News
Mosquito control guided by mosquito surveillance & arboviral testing
Mosquito control guided by mosquito surveillance only
Military installations having mosquito surveillance & control capability
Mosquito control programs are mostly found in some of Virginia’s most heavily populated jurisdictions. 7

8. Public Messaging/Communication 8

9. Zika Messaging Multimedia Approach
Leave-Behind Printed Material
Clinician Outreach
3 Animated Videos
(English & Spanish)
TV, Radio and Movie Theaters
Airport Signage
Social Media Campaign
Zika Prevention Kits 9

10. Zika Table top Exercise
June 17, 2016: Mosquito (Vector) Control
Zika task force
VDH LeadershipTeam
5 local health districts
Tabletop Exercise Template
Available for other jurisdictions to use 10

11. http://www.virginiawellbeing.com 11
Data Source: Virginia Department of Health Plan for Wellbeing, January 2016 11

12. Thank you! Summary/Questions?12