Planning for Zika should start now— and not just at your Department of Public Health

By Jill Reynolds, PCG Manager, and Heather Gann, PCG Senior Consultant

Winter may not be ending until March 20—but it is never too early for state officials from many agencies, not just public health specialists, to start planning for this coming summer’s likely spike in Zika infections.

As of this writing, 47 women in the U.S. have given birth to babies with neurological defects caused by the Zika virus, according to the latest data from a U.S. Centers for Disease Control (CDC) registry. That’s approximately 6 percent of all pregnant women infected with Zika who have given birth, and the numbers look certain to rise as more and more women infected by Zika last August and September come to the full term of their pregnancies.

Given its steady spread from its origins in Africa, we have every reason to expect the Zika virus could be as widespread in North and South America in 2017 as it was in 2016.  Zika is a flavivirus, spread by the bite of an infected Aedes species mosquito. For young children and adults, Zika may cause no symptoms at all although some may experience fever, joint pain, conjunctivitis, rashes, and other symptoms. For infected fetuses, however, Zika can lead to severe birth defects, most notably Microcephaly, characterized by an abnormally small head at birth, and mild to severe brain damage, hearing loss, vision problems, intellectual disability, seizures and other significant growth and developmental issues.

With the CDC now requiring all 50 states and the District of Columbia to establish plans to deal with Zika, here are three important lessons we already have learned:

  1. Just because your state is well north of the “Zika zone” in which the virus spreads does not in any way shield your state’s population from the risks. In fact, some of the most significant infection and birth-defect numbers we are seeing are in New York and New Jersey, owing to patterns of heavy travel by residents of those states to areas of Puerto Rico, the Caribbean, and Central and South America where Zika has been most prevalent. Every state planning for the future effects of Zika will be well served to understand the travel patterns of residents that may expose them to Zika, especially women of childbearing age, in order to make the best efforts to educate them about the risks and how to protect themselves.
  2. State Departments of Public Health take, as would be expected, the lead in managing Zika response. But after the DPH, one of the most important agencies to set up a plan for handling Zika may be the state agency that oversees and regulates child-care centers. Why is that? Because some states’ licensing regulations prohibit child care staff from applying insect repellents and creams to young children. Still more states have strict regulations requiring expressed, written parental permission before applying any creams or repellents. Mosquitoes carrying the Zika virus are aggressive daytime biters—peaking during the hours children at child care centers are most likely to be playing outside. Especially in warm-weather states where Zika is most likely to be present in mosquitoes, child-care regulatory agencies should review current standards, and, if those are prohibitive or restrictive on the use of repellents, would be wise to consider temporarily changing policies to allow, by default, that staffers may apply insect repellents and creams unless parents object.
  3. Multiple other state agencies may also be in positions to have their staff take important roles in educating women who are or may become pregnant about the risks of Zika and how to protect themselves and their unborn fetuses. These can include administrators of programs serving women including the Special Supplemental Nutrition Program for Women, Infants and Children (WIC), Supplemental Nutrition Assistance Program (SNAP), and Temporary Assistance for Needy Families (TANF). As these administrators are interacting with women participating in these programs, they can be asking them questions like: Do you know what Zika is? Do you know how to protect yourself? Are you pregnant or trying to become pregnant in the near future? Do you expect to travel to areas where Zika is known to be prevalent? Through asking questions like this, staff working for other programs can become partners bolstering the work of public health departments in educating women about Zika and empowering them to protect themselves and their future children.

As we wrote in this white paper last October, the costs of Zika infection to newborns are profound, both in lost human potential and the fiscal impact to state governments. For society, it’s estimated that it can cost $1 million to $10 million over the lifetime of a newborn affected by Zika in lifelong treatment and care costs.

For all these reasons, we urge state officials to start planning now for the 2017 Zika season, and to enlist all available and relevant resources–not just public health departments–in preparing for this threat and protecting women, children, and most importantly the not-yet-born.