Zika Outbreak: a PHEIC & Zika virus preparedness and response ac:vi:es in the African Region Dr Zabulon Yo, & Dr Anthony Stewart
Presenta:on Outline Background informa:on on Zika Global situa:on and Zika as a Public Health Event of Interna:onal Concern Zika virus in the African Region & Regional preparedness and response
Background informa:on (1) Zika Virus Disease: transmiied through mosquito bite (especially Aedes aegyp*) Same mosquito species transmits Chikungunya, Dengue, Yellow Fever First iden:fied in 1947 in rhesus monkeys in the Zika forest of Uganda Isolated in humans in 1952 in Uganda and Tanzania Clinically mild, self-limited disease with rash, fever, conjunc:vi:s and arthralgia
Background informa:on (2) There is no specific treatment or vaccine currently available The best form of preven:on is protec:on against mosquito bites The virus is known to circulate in Africa, the Americas, Asia and the Pacific Zika Virus geographical distribu:on has steadily increased since discovery in 1947 (and especially in 2015-2016)
Predicted distribu:on of Zika virus vector, the Aedes aegyp* mosquito
Countries & territories with Zika Virus (1947-2016) Steady increase in 2015-2016
Confirmed and Suspected Cases 18000 16000 14000 12000 10000 Confirmed & suspected Zika cases reported by countries and territories in the Americas, 2015-2016 8000 6000 4000 2000 0 Cumula:ve cases as of 12 Feb: - Confirmed: 2,063 - Suspected: 118,208 -Total cases: 120,271 Epidemiological Week Venezuela United States Virgin Islands Suriname Saint Mar,n Puerto Rico Paraguay Panama Nicaragua Mexico Mar,nique Jamaica Honduras Hai, Guyana Guatemala Guadeloupe French Guiana El Salvador Ecuador Dominican Republic Curaco Costa Rica Columbia Brazil Bolivia Barbados Source: hup://ais.paho.org/phip/viz/ed_zika_epicurve.asp
Zika Outbreak as a PHEIC May-Dec 2015: Regular situa:on reports issued by PAHO and HQ indicated increase in cases of microcephaly & GBS The cluster of microcephaly cases and other neurological disorders reported in Brazil and Polynesia 8 other countries reported increase in cases of Guillain-Barré syndrome IHR CommiIee advised DG WHO that the increase in neurological complica:ons with possible associa:on with Zika virus infec:on cons:tutes a Public Health Emergency of Interna:onal Concern (PHEIC)
Columbia GBS cases increase with Zika virus
DG/WHO declared microcephaly & GBS to be a Public Health Emergency of Interna:onal Concern (PHEIC) Global Response Timelines May 2015: Incident management established in PAHO May-Dec 2015: Regular sit reps issued by PAHO and HQ on spread of Zika Virus, microcephaly, and GBS 26 Jan 2016: WHO declared grade 2 emergency and established IMS 1 Feb 2016: DG declares PHEIC 3-4 Feb 2016: Strategic plan reviewed with GOARN and IASC partners 8 Feb 2016: $2.3 m released from Con,ngency Emergency Fund Feb 2016: all Regional Offices appointed Incident Managers. 17 Feb 2016: WHO release Strategic Response Plan
WHO Strategic Response Plan (17 Feb 2016) Inves:gate and respond to microcephaly and GBS that could be linked to Zika infec:on, while increasing preven:ve measures, communica:ng risks and providing care to those affected.
Zika virus in the African region Aher 1952, Zika virus was reported in Uganda, Tanzania, CAR, Senegal, Cote d Ivoire, Various surveys indicate the existence of Zika virus infec:ons in some African countries among persons and mosquitoes e.g. Zambia: Serologic surveys in Yellow Fever found 6% Zika virus in 2013 Gabon : Zika virus reported in Aedes mosquito in 2007 ZIKV-associated disease may be underreported or misdiagnosed
Zika virus outbreak in Cape Verde Outbreak of Zika declared in October 2015 7,258 suspected and confirmed cases reported since the onset Down-ward trend since December 2015 No neurological complica:ons observed so far Control measures ins:tuted include: enhanced surveillance, lab diagnosis, case management, IVM and risk communica:on AFRO provided support to ship samples to Ins:tute Pasteur in Dakar for laboratory tes:ng and confirma:on
Zika virus Epidemic curve, Cape Verde as of week 4, 2016 2015
Zika virus Outbreak Risk Assessment & Mapping Transmission poten:al Outbreak Risk
AFRO Response to Zika virus PHEIC Communica:on to all the 47 countries through WRs providing guidance to the Ministries of Health/partners, RCs/UNCTs Incident Management System (IMS) established in the RO to coordinate the preparedness and response ac:vi:es (03/02/2016) Briefing of Ministers of Health and partners from the Central African sub-region in Libreville, 10-14 Feb 2016 On-sight trainings and provision of reagents planned to support lab confirma:on through the exis:ng Emerging Dangerous Pathogens Lab network (EDPLN) Contribu:on to the development of the Global Opera:onal Plan AFRO developed a regional preparedness and response plan
AFRO Preparedness & Response Strategy Partnerships PREPAREDNESS SURVEILLANCE RESPONSE MONITORING & RESEARCH Ø Strengthen coordina,on mechanisms for PHE response Ø Conduct risk assessment and mapping Ø Strengthen surveillance and capacity for lab tes,ng Ø Monitor for Zika virus (entomological and human) Ø Increase access and interven,ons for vector control/ personal protec,on Ø Risk communica,ons/community engagement Ø Management of cases and neurologic syndromes Ø Control spread of Aedes mosquito (IVM) Ø Provide guidance & care for pregnant women, those considering pregnancy, and families with children affected Ø Inves,gate e,ology of microcephaly, neurological syndromes and establish possible consequences of Zika virus infec,on Ø Fast-track R&D of new products (e.g. rapid diagnos,cs, vaccines, therapeu,cs). Opera,onal partners network Technical partners network Opera,onal & Technical partners Technical networks R&D partners
Priori:za:on of ac:vi:es Country Context Category 1: High risk Category 2: Medium risk Category 3: Low risk Countries Angola, Benin, Burundi, Cameroon, Cape Verde, Central African Republic, Chad, Comoros, Cote d'ivoire, Equatorial Guinea, Eritrea, Ethiopia, Guinea-Bissau, Liberia, Madagascar, Mauritania, Mozambique, Nigeria, South Sudan and Togo Algeria, Botswana, Burkina Faso, Congo, DRC, Gabon, Gambia, Guinea, Kenya, Malawi, Mali, Niger, Rwanda, Sao Tome and Principe, Senegal, Seychelles, Sierra Leone, Tanzania, Uganda and Zimbabwe Ghana, Lesotho, Mauri:us, Namibia, South Africa, Swaziland and Zambia Strengthen coordina:on mechanisms for PHE response Strengthen surveillance and capacity for lab tes:ng Engage communi:es communicate risks Monitor for Zika virus Control* transmission Inves:gate possible complica:ons associated with Zika virus* * Only in countries with ongoing infec,on
Thank you More informa,on on: hup://who.int/emergencies/zika-virus/response/en/