2017 Zika Update: A Synopsis

by scanyatonwu, posted in APHA IH Section

In 2015, I put together a panel of diverse public health professionals in order to provide graduate students with guidance on how to best prepare for (and land) a relevant public health job. The majority of the seasoned professionals on the panel (all epidemiologists) mentioned the impact 9/11 had on them being able to get a job, as a result of new positions created with emergency preparedness funding. I graduated shortly after this presentation and was able to secure a High-Consequence Infectious Disease (HCID) position at a local health department in Texas. These surge capacity epidemiologist positions had been made available as a result of the Ebola outbreak. Some of my peers were able to land similar positions around the state of Texas during the same time (or shortly after).

Although these positions were created in response to the Ebola outbreak, the emerging Zika crisis in Brazil became the high-consequence infectious disease of focus for us. Within a few weeks of starting my position, the epidemiology office at my local health department began to receive requests from local media for more information about Zika virus and the risk it posed to community members. Additionally, we were receiving continual updates from the Department of State Health Services, Zoonosis Control Branch concerning laboratory testing, preventive measures, and risk assessments for pregnant women and their partners. I was in charge of consolidating and disseminating this guidance to our local health care providers and community partners. It was also during this time that I  created a short quiz to gauge knowledge of key aspects of the illness and provide answers from relevant sources such as the Centers for Disease Control and Prevention (CDC), the Pan American Health Organization (PAHO), and the World Health Organization (WHO). The survey was tested out in the LinkedIn Global Health group and then later included in a presentation I put together for local health department and county staff. The quiz answers and presentation were updated periodically, as we learned more about Zika virus through conference calls and webinars. By the time I started a new position a year later, the number of Zika virus cases being reported globally had started to decrease.

That’s just a little of my experience with Zika. Now, I will share a brief, global synopsis of Zika.

In 2016, the World Health Organization (WHO) declared Zika virus to be a Public Health Emergency of International Concern due to its association with congenital microcephaly in infants born to women who had been infected during their pregnancy. Additionally, neurological conditions such as Guillain-Barre syndrome (GBS) were also being reported in adults who had been infected with Zika virus. Zika virus is said to be transmitted through the bite of an infected Aedes aegypti mosquito. It is also spread through sexual and congenital transmission.

Since May 2015, more than 750,000 confirmed and suspect Zika virus cases have been reported globally. Cases have been spread throughout more than 60 countries and territories. From May 2015-Dec 2016, there were 707,133 suspect and laboratory confirmed Zika virus cases in the Americas due to local transmission. Twenty-five percent of these cases were laboratory-confirmed. By late 2016, Zika virus transmission had occurred in 48 countries and territories in the Region of the Americas. Peaks were observed at various points during this time period (some regions even experienced more than one):

-January 2016 (Central America)
-February 2016 (Southern Cone, Andean subregions, and non-Latin Carribean)
-June 2016 (Central America and non-Latin Carribean)
-January-July 2016 (Latin Carribean; also the region with the highest number of Zika virus cases)

Zika virus rates in North America were relatively low, with a small peak occurring in October 2016. According to the U.S. Zika Pregnancy Registry (USZPR), 10% of completed pregnancies with confirmed Zika virus infection reported birth defects. Microcephaly was reported in 84% of completed pregnancies with birth defects. Additionally, birth defects were higher during the first trimester of pregnancy. Compared to pre-Zika levels in 2013-2014, 30 times more fetuses/infants were reported to have birth defects in 2015-2016. A similar trend was seen in Brazil when comparing pre-Zika data to data collected from mid-2015 to Jan 30, 2016 (read limitations in both articles).

In November 2016, WHO re-classified Zika virus as a long-term public health challenge  (instead of a Public Health Disease of International Concern). Since December 2016, there has been a significant drop in the number of cases being reported, however, CDC is reminding the public to follow preventive measures as the mosquito season gets closer.

April 20 Adaptation Community Meeting Invitation: Preparing Africa for extreme climate events – the role of the African Risk Capacity

by ihsection, posted in APHA IH Section, Events and Webinars
SPONSORED BY

USAID ATLAS Project

ABOUT THIS EVENT

Please join the Adaptation Community Meeting on April 20 for a discussion on African Risk Capacity.

African Risk Capacity (ARC) is a sovereign insurance pool and early disaster response mechanism owned and governed by its African Member States. ARC helps its Member States to take the lead on disaster response by bringing together three elements: early warning, contingency planning and insurance. In order to participate in ARC, Member States must customize ARC’s early warning software Africa RiskView for their country context; identify and quantify their weather risk and what to transfer through insurance; and define a pre-agreed contingency plan in the event of ARC insurance payouts. Governments can then access immediate funds for early responses in the case of a natural disaster. Reducing the time it takes for assistance to reach those affected through early, nationally-led response reduces costs and the reliance on international appeals for assistance over time, but, more importantly, it saves the lives and livelihoods of those affected. Together ARC countries are catalyzing an essential paradigm shift in the humanitarian landscape to anticipatory, nationally-owned responses to natural disasters, but also providing an opportunity for donors, humanitarian organizations and private sector actors to reinforce the government-led risk management system they are building and to define a new way of responding to predictable natural disasters.

This meeting will dive into ARC’s new Extreme Climate Facility (XCF), and the underlying Extreme Climate Index (ECI). XCF will be a multi-year financial vehicle that will track the frequency and magnitude of extreme climate shocks in Africa and provide additional climate adaptation funds for countries already managing their current weather risks through the ARC system. A prototype ECI has been developed and climate scenario stress test simulations will be conducted, and we are working to determine how it could be used to underpin XCF payment triggers.

Register here.

Speakers

Erica Hovani was part of the team that established ARC, including developing the legal structure of the ARC entities, writing the ARC Treaty and working with ARC Member States. She is currently the Legal Counsel of ARC Agency and oversees all of ARC’s legal and governance activities, works with Member governments and coordinates activities with ARC’s financial affiliate, the African Risk Capacity Insurance Company Limited.

Ekhosuehi Iyahen is the Director for Policy & Technical Services a.i. for the African Risk Capacity Agency Secretariat (ARC). In this capacity she is responsible for consolidating partnerships with regional and international bodies in line with the ARC vision and goals and for ensuring quality knowledge and learning enhancement within the ARC Secretariat.

Date and Time

Apr 20, 2017
4:00PM to 5:30PM EDT

Location

Chemonics International, Inc.
1717 H St. NW, Washington, DC 20006
Detailed directions are available at:  http://www.chemonics.com/Pages/Contact-Us.aspx
To join remotely:
This event is organized by the USAID Climate Change Adaptation, Thought Leadership, and Assessments (ATLAS) project. All Adaptation Community Meeting webinars can be found here. 

Highlights from National Public Health Week (NPHW)

by ihsection, posted in APHA IH Section, Section Announcements

NPHW Twitter Chat

Thank all of you that participated in a plethora of events during NPHW (April 3rd-April 7th)! One of the events we participated in was the NPHW Twitter Chat (#NPHWchat) sponsored by APHA. During the chat, attendees were presented questions such as those below to foster a discussion on the significant role public health plays in safeguarding and advocating for health!

Global Health Day Photovoice Activity at NDSU

Mark Strand, Section Councilor in the International Health Section of the APHA, teaches Global Health to MPH students.  This semester the 16 students in his class are from Jordan and Syria; Kenya, Somalia and Ghana; Brazil; Nepal and China; and the United States.  As part of National Public Health week the students contributed photos from their home country, and organized a Photovoice activity for visitors to the event.  Attendees were invited to use Post-It notes to write their reactions or thoughts after seeing the photos.  The room buzzed with conversation about how to bring stable government to Somalia, and how to support Syrian refugees around the world.  Many other countries were also represented, and stories of success and hope were shared.  The attendees were enlightened and inspired by what they learned, and students were proud to be able to introduce their own country’s successes and struggles.

Global News Round Up

by abbhirami, posted in APHA IH Section, News

Politics & Policies

The President of Malta said that maternal health care for refugee women is much needed. One in 10 women in EU have no access to maternal health and refugee women are particularly vulnerable.

The WHO is supporting South Sudan’s Ministry of Health of roll out a new community health service delivery called Boma Health Initiative aimed at improving access to primary care services.

Programs, Grants & Awards

At GlobeMed’s 5th Annual Benefit Dinner, Dr. Adams discussed the importance of partnerships rather than simply donor-recipient relationships, which is a founding tenet of GlobeMed’s framework and organization.

The week of April 4th is National Public Health Week and public health professionals are celebrating the power of prevention.

The Living Goods’ project was launched in Uganda in 2007 and in Kenya in 2015. It is one of 23 projects in 43 countries that were selected by the Social Innovation in Health Initiative, out of a total of 170 nominated in 2015, as promising new ways to improve healthcare delivery.

Research

Eating a high fat and high sugar diet when pregnant leads to metabolic impairments in both the mother and her unborn child, which may ‘program’ them for potential health complications later in life, a study in mice has shown.

A new study shows that about 21 million lives were saved due to the progress made during the MDG era.

Adults who become overweight or obese have a higher risk of dying from from heart disease, cancer or other illnesses, a new study suggests.

A new study shows that about 6.4 million deaths in 2015 can be attributed to smoking and half of these were in just 4 countries – India, US, Russia and China.

Seven months after Rio Olympics, Zika continues to plague babies in urban slums.

Diseases & Disasters

2017 is shaping to be a bad year for the measles worldwide, says Dr. Seth Berkley, who leads the nonprofit Gavi, The Vaccine Alliance, devoted to vaccinating children worldwide.

Heart disease kills more people than all types of cancer combined. Every year, nearly 450,000 Americans die suddenly from cardiac arrest.  Nearly 88 percent of cardiac arrests occur at home, and the survival rate for an out-of-hospital sudden cardiac death is only 7 percent but can be significantly increased with prompt activation of the 911 emergency system and bystander intervention.

Direct Relief has contributed $32 million in medical resources for Colombia and Peru, where historic flooding and mudslides have killed hundreds of the region’s most vulnerable people and displaced hundreds of thousands more.

Sleep deprivation may be linked to a gene mutation.  According to researchers at The Rockefeller University, there’s a variant of a gene called CRY1 that slows the internal biological clock (also known as the circadian clock) – which normally is what tells the body when to feel tired at night and when you’re ready to wake.

Cancer death rates in the United States are continuing to fall and the five-year survival rates of those diagnosed with the disease have risen, research shows.

For the first time, doctors can determine which medication is more likely to help a patient overcome depression, according to research that pushes the medical field beyond what has essentially been a guessing game of prescribing antidepressants.

Aid agencies have warned that self-harm and attempted suicides are on the rise among refugees in Greece.

A series of interviews  and investigations shed light on how Syrian military hospitals have been used as sites of torture since 2011.

As part of a collaborative project with the Oxford University Clinical Research Unit, Eijkman Oxford Medical Research Unit, Jakarta and J. Kevin Baird, PhD, photos taken by photographer Pearl Gan were meant to increase awareness of the plight of people affected by malaria in the Asia Pacific.

Technology

Institut Pasteur Shanghai-Chinese Academy of Sciences (IPS-CAS), a partner of the ZIKAlliance consortium, announced that it has entered into a collaborative research agreement with Chongqing Zhifei Biological Products Stock Co., Ltd. (Zhifei) for the clinical studies and commercialization of a recombinant Zika virus subunit vaccine developed by IPS-CAS.

Since their advent in the early twentieth century, antibiotics have saved countless lives, curing human beings of diseases caused by harmful bacteria. But from the beginning of the antibiotics era, in the middle of the twentieth century, scientists warned that misuse or overuse of the drugs would render them less effective, or even useless as bacteria evolved into drug-resistant forms.

Environmental Health

Gov. Jerry Brown declared an end to California’s historic drought Friday, lifting emergency orders that had forced residents to stop running sprinklers as often and encouraged them to rip out thirsty lawns during the state’s driest four-year period on record.

Polycyclic aromatic hydrocarbons — toxic air pollutants produced by fuel combustion – are typically treated as a local issue in places with smog and bad air quality. A recent study suggests, however, that these pollutants may actually travel long distances and affect people across the globe.

An alliance of green groups has warned that the UN-backed hydro-projects will have serious environmental consequences and has condemned the use of  climate fund for large dams.

Equity & Disparities

Since its inception, the Yale-UKZN Collaborative has expanded dramatically. Today, the collaborative focuses on addressing public health priorities in at-risk communities, while simultaneously advancing research programs and supporting the education of trainees at both Yale and UKZN.

US President Donald Trump’s recently released 2018 budget blueprint proposes deep cuts in US foreign aid, prompting a discussion on the role of such spending in improving the health and well being of the world’s most vulnerable people.

Smoking rates in the US have been falling for decades.  Yet, about 15 percent of adults – more than 36 million – continue to smoke cigarettes.

At the Harvard T.H. Chan School of Public Health’s 4th Annual State of Global Health Symposium, entitled “Urban Evolution: Optimizing Women’s Health in the World’s Cities,” Lynn Freedman, professor of population and family health at Columbia University, talked about the “deeply vulnerable” population of poor women and girls who are hidden from view in the world’s cities.

Maternal, Neonatal & Children’s Health

Pregnant women who have gotten their booster vaccine against whooping cough (pertussis) have reason to cheer: their newborns are far less likely to get the disease than any other babies.

Many women in sub-Saharan Africa face high risks of dying from cervical cancer.  Here the chances of getting diagnosed and treated for cancer are extremely slim, unlike in developed countries that have well-funded, sophisticated cancer programs.

 

The (non)link between refugees and crime takes on new urgency

by Shazie Senen, posted in APHA IH Section

The world is currently being forced to confront an unprecedented crisis of forced migration, and the tension in the current public discourse surrounding it is undeniable. For many, the refugee crisis is closely related to terrorism for many reasons, some more legitimate than others. Unfortunately, that association – and the fear that accompanies it – has been opportunistically leveraged by President Donald Trump and others hoping to ride a wave of nativist xenophobia to elected office. This toxic political rhetoric has included twisting data on crime statistics, painting a false perception between refugees and crime – hurting the stance on immigration alongside people’s hopes for a better life. While public attitudes toward asylum seekers have been hotly debated in the U.S. since the election, and reached a fever pitch after Trump’s failed first attempt at a travel ban, Trump’s impulsive decision to respond to the use of chemical weapons in Syria gives the debate new urgency.

Trump’s comments on Sweden during a campaign-style speech in February led to confusion from both Swedes and non-Swedes alike. Sweden, which welcomed 160,000 foreigners in 2015, was called out by the president after watching a documentary highlighting Sweden’s acceptance of migrants and their crime rates. While he attributed his remarks to a report featured by Fox News the night before, the claim that Sweden had experienced a surge in gun violence and rape following asylum applications in 2015 was spurious. Data shows that Sweden accepted more than 160,000 refugees that year (more than any other country) but experienced no surge in said violence. In fact, while rape rates in Sweden are higher than in other European countries, this is due to a policy change in 2005. Each act of sexual violence now counts for one separate attack as opposed to “one victim, one type of crime, one record.”

While the influx of migrants has been claimed by some to parallel such crimes, there is no relationship between the two trends. Rather, filmmaker Ami Horowitz is facing serious allegations for misconstruing and editing footage of Swedish police officers. Consequently, Trump’s misinterpretation speaks volumes on the importance of fact-checking; he, unfortunately, amplified the stigma surrounding refugees based on a faulty Fox News segment with non-credible references.

Recent U.S. military action in Syria adds insult to injury as inconsistent decision-making creates an incoherent policy toward the Syrian civil war. In rapid succession, U.S.-led coalition killed 30 civilians in Raqqa in an airstrike meant for IS forces. The next week, both Secretary of State Rex Tillerson and U.S. ambassador to the UN Nikki Haley made clear that the U.S. has no interest in removing Syrian President Bashar al-Assad from power. Then, in a stunning change of course, President Trump ordered air strikes against the Shayrat air base in central Syria in response to a chemical attack that killed dozens of Syrian civilians this past week, the first time the U.S. has intervened directly with regime forces. Multiple officials insisted that Trump had been deeply moved by images of Syrian children screaming in pain after exposure to sarin gas – the same children in whose face he vowed boldly to slam the door of American asylum. The hypocrisy has not gone unnoticed.

Many are concerned that the U.S. involvement would only cause further destruction to the region, and for good reason. Continued military action will inevitably prolong Syria’s civil war, displacing civilians in even greater numbers. Will Trump’s new-found sense of compassion and moral outrage drive him to fulfill our moral obligation to receive refugees as our own military actions drive them to flee their homes? Will he disavow his previous statements that falsely painted a correlation between crime and immigration? As leader of the free world, he has the power to ultimately change people’s perceptions of refugees. Instead of misinterpreting the media and encouraging others to close the doors on those fleeing their war-torn homes, he should push for policy to ensure equity for all regardless of who they are. We would only be retrogressing if we allow biased media and ongoing negative attitudes cloud our beliefs on refugees. Now that U.S. military action could be creating more of them, perpetuating such narratives for political gain comes at a grave moral cost. It is only when our leaders have the courage to shift this paradigm that false perceptions can be rewritten and global relationships can be established.