Applying

Primary Prevention Principles

to Combatting Zika Virus
 Zika Virus Information
Zika virus disease (Zika) is a disease caused by Zika virus
that is spread to people primarily through the bite of an
infected Aedesspecies mosquito.
The most common symptoms of Zika are fever, rash, joint
pain, and conjunctivitis (red eyes).
The illness is usually mild with symptoms lasting for
several days to a week after being bitten by an infected
mosquito. Around 80% of people are asymptomatic and
may not realize they have been infected.

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Data Source: Centers for Disease Control and Prevention. National Center for Emerging and Zoonotic Infectious Diseases (NCEZID)
Division of Vector-Borne Diseases (DVBD). http://www.cdc.gov/zika/about/index.html
 What we know about Zika
No vaccine currently exists to prevent Zika virus disease
(Zika).
Zika can be prevented by avoiding mosquito bites.
Mosquitoes that spread Zika virus bite mostly during the
daytime.
Mosquitoes that spread Zika virus also spread dengue and
chikungunya viruses.
Zika can cause birth defects if a mother is infected during
pregnancy.
Sexual transmission of Zika can be prevented by using
condoms or not having sex.

Data Source: Data Source:Centers for Disease Control and Prevention. National Center for Emerging and Zoonotic
3 Infectious Diseases (NCEZID)
Division of Vector-Borne Diseases (DVBD). http://www.cdc.gov/zika/prevention/index.html
Zika virus: Public Health Threat
Emergence unpredicted

Serious risk for fetus

Microcephaly
Other birth defects
Poor pregnancy outcomes

Guillain-Barr syndrome

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 Transmission of Zika
Through Mosquito Bites
These mosquitoes typically lay eggs in and near standing
water in things like buckets, bowls, animal dishes, flower
pots and vases. They prefer to bite people, and live indoors
and outdoors near people.
From Mother to Child
A mother already infected with Zika virus can pass on the
virus to her newborn.

Data Source: Data Source:Centers for Disease Control and Prevention. National Center for Emerging and Zoonotic
5 Infectious Diseases (NCEZID)
Division of Vector-Borne Diseases (DVBD). http://www.cdc.gov/zika/transmission/index.html
 Transmission of Zika
Through Sexual Contact
Zika virus can be spread by a man to his sex partners.
In known cases of sexual transmission, the men developed
Zika virus symptoms. From these cases, we know the virus
can be spread when the man has symptoms, before
symptoms start and after symptoms resolve.
From Blood Transfusions
As of February, 1, 2016, there have not been any
confirmed blood transfusion transmission cases in the
United States.

Data Source: Data Source:Centers for Disease Control and Prevention. National Center for Emerging and Zoonotic
6 Infectious Diseases (NCEZID)
Division of Vector-Borne Diseases (DVBD). http://www.cdc.gov/zika/transmission/index.html
Zika Transmission Routes

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Case Counts (4/11/2016)
US States:
346 travel-associated
0 locally transmitted

Including:
32 pregnant women
1 case of Guillain-Barr syndrome
7 sexually transmitted

Tennessee:
2 travel-associated cases as of April 11, 2016

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Local Transmission

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Strategy for Tackling the
Problem
Step 1: Define the problem and population
Problem: Zika Virus
Population: Who should you target? And why?
Step 2: Set a goal what are you going to change?
Awareness/knowledge
Behaviors/habits
Policies
Step 3: Create a how to approach
Create Objective
Identify Partners and Resources
Implementation
Learn from the project to inform future improvement
What populations should you target now
(no local transmission)?
Travelers to countries with ongoing Zika Virus transmission
Vacationers/Tourists/Visitors from countries with ongoing
transmission
Partners could include: travel agencies and airports
College/high students in field trips or study abroad programs
Partners could include: colleges and universities, high schools and
travel agencies
Mission groups
Partners could include: religious institutions and non-profits
Migrants
Partners could include: non-profits that work with refugee
populations and churches
What populations should you target if
there is local transmission?
High Risk Individuals like:
Homeless
Partners could include: churches and non-profit advocacy groups
Pregnant women
Partners could include OB/GYN and other healthcare
workers/organizations
Low income individuals in urban areas
Partners could include: non-profits who work with low income
populations, religious organizations, and community centers
Continue Targeting the General Public
Partners could include: housing authorities, local elected officials
The how to approach for 3 bundles of
change
Increasing awareness/knowledge
Changing behaviors/habits
Changing policies around mosquito control
Awareness/Knowledge
Step 1: Objective
Provide education and increase knowledge of Zika Virus and
prevention measures/personal protection messages
Population: General public, travelers, mission groups,
migrants, pregnant women, low income individuals
Step 2: Identify partners and resources
Collaborate
Leverage your partners
Increasing Awareness/Knowledge: Step 3-
Implementation
Distribute educational materials
Housing authorities, senior centers, parks/recreation facilities,
rest stops, convenience centers, bus terminals, churches,
schools/PTAs, low income neighborhoods
Include pamphlets with utility bills or other community mailings
Use community events to distribute information
Encourage partners to post links to TDH Zika page on their
Facebook, website, any other social media
Zika Prevention kit

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Example of Educational Materials

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Zika Prevention Kit
The CDC has developed recommendations for a Zika Prevention
Kit that you could assemble
The Kit includes:
A bed net
Insect Repellent
Permethrin spray
Standing water treatment tabs
A thermometer
Condoms
http://www.cdc.gov/zika/prevention/prevention-kit.html

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18
Educational App for Learning about
Zika
The Caribbean Public Health Agency (CARPHA) developed the app Zap-a-quito
Zap-a-quito provides information about where mosquitos breed, how to stop
breeding, and other facts about mosquitoes and the diseases they can carry
When the user zaps a mosquito, the app states facts about the mosquito, the
player has to answer questions and get them right before moving to the next
level
This game is a user-friendly way to learn about vector-borne illnesses and raise
awareness among children (adults enjoy it too)
The game is recommended for ages 3 and older
The game is free and available on the Google Play store (only available on
android devices)
Behaviors/Habits
Step 1: Objective
Provide information and outreach to assist in
environmental changes to reduce breeding grounds
Population: You know your communities better than
anyone, think about where there are tire dumps, untidy
yards with containers collecting water, individuals living
in houses without AC/screens on the windows
Step 2: Identify partners and resources
Collaborate with local health councils, schools, service
groups (Rotary, Lion, Kiwanis, 4-H clubs), neighborhood
associations, churches, and scouts
Changing Behaviors/Habits:
Step 3-Implementation
Step 3: Implementation
Form community clean up days, this not only is an
opportunity to reduce breeding grounds for mosquitos
but also to make your community beautiful

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Changing Behaviors/Habits:
Step 3-Implementation Cont
Bridgestone/Firestone
-Take tires of any brand and recycle them
-Community clean-up events must register:
http://
www.bridgestoneamericas.com/en/corporate-social-responsibility/environment-an
d-sustainability/tires4ward-request

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Tires4Ward-Hamblen County Tire
Recycling Collection Event
6 hour event that was aimed at Zika virus
prevention and community beautification.

88,720 pounds of tires were collected in

containers provided by Bridgetone Tires.

For more information, contact Sherrie

Montgomery, County Director, Hamblen &
Jefferson County.
Policy

Step 1: Objective
Change local ordinances regarding standing water
Population: Local municipalities
Step 2: Identify partners and resources
Collaborate with local councils to implement best
practices for ordinances related to standing water
Changing Policy:
Step 3- Implementation
Step 3: Implementation
Make the collection of standing or flowing water in which
mosquitos breed unlawful unless treated
Outline in code methods of treatment
Require permits for fish ponds
Incorporate provisions on enforcement and police
cooperation
See Title 13 Chapter 2 in Fayettevilles Code of Ordinances
at
http://www.mtas.tennessee.edu/public/municodesweb.nsf?
OpenDatabase

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Improving Your Strategy
Theres always room for improvement!
When implementing your strategy to combat Zika think about
Reach: What proportion of the target population
participated?
Efficacy: Success of the strategy, what might need to be
altered to achieve better results or reach more individuals?
Adoption: Did individuals change their behavior in regards to
standing water and prevention methods?
By keeping these areas in mind during implementation you can
continually improve strategies to combat Zika!