Zika cases become rare, but CDC cautions travelers to maintain vigilance when traveling in infected areas

As of mid-August, only one confirmed case of locally transmitted Zika had been recorded in the continental U.S., compared to hundreds of locally transmitted cases last year, John Cohen reports for Science.

That's because Zika cases have "plummeted" in Latin America and the Caribbean, which were hit hard by the virus, and now much of their population is immune to it, Cohen writes. And that means fewer Americans are being infected while traveling and bringing it home with them, which reduces the chances of local transmissions in the U.S.

Zika is a virus that is spread primarily through the bite of an infected mosquito. It can also spread through sexual transmission and from a mother to her child during pregnancy. Click here for more information about Zika.

Infectious disease experts told Cohen that this respite could last for years.

They had expected the Zika virus, much like dengue, West Nile and yellow fever, to initially surge through the population, then decrease as people developed immunity, but "few predicted that cases would disappear so quickly," Cohen writes.

Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases, told Cohen that this "herd immunity" has reduced the number of vulnerable people to the point that the virus can't easily move between humans and mosquitoes.

But caution was advised by Lyle Petersen, head of the vector-borne disease division of the Centers for Disease Control and Prevention. "Just because cases go down, it doesn't mean we should stop worrying about it," he told Cohen. "We need to maintain our vigilance."

Peterson said the decline in Zika cases doesn't lessen the need for a vaccine against the virus, but Cohen says the sharp decline in cases will make it hard to perform clinical trials for a vaccine.

The CDC cautions that anyone living in or traveling to areas with the risk of Zika should continue to protect themselves from mosquitoes, especially if you are pregnant or going to become pregnant.

Last year in the U.S., the CDC recorded 224 cases of local transmission, all in Florida and Texas, and 4,830 travel-related cases. This year, the CDC has recorded no locally transmitted cases and 213 travel-related ones, though Cohen reports that one case of locally transmitted Zika was recorded on July 26 in Hidalgo County, Texas, which borders Mexico.

"I think it's highly unlikely we will see any resumption of significant transmission for at least a decade," Neil Ferguson, a mathematical biologist at Imperial College London, told Cohen.

Biostatistician Ira Longini of the University of Florida in Gainesville disagreed. He said his models predict Zika "will still thrive in susceptible populations that have yet to be hit by the first wave of transmission, leading to 'flare-ups here and there'," Cohen writes.

Cabinet for Health and Family Services promotes health and wellness at state fair, and collects duffel bags for foster kids

helpourkidsinc.org

The Kentucky State Fair is not just a great place to support Kentucky's agriculture or to spend the day on the midway; it's also a great place to learn about some of the state's health and wellness initiatives and to donate a new duffel bag or backpack to a foster child.

“Often times, when children are removed from their home and placed into state care, all their belongings are literally stuffed into a black garbage bag,” Health Secretary Vickie Yates Brown Glisson said in a news release. "This effort changes that. Donating a duffel bag or backpack is a small but meaningful way to help foster children and give them the dignity of carrying their possessions in a new bag that is all their own.”

New duffel bags and backpacks will be collected at the Cabinet for Health and Family Services' exhibit in the Health Horizons area of the South Wing B. The fair runs through Aug. 27 at the Kentucky Exposition Center in Louisville.

The cabinet's exhibit will offer daily interactive displays that features learning activities for children and adults, free health screenings and on-site health educators who can speak to individuals about wellness and prevention. It will also offer free dental screenings for children with signed consents who are entering public school kindergarten or first grade from 10 a.m. to 2 p.m. daily.

In addition to these daily health initiatives, they will also have special "focus days," including:

• Tuesday, Aug. 22: Services for Seniors, including Adult Protective Services, Aging and Independent Living/Long Term Care Ombudsman, and the Kentucky Prescription Assistance Program
• Wednesday, Aug. 23: Focus on Foster Care and Adoption, 10 a.m. to noon
• Thursday, Aug. 24: Focus on Zika Education and Mosquito Control, 10 a.m. to noon
• Friday, Aug. 25: Focus on Substance Use Disorder Strategies and Services, 10 a.m. to noon

Exhibit buildings are open daily from 9 a.m. to 9 p.m. Sunday through Thursday and until 10 p.m. Friday and Saturday. Admission at the gate is $10 for adults, seniors and children; free for children 5 years and under. Parking at the gate is $10 per car.

New state public-health veterinarian appointed; her responsibility is diseases that spread from animals to humans

Dr. Kelly Giesbrect

According to the World Health Organization, nearly 75 percent of the new diseases that have affected humans over the past 10 years originated from an animal or an animal product. Kentucky has just appointed a new public health veterinarian, Dr. Kelly Giesbrecht, to help protect Kentuckians and the state's animal populations from such diseases.

“We are very pleased to have Dr. Giesbrecht join our staff at the Cabinet for Health and Family Services,” Health Secretary Vickie Yates Brown Glisson said in a news release. “Her wealth of experience in public health and veterinary science is a perfect fit for this extremely important role and will be a tremendous asset to our work to improve the public health of Kentucky.”

Among other things, Giesbrecht is tasked with identifying and evaluating diseases that are spread between animals and humans, called zoonotic diseases.

The federal Centers for Disease Control and Prevention says every year tens of thousands of Americans get sick from diseases spread between animals and people, which are caused by harmful germs like viruses, bacteria, parasites and fungi.

Zoonotics are transmitted in several ways, including direct contact with the body fluid of an infected animal; indirect contact from touching a contaminated surface; being bitten by a tick, flea or mosquito; or eating contaminated food.

Some of the more recognizable ones in the United States are Zika virus, West Nile virus, bird flu (Avian influenza), rabies, cat scratch disease, Lyme disease, E.Coli and Salmonella, though there are many more.

Giesbrecht, who will be part of the Division of Epidemiology and Health Planning in the state's Department of Public Health, will develop policies, guidelines and strategies to control zoonotic and foodborne diseases and share information as needed to health experts and the public.

Giesbrecht comes to the department with over 22 years of combined experience in veterinary medicine and public health. She has a doctorate in veterinarian medicine from the University of Florida and a masters of public health from the University of Texas. After clinical practice, she spent 11 years in the U.S. Air Force as a public health officer and most recently worked at the Northern Kentucky Health Department as a regional epidemiologist.

The Zika virus has come to Ky. through travelers, and could spread at any time, but few people know or do much about it

This species of mosquito carries Zika.

By Melissa Patrick
Kentucky Health News

As temperatures and travel increase, so does the possible threat from the Zika virus, which can cause dangerous or even deadly birth defects, but many potential victims are uninformed and unprepared.

The best prevention for now may be vigilance by property owners against standing water where mosquitoes breed. Experts say those who travel to Zika-affected areas such as Florida and Texas should use insect repellents after they return to keep local mosquitoes from picking up the virus, which causes no symptoms in some people.

Nearly two out of five people who had traveled to an area affected by the Zika virus hadn't heard or seen any information about how to protect themselves or others from it, and even those who knew how to protect themselves didn't always do so, according to a recent poll.

A senior research scientist at the Harvard T.H. Chan School of Public Health presented the poll results at the 2017 Zika Conference in Lexington May 11. Dr. Gillian SteelFisher said the results emphasized the need for more preventive education, noting that many people don't realize that it "just takes one bite" to become infected.

A Kentucky study of 55 women of childbearing age who had traveled to Zika-affected areas found a similar need for more information, especially among Spanish-speaking women with less education under the age of 30, said Kristen Heitzinger, a Centers for Disease Control and Prevention fellow at the state Department of Public Health.

State Health Secretary Vickie Yates Brown Glisson called on the more than 400 conference attendees to go back to their communities and become "unwavering" in their efforts to get and deliver a simple, easy-to-understand message about Zika, its dangers and how to fight it.

Dr. Ardis Hoven (file photo)

State infectious disease specialist Dr. Ardis Hoven told the conference that local health departments will educate community leaders about the virus. For an 86-second audio clip of her remarks, via Stu Johnson of WEKU, click here.

"Our research tells us that not nearly enough pregnant women in particular, or those who are of the age to become pregnant, know about the Zika virus and what they should do to protect themselves and their unborn baby, or a potential unborn baby," Glisson said. "Overwhelming evidence has shown a link between Zika and dangerous birth defects that cause delayed development and sometimes even death in infants."

Zika is spread mostly by the bite of an infected mosquito, though it can also be transmitted through sex, and from a pregnant woman to her fetus. It circulates in many parts of the world where Kentuckians vacation, do mission trips or work.

So far, only Florida and Texas have had locally transmitted infections in the U.S., but Kentucky has the mosquito that is known to carry it. Click here to see the locations where Zika is a risk.

The virus can cause microcephaly, a condition where a baby's head is smaller than normal because the brain does not develop properly, and other birth defects in infants born to women infected during pregnancy.

It is also associated with adult Guillain-Barre syndrome, a rare disorder in which the body's immune system attacks its nerves.

The most common symptoms of Zika are fever, rash, joint pain and red or burning eyes, though many who are infected have few if any symptoms, which can be so mild they go unrecognized.

There is no vaccine to prevent Zika, and no antiviral treatment for it.

According to the CDC, 5,000 cases of Zika have been identified in the U.S. and its territories including 37 in Kentucky and 1,367 in pregnant women. Among those women, 65 gave birth to babies with some type of Zika-related birth defect.

Of the 37 Kentucky cases, four were pregnant women whose children have had no complications, but are still being monitored. All the Kentucky cases were a result of travel to Zika-affected areas or through having sex with someone who had traveled to those areas.

The state health department has adopted the tag line "Dress, Drain and Defend -- to Fight the Bite Day and Night" to help Kentuckians remember to be vigilant about mosquito control:

• Dress in light-colored, long-sleeved shirts and pants;
• Drain all standing water where mosquitoes can breed, such as birdbaths, tires, buckets, gutters and anything, however small, that may act as a vessel for rainwater;
• Defend against mosquitoes with approved insect repellents for outdoor activities at all times.

Luke Mathis, the environmental health supervisor at the Lexington Fayette County Health Department, said citizens must do their part to make sure Kentucky doesn't have a Zika outbreak.

"We could work ourselves to exhaustion, we could spend every dime of money, and it would have little effect on the mosquito population," Mathis said. Instead, he said it would be more effective to "have every homeowner check out their yard for a few minutes every couple of weeks and kick over those buckets or get rid of those tires."

"We need to begin changing people's attitude to make it socially unacceptable to breed mosquitoes in and around their property," Brown said. "It's going to take decades."

The state health department has advice for those considering travel to Zika-affected areas:

• Pregnant women and their partners should not travel to Zika-affected areas;
• Consult with a health-care provider prior to travel if you are pregnant or planning to conceive;
• Couples who are planning to become pregnant should postpone conception for six months after travel to a Zika-affected area, and should discuss plans for pregnancy with their health provider
• Follow steps to prevent mosquito bites: Dress and defend!
• Wear a condom every time you have sex, including vaginal, oral and anal sex, or practice abstinence, while in a Zika-affected area.

Advice for those who have been to a Zika-affected area after they get home:

• Women who have been exposed to the virus should use condoms or abstain from sex for at least eight weeks after symptom onset or last possible exposure.
• Men who have been exposed to the virus should use condoms or abstain from sex for at least six months after symptom onset or last possible exposure.
• Male travelers with pregnant partners should wear condoms throughout the pregnancy.
• Travelers to Zika-affected areas who have symptoms within two weeks of their return to Kentucky should contact their health-care provider.
• Travelers returning from Zika-affected areas should wear mosquito repellent for three weeks after returning, so they won't infect other mosquitoes that could bite others.
• Remember that these precautions are necessary because many infected people have no symptoms.

Dr. Grayson Brown, professor of entomology at the University of Kentucky and director of the Public Health Entomology Laboratory, said many people are concerned about the safety of insecticides, but that they shouldn't be. He said "insecticide technology has changed" in the last 50 to 60 years and that products today are "nontoxic to humans and other vertebrates, but so powerful against mosquitoes."

"If we don't use them," Brown said, "the suffering is going to be absolutely enormous." He said South Florida officials averted a crisis last summer by using insecticides to kill Zika-carrying mosquitoes. Without that, there could have been "hundreds of thousands of cases, and thousands of micrcocephalic babies. . . . They avoided a serious, serious public-health crisis."

Kentucky sprays for mosquitoes each year, but Brown said the spray in mosquito trucks kills very few Zika-carrying mosquitoes, which require a different product that is hand-applied under bushes and brush.

For further information or to sign up for health alerts, visit http://healthalerts.ky.gov/zika or the CDC website at www.cdc.gov/zika. The UK College of Agriculture, Food and Environment website also offers Zika updates.