D.C. Department of Health hands out mosquito kits as part of a District-wide ‘Fight the Bite’ public health campaign against Zika. (WTOP/Kathy Stewart)

Summer is officially here and with it comes elements that increase communities’ risk for Zika virus: more heat, more travel, more time spent outdoors, more standing water, and, maybe most importantly, more mosquitoes. But through proactive public health strategies – from education and outreach to vector surveillance and control – local health departments (LHDs) are standing on the frontlines to protect their communities.

Education, Outreach, and Partnership
When it comes to Zika prevention and preparedness, knowledge is power. Local health departments across the country are actively reaching out to partners, healthcare providers, and community members to impart information and increase awareness about Zika.

• Fairfield Health Department (CT) health officials are kicking off a new initiative to raise awareness about the Zika virus. With the help of the Fairfield Easton Medical Reserve Corps and the Fairfield Community Emergency Response Team, the department is handing out reading materials with tips on how people can prevent becoming victims of Zika.

• DC Department of Health (Washington, DC) is organizing information sessions in all eight wards across the city and distributing Zika “FIGHT THE BITE!” survival kits, complete with information sheets for travelers, EPA-approved bug spray, mosquito dunks, and condoms.

• Florida Department of Health in Leon County launched a public information campaign in Mayto broadcast 40 Zika prevention announcements a week on a local NPR affiliate; feature the prevention tips in a full-page newspaper ad; release a 30-second mosquito prevention video; and distribute information via social media and at community events.

• Montgomery County Department of Health and Human Services (MD) is holding town hall meetings to educate the community, raise awareness, and provide a forum for questions and concerns.

• Tarrant County Public Health (TX) developed a Zika home care kit with and a 2.5-minute video about general mosquito control.

• Westchester, Dutchess, Ulster, Rockland, Putnam, Sullivan, and Orange counties (NY) held a Hudson Valley Regional Zika Action Plan Summit in April 2016 to coordinate Zika response efforts on enhanced human surveillance, enhanced educational strategies, and vector control support in the region.

Vector Control and Surveillance
Mosquitoes don’t recognize borders, making vector control and surveillance a critical mechanism in Zika defense. Gaps in vector control services mean that even if vector control is done within one county, those efforts can be undermined if surrounding counties do not conduct vector control as well. While the availability and capacity of vector control services can vary widely on a state and local basis, the below examples suggest a full spectrum of scalable activities.

• County of Los Angeles Public Health (CA) is developing surveillance approaches, forms, databases, dashboards, etc., and is working with local vector control agencies to advise on improving Aedes mosquito control activities.

• Mobile County Health Department (AL) is hosting Community Clean Ups and promoting ‘Standing Water Saturdays,’ throughout the summer to encourage residents to eliminate standing water(where mosquitoes breed).

• Mecklenberg County Health Department (NC) hired 14 people to conduct a countywide survey of various neighborhoods to assess mosquito conditions and take larvae samples from 50-60 houses in each neighborhood.

• Douglas County Health Department (NE) is setting traps beginning in June to detect the presence of the two types of mosquitoes known to be able to carry the Zika virus, Aedes albopictusand Aedes aegypti.

• Florida Department of Health has multiple counties engaged in vector control and surveillance.Hillsborough County Mosquito Control set more than 30 new traps across the county, while Pinellas County Mosquito Control is focusing their efforts at the larval level (before mosquitoes can become a vector) and tasking agricultural officials with distributing mosquito traps to areas that lack surveillance.

Laboratory Testing and Clinical Efforts
Since Zika can be transmitted from mosquito to human (and back to mosquito) and testing the most at-risk individuals (i.e., pregnant and/or symptomatic returning travelers) is an important step in containing the Zika virus. When health departments in the localities with infected individuals are aware of positive Zika cases, they can better prepare their communities to prevent further transmission. Currently, Zika virus testing is only performed at the Centers for Disease Control and Prevention (CDC) and at some state and territorial health departments. But local health departments also play a key role in coordinating and facilitating that testing.

• Los Angeles County Department of Public Health (CA) is reviewing and approving specimen testing; arranging for specimen collection and transportation to the LACDPH Public Health Lab and the state’s lab; and ensuring that all relevant information is collected on reporting forms.

• Chicago Department of Public Health (IL) instituted a call line to coordinate testing for pregnant and/or symptomatic returning travelers, is reporting test results, and will monitor fetal outcomes.

• Florida Department of Health in Orange County (FL) is engaging in a public-private partnership to test for suspected Zika virus cases. Thanks to existing partnerships with Florida Hospital and Orlando Health Systems, DOH-Orange has been able to build the capability to support medical providers with resources to facilitate the collection and shipping of appropriate specimens to the state’s lab for Zika virus testing.

These are just a few examples of the many activities LHDs are undertaking to maximize awareness and minimize risk of Zika. The broad spectrum of strategies being used throughout the nation demonstrates that, even in the face of funding cuts and resource challenges, LHDs are using what they have to actively engage in Zika preparedness and response efforts.

NACCHO is continuing to work with the CDC and other federal partners to further support LHDs in protecting their communities against the threat of Zika. These efforts include sharing resources, collecting feedback about preparedness needs, and raising awareness of the potential impact of funding cuts on the ability of local health departments to respond to Zika.

To share your LHD’s Zika prevention strategies or learn more about any of the strategies described in this post, please contact the NACCHO Preparedness team.