The Environmental Health Director and staff performed a vector control assessment using the Environmental Public Health Performance Standards and identified areas in need of improvement. A meeting took place between the Broward County Mosquito Control (BCMC) and the Florida Department of Health in Broward County (FDOH-Broward). Gaps were identified in communication, treatment, and enforcement activities. Shortly following the above activities, Zika decided to visit South Florida but we were ready.

Outbreaks may occur due to unreported and/or underreported mosquito borne illness, such as Chikungunya, Dengue, West Nile virus, and Zika. Surveillance and treatment response times could be improved through enhanced collaboration between FDOH-Broward, BCMC, hospitals, urgent care centers, and increasing awareness and education in the community. Zika knows no boundaries in population so the challenge was to engage the private, business and medical communities to help address reducing Zika mosquito breeding and exposure using drain and cover message, improve communication in reporting Zika cases for early intervention and perform mosquito assessments and apply treatments to mosquito breeding sites with a team effort between BCMC and FDOH-Broward. During meetings between BCMC and FDOH-Broward, it was discovered the Mosquito Control did not have authority to enter private property to investigate potential/actual mosquito breeding conditions. FDOH-Broward does have authority to enter a property if a potential public health threat in suspected. This authority is granted by the Broward County Ordinance Section 15-243-Inspections.

As a result of the challenges noted above, communication flowcharts were developed to address BCMC gaps. The flowcharts were laminated and distribute to all involved staff within the agencies. Another communication gap was identified between BCMC, FDOH-Broward, and the local hospital, primary care, and urgent care centers. This gap involved a lack of notification of potential mosquito borne illness cases presented at these facilities. Having advanced notification allows BCMC and FDOH-Broward to treat and perform surveillance of the affected areas to minimize the potential risks of an outbreak. FDOH-Broward developed a mosquito poster that was mounted in every treatment room of the hospital ER’s, primary care, and urgent care centers. The posters were distributed to 140 urgent care centers and 17 emergency room departments. This poster advises and lists the notification process if a suspected case presents. Mosquito information door hangers were also developed by FDOH-Broward. These door hangers were distributed to the affected local community to engage the community in the process of reducing the risk of outbreak in their neighborhood.

Over 7,000 mosquito assessments were performed in conjunction with BCMC. These assessments were the result of improved communication between the Department of Health in Broward County and the local hospital district, primary care physicians, and BCMC. With a communication plan in place, all suspected and confirmed positive cases for Zika were immediately reported to FDOH-Broward. Environmental Health teams were immediately deployed to the affected in conjunction with BCMC to assess, abate, and treat any condition conducive to mosquito breeding and active breeding sites. Over one million mosquito palm cards, door hangers, and informational flyers were distributed to the business, residential, and medical communities. Due to the efforts described above only one locally-acquired case of Zika was confirmed, All other cases of confirmed Zika were acquired out of the county in other affected areas.

This has been an incredible opportunity to improve FDOH-Broward’s relationship with external partners. This project helped FDOH-Broward identify and address gaps in our processes, both internally and in collaboration with other agencies. New communication charts, posters, and door hangers were developed to help improve the health and safety of all residents and visitors of Broward County.