Zika Strategic Response Framework & Joint Operations Plan - WHO

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ZIKA STRATEGIC RESPONSE FRAMEWORK & JOINT OPERATIONS PLAN

JANUARY-JUNE 2016

 

http://who.int/emergencies/zika-virus/strategic-response-framework.pdf?ua=1

 

[niman]

 Dear journalists,


This is to inform that ZIKA Strategic Response Framework &Joint Operations Plan (January- June 2016 ) has been posted.


The plan can be found here: http://who.int/emergencies/zika-virus/strategic-response-framework.pdf?ua=1
 
WHO has launched a global Strategic Response Framework and Joint Operations Plan to guide the international response to the spread of Zika virus infection and the neonatal malformations and neurological conditions associated with it.

The strategy focuses on mobilizing and coordinating partners, experts and resources to help countries enhance surveillance of the Zika virus and disorders that could be linked to it, improve vector control, effectively communicate risks, guidance and protection measures, provide medical care to those affected and fast-track research and development of vaccines, diagnostics and therapeutics.

WHO says $56 million is required to implement the Strategic Response Framework and Joint Operations Plan, of which $25 million would fund the WHO/AMRO/PAHO response and $31 million would fund the work of key partners. In the interim, WHO has tapped a recently established emergency contingency fund to finance its initial operations.

As part of WHO’s new emergency programme, the agency’s headquarters activated an Incident Management System to oversee the global response and leverage expertise from across the organization to address the crisis. WHO is tapping a recently established emergency contingency fund to finance its initial operations.

WHO’s Regional Office for the Americas (AMRO/PAHO) has been working closely with affected countries since May 2015, when the first reports of Zika virus disease emerged from northeastern Brazil. AMRO/PAHO and partner specialists were deployed to help health ministries detect and track the virus, contain its spread, advise on clinical management of Zika and investigate the spikes in microcephaly and Guillain-Barré syndrome in areas where Zika outbreaks have occurred. AMRO/PAHO will continue to work with partners to manage the response in the Americas.

WHO is issuing regular information and guidance on the congenital and neurological conditions associated with Zika virus disease, as well as related health, safety and travel issues.

Working with partners, WHO is also mapping efforts to develop vaccines, therapies, diagnostic tests and new vector control tactics and putting in place mechanisms to expedite data sharing, product development and clinical trials.

On 1 February 2016, based on recommendations of the International Health Regulations Emergency Committee, WHO declared the increasing cases of neonatal and neurological disorders, amid the growing Zika outbreak in the Americas, a Public Health Emergency of International Concern.

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PART I: FOREWORD BY THE DIRECTOR-GENERAL

Since the Zika virus was first identified in a monkey in Uganda in 1947, it has rarely caused illness in humans. When people have become infected with the virus, the disease it causes has generally been mild, with small outbreaks occurring in a relatively narrow geographical band around the equator.

The situation today is dramatically different. Last year the virus was detected in the Americas, where it is now spreading explosively. Possible links with neurological complications and birth malformations have rapidly changed the risk profile of Zika from a mild threat to one of very serious proportions.

The Zika situation is particularly serious because of the potential for further international spread, given the wide geographical distribution of the mosquito vector, the lack of population immunity in newly affected areas, and the absence of vaccines, specific treatments and rapid diagnostic tests.

WHO has activated its Emergency Operations incident management system to coordinate the international response to this outbreak.

This Strategic Response and Joint Operations Plan aims to provide support to affected countries, build capacity to prevent further outbreaks and control them when they do occur, and to facilitate research that will help us better understand this virus and its effects.  

Margaret Chan Director-General

Edited February 17, 2016 by niman

[Admin]

[niman]

OVERVIEW OF THE SITUATION

This strategy has been developed to guide the international response to the current cluster of congenital malformations (microcephaly) and other neurological complications (Guillain-Barré Syndrome) that could be linked to Zika virus infection.

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Background

Zika virus is an emerging viral disease that is transmitted through the bite of an infected mosquito, primarily Aedes aegypti, the same vector that transmits chikungunya, dengue and yellow fever. Zika has a similar epidemiology, clinical presentation and transmission cycle in urban environments as chikungunya and dengue, although it generally causes milder illness.

Symptoms of Zika virus disease include fever, skin rash, conjunctivitis, muscle and joint pain, malaise and headache, which normally last for 2 to 7 days. There is no specific treatment but symptoms are normally mild and can be treated with common pain and fever medicines, rest and drinking plenty of fluids.

Zika virus was first identified in 1947 in a monkey in the Zika forest of Uganda, and was first isolated in humans in 1952 in Uganda and the United Republic of Tanzania. Zika virus has been causing sporadic disease in Africa and Asia. Outbreaks were reported for the first time from the Pacific in 2007 and 2013 in Yap Island (Federated States of Micronesia) and French Polynesia, respectively. There was subsequent spread of the virus to other Pacific islands, including New Caledonia, Cook Islands, Easter Island (Chile), Fiji, Samoa, Solomon Islands and Vanuatu. The geographical range of Zika virus has been steadily increasing ever since (Figure 1). 

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Current Situation

In February 2015, Brazil detected cases of fever and rash that were confirmed to be Zika virus in May 2015. The last official report received dated 1 December 2015, indicated 56,318 suspected cases of Zika virus disease in 29 States, with localized transmission occurring since April 2015. Due to the magnitude of the outbreak, Brazil has stopped counting cases of Zika virus. Today the Brazilian national authorities estimate 500,000 to 1,500,000 cases of Zika virus disease. In October 2015, both Colombia and Cape Verde, off the coast of Africa, reported their first outbreaks of the virus.

As of 22 January 2016 Colombia had reported 16,419 cases, El Salvador 3,836 cases and Panama 99 cases of Zika virus disease. As of 12 February, a total of 39 countries in multiple regions have reported autochthonous (local) circulation of Zika virus, and there is evidence of local transmission in six additional countries (Figure 1). Imported cases have been reported in the United States of America, Europe and non-endemic countries of Asia and the Pacific.

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Increase in neurological syndromes

National health authorities have reported an observed increase of Guillain-Barré syndrome (GBS)1 in Brazil and El Salvador which coincided with the Zika virus outbreaks.

During the French Polynesia outbreak in 2013/2014, national authorities also reported an observed increase in neurological syndromes in the context of co-circulating dengue virus and Zika virus. Seventy-four patients presented with neurological or auto-immune syndromes after the manifestation of symptoms consistent with Zika virus infection. Of these, 42 were classified as GBS.

On January 22 Brazil reported an increase of GBS at the national level. A total of 1708 GBS cases were registered between January and November 2015. Most of Brazil’s states have Zika, chikungunya and dengue virus circulation.

1 Guillain-Barré syndrome is a rare condition in which a person’s immune system attacks their peripheral nervous system. The syndrome can affect the nerves that control muscle movement as well as those that transmit feelings of pain, temperature and touch. This can result in muscle weakness and loss of sensation in the legs and/or arms. The cause of Guillain-Barré cannot always be determined, but it is often triggered by an infection (such as HIV, dengue, or influenza) and less commonly by immunization, surgery, or trauma.

Edited February 17, 2016 by niman

[niman]

Increase in congenital malformations

On 27 January 2016, Brazil reported that of 4180 suspected cases of microcephaly, 270 were confirmed, 462 were discarded and 3448 are still under investigation. This compares to an average of 163 microcephaly cases recorded nationwide per year. Only six of the 270 confirmed cases of microcephaly had evidence of Zika infection.

According to the US Centers for Disease Control and Prevention (US CDC) and Ministry of Health Brazil, the results of two specimens taken during autopsy from the brain tissues of microcephalic patients, indicated infection with Zika virus. A placenta was also evaluated and found to be PCR positive for Zika. Although the microcephaly cases in Brazil are spatiotemporally associated with the Zika virus outbreak, health authorities and agencies are investigating and conducting comprehensive research to confirm a causal link.

Following the Zika outbreak in French Polynesian, health authorities reported an unusual increase in the number of congenital malformations in babies born between March 2014 and May 2015. Eighteen cases were reported, nine of which were diagnosed as microcephaly. Other countries with current outbreaks (Cape Verde, Colombia, El Salvador and Panama) have not reported an increase in microcephaly.