Attachments
Outbreak Overview
On March 15, 2016 Kosrae State was notified of its first confirmed case of Zika. Since Feb 2016 there have been 12 confirmed cases and 11 probable cases of Zika disease in Kosrae.
-Onset dates of first 3 confirmed (PCR+) cases: 02/23/2016, 03/17/2016, 3/19/2016. Ages (and sex): 49 (F), 8 (F), 37 (F). None with a travel history.
-75 other suspect cases identified since enhanced Zika surveillance began on 02/10/2016 when Marshall Islands reported a confirmed case.
Case Definition (updated)
Suspect: Rash AND/OR Fever AND any: retro-orbital pain, arthritis, non-purulent conjunctivitis, red eyes, body aches, edema, headache or malaise
Probable: Suspect case with presence of IgM antibody against Zika virus and an epidemiological link
Confirmed: Meets suspect case definition with lab confirmation:
Zika RNA/antigen or IgM+ with Zika PRNT90 titre ≥20, ratio ≥4
Response Measures
• EpiNet Team Activated with enhanced Surveillance
Enhanced surveillance for Zika and Zika related outcomes at all clinics including OB/nursery
• Entomologic survey completed: main vectors A. Albopictus and A. Egypti
• Ongoing public awareness campaign (radio, posters, flyers) on: Zika awareness/prevention, Vector source reduction, Risks to unborn baby
• Zika Prevention Kits distributed to Pregnant Women (bednets,repellent, condoms)
• Vector control efforts ongoing including source reduction at case homes, public areas, and island-wide clean-up with assistance from island mayors and Department of Transportation and Infrastructure
• FSM Epidemiologist support continues
MRC activatied for municipalities public awareness/Health Ed, distributing Zika flyers, doing environmental inspections, and identifying any pregnant women w/o ANC
• Meetings and workshops with women groups will be convened
• Translated flipchart for pregnant woman
Collection of household checklist completed
Pregnancy Line list and monitoring sheet for issuance of Zika kits
• Received and utilized spray sent by WHO
• Two municipalities started moving heavy junk, such as cars, trucks, refrigerators, and others from their respective municipalities to Tofol dumpsite
• New measures: Epi-Week 16-27 (June 27 – July 3)
• Site visits to villages where new cases were located in Utwe and Lelu
• Governor’s Health Advisory Council met with the Epinet Team for progress reports, actions evaluations, and other updates
• Released ZIKA slide show for delivery at FSMTC
• Municipality of Malem scheduled its second round of clean-up starting next week.
Response Needs
• A hand-compression sprayer for residual spraying
• Carbon-copy paper for printing Zika surveillance forms
• Printing support for risk communication flyers, posters, and pamphlets
• Transportation costs & overtime compensation for field investigation, lab, and medical records staff
• Backup portable hard drive and rechargeable laptop computer for Medical Records to facilitate continuation of Zika surveillance during power outage
• Overpacks for laboratory to package specimens for shipping
• Shipping costs for Zika testing at off-island reference laboratory
• Bednets and repellent for distribution to suspected cases and pregnant women
• Replacement stock of insecticides and vector surveillance equipment
• Resources to fill sandmining pits, remove abandoned cars, and cover open septic tanks around homes.
• Fuel and maintenance support for garbage trucks to transport trash from households to dump sites