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For a few minutes, travel back in time to January 2016.

The mosquito-borne Zika virus spread across South America, Central America, and the Caribbean. Brazil reported cases of infant microcephaly and other alarming pregnancy outcomes for women who had been infected. On January 15th, the Centers for Disease Control and Prevention (CDC) issued a travel alert for people traveling to regions where Zika virus transmission was ongoing.

As news of a Zika epidemic tore through public consciousness, the Region IV – Public Health Training Center (Region IV PHTC), based in Atlanta, housed in Emory University, Rollins School of Public Health (RSPH) and serving much of the southeastern United States, knew time was of the essence.

Uncertainty, anxiety, and the need to know—when much remains unknown

Health officials and the public had only hazy details about Zika virus transmission and the existence of what has since been established as an especially alarming causal link between Zika and associated birth defects. By February 2016, the World Health Organization declared the outbreak of the Zika virus a “public-health emergency of international concern,” a rare designation reserved for scourges like Ebola, Polio, and H1N1. Health officials soon learned that Zika-transmitting Aedes mosquitoes might enter the southern United States as the weather grew warmer.

With the Summer Olympics in Brazil approaching and mosquito season in the United States impending, public health officials around the globe prepared to manage expectations, raise awareness, and martial the resources necessary to push back the threat. Success would rely on a public health workforce primed and ready for the onslaught.

Bringing the best pieces together for the public health professional

Facing minimal and ever-changing information, public health workers at home and abroad needed training on the latest epidemiological evaluations, administrative strategies, clinical concerns, and public messaging about the Zika virus. Region IV PHTC confronted a daunting challenge: finding an efficient and effective way to share urgent health communications messages and the results of epidemiological investigations that were still in-progress and dynamic.

Responding to pressing needs, the training center invited State Epidemiologist Cherie Drenzek, DVM, MS, from the Georgia Department of Public Health (Georgia DPH) to present a webinar entitled “The Zika Virus: What It Is and How to Protect Against It.”

A gifted instructor with 17 years at the Georgia DPH under her belt, and a veteran member of the CDC’s Epidemic Intelligence Service, Dr. Drenzek is a longtime colleague. As an engaging, clear, concise communicator, and leader in her state, she had the expertise and skills necessary to contextualize Zika updates and model the practical application of the material she shared.

Despite limited planning and promotion time, the webinar took place just three weeks after the CDC released its travel alert. More than 800 professionals attended the webinar or accessed its archived recording.

Dr. Drenzek offered a comprehensive overview of everything known to that point, including the latest news of three cases of sexual transmission of Zika in Texas.

Participants’ questions reflected the range of concern about Zika transmission and the possibility of a local epidemic: “Do you agree with the Florida Governor’s declaration of a state of emergency?” “Are we at the point of declaring a natural disaster or emergency as a nation?” “How long does Zika stay in our systems after infection?” “Can dogs and horses get Zika?”

Participants seemed confident that Dr. Drenzek had the answers.

“Very up to date information,” noted one participant’s post-webinar evaluation. “Glad I was able to participate and increase my knowledge. I feel I can better answer questions put to me by my co-workers and community.”

The feedback was exactly as training center staff members had hoped.

Examining the research with the help of the CDC

Delving into the research came next.

A month after Dr. Drenzek’s overview in February, Region IV PHTC invited Beth Bell, MD, MPH, Director of the National Center for Emerging and Zoonotic Infectious Diseases at the CDC Office of Infectious Disease, to present an updated national webinar entitled, “Protecting the Public from Mosquito-borne Illnesses: The Zika Challenge.” For years, RSPH has welcomed CDC experts to lead presentations and facilitate discussions as part of a longstanding relationship between the school and the agency. Before the Zika outbreak emergency, Dr. Bell had already committed to lecture on vector-borne diseases at the training center. When Zika emerged, she agreed to refocus her talk and present the latest research findings about the outbreak earlier than planned.

In addition to sharing an overview, Dr. Bell identified credible resources that health officials and health care providers can use to train staff and educate the community about Zika and other mosquito-borne illnesses.

She also described prevention messages targeting both the general public and special groups such as pregnant women and travelers.

“I think that social mobilization and people taking ownership of ways that they can protect themselves and their communities is really going to be pivotal to success,” said Dr. Bell.

Participants wanted to know more about the latest research in antiretroviral therapy, whether microcephaly could be identified during an anatomic ultrasound, and why the CDC was not encouraging testing among male sex partners who had travelled to Zika prone locations. Dr. Bell’s compelling answers provided a window into how the nation’s leading public health agency saw its role as an advisor, partner, and communicator as it aimed to raise public awareness of the virus among public health professionals and the general public.

Building on the Strength of Our Network: Trainings Available at Partner Organizations

The training center’s six partner institutions, known as local performance sites, also provided timely training on Zika. In February 2016, the University of Alabama at Birmingham School of Public Health sponsored an in-person session entitled “Zika Virus Challenge 2016 Training,” which is now archived in video format. The training provided general background on the Zika virus and mosquito vectors, and discussed responses to similar outbreaks.

By June 2016, knowledge about Zika had increased, along with preparedness approaches. The Medical University of South Carolina, a local performance site, collaborated with the South Carolina Department of Health and Environmental Control and Johns Hopkins Medicine to offer a special symposium focused on this knowledge.

An estimated 180 participants attended the event, called Zika: Z to A – What We Know, What We Don’t, and How to Prepare. ABC and CBS television stations aired interviews with presenters and South Carolina local performance site director John Vena, PhD. The symposium began with greetings from Sen. Tim Scott (R-S.C.) and continued with presentations and discussions for both the public health workforce and the larger community. Presenters shared details about Zika virus’s clinical and public health implications, and strategies to minimize its effects.

Building on Experience

An avalanche of information and guidance has emerged since the early months of 2016 and the workforce is struggling to keep all of it organized. Recognizing this need, Region IV PHTC continues to cultivate and maintain a wealth of relationships with thought leaders able to pull together crucial insights steadily and quickly during confusing times. In partnership with local performance sites and supported by a national network of public health training centers, Region IV PHTC is ready and able to help.

The training center’s experiences will be modeled by the National Coordinating Center for Public Health Training as it works with regional public health training centers and local performance sites to develop a standard protocol for emergency response.

Learn more about all the Zika-related trainings and resources of the Region IV Public Health Training Center and its associated local performance sites, including archived recordings of these webinars. In addition, access more than 500 infectious disease trainings, including those related to Zika.

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Authors:

Laura M Lloyd, MPH, CHES, Director of Continuing Professional Education at Region IV – Public Health Training Center

Deborah Gardner, MPH, MFA, Project Manager, Region X – Northwest Public Health Training Center

Meghan Fitzpatrick, BA, Communications Specialist, Region X – Northwest Public Health Training Center

Mikhaila Richards, MS, Communications Strategist for the National Network of Public Health Institutes and the Public Health Learning Network (National Coordinating Center for Public Health Training)