States Familiar With West Nile Response Are Better Prepared for Zika

Mosquito larvae.

Mosquito larvae. arhiv /


Connecting state and local government leaders

Many health agencies already have protocols in place to monitor the new virus that’s been spreading in countries across the Americas.

If your state government has dealt with a West Nile virus outbreak previously, it’s better prepared for the new threat from the Zika virus, according to Christy Hockett, an epidemiologist with Consilience Software, an Austin, Texas-based company that is part of Xerox Corp.

While different genuses of mosquito carry the two viruses, both prefer wetter, warmer climates,

and some states routinely capture mosquitoes to test for West Nile and calculate outbreak probability.

West Nile cases have taught state health departments to react quickly and improve their capacity for outbreak surveillance and early warning with software.

“We don’t know how customers are using this,” Hockett said. “But the majority of all our clients has set up a Zika module.”

Hockett worked for the South Dakota Department of Health from 2010 to 2012 as a database manager and system administrator, developing the Norwalk, Connecticut-based business services company’s outbreak surveillance and management software, Maven, for the needs of the program and office managers. During that time, the department had to deal with several instances of foodborne illness in the Mount Rushmore State, she said.

The online case management system helps collect, manage and analyze health data without needing developers to alter source code to establish modules. State epidemiologists can make those changes themselves.

Elsewhere, the Florida Department of Health uses a system called Merlin implemented in 2001 to track familiar, mosquito-borne diseases like West Nile, dengue fever and chikungunya fever.

“Our experience conducting surveillance on other exotic arboviruses such as dengue and chikungunya that have similar epidemiology to Zika virus has put us in a good position for conducting surveillance for Zika virus,” department spokeswoman Mara Gambineri said in an email. “The established surveillance system application (Merlin) was able to be quickly adapted to capture data about Zika fever cases.”

Using systems like Maven and Merlin, state health departments can view the distribution of cases by area. Should a resident contract Zika, Maven puts demographic and other local data at officials’ fingertips to ensure the patient is treated.

Maven’s rules engine is critical to the process.

“These rules allow the data to be processed, assessed and triaged,” Hockett said. “So it really allows for automation and helps with workflow processes of cases during an outbreak.”

Other states rely on the federal Centers for Disease Control and Prevention’s National Notifiable Diseases Surveillance System, which collects case data for transmission back to the CDC.

The Illinois Department of Public Health’s version, I-NEDSS, is a web-based app used for surveillance along with an analysis, visualization and reporting app containing real-time and historical data. IDPH quickly added questions specific to Zika concerning symptoms, travel and pregnancy status to improve real-time reporting, said spokeswoman Melaney Arnold.

Texas’ Department of State Health Services uses NEDSS as well.

“We use an arbovirus template in NEDSS to report arboviruses like Zika and West Nile cases,” said spokeswoman Christine Mann in an email. “From NEDSS, case notifications are sent to ArboNET (official arbovirus reporting source for CDC).”

Maven takes reporting a step further.

In the case of both South Dakota’s foodborne outbreak and last year’s response by the New York City Department of Health and Mental Hygiene to isolated cases of the Ebola virus, Maven was used to administer surveys via secure text message or email URLs that people can fill out on their mobile devices detailing information about their recent diagnosis. The more efficient process decreases data entry errors that were prevalent when patients were called and notes written down on paper.

Outbreak detection in Maven alerts epidemiologists when a potential threat has emerged and identifies cases. Alerts can be triggered by a certain number of cases in a geographic area or particular timeframe—a disease-specific algorithm.

“It’s not going to make decisions for you; those need to be made by a person with knowledge of the situation,” Hockett said. “It doesn’t do the work for people, but it helps.”

Dave Nyczepir is a News Editor at Government Executive’s Route Fifty.

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