Zika virus is here to stay. Here's how California is preparing for that new reality

Information to keep in mind this summer.
— Dr. Dale

From Zika virus is here to stay. Here's how California is preparing for that new reality 

Jason Farned set down a clear container in the middle of a table. The people gathered around leaned forward to peer at the tiny, zooming blurs trapped inside.

“The deadliest creature in the world is the mosquito,” said Farned, who works for the San Gabriel Valley Mosquito and Vector Control District, a government agency that manages insect populations. By some estimates, mosquitoes transmit diseases that kill more people each year than any other creature.

The ones Farned brought to this recent meeting in El Monte were Aedes mosquitoes — the kind that spread Zika virus, the disease discovered last year to cause birth defects.

Though no one has contracted Zika virus from a mosquito in California, hundreds of residents have been infected in other countries and then returned to the state. All it would take for the disease to start spreading here is for an Aedes mosquito to bite an infected traveler and then another person, experts say.

It’s been a year since the World Health Organization declared Zika an international public health emergency, but officials are still far from eliminating the virusWinter has slowed its worldwide spread, but rising temperatures in the spring are bound to bring more cases.

And because a vaccine won’t be ready for years, California mosquito-control and health officials are making plans to battle Zika every summer for the foreseeable future.

“Unfortunately, we’re able to adjust to the new normal that now includes Zika, but we have to remember that there are people behind the statistics — babies, pregnant women,” said Dr. Edward McCabe, chief medical officer for the March of Dimes. “We cannot let down our guard.”

The first line of defense against Zika is mosquito control, officials say.

The disease is transmitted only by Aedes mosquitoes, which aren’t native to the Americas. But the insects showed up in El Monte in shipments of bamboo from Southeast Asia about 15 years ago. The local vector control agency assigned seven people to work full time to try to get rid of the incredibly resilient bugs, Farned said. 

“No community anywhere on the planet has successfully been able to eradicate them. We were really trying to be the first,” he said. “They’re pretty much here to stay.”

The mosquitoes are now found in 12 counties in California, with particularly dense infestations in the San Gabriel Valley.

Farned has enlisted the help of the Buddhist organization Tzu Chi to try to spread the word about Aedes mosquitoes in the region. The recent meeting included a dozen volunteers who collectively spoke Mandarin, Cantonese, Malay and Vietnamese in addition to English.

Part of the reason Aedes mosquitoes are so intractable is because spraying pesticides doesn’t work on them as well as it does on the Culex mosquitoes that Californians are more familiar with, officials say.

The only tactic that’s proved successful in curbing Aedes populations is sending workers door-to-door to check every home for standing water. It’s a tedious task because Aedes mosquitoes can breed in “anything from a bottlecap to a jacuzzi,” said Gimena Ruedas, an assistant vector ecologist with the San Gabriel Valley vector agency.

The insects need only a few drops of water to reproduce, and can even survive inside people’s homes. Their eggs can tolerate months of drought, waiting for rain to hatch.

On a recent morning, Ruedas and her colleague Javier Romo scoured backyards in East Pasadena searching for the mosquitoes and their eggs, which are barely visible to the human eye. Ruedas and Romo get called when homeowners notice the small mosquitoes, usually because they were bitten in the daytime, characteristic of Aedes.

The two looked inside storm drains and fountains and shined flashlights on the lips of upturned pots. Any pool of water as big as a teaspoon could be a danger. Ruedas said she once saw mosquitoes breeding in water droplets collected in a dried-up leaf.

“We cannot go to every single house and look for every single bottle cap,” Ruedas said. 

Pilot projects in El Monte and the Central Valley have tried to curb mosquito populations by releasing male Aedes aegypti that are infected with a bacteria that prevents their eggs from hatching. The efforts had positive results, but these new methods will likely require federal approval and take several months before they’re widespread. 

Officials say that at the very least, the attention around Zika virus has made people more aware of the invasive mosquitoes, which can also transmit deadly diseases such as dengue and chikungunya. Vector control agencies had been sounding the alarm about Aedes mosquitoes since they arrived in California, but didn’t get much traction until Zika came on the scene.

The Zika outbreak began in Brazil last year but then spread to dozens of countries, including the United States. Mosquitoes in parts of Florida and Texas began transmitting the virus.

That has yet to happen in California, which doesn’t have such high mosquito populations. But there is a lot of travel between California and countries with outbreaks, such as Mexico and Guatemala, which increases the risk; 479 Californians have contracted Zika elsewhere, and three babies in California whose mothers were infected with the virus have been born with birth defects.

The Los Angeles County Department of Public Health is setting up surveillance sites at clinics in areas that could be susceptible to a local outbreak, including the San Gabriel Valley and East L.A., said the department’s Dr. Rachel Civen. If patients show up with Zika symptoms, they would be encouraged to get tested, she said. 

Still, it would probably take a while for officials to find out if there were an outbreak in California. Zika symptoms are usually too mild to make someone seek out medical treatment, and only 20% of those infected have symptoms at all. Many people would have to get Zika before one of them was sick enough to go to a doctor to be tested, she said.

Zika virus has kept health officials on their toes across the country. Most doctors had never heard of the virus before last year, and information about the virus rapidly evolves. Since the early reports linked Zika to microcephaly, scientists have discovered the primarily mosquito-borne virus can also be sexually transmitted, cause the neurological disorder Guillan-Barre and also damage adult brains. 

“It’s pretty stressful — things are not ideal,” Civen said. But the constant stream of new findings means health officials are able to provide up-to-date recommendations to help keep people safe, she said. 

Civen said it’s too early to know whether there will eventually be a case of Zika in L.A. It depends on the weather and how big outbreaks in other countries will be this year. Regardless, a different threat could be around the corner, she said, especially considering how much people travel between different parts of the world.

“It may not be Zika, it may be some other virus,” she said. 

National Youth HIV & AIDS Awareness Day

A day which we highlight the impact HIV/AIDS has on the youth and the impact the young people have in the fight against HIV/AIDS.
— Dr. Dale

From National Youth HIV & AIDS Awareness Day  

April 10th is National Youth HIV & AIDS Awareness Day (NYHAAD). NYHAAD is the first annual observance day set aside to recognize the impact of the HIV/AIDS epidemic on young people.

National Youth HIV & AIDS Awareness Day (NYHAAD) serves as a reminder that investing in young people's health and education is a critical step to achieving an AIDS-free generation. This annual observance was created in 2013 by Advocates for Youth and other partners to educate the public about the impact of HIV/AIDS on youth.

Teens in the United States

In the United States, more than 1 in 5 new HIV diagnoses were in young people aged 13-24 years. Despite the disproportionate number of new HIV infections occurring among youth, the percentage tested for HIV is low compared to other age groups. Only 10% of sexually experienced U.S. high school students have ever been tested for HIV.

From 2005 to 2015, CDC data show declines in sexual risk behaviors among teens, including fewer currently sexually active high school students. Still, the prevalence of some behaviors remains high and puts young people at risk. For instance, condom use has decreased among teens, with more than 40% of sexually active high school students not using a condom the last time they had sex.

Additionally, some teens, including lesbian, gay, and bisexual (LGB) teens, often remain at greater risk for negative health outcomes. It is critical to use tailored approaches to reach the highest risk teens with the right interventions, in the right way, at the right time.

Addressing HIV in youth requires that young people are provided the tools they need to reduce their risk, make healthy decisions, and get treatment and care if needed.

The Role of Schools

Schools can play a critical role in promoting the health and safety of young people. The nation's schools provide an opportunity for 56 million students to learn about the dangers of unhealthy behaviors and to practice skills that promote a healthy lifestyle.

Schools and other youth-serving organizations can help young people adopt behaviors that reduce their risk for HIV, sexually transmitted diseases (STDs), pregnancy, and other related health problems. Some ways to encourage youth to stay healthy is to teach them about HIV/AIDS and other STDs, promote communication between youth and their parents, and support student access to confidential HIV counseling and testing services.

What CDC is Doing

CDC works with an established network of leaders in school-based HIV prevention, funding 18 state and 17 local education agencies that reach 1.8 million students nationwide. These funded partners:

  • deliver HIV, STD, and pregnancy prevention programs grounded in the latest research
  • select effective health education curricula
  • build local capacity to connect students to school-based and school-linked health services
  • engage parents to promote a positive school environment that’s safe and supportive for all students

Six national organizations also are funded to help state and local agencies with training, technical assistance, and resource development.

CDC uses three state-of-the-art monitoring systems designed to collect, analyze, and disseminate data on youth risk behaviors and school health policies and practices. These systems provide state and district level educators with information that they can translate into programs, policies, and practices that reduce health costs and improve teens’ lives.

This year marks the 5th year of NYHAAD-an observance that highlights the exceptional work young people are doing across the country to stregthen the fight against the HIV/AIDS epidemic.

What Can You Do?

CDC recognizes the impact of the HIV/AIDS epidemic on youth and the importance of HIV prevention. On NYHAAD, CDC joins with partners across the country to work to ensure young people know how to protect themselves against HIV. NYHAAD encourages everyone to:

  • Get educated. Learn the basic facts about HIV transmission, testing, and prevention.
  • Get tested for HIV. CDC recommends that everyone between the ages of 13 and 64 years get tested for HIV at least once as part of routine health care. Contact your health care provider about testing.

To have the most positive impact on adolescent health, parents, schools, and community- and school-based organizations and health centers must work together to help provide safe and nurturing environments for youth.

Help raise awareness about this important day by sharing communication messages and resources.

  • NYHAAD Resources Web page: This page contains information that is helpful in planning communication activities to inform and educate partners, stakeholders, and media about HIV in youth and the importance of recognizing the impact of the disease on young people. Included are graphics, sample social media posts, and links to additional resources for state and local education agencies, healthcare providers, and parents.
  • NYHAAD button: Post this web button on your site.

April is IBS Awareness Month

A month aimed to reduce the stigma with IBS and encourage individuals who have symptoms to get help.
— Dr. Dale

From April is IBS Awareness Month 

If you have irritable bowel syndrome (IBS), you are not alone – IBS is common with prevalence estimated at 10% to 15%. Yet many people remain undiagnosed and unaware that their symptoms indicate a medically recognized disorder.

In 1997, IFFGD designated April as IBS Awareness Month. During this time, we work to focus attention on important health messages about IBS diagnosis, treatment, and quality of life issues.

IBS Awareness Month is listed on the U.S. National Health Observances calendar. Health observances are days, weeks, or months devoted to promoting particular health concerns. Individuals, health professionals, teachers, community groups, and others can use these special times to sponsor health promotion events and stimulate awareness of health issues.

How you can get involved

The more we work together to raise awareness for IBS, the greater our ability to impact positive outcomes, such as additional research, increased educational opportunities and improved patient care, for the functional GI community. Here are a few tools for you to raise the visibility of IBS in your community.

  • Send our 2016 IBS Awareness Month press release to your local media outlet or share a link to it on social media.
  • Read Some Take Things to Heart, Others to their Belly – Irritable Bowel Syndrome: What is it and how is it treatedby Ami D. Sperber, MD. Available online at Amazon.com.
  • Join with IFFGD and use your voice to make a difference.
  • Find other resources to raise awareness for IBS in your community, including flyers and a link to contact your legislator at Advocate for Digestive Health.
  • Find IFFGD on Facebookand Twitterand join the conversation.