Analyzing climate variations at multiple timescales can guide Zika virus response measures

Background: The emergence of Zika virus (ZIKV) in Latin America and the Caribbean in 2014–2016 occurred during a period of severe drought and unusually high temperatures, conditions that have been associated with the 2015–2016 El Niño event, and/or climate change; however, no quantitative assessment has been made to date. Analysis of related flaviviruses transmitted by the same vectors suggests that ZIKV dynamics are sensitive to climate seasonality and longer-term variability and trends. A better understanding of the climate conditions conducive to the 2014–2016 epidemic may permit the development of climate-informed short and long-term strategies for ZIKV prevention and control. Results: Using a novel timescale-decomposition methodology, we demonstrate that the extreme climate anomalies observed in most parts of South America during the current epidemic are not caused exclusively by El Niño or climate change, but by a combination of climate signals acting at multiple timescales. In Brazil, the dry conditions present in 2013–2015 are primarily explained by year-to-year variability superimposed on decadal variability, but with little contribution of long-term trends. In contrast, the warm temperatures of 2014–2015 resulted from the compound effect of climate change, decadal and year-to-year climate variability. Conclusions: ZIKV response strategies made in Brazil during the drought concurrent with the 2015-2016 El Niño event, may require revision in light of the likely return of rainfall associated with the borderline La Niña event expected in 2016–2017. Temperatures are likely to remain warm given the importance of long term and decadal scale climate signals. Keywords: Zika virus Epidemic Climate Climate change Decadal Inter-annual El Niño Brazil Drought Vector contro

The Latin American and Caribbean Climate Landscape for ZIKV Transmission

This document presents a short review of the basic climate of Latin America and the Caribbean (LAC), focusing on the rainfall and temperature regional differences at multiple timescales, and where present climate forecasts tend to be more skillful for these two variables. The paper aims to provide information to understand how the regional climate plays an important role in vector borne diseases in general and Zika virus (ZIKV) in particular. As an emerging disease a great deal of basic information on ZIKV transmission dynamics is lacking. Knowledge on other Flaviviruses such as chikungunya virus (CHIKV) and dengue virus (DENV), also transmitted by the same mosquito vectors may therefore be used to impute likely climate-related impacts

Importance of animal/human health interface

This study analyzed the importance of zoonoses and communicable diseases common to man and animals as potential Public Health Emergencies of Internationa

Global health security and the International Health Regulations

Abstract Global nuclear proliferation, bioterrorism, and emerging infections have challenged national capacities to achieve and maintain global security. Over the last century, emerging infectious disease threats resulted in the development of the preliminary versions of the International Health Regulations (IHR) of the World Health Organization (WHO). The current HR(2005) contain major differences compared to earlier versions, including: substantial shifts from containment at the border to containment at the source of the event; shifts from a rather small disease list (smallpox, plague, cholera, and yellow fever) required to be reported, to all public health threats; and shifts from preset measures to tailored responses with more flexibility to deal with the local situations on the ground. The new IHR(2005) call for accountability. They also call for strengthened national capacity for surveillance and control; prevention, alert, and response to international public health emergencies beyond the traditional short list of required reporting; global partnership and collaboration; and human rights, obligations, accountability, and procedures of monitoring. Under these evolved regulations, as well as other measures, such as the Revolving Fund for vaccine procurement of the Pan American Health Organization (PAHO), global health security could be maintained in the response to urban yellow fever in Paraguay in 2008 and the influenza (H1N1) pandemic of 2009-2010.</p

The Latin American and Caribbean Climate Landscape for ZIKV Transmission

This document presents a short review of the basic climate of Latin America and the Caribbean (LAC), focusing on the rainfall and temperature regional differences at multiple timescales, and where present climate forecasts tend to be more skillful for these two variables. The paper aims to provide information to understand how the regional climate plays an important role in vector borne diseases in general and Zika virus (ZIKV) in particular. As an emerging disease a great deal of basic information on ZIKV transmission dynamics is lacking. Knowledge on other Flaviviruses such as chikungunya virus (CHIKV) and dengue virus (DENV), also transmitted by the same mosquito vectors may therefore be used to impute likely climate-related impacts

Evidence in decision-making in the context of COVID-19 in Latin America

Summary: Background: The pace of the COVID-19 pandemic poses an unprecedented challenge to the evidence-to-decision process. Latin American countries have responded to COVID-19 by introducing interventions to both mitigate the risk of infection and to treat cases. Understanding how evidence is used to inform government-level decision-making at a national scale is crucial for informing country and regional actors in ongoing response efforts. Objectives: This study was undertaken between February-May 2021 and aims to characterise the best available evidence (BAE) and assess the extent to which it was used to inform decision-making in 21 Latin American countries, in relation to pharmaceutical (PI) and non-pharmaceutical interventions (NPI) related to COVID-19, including the use of therapeutics (corticosteroids, hydroxychloroquine/chloroquine and ivermectin), facemask use in the community setting and the use of diagnostic tests as a requirement for international travel. Method: A three-phase methodology was used to; (i) characterise the BAE for each intervention using an umbrella review, (ii) identify government-level decisions for each intervention through a document review and (iii) assess the use of evidence to inform decisions using a novel adapted framework analysis. Findings: The BAE is characterized by 17 living and non-living systematic reviews as evolving, and particularly uncertain for NPIs. 107 country-level documents show variation in both content and timing of decision outcomes across intervention types, with the majority of decisions taken at a time of evidence uncertainty, with only 5 documents including BAE. Seven out of eight key indicators of an evidence-to-decision process were identified more frequently among PIs than either NPI of facemask use or testing prior to travel. Overall evidence use was reported more frequently among PIs than either NPI of facemask use or travel testing (92%, 28% and 29%, respectively). Interpretation: There are limitations in the extent to which evidence use in decision-making is reported across the Latin America region. Institutionalising this process and grounding it in existing and emerging methodologies can facilitate the rapid response in an emergency setting. Funding: No funding was sourced for this work

El Reglamento Sanitario Internacional, la enfermedad por el virus del Ébola y las enfermedades infecciosas emergentes en América Latina y el Caribe

RESUMEN La determinación por parte de la Organización Mundial de la Salud de que el brote de enfermedad por el virus del Ébola constituía un evento de salud pública de importancia internacional llevó a los países que no estaban afectados a aplicar medidas para prevenir y detectar la introducción del virus en sus territorios y para reaccionar frente a ella. El brote brindó la oportunidad de evaluar la aplicación operativa de las capacidades básicas del Reglamento Sanitario Internacional y la preparación de los sistemas de salud para hacer frente a un caso posible o confirmado de enfermedad por el virus del Ébola. Un marco rector de salud pública aplicado en los países de América Latina y el Caribe, que abarca autoevaluaciones preparatorias, visitas a los propios países y seguimiento, sugiere que esa región debe aumentar sus esfuerzos por consolidar y mantener los progresos en las capacidades básicas y en la preparación del sistema de salud para hacer frente a eventos de salud pública que tengan repercusiones a escala nacional o internacional