Central America and the Caribbean Region's United Front to Fight Zika is a Winning Formula

Central America’s landscape and ease of movement from one country to another presents many opportunities for travel and trade, but it can also pose serious public health challenges when an outbreak occurs. “If there’s an outbreak in Guatemala, it is likely that an outbreak is soon to follow in Honduras or El Salvador,” said Luis Hernandez, a DGHP emergency management specialist in Central America, a region hard hit by the Zika virus outbreak.

Therefore, it was no surprise that Zika in El Salvador and Guatemala soon spread to other countries in the area and required a regional outbreak response. More than 3,000 trainees and graduates from the Central America Field Epidemiology Training Program (CA-FETP), which extends to seven countries in Central America, the Dominican Republic and Haiti, were mobilized to respond to the outbreak. Working with the ministries of health and other partners, the disease detectives are hard at work. El Salvador and Belize have both made participating in Zika virus investigations a requirement for their intermediate-level CA-FETP trainees. These trainees are collecting data that is being used to guide decision-making throughout the region.

The CA-FETP has a long history in Central America with nearly 4,000 graduates from three levels of training (basic, intermediate, and advanced) who continue to work in local public health, making it easier to reach everyone who might be at risk. The region also has established systems to monitor selected diseases. For Zika virus, CA-FETP expanded surveillance to additional sites, including areas where the mosquito population was unknown. Successful prevention against Zika virus requires controlling the Aedes aegypti and Aedes albopictus, the mosquitoes that spread the virus. Controlling these types of mosquitoes would also reduce the spread of dengue and chikungunya. With more to be known about the effects of the virus on unborn babies, CA-FETP prioritized following up with pregnant women potentially infected with Zika virus.

CA-FETP trainees and residents have strong community ties and their training builds the skills and relationships required to become trusted sources of information for the communities they serve. Mosquito control requires strong community participation to remove standing water habitats where mosquitoes lay eggs, which includes some unexpected places, such as flower vases left at cemeteries and car tires stacked on the side of the road. With Zika virus linked to microcephaly and other birth defects, CA-FETP communication outreach efforts continue to stress the importance of pregnant women and women of childbearing age to use repellants and bed nets to protect themselves and their families from getting infected with Zika virus.

Beyond Zika virus control, CA-FETP is improving the capacity of partners in Central America to more quickly detect and respond to public health emergencies, making it more likely that countries in the region can control outbreaks close to their source, regardless of how they spread or where they start.