Zika Virus Outbreak in Miami, Florida Case Study Read the following case

Zika Virus Outbreak in Miami, Florida
Case Study
Read the following case study. You will be assigned to a stakeholder group from one of the groups below and you will need to defend your stakeholder position on how to prevent the spread of Zika Virus in Miami, FL. For this assignment, you will write a letter to the Florida Governor. You will then orally defend your position in a mock state health department meeting open to the public.
Stakeholder groups are:
· Expectant parent living in Miami – you are fearful of Zika for your unborn child
· Aerial Spraying Company – advocating aerial spraying of pesticides
· Oxitec Scientist – developed a Genetically Modified Mosquito that kills mosquito offspring
· Lead Scientist for Florida Public Health Department – you have a fixed budget and high level of concern with in the public. Many are very concerned with Zika and want to see “something” done.
Zika History
In July of 2016, the Centers of Disease Control and Prevention (CDC) was informed by the State of Florida that there were four confirmed Zika virus cases in the city of Miami. These cases were likely the first known cases of local mosquito borne Zika virus transmission in the continental United States (CDC, 2016).
Zika virus was first identified in Uganda in the 1940s (WMP, 2019). It is a mosquito-borne virus that can be transmitted to humans and other animals. First seen in monkeys, it was later identified in humans in the 1950s. Small, rare outbreaks of Zika viruses have been recorded since the 1960s, but the first, large scale outbreak was recorded in 2013 in French Polynesia and other countries and territories in the Pacific (WHO, 2018). This was followed by the most well-known outbreak of the disease in Brazil, 2015.
Zika Health Implications
The incubation period of Zika virus is estimated to be between 3 and 14 days. Many people with Zika are asymptomatic, but when signs of infection do occur, symptoms are generally mild and can last for 2 to 7 days. (WHO, 2018) Many people who feel ill may confuse the Zika virus symptoms with a common cold or flu. Zika virus is spread through mosquito bites but can also be transmitted from mother to fetus during pregnancy, through sexual contact, transfusion of blood and blood products, and organ transplantation (CDC, 2016).
There are several species of mosquitoes that serve as vectors for diseases that can harm human health. The primary species of mosquito that is responsible for transmitting Zika, and other viruses, is Aedes Aegypti. Aedes Aegypti originates from Africa but is now found globally across tropical and subtropical regions. (WMP, 2019) With the advance of climate change, their range is spreading poleward into areas that they could not survive before. They reside predominantly indoors and primarily around people. In fact, they are one of the few species of mosquito that prefers humans and Aedes Aegypti bites both day and night. Aedes Aegypti is also very skittish, they fly off at the slightest hint of danger. Many who are bitten do not know they are bitten until later when an itchy welt forms. The Aedes Aegypti mosquito also loves human trash where there are often pockets of water. Mosquitoes can lay eggs in something as small as a bottle cap. Only the female mosquito will bite humans for blood, to aid in egg production, therefore only females can transmit viruses. Mosquitos do not inherently carry viruses and must become exposed by feeding off an infected human first. (WMP, 2019)
In pregnant women, there are many health complications for the developing fetus that can arise if a mother contracts the Zika virus. Zika virus infection during pregnancy can result in complications such as fetal loss, stillbirth, or preterm birth. Additionally, Zika can cause microcephaly where the head circumference is smaller than normal resulting in severe loss of cognitive function. There are also other congenital abnormalities such as damage to the back of the eye, congenital contractures (permanent shortening of the muscles or tendons), and hypertonia (tightening of muscles) restricting body movement after birth. Zika virus is also a known trigger for Guillain-Barré Syndrome, neuropathy (nerve damage), and myelitis (spinal cord inflammation) in older children and adults. (CDC, 2019a)
The highest risk of birth defects contracted from Zika occurs in the first trimester of pregnancy. Approximately 5-10% of babies will experience birth defects if a woman is confirmed with a Zika virus infection (CDC, 2019b). While this number may seem small, it may be an underestimation due to the fact that some women do not experience symptoms and may become pregnant while experiencing asymptomatic infection. Additionally, babies may not exhibit possible birth defects right away, and may be require monitoring during their development if they were exposed to Zika virus.
Aerial Spraying
Aerial spraying uses larvicides and adulticides reduce mosquito populations, which can help reduce the likelihood of becoming infected with the Zika virus. Larvicides will kill larvae after hatching from eggs, while adulticides kill adult mosquitos. Airplanes will spray low volumes of either chemical in areas with large mosquito populations or in areas where mosquito borne pathogens are spreading. (CDC, 2017)
Aerial spraying is most effective when used as part of an integrated mosquito control program, especially in conjunction with eliminating habitats (eg. trash, old tires, water sources) and creating structural barriers to prevent mosquito population growth (CDC, 2018). Aerial spraying can quickly reduce the number of mosquitos in a large area. Insecticides and larvicides are chosen by state and local officials and must be EPA-registered. The EPA has done extensive studies on the toxicity levels in humans and has determined a list of insecticides and larvicides that are safe to use, in areas with humans, due to the low amount used. (CDC, 2018) Additionally, aerial spraying should have no negative effects on the environment. When applied correctly, it does not contaminate soil or water. One drawback is the effectiveness for Aedes Aegypti is not particularly high since they are often inside or under cover and therefore protected from the spray.
Genetically Modified Mosquitoes
Oxitec has developed a genetically modified mosquito that helps control mosquito populations by passing on a genetic trait that is lethal to the offspring. This prevention method is considered to be safer than aerial spraying because no chemicals are released into the environment that could potentially impact human health (Rasgon, 2018). However, there has been some backlash over concerns with unintended consequences of releasing genetically modified mosquitoes.
Critics fear that these genetically modified mosquitoes could have adverse effects on the environment (Stein, 2019). By drastically reducing the Aedes Aegypti species, it can lead to negative effects in crop growth by removing important pollinators and it can potentially pave the way for other mosquito species to “step up” as disease carrying vectors once Aedes Aegypti has been eliminated. A counterpoint is that the Aedes Aegypti is not native to the United States, spreads several human diseases and the GM mosquito appears to be very effective at reducing the mosquito population. (Campbell, 2012)
Smart Mosquito Bite Protection Programs
Mosquito Bite Protection Programs have been put in place to inform the general population on the best way to prevent mosquito bites. Most programs center around the use of insect repellant (eg. DEET) that has been registered by the EPA and following the product label instructions when applying it. The appropriate method of applying mosquito repellent is on bare skin or clothing, and it is recommended that any lotions or sun blocks are administered first before applying insect repellent (CDC, 2015). Additionally, it is recommended that individuals cover their skin with long-sleeved shirts and long pants when they can and treat clothing with repellent since mosquitoes can bite through thin fabric.
Insect repellant should contain the active ingredients of DEET, Picaridin, Para-menthane-diol, lemon eucalyptus oil or IR3535 (CDC, 2015). These ingredients have been tested and registered by the EPA. Many “natural” insect repellants have not been evaluated by the EPA and so the effectiveness of other products is unknown. Unregistered insect repellents may have ingredients such as citronella oil, cedar oil, geranium oil, peppermint/peppermint oil, pure lemon eucalyptus oil, or soybean oil.
The Paper Assignment:
You are to write a 2-3 page letter (Times New Roman 12 point font, double spaced, 1 inch margins), to the Governor of Florida, detailing the intervention you would advocate relative to your stakeholder perspective. You can take whatever position you desire with your stakeholder perspective but you need to defend it with three distinct evidence based points. The first paragraph will introduce you and your position (you can be creative here and even make up a character). The next 3 paragraphs will each make a separate and distinct point that backs up your position in the first paragraph. You must justify your point with fact/science (not just an emotional plea). The last paragraph will contain your summary and your recommendations to the Governor on what actions you think s/he should take. The quality and clarity of your three talking points along with proper grammar, sentence and paragraph structure and spelling will be assessed for grading purposes. The paper requires at least three (3) mainstream references. Mainstream means a peer reviewed science journal, government agency, an article in a major magazine or newspaper, a science based advocacy group or information posted by industry. You may use a separate page for your citations that will not count against your page count or you can use footnotes but you must follow APA citation style. http://libguides.gwu.edu/content.php?pid=8881&sid=57324.
Below are some links you may find helpful to get started though you are certainly not limited to these links. Anti-plagiarism software will be used so be sure all work is your own. Do not cut and paste sentences from the internet.
· American Council on Science and Health, Time To Embrace Genetically Modified Mosquitoes To End Their Disease Transmission, Aug 2018. Downloaded at: https://www.acsh.org/news/2018/08/20/time-embrace-genetically-modified-mosquitoes-end-their-disease-transmission-13329
· CDC, Zika Virus and Aerial Spraying, Oct 2018. Downloaded at: https://www.cdc.gov/zika/vector/aerial-spraying.html
· Genetic Literacy Project, Authors of Controversial Study That Raised Alarms About Oxitecs Gmo Mosquito Release In Brazil Call For Papers Retraction, Sep 2019. Downloaded at: https://geneticliteracyproject.org/2019/09/26/6-authors-of-controversial-study-that-raised-alarms-about-oxitecs-gmo-mosquito-release-in-brazil-call-for-papers-retraction/

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