Border Infectious Disease Surveillance - Mosquito-borne Diseases

Background

Mosquito-borne diseases pose a risk to the California border region, as the mosquito species responsible for the spread of Zika, Chikungunya, Dengue, and West Nile Virus can be found in the area. The presence of these mosquitoes, coupled with returning travelers from areas where there is local transmission of these diseases, increases the possibility of local transmission in the border region.

Health Providers - Knowledge, Attitudes and Practices Survey

Activities

BIDS administered a survey to local providers addressing Zika, Chikungunya, Dengue, and West Nile Virus. The objective of this study was to provide a comprehensive evaluation of local providers' knowledge of these 4 arboviral infections. The information gathered will be used to create binational educational programs as well as implement physician trainings on both sides of the border. Local transmission for these diseases is different on each side of the border, therefore, it is essential to the health of both nations that providers in the area are knowledgeable about clinical presentation, diagnostic methods, and prevention measures.

Outcome

A total of 220 providers participated in the survey in 2016-2017. The responses gathered with the 24-item questionnaire helped BIDS identify gaps in knowledge of local providers regarding transmission, diagnosis, and prevention. This assessment demonstrates the need for additional provider education and training to enhance current levels of knowledge and practices as they relate to vector-borne diseases. 

Activities

BIDS implemented an enhanced surveillance project to capture possible Zika cases in residents of San Diego County seeking healthcare in Tijuana. This project is carried out in collaboration with SIMNSA healthcare facilities in Tijuana. Physicians will refer patients that meet surveillance criteria to BIDS, and testing of blood and urine specimens will be performed in San Diego. Positive cases will be reported to the appropriate officials for implementation of control and preventive measures.

Case criteria:

1.Patient presents with maculopapular rash AND any of the following: fever, joint pain, or conjunctivitis, OR

2.Patient is a suspect Guillain-Barre syndrome case, OR

3.Patient is pregnant.

Outcome

Zika enhanced surveillance will allow BIDS to identify positive cases of arboviral disease and assess the risk of Zika in San Diego County, especially in the community that seeks care across the border.