We describe and discuss the rationale, design and current implementation of a model for an integrated intervention for the primary and secondary prevention of Zika and other Aedes-borne diseases and sexually transmitted infections that impact reproductive health, pregnancy and perinatal life stages in women and their families in Merida, Mexico. The intervention includes enhanced surveillance of pregnant women, implementation of communication strategies to promote good practices to prevent disease transmission, determination of the frequency of structural anomalies detected prenatally in the foetus, umbilical cord and placenta of pregnancies diagnosed with ZIK infection, detection of ZIKV and other arboviruses/viruses in products of abortion, in-utero and early newborn, provision of Aedes aegypti-proof houses? (protecting homes with door/window screens with insecticide to prevent the access of mosquitoes), mosquito repellents, larvicides and education/promotion of best practices for the prevention of infection with dengue (DENV), chikungunya (CHIKV) and Zika (ZIKV) and an anthropological studies on sociocultural factors of pregnant women associated with ZIKV. This intervention is being developed in a population of 10,000 people of the city of Merida and with the participation of a multidisciplinary group of public health professionals in collaboration with the Ministry of Health and the Government of Yucatan.
Part of the book: Current Topics in Zika
Innovative control tools for the dengue, chikungunya and Zika vector Aedes aegypti, such as genetically modified mosquitoes and biological control and manipulation with the bacteria Wolbachia, are now becoming available and their incorporation into institutional vector control programs is imminent. The objective of this chapter is to examine the technical and organizational mechanisms together with the necessary processes for their introduction and implementation, as well as the indispensable indicators to measure their entomological effect on vector populations and their epidemiological impact in the short, medium and long term as part of an integrated vector management approach.
Part of the book: Dengue Fever
Dengue, Chikungunya and Zika are arboviruses transmitted by Ae. aegypti with significant public health impact. In the first trimester of 2015, autochthonous Zika transmission was reported in Mexico. The state of Yucatan is an endemic region where pregnant women with acute infection and related congenital abnormalities in fetus and newborns were observed. We describe results from a cohort of pregnant women and their babies followed up in Yucatan during the first Zika transmission outbreak (2016–2018). Clinical manifestations of acute ZIKV infection, persistence of viral RNA in pregnant women, as well as congenital abnormalities were observed. In addition, we describe the phenotype of newborns from confirmed or suspected ZIKV prenatal infection.
Part of the book: Current Concepts in Zika Research