While there have been reports of an increase in concerning health effects (e.g., congenital microcephaly and Guillain-Barré syndrome) concurrent with the ongoing Zika virus outbreak, we do not currently have systematic data on risk factors for severe Zika virus disease. There are also few published data on infections in individuals with conditions that could compromise their immune response, including HIV, and outcomes vary. For more information, please visit cdc.gov/zika/hc-providers/hiv-zika.html. We do know that for West Nile virus, a related flavivirus, immunosuppression does appear to be a risk factor for more severe disease. Similarly, serious adverse events are more likely following administration of live yellow fever vaccine, which is also a related flavivirus. However, we do not know whether Zika virus would pose a similar risk in immunosuppressed patients.
Unlike West Nile virus which is normally transmitted between birds and mosquitoes, Zika virus is transmitted between humans and mosquitoes. Birds are not known to be a part of the transmission cycle and there is no expected impact on water fowl.
No. More research and funding is needed in this area.
One of the primary methods used for vector control for Zika virus is the spraying of insecticides to eliminate. It should be said that the authority to decide and initiate any manner of vector control resides with the Tribes. Once a decision has been made to undertake vector control efforts (which includes spraying insecticides to kill the Aedes aegypti and the Aedes albopictus mosquitoes that are known to carry and transmit the Zika virus), the responsibility could lay with a number of different entities. The Indian Health Service, Division of Environmental Health Services, has a vector control and communicable disease program that has maintains responsibility for disease prevention on Tribal lands. According to the IHS website, “[n]ationally, concerns regarding West Nile virus, Hantavirus, Zika virus, H1N1, and many other environmental health issues, illustrate the complex environment where humans reside. In some instances the infectious organisms remain unnoticed until a noticeable amount of disease presents itself. DEHS [Division of Environmental Health Services] funding is used to prevent and control environmental health risks that contribute to disease.”* If the Tribe has contracted or compacted its environmental health services, then it will be the responsibility of the Tribe to conduct vector control activities. If the land in question is on national park lands, then the it is the responsibility of the National Park Service to conduct vector control activities (under the auspice of their own insecticide use policy which states that the National Park Service will not use insecticides without a provide public health necessity). Any federal entity that undertakes vector control activities on or near Tribal lands are required to consult with Tribes within the area first.
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