The Importance of Risk Communication Plans During Zika Virus Outbreak

Introduction

Risk communication is the sharing of ideas and knowledge between two parties about the nature, purpose and control of the risk. Risk communication in public health means the involvement of audience and responding to the question and concern as well as providing the important public health messages. Risk communication assists the public in making decision about the risk relieve measures and also helps in improving the public knowledge of potential and actual health threats.

The outbreak of Zika virus was first reported in Africa and Asia in 2007. Later on, there was the large outbreak in pacific Island in between 2013 and 2015 and in America Zika virus is still ongoing. In the South Asian countries like Thailand and Indonesia, there is the evidence of cases of Zika virus have been presents at the low levels for several years. This paper investigates the risk communication plans against Zika virus.

Zika virus

Zika virus is the mosquito-borne flavivirus which is affected by the virus transmitted originally by the Aedes mosquitoes. This mosquito usually bites during the day time, mainly during early morning and late afternoon/ evening. The same mosquitoes can also cause the yellow fever, dengue and chikungunya. Zika virus can be transferred through mother to the fetus during the pregnancy resulting in microcephaly, through sexual contacts, transmission of blood and blood products, organ transplantation and has been also detected in semen, urine, amniotic fluid, saliva along with the body fluid found in brain and the spinal cord.

Signs and symptoms

It normally takes 3 to 12 days to appear symptoms once the person is infected by the Zika virus. Person infected by Zika virus may feels symptoms similar to flu like, fever, skin rashes, muscles ach, and joint pain, headache especially back of the eyes, conjunctivitis, weakness and lack of energy. These symptoms just last for few days so must people undergo with mild infection without any difficulties. However, it is generally accepted that, Zika virus is transfer from mother to their unborn babies resulting in small head and brain size known as Microcephaly. Scientist has proved that, Zika virus can induce the paralysis condition called Guillain- Barre Syndrome, which can be also caused by other viruses and bacteria.

Vulnerable group

The women infected by the Zika virus during pregnancy are consociated with the birth defect and unsympathetic pregnancy outcomes, so we can say that the women during the pregnancy are highly considered as vulnerable population group with additional needs. Zika virus is the key cause for the complications during the pregnancy which leads to miscarriage, stillbirth, fetal birth and preterm birth.

Social factors

Social factors as well as environmental factors contribute in upgrading the emergence of the Zika virus. For example abundant people are exposing to the high density of infected mosquito due to the social change during and after the natural disaster. In addition, due to the earthquake that struck the Manabí province in April 2016, leads to the destruction of infrastructure, contaminated the source of water and compelled people to leave outdoor resulting in increased local Zika virus transmission and also increases the rate of human contact with infected mosquitoes. Similarly, people living in the poor urban area with inadequate sanitation, water access and infrastructure are susceptible for Zika virus.

Protection and prevention

The main solution for the prevention of Zika virus infection is to protect against the mosquito bite during the day and evening time, especially attention is given to pregnant women, women of reproductive age and young children. For the personal protection people should were the clothes that cover the body part which is exposure to mosquito bite as much as they can and use of physical barrier such as closing the windows and door, apply the insect protector creams to skin. Young children should always sleep under the mosquito net if sleeping during the day and evening time. Aedes mosquito mostly breads in the small collection of water around home, school, and worksite, so the water storage container should always be covered and the surrounding area always need to keep clean and smells free. People should be updated with the information regularly to encourage the individual consistent of behavioral change and reduce the chance of confusion and panic.

Risk communication

Communication has become as essential to outbreak control as epidemiological training and laboratory analysis. WHO and CDC have developed outbreak communication guide manuals that provide an evidence-based framework and best practices to communicate on behalf of an organization responding to public health emergencies.

The CDC crisis and emergency risk-communication manual state six principles of effective emergency and risk communications, which include being first, being right, being credible, expressing empathy, promoting action and showing respect. The manual also helps to ensure that limited resources to be managed well and to do the best at every phase of an emergency response.

Credibility refers to Honesty and truthfulness during crises. The key principle of outbreak communication is to communicate in ways that build, maintain or restore trust between the public and outbreak managers. Without this trust, the public will not believe or act on, the health information that is communicated by health authorities during an outbreak.

Announcing information early or being first is also an important principle which prevents rumors and misinformation. For members of the public, Communicating information quickly is crucial because crises are time-sensitive and the first source of information often becomes the preferred source. The accuracy or being right establishes credibility. Information in communicating risk can include what is known, what is not known, and what is being done to fill in the gaps. WHO also recommends ongoing transparency for maintaining the public’s trust throughout an outbreak including timely and complete information.

Expressing empathy is also one of the risk communication principles. Suffering during emergencies should be acknowledged in words. Addressing what people are feeling, and the challenges they face builds trust and rapport. Align with this respectful communication is particularly important when people feel vulnerable to promote cooperation and rapport.

Emergency risk communication is increasingly recognized as significant for preparing for and responding to public health emergencies which is evidenced by its inclusion as one of the International Health Regulations’ 8 core capacities needed by World Health Organization (WHO) member states to strengthen national and global systems for detecting and responding to public health threats.

Every emergency, disaster, or crisis evolves in different phases. Therefore risk communication efforts and priorities should align with these phases, and communicators need to adapt and respond according to each phase with specific types of information need to be created.

According to CDC manual for risk communication, the emergency risk communication process evolve through four phases in every emergency. Which are namely preparation, initial, maintenance and resolution (recovery). During preparation phase the risk communication process involves activities such as developing partnerships and building relationships with organizations and community stakeholders, drafting and testing messages with different populations, creating risk communication plans, Select and train spokespersons and engaging communities in preparedness planning.

Risk communication during Initial phase of emergency involves expressing empathy, providing simple explanations of risk, promoting action and establishing organization’s credibility. A study conducted to explore risk communication experiences in post- Ebola outbreak in Liberia stated that during the outbreak intervention, the country incident management system coordinate various risk communication approaches including risk assessment, understanding community risk perception, advocacy meetings, targeted community engagements, inter-personal communication and media engagements to seek communities’ support and participation in the response. The study also described that risk communication increased the level of trust in the health system contrary to the perceptions exhibited during Ebola outbreak.

On maintenance phase communication includes ensuring if community understands ongoing risks and actions they can take to reduce risk or harm, providing more background information, segmenting audiences, encouraging public support and cooperation with a response and recovery efforts and addressing misunderstandings, rumors, and unclear facts. A qualitative study conducted to explore residents’ beliefs and perceptions about the Nipah virus and prevention messages during an outbreak in Bangladesh found that the residents initially believed that the outbreak was caused by supernatural forces and continued drinking raw sap despite messages from local health authorities to stop because of the initial messages did not explain that bats were the source of this virus. After interactive communication strategy using local language participants responded that they understood how NIV could be transmitted and would abstain from raw sap consumption and maintain safer behaviors while caring for patients.

Another study done to describe risk and outbreak communication for post severe acute respiratory syndrome (SARS) in Taiwan shows that the risk communication system in the city was well-established and a closer relationship with the media has been developed according to the WHO principles of effective risk communication. In the resolution phase, risk communication activities include motivating people to take action or remain vigilant, Promoting community preparedness for possible future crises, a discussion between organization and partners, documenting, sharing lessons learned from the response and evaluating communication plans. The reporting and documenting final activities will be used as an input for future emergency responses.

Conclusion

The main aim of risk communication is to address the detail knowledge, ideas, possible outcomes and remedies to the public about an outbreak of the different communicable, infectious and epidemic disease. There should be understanding, transparency and trust between both the public and the health workers or advisors. Planning for the risk communication is not only the main concern but also should be aware about the possible drawbacks along with reliable backup plans.

Effective health communication programs identify and prioritize audience segments, deliver accurately, scientifically based messages from credible sources and reach audiences through familiar channels. Also, emergency communication messages for the public and affected communities during an emergency should aim to educate, save lives, and reduce risks. Therefore, health communications have a great impact on the public to prepare for and respond to a health threat by recommending protective behaviors.