Zika Virus and Emerging Mosquito-Borne Diseases: The European Emergency Risk Communication Challenge

This manual and the associated app are designed to assist public health authorities in the World Health Organization (WHO) European Region communicate in response to possible outbreaks of the Zika virus and other mosquito-borne diseases (MBDs). Countries in the Region are diverse, and the Zika/MBD outbreaks they may face could vary in size, complexity, cultural context, socioeconomic reality, and preparedness and response capacity. As a result, the guide cannot offer a "one-size-fits-all" solution. It does, however, offer practical ideas and options for countries as they reinforce their preparedness and communicate about Zika/MBDs.

Produced in follow-up to the WHO Regional Technical Consultation on Zika virus, held in Portugal in June 2016, the guide takes a closer look at recent experience from the Americas and illustrates how this can inform countries in Europe on risk communication preparedness and response to Zika. This guide also aims to support countries in the strengthening of their national risk communication preparedness and response to MBDs in general.

Following interviews with key experts across Europe, this guide seeks to address three sets of challenges identified at the above-mentioned meeting, which are explored in an opening section of the report on "Lessons learned and gaps: How this guide can help":

• Challenge 1: Will Zika and related complications be an issue in my country? Due to competing priorities, European countries struggle with the following issues as they relate to Zika preparedness and response planning: low urgency and lack of planning, lack of political buy-in, limited resources available, low public risk perception, and lack of advice on sexual and reproductive health.
• Challenge 2: Managing and communicating uncertainty related to Zika makes it a challenge to: establish and maintain trust, determine risk and appropriate prevention measures, and convey consistent public health messages.
• Challenge 3: Low risk perception may be due to a host of factors, some of which are: lack of direct experience and knowledge of the disease as well as the knowledge, attitudes and practices (KAP) within the affected community that could be barriers to infection control; lack of effort in raising awareness, which include key prevention measures so those affected know how to protect themselves; and limited access to resources in order to increase awareness and raising the profile of Zika through various channels.

The resource continues with:

Part 1: What to expect - the complex communication challenges of Zika/MBD outbreaks

1.1 Zika virus and the threat to Europe - the basics
• 1.1.1 What we know, what we don't know and how to keep up-to-date
• 1.1.2 The threat of a Zika outbreak in Europe
• 1.1.3 Emergency risk communication (ERC)
• 1.1.4 Some questions to expect during a Zika outbreak
• 1.1.5 Other MBD threats to Europe
• 1.2 ERC - the basics
• 1.3 ERC - the challenges posed by Zika
  • 1.3.1 Challenge 1: Uncertainty and how to manage it
  • 1.3.2 Challenge 2: Different segments of a population may react differently
  • 1.3.3 Challenge 3: Vaccines, sex, insecticide and other difficult issues
  • 1.3.4 Challenge 4: Vulnerable populations - engaging communities
• 1.4 Key steps in community engagement
• 1.5 Challenges with outbreaks of dengue or chikungunya
• 1.6 Sample draft questionnaire

Part 2: Building a Zika/MBD emergency risk communication plan

• 2.1 National ERC plans and how they relate to Zika preparedness
  • 2.1.1 Preparation phase
  • 2.1.2 Initial response
  • 2.1.3 Crisis response and control
  • 2.1.4 Recovery and evaluation
• 2.2 Recognizing early signs of a potential Zika emergency

Checklist - Are you ready for a Zika outbreak?

An app has been developed in parallel with this guide. Its focus is on the tools, checklists, and surveys presented in the document. Interactive and easily accessible, such a tool is designed to guide those working on the frontlines of the response at country level.