Zika Sets Off Urgent and Complex Communications Effort From CDC

Agency Puts Emergency Operation Center on Highest Level of Activity

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A blood-engorged female Aedes albopictus mosquito feeding on a human host.
A blood-engorged female Aedes albopictus mosquito feeding on a human host. Credit: CDC/ James Gathany

The Centers for Disease Control and Prevention is pushing hard to spread the word about Zika, the first new cause of birth defects identified by the CDC in 50 years and the first time ever that the cause has been spread by mosquitos.

CDC communications professionals are working side-by-side with scientists and emergency responders as the Zika hazard grows. And even though the agency still has to protect against all other hazards, anyone who can spare time from their normal duties is helping through the CDC's Emergency Operations Center.

The center is running at its highest state of activity, Level 1, under which the CDC says it assigns the most staff possible to work around the clock. It is the fourth Level 1, following the Ebola outbreak in 2014, the H1N1 outbreak in 2009 and Hurrican Katrina in 2005.

The work is complicated by the multiple fronts on which Zika transmission must be fought, apathy among those who don't feel at risk and a still-evolving understanding of the threat.

"This is probably one of the most complex communication responses the CDC has ever faced," said Katherine Lyon Daniel, associate director for communication at the Atlanta-based government agency.

"We know we can't stop every mosquito from coming here, and we know this is a terrible outcome, so we feel we have to do everything we can to be as ready as we can be," she added, calling Zika a "global crisis" that can potentially affect tens of thousands of babies.

There were 820 reported cases of Zika infection in the U.S. as of June 22.

To reach health professionals around the country, the CDC is hosting thousands of clinician calls where doctors and nurses can learn how to answer patient questions substantively and in an understandable manner.

It is sending messages through its Health Alert Network, or HAN, to its priority recipient list, which includes about 1,200 public information officers, health practitioners from the federal to local level, clinicians and public health laboratories. All HAN messages are also distributed through the CDC's Clinician Outreach and Communication Activity listserv of 36,500 subscribers and 155 partner organizations, posted on CDC.gov and Facebook, and distributed via GovDelivery to HAN professional and media partners and individual subscribers.

But the agency is emphasizing the media as well. That's partly just another route to medical professionals. "We know physicians and clinicians are people too and they also consume the news, so that's one way were trying to get out the correct information," Ms. Lyon Daniel said.

It can also provide a more direct line to people concerned about the virus. The CDC's communication team is reaching out to mommy bloggers with suggested talking points for their audiences.

The organization recently created a Spanish-language PSA about Zika for Puerto Rico, which will run in movie theaters, on the radio and on social media.

On Facebook and Twitter, the CDC has been regularly posting relevant Zika-related infographics, videos and podcasts, focusing on vacation and travel themes as summer got underway. A post last week urged people to protect themselves if they are going to the Summer Olympics in Rio.

And the CDC website separates Zika information into sections for specific audiences, such as pregnant women or healthcare providers.

Because partner organizations are key to getting the word out to both health professionals and the general public, the CDC has also been working with the American Congress of Obstetricians and Gynecologists around Zika.

And the agency has hired Abt Associatates to help with productions, marketing and communcations.

Part of the challenge is "getting people prepared for something they're not really worried about yet," Ms. Lyon Daniel said, citing those who are neither pregnant nor thinking about having children soon, she said.

There's also still plenty of uncertainty about the virus itself. "We're sharing all the information we have as quickly as we can, but things will change and people's personal risk may be uncertain," she said.

And Zika's many facets, including sexual transmission and travel, complicates matters further.

The CDC is trying to get people to act now when possible, which means not leaving sitting water outside that could attract mosquitos and wearing insect repellent for three weeks after returning from countries with Zika to prevent mosquitos from spreading it in the U.S.

"We're trying to drive behavior change in a way we haven't tried to communicate before," said Ms. Lyon Daniel.

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