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AAP National Conference: CDC official: Preparation key to lowering toll of outbreaks :

October 25, 2016

Over the course of a year, Zika virus went from near obscurity to making front page headlines as it moved closer to home and the risks became clearer.

While trying to keep up with the evolving research may seem overwhelming, pediatricians have a key role to play in preparing their practices and communities for Zika and other emerging diseases, said Eric Dziuban, M.D., D.T.M., FAAP, team lead of the Centers for Disease Control and Prevention’s (CDC’s) Children’s Preparedness Unit.

“The reality is that your position on the front lines of children’s health guarantees that you will be playing a role in these events whether you have prepared for it or not,” he said.

In his plenary address “Preparing for Emerging Infectious Disease Outbreaks: Zika and More,” Dr. Dziuban provided pediatricians with steps they can take.

Eric Dziuban, M.D., D.T.M., FAAP discusses pediatricians’ role in preparing for emerging infectious diseases like Zika virus.Eric Dziuban, M.D., D.T.M., FAAP discusses pediatricians’ role in preparing for emerging infectious diseases like Zika virus.

Early preparation for public health emergencies is key, he said. When working in a pediatric HIV clinic in the African country Swaziland he saw firsthand the danger of trying to ignore a disease in the hope that it wasn’t real.

“They will happen and they will hurt us, even if we choose to ignore them until we can see them in front of us,” Dr. Dziuban said. “In fact, the damage will be more severe if we wait until it’s already happening, already evident.”

When making plans, public health officials and doctors alike must account for the unique needs of children, including their metabolic and respiratory rates and common behaviors like putting their hands on the ground and in their mouths, all of which can make them more susceptible to toxins.

“The reality is an outbreak that spreads from person to person will find an easy path in our children’s day-to-day lives,” Dr. Dziuban said.

Preparations for emerging diseases need to include medical countermeasures for children like appropriately sized medical equipment and weight-based medicine dosing and formulations. Health officials and physicians also must take children into account when implementing infection control measures such as whether a parent can be in a room with an infected child.

“We cannot wait until the patients are in front of us needing split-second decisions,” Dr. Dziuban said.

Planning should happen on the national, state and local levels. Pediatricians can watch for unusual trends in their practice and form partnerships with schools and other children’s advocates in the community. They can provide education on basic infection control and participate in local disaster coalitions. The CDC and Academy recently held a tabletop exercise in which pediatricians and public health experts simulated a smallpox outbreak (

“Like vaccines and anticipatory guidance and just prevention efforts in general, our successes are not going be judged by events that are witnessed but by ones that are avoided,” Dr. Dziuban said. “It’s truly worth the investment.”

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