The role of The Federal Emergency Management Agency (FEMA) in post-disaster financial assistance for local governments facing budgetary constraints in Eastern North Carolina

Natural disasters such as hurricanes increase mosquito abundance as large amounts of rainfall, flooding, and standing water provide mosquito oviposition sites and facilitate population growth. Many mosquito species associated with flooding in North Carolina can potentially transmit pathogens such as West Nile virus and Eastern equine encephalitis virus. Hurricane Irene impacted Eastern North Carolina from August 26 until August 28, 2011 and resulted in drastic increases in mosquito abundance. In the past, many regions in NC received state financial support for arbovirus surveillance and mosquito control. Recent federal and state budget cuts have resulted in reductions in mosquito programs across North Carolina.

Consequently, many North Carolina counties now rely solely on funding from The Federal Emergency Management Agency (FEMA) for mosquito control following disasters such as Hurricane Irene that devastated Eastern North Carolina. This emergency funding is critical for short-term suppression of potential vector populations; however, funding is also needed to support continuous arbovirus surveillance for regional programs. In the current study, we examine the role of FEMA in mosquito control for local governments facing budgetary constraints. We discuss the extent to which federal funding has impacted mosquito control and arbovirus surveillance in eastern NC. Implications of reliance on reactive post-disaster assistance rather than preventive strategies will also be discussed.

The Fight Against Bed Bugs [POSTER]

A study was conducted to consider whether the knowledge base of East Carolina University students would be sufficient to provide identification and proper control of bud bugs, or if a more formal educational curriculum should be established to better protect the area, staff, and students from a potential infestation. The survey was completed voluntarily by 1837 students. Despite widespread media coverage of bed bugs in major department stores, homes and institutions in 2010, the study showed that students have a limited scope of bed bug knowledge. Approximately 40% of respondents believed that a bed bug would be the size of a dime, and over 60% considered that in the event of an infestation they would choose to use a bug “bomb” every night until the issue subsided. The study has shown that students lack knowledge in the identification, prevention, and mitigation techniques that would be used in defending the campus against future bed bug infestations. A formal educational approach for incoming students may provide a more adequately prepared East Carolina University population against the rise of bed bugs in the area.

Vector Control for Public Health in North Carolina

In the 1970s the North Carolina Department of Environment and Natural Resources (NCDENR) formed the NC Public Health Pest Management (NCPHPM) division to assist community vector control programs. The NCPHPM in its leadership role has been actively involved in training and support for vector control programs across NC. However, NCPHPM was disbanded in July 2011 due to state budget cuts. Many local agencies that rely on state funds to carry out their vector control programs may also experience budget cutbacks. The impact of these budget shortfalls on services provided by vector control programs is still largely unknown. The objectives of this study are to: 1) assess the current status of vector control programs in NC, 2) evaluate the extent to which the status of local programs may be related to vector borne disease incidence and public health, 3) determine the impacts of losing the NCPHPM division to vector control programs in NC. The results of this study are expected to assess the current status of vector borne disease surveillance in NC that will inform the legislature about the implications of budget cuts to public health. The implications of our findings to public health risk assessment strategies will be discussed.

Bed Bugs, A Re-emerging Public Health Challenge

As with other major cities in North America, Toronto continues to experience an increase in bed bug infestations and the most vulnerable populations in Toronto continue to be the most seriously impacted by these infestations. Divisions within the City and community agencies in Toronto have responded to this re-emerging pest by developing partnerships, maximizing existing programs, and diverting resources from other funded programs. Bed bug control strategies can include both chemical and non-chemical approaches, but non-chemical techniques alone cannot effectively control or eliminate established infestations. The integrated pest management (IPM) approach is viewed as the best practice for most bed bug infestations today. This involves the application of both non-chemical and chemical techniques with an emphasis on those methods and products that will have the least impact on human health and the environment. Non-chemical controls include the use of vacuuming, steam cleaning, controlling indoor temperatures and exclusion strategies. Chemical approaches in Canada are restricted to synthetic pyrethroids which are available in liquid or powder forms.

Toronto Public Health continues to respond to request for service regarding bed bugs. The response includes amongst others, providing advice , bed bug identification services, providing inspection services in problematic cases, conducting education/ outreach sessions, liaising with landlords and coordinating extreme clean events and future case management for vulnerable clients.

Rocky Mountain Spotted Fever - Dog Population Survey and Prevention Efforts

A dog population survey was conducted on two southwestern reservations to determine the number of dogs and identify how specific factors among the dog population are contributing to the spread of Rocky Mountain spotted fever (RMSF).  The tick responsible for transmission of RMSF in the southwest is the brown dog tick, which is found on dogs and around homes.  A large population of free-roaming dogs combined with a widespread infestation of ticks on reservation lands has adversely impacted the health status of tribal members.  Dogs bring ticks in close contact with people, and free roaming and stray dogs are contributing to the extensive distribution of ticks in homes and yards.  The survey found that the number of dogs per household was comparable to the national average, however results revealed there was a greater percentage of free roaming dogs on the reservations.  The presentation will describe how information gathered from the dog population survey is assisting health officials to improve control measures and reduce the risk of RMSF.

Where Have All The Vector Programs Gone?

For decades, state and local public health agencies throughout the United States have experienced a steady loss of vector and pest control programs and capacity.  The ongoing economic crisis that began in 2008 has greatly expedited these losses with several states and many local public health agencies eliminating their vector control programs in entirety.  However, even when vector control programs or activities have been reduced or eliminated, environmental health programs are usually expected to respond to and mitigate vector or public health pest problems within the local community.

This presentation will discuss potential health impacts from the loss of vector and pest control programs and capacity throughout the country.  The presentation will also present activities that have been implemented by the CDC National Center for Environmental Health to provide the environmental health workforce with the knowledge and skills needed to effectively reduce health threats from disease vectors and public health pests.

Prevalence, Knowledge, and Concern about Bed Bugs [POSTER]

Recent research suggests that the United States and the world are on the verge of a bed bug pandemic. Physical and psychological injuries result from not only the infestation but also from the misuse of pesticides to treat the bed bugs. Assumptions have been made that socioeconomic status (SES) is not an indicator of bed bug infestations. However, little information is available at the local level about the prevalence of bed bugs in private homes in areas of higher SES. This study aimed to identify prevalence, knowledge, and concern about bed bugs in one village in Ohio. Responses from 96 individuals who completed the Prevalence, Knowledge, and Concern about Bed Bugs (PK CABB) survey were utilized for data analysis. The majority of the sample was white non-Hispanic and about 95% of the respondents in the survey reported that they owned their residence.  Only about 6% of the respondents knew someone with bed bugs. Additionally, 50 people (52.1%) reported they were somewhat concerned about bed bugs, despite recent media attention. About 43% of people reported that they had changed their behavior. There were no differences in the responses based on data collection method. For this higher income area the prevalence was dissimilar to the rate reported in the general public (about 20%).  This suggests that bed bugs may be an environmental issue effecting low income disproportionately. Confounding issues, such as reluctance to report infestations could have resulted in inaccurately low results. Further research is needed in areas of differing socioeconomic levels. Education is needed for all in the general public related to bed bug prevention and elimination. 

Bed Bug Medicolegal

Bed bugs, Cimex lectularius, have become one of the most prominent structurally infesting public health nuisance pests in the United States.  Combined rapid re-emergence and insecticide resistant population strains have made bed bugs a formidable pest foe with considerable medical and legal significance. Requirements for new and innovative bed bug elimination methods demands priority action by both pest management and environmental health professionals. In this session, you will discover the unique biology and behavior that allows bed bugs to be incredibly successful within the human environment. In addition, you will learn the medical and legal issues of bed bugs as well as an update on best practices in bed bug elimination.

A Cross-Sectional Study of West Nile Virus in Clinic-Admitted Raptors

West Nile Virus (WNV) is an arbovirus that is typically transmitted through a mosquito vector via direct inoculation. This virus had never been seen in the U.S. prior to 1999 when an outbreak occurred in New York. Since then, it has spread across the U.S. and is now considered endemic among many bird species. Birds are the natural reservoir for this virus, and transmission occurs when a mosquito takes a blood meal from an infected bird and proceeds to bite other birds or humans. Although a small percentage of human West Nile cases exhibit moderate to severe symptoms, most cases are asymptomatic. Avian WNV research has important public health implications because of the relationship between birds and humans in the transmission cycle. Studies have shown that raptors are particularly sensitive to WNV; therefore, understanding how the virus affects raptor species may be a useful indicator of regional virus activity.  In this study, 1,455 injured raptors were admitted to a rehabilitation clinic from 2003-2008. Species, symptoms, and season of admission were documented, and each specimen was tested for WNV antibody. Antibody seroprevalence was then compared to the number of reported human cases in the same region.  Seroprevalence varied greatly depending on the year of admission. Seroprevalence was as low as 3.4% (9/264) in 2008, and as high as 46.8% (109/233) in 2005.  Overall, WNV seroprevalence for all years was 17.9% (260/1455). Specimens were more likely to be WNV positive in the summer months. The number of local human cases and the proportion of infected raptors did not appear to correlate annually. Reported human cases were by far the highest in 2003 (n=948), when raptor seroprevalence was 32.6% (76/233). However, in 2005, when raptor seroprevalence was highest (46.8%), there were only 30 human cases reported. Our data agree with prior studies showing that WNV is highly prevalent among raptor populations. Although the relationship between human and bird cases did not correlate annually in the present study, possibly because most human cases are never reported, continued monitoring of the annual fluctuations in avian WNV prevalence could prove useful for protecting human health.

What is the Buzz about PCRs?

The Maricopa County Environmental Services Department is excited to present an innovative vector surveillance program tying vector controls over 17,000 routine and special trapping mosquito samples with the latest in mosquito borne disease detection. Maricopa County has had a treatment protocol for West Nile caring mosquitoes since 2004. Previous to 2011 the Department would use Biomedical Corp.’s RAMP testing to determine if local thresholds were met indicating the need for treatment. In 2010, 190 RAMP positive samples were sent into the state lab for PCR testing, 172 of those samples were false positives resulting in an additional 73,000 acres being treated. Due to extensive turnaround times and state budget cutbacks, in 2011 the department saw an opportunity to obtain its own PCR machinery to test the needed mosquito samples for the presence of West Nile and other vector-borne diseases. Additionally, the need for the latest equipment to analyze vector borne diseases in a accurate and timely fashion were highlighted by the finding on a new West Nile variant in 2010.