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2005 Model Practice Application (Public)

Practice Title
West Nile Virus Surveillance and Control Program – Sedgwick County, Kansas
Submitting LHD/Agency/Organization
Sedgwick County Health Department, Kansas

Overview

West Nile Virus (WNV) activity was first detected in Sedgwick County in 2002. In 2003, around 100 confirmed and probable human cases of WNV were reported. WNV was also detected in birds, horses and mosquitoes. With the growing threat to the public from the WNV, Sedgwick County Health Department (SCHD) enhanced its vector control activities in 2004 and developed a comprehensive response plan for mosquito control and WNV disease reduction. The primary goal of the program is to protect the public from WNV by early detection of WNV and elimination of mosquitoes. Community outreach and education, mosquito surveillance and control, and interagency collaboration are the core elements of the program. The program utilizes Integrated Mosquito Management Practices (IMMP) for responsible pesticide use and effective prevention and mitigation of WNV threat to population. Along with IMMP the program use modern disease tracking methods such as GIS applications that resulted in efficient and accurate information gathering, reduced program costs, and increased productivity. The revitalized mosquito control program took two approaches, taking immediate action relying on historic information about mosquito breeding hotspots, and putting into place an enhanced surveillance program to document changing mosquito habitat patterns.

Responsiveness and Innovation
In 2002, WNV activity was detected for the first time in Sedgwick County and since then it became established as an endemic disease. Around 100 confirmed and probable human cases were reported from Sedgwick County in 2003. WNV had also been detected in a number of horses, mosquito pools, and birds in Sedgwick County.

Prior to the arrival of WNV in Sedgwick County, SCHD had a rudimentary vector control program with very limited capacity. Only function of the program was to perform larvicide applications on a complaint basis. There was no infrastructure available to deal with risks and threats of WNV. The program did not have any dedicated staff, any reliable mosquito control equipment, any mosquito surveillance program, or supplies of mosquito control pesticides. There was no resource available for public education and community outreach.

As WNV became a major threat for public health and to fulfill its mission of promoting and protecting the health of its residents, SCHD revitalized the program and enhanced its capacity to meet the challenges posed by WNV. SCHD developed a comprehensive plan and identified several needs necessary for WNV response and mosquito control. SCHD West Nile Virus Surveillance and Control Program made significant investments in acquiring expertise and equipment related to mosquito control and West Nile Virus prevention. The program now has a heavy duty truck with mounted fogger, a small motorized vehicle and non motorized bicycle for larvicide applications, a large supply of pesticides, surveillance equipment, laboratory testing equipments and materials, and handheld GIS application for data capturing and mapping.

SCHD WNV surveillance and Control Program uses contemporary technology such as computers and internet for program operations along with state of the art disease tracking GIS application.

Agency Community Roles
The Board of County Commissioners, who serves as the Board of Health, is required to act when it becomes aware of contagious or infectious diseases – KSA 65-119. The Board of County Commissioners directed the health department to prepare and submit a plan for impending WNV response.

A comprehensive plan for mosquito control program was developed in late 2003 and presented to the Board of County Commissioners for approval. In 2004, Sedgwick County revitalized its mosquito control program to respond effectively to the growing threat from the WNV.

Early in the season, the SCHD WNV surveillance and control program convened a meeting of local partners and collaborators. Sedgwick County Code Enforcement, Sedgwick County Animal Control, Sedgwick County Environmental Resources, Sedgwick County Extension Services, Sedgwick County GIS department, Association of Sedgwick County City Governments, and City of Wichita Environmental Health are some of the collaborating agencies. Regular meetings of collaborating agencies are held and all collaborators work closely to implement WNV surveillance and control plan.

The public is informed about the County’s comprehensive preventive strategies and activities (community education, surveillance, source reduction, larviciding, etc.) to address the threat of WNV and to minimize the necessity of pesticide applications for adult mosquito control.

Costs and Expenditures
The program does not employ any permanent staff. Epidemiology Program supervisor manages the program and his salary is paid out of Epidemiology Program budget. One part time worker was hired for a three month period. A graduate student worked for the program for a period of three months without any reimbursement.

The program has a yearly budget of $ 65,000. The program is funded through general county funds. Total operating expenses for the program were $ 50,000 and total capital costs of program in 2004 were $ 15,000.

Following is a list of all operating expenses:

  • Surveillance contract: $22,000

  • Pesticide supplies: $20,000

  • Temporary staff: $2,000

  • Equipment maintenance: $5,000

  • Miscellaneous: $1,000

  • Total Operating Costs: $50,000
Following is a list of all capital expenses:
  • Fogger/sprayer: $10,000

  • Surveillance equipment: $5,000

  • Total Capital Costs: $15,000
Implementation
The day to day operations of the program are managed by the Senior Epidemiologist who also supervises the Epidemiology program. Basic components of the program are community outreach and education, mosquito and host surveillance, human surveillance and disease investigation, and mosquito control.

Community Outreach and Public Education

The objective of this activity is to increase public awareness of mosquito-borne diseases, prevention and control techniques. This objective was achieved by:

  • Setting up a disease information hotline for general public for information about WNV disease, personal protective steps, eliminating mosquito-breeding sites, reporting standing water and dead birds

  • Preparing and making available different educational materials e.g. fact sheets, prevention tips etc and provide regular WNV activity updates to general public through health department web site

  • Delivering presentations about WNV disease and prevention to a wide variety of high risk audiences

  • Issuing press releases regarding surveillance and response activities and current situation on a regular basis

  • Participating in a countywide “tire round-up” campaign to reduce mosquito breeding sites

Mosquito and Host Surveillance

The objective of the mosquito surveillance is to monitor the number and type of mosquitoes and to detect the presence of WNV in mosquitoes. Objective of host surveillance is to detect mosquito-borne disease in animals before people become sick. Mosquito and host surveillance activities include mosquito collection, identification, testing for WNV, monitoring public complaints regarding mosquitoes and standing water, and collection of dead birds for WNV testing on a regular basis. To achieve this objective surveillance component is contracted out to a private firm that specializes in mosquito surveillance. The contracted firm works closely with the epidemiology program and under supervision of the Senior Epidemiologist.

Human Surveillance and Disease Investigation

The objective of human surveillance is to quickly detect human illness due to mosquito-borne diseases and implement control measures to reduce WNV incidence. Epidemiology program staff is responsible for this task. Beginning early in the mosquito season enhanced surveillance for WNV is implemented and area physicians and other healthcare providers are requested to report immediately all suspected or confirmed cases of WNV and submit appropriate laboratory samples.

Mosquito Control

The objective of mosquito control is to reduce the abundance of adult mosquitoes. The objective is achieved through the use of Integrated Mosquito Management (IMM) practices. Primary methods included in the integrated mosquito management are source reduction of mosquito population, killing immature mosquitoes (larviciding) and eliminating adult mosquitoes (adulticide). Known mosquito problems are treated with a pre-hatch application to prevent mosquitoes from hatching. During routine larvicide application, catch basins, storm drains, wastewater treatment plants, parks, sewers, and other surface waters are treated with pesticides. The program has a phased response plan for adulticide application. Since adulticiding is not the primary method of mosquito control in Sedgwick County, adulticiding is only implemented in response to surveillance findings. The program has appropriate equipment for mosquito control. Mosquito control activities were completed by a seasonal part time staff, designated staff from collaborating agencies, and a graduate student intern.

Sustainability
Outcome Process Evaluation
Lessons Learned
Key Elements Replication