HomeMy WebLinkAboutCOUNCIL - AGENDA ITEM - 04/22/2008 - WEST NILE VIRUS MANAGEMENT POLICY UPDATE DATE: April 22, 2008 WORK SESSION ITEM
STAFF: Tess Heffernan FORT COLLINS CITY COUNCIL
Wendy Willams
SUBJECT FOR DISCUSSION
West Nile Virus Management Policy Update.
EXECUTIVE SUMMARY
The City Manager formed the West Nile Virus Technical Advisory Committee in December 2007
for the purpose of reviewing and making recommendations about the City's policy related to West
Nile virus mitigation. Components of the policy that have been reviewed thus far by the Committee
include mosquito trapping and testing,public education,and larva control. Committee members are
currently discussing the practice of adulticiding(the spraying of adult mosquitos). The Committee
hopes to finalize recommendations by June 1, 2008. The overall goal of the West Nile Virus
Management Policy - and the challenge for the Advisory Committee and decision-makers - is to
reduce the risk of West Nile virus infection while minimizing potential short and long-term human
health risks and impacts to the environment.
GENERAL DIRECTION SOUGHT AND SPECIFIC QUESTIONS TO BE ANSWERED
1. Is Council comfortable with the current direction ofthe West Nile Virus Technical Advisory
Committee?
2. Does Council have any questions or additional direction for the Committee?
BACKGROUND
West Nile virus first arrived in Colorado in late summer of 2002 and an initial outbreak occurred
in 2003. The City's policy for responding to West Nile virus evolved through a series of operational
experiences and reviews with City Council, beginning in 2003. The City employs a broad based,
prevention-focused management program that includes public information and education,mosquito
data collection and monitoring, larva control and, in the case of a public health emergency,
adulticiding.
Since that first season, the research and knowledge about West Nile virus has increased
significantly. In 2003,the Air Quality Advisory Board convened a West Nile Task Force to review
the response of that first season and make recommendations. Since then, staff and community
members have reviewed findings and refined the response plan.
April 22, 2008 Page 2
Despite these efforts,in 2007 the community experienced a severe outbreak of West Nile virus and
adulticides were applied for the first time since 2004. Following that experience,the City Manager
formed a Technical Advisory Committee for the purpose ofreviewing and making recommendations
about the City's current policy and response plans. The Committee began meeting in January.
Committee members are listed on Attachment 1.
Existing Policy and Program
The City's West Nile Virus Management Policy is focused on disease prevention. The overall goal
of the policy-and the challenge for the Advisory Committee and decision-makers-is to reduce the
risk of West Nile virus infection while minimizing potential short and long-term human health risks
and impacts to the environment.
As noted earlier, the basic components of the program are:
• Public information and education
• Surveillance, trapping and testing, focusing on the Culex species
• Larva control
• At-risk employee training.
The City's practice has been to only consider adulticiding as an emergency response to a public
health crisis.
The City recognizes the State of Colorado Department of Health and the Larimer County
Department of Health and Environment as the authorities on local public health issues. The City's
primary role in managing the threat of West Nile virus is to inform and educate citizens,participate
in regional public education and outreach efforts, and administer the pest management program.
The City selects a contractor to carry out many of the program components; the current contractor
is Colorado Mosquito Control.
Attachment 2, "Program Response to Mosquito-Borne Arboviral Activity,"describes the potential
levels of response employed by the City throughout the season. This document is still in draft form
pending the outcome of the current review, however it provides an overview for those unfamiliar
with mosquito management practices.
The ongoing cost of the program includes the following:
• Contract with Colorado Mosquito Control
■ $ 44,700—surveillance and trapping
■ $ 7,500—public education
■ $ 178,400—larval site inspection and control
• Public information and education—direct costs and in-kind
■ $ 6,000—City Communications and Public Involvement
■ $ 12,000—County Department of Health and Environment
■ $ 300—Community donations of repellent
April 22, 2008 Page 3
• Program administration and oversight—in-kind
■ $ 4,900—City Parks Department
Additionally, emergency adulticiding was conducted in 2003, 2004 and 2007. Costs for those
operations included:
• Truck-based adulticiding operations
■ $ 46,300—2003
■ $ 30,200—2004
■ $ 72,000 - 2007
• Reverse 9-1-1 notifications
■ $ 15,000—2003
■ $ 21,400—2004
■ $ 19,200—2007
Technical Advisory Committee Review Thus Far
The Committee has not yet finalized its recommendations; however members have discussed the
following modifications to the existing policy and program:
Public Information and Education
• More public information and education overall - expand methods of reaching people, use
more volunteers to communicate the risk and prevention measures.
• Better,more timely information about results of adult mosquito trapping program—clearer,
up-to-date maps illustrating risk areas should be posted online and in other media.
• More efforts to reach people at higher risk of contracting West Nile virus, e.g., transplant
recipients, people over 55, diabetics, persons with high blood pressure, those taking
immunosuppressant drugs and people who spend a lot of time outside.
• Pre-developed messages to be used when risk escalates.
• Contact community leaders and others in positions of trust for their assistance in
communicating with their constituencies when risk is elevated.
• Many people are apprehensive about using DEET, therefore emphasize CDC and EPA-
approved alternative products,e.g.,products containing Picaridin, oil of lemon eucalyptus,
etc. The City could also consider distributing samples of these products.
• Ensure the contract requires sufficient levels of staffing for back yard catch basin inspection,
related property owner notification and phone staffing.
City and County public relations staff have begun meeting to develop enhancements to the existing
program elements.
Surveillance, Trapping and Testing
• Document the current design of surveillance program and trapping grid: the number of trap
sites, types of traps used and number of trap nights per week. This provides data that
contributes to decisions regarding the level of risk.
April 22, 2008 Page 4
• Collect data to determine if backyard larval habitats are a significant source of infected adult
mosquitos.
• Amend the Code definition of public nuisance to include stagnant water creating potential
larval habitats for disease carrying mosquitos. Though voluntary compliance is currently
very high,this would provide the means to mitigate a problem property should an owner not
respond to requests to do so. The primary emphasis would be to educate the public and
proactively mitigate problem sites.
• Conduct research to determine if there is a benefit to extending the buffer zone in some areas
around the city. This would be designed to more accurately identify the source of the
mosquitos—i.e., whether they are coming from within or outside the city limits—and thus
guide further mitigation efforts.
• Evaluate whether remote sensing technology should be used to identify habitats more
effectively than can be done using manual techniques.
• Require that Quality Control become a standard provision of the contract, including
monitoring and evaluating larval control efficacy to insure larval management is performing
optimally.
• Appoint an ongoing Technical Advisory Committee to annually review the prior season,and
assist in interpreting data during season
Larva Control
• As noted previously, public education is a key component of a successful West Nile
prevention program. Expand public education,including information on locations of likely
larval habitats and alternatives for self protection from disease-carrying mosquitoes.
• Consider additional early use of Altosid as a pre-hatch time release formulation. Increasing
the use of this product in the appropriate habitats may save money in labor costs because it
could reduce the overall number of applications needed.
• Allocate funding and develop a plan for using helicopters to apply larvicides to larger sites.
While more expensive, helicopters are effective, minimize air pollution (as compared to
backpack blowers with two stroke engines and ATVs)and make it possible for the contractor
to focus on smaller sites, especially during critical peak periods.
Technical Advisory Committee Review Still Underway
Adulticiding
The Committee is unanimous in its support for an aggressive prevention and public education
program. There is also recognition that adulticiding may be the only alternative to prevent a public
health crisis. Discussion has focused on understanding and balancing the human health risks from
West Nile virus vs. the human and ecological health risks of the pesticides used to reduce the
population of disease-carrying adult mosquitoes. More discussion is needed regarding what the
triggers should be for determining when and if adulticiding is employed.
Recommendations related to the current policy and program for adulticiding are not yet complete.
Members have reviewed a great deal of research and consulted with additional experts, including:
• Bob Peterson, PhD—Department of Entomology, Montana State University
• Theo Colbom, PhD and Lynn Carroll,PhD—TEDX/The Endocrine Disruption Exchange
April 22, 2008 Page 5
Additional Issues
Over the past several years the Centers for Disease Control and Prevention (CDC) has provided
mosquito testing services at no cost to the City or County. The City recently learned that the CDC
will no longer fund this service after 2008. Staff has begun to explore options for future cost-sharing
with surrounding cities and counties. For example, Weld County has a lab and facilities that could
possibly be utilized.
A multi-county group called the Northern Colorado Vector-borne Disease Advisory Council
(VDAG) will soon be meeting with municipalities to discuss options for a long-term, regional
approach to mosquito management. VDAG is comprised of health department staff from Boulder,
Weld and Larimer counties. Their timeline is very fluid at this point and very much depends on the
level of interest they receive from the municipalities of the three counties.
Finally, staff is exploring the possibility of performance contracting for future West Nile services.
This assessment will determine if incentives or other means could be used to increase the efficacy
of the current program.
Next Steps
It is hoped that the Technical Advisory Committee can complete its analysis and recommendations
no later than June 1,2008. The final recommendations will then be brought to Council, along with
a resolution supporting any modifications to the current policy.
This summary has discussed only the City's response to the threat of West Nile virus. Citizens who
wish to learn more can begin with the City or County web sites:
www.fcvov.com/westnile
ham://www.lrimer.orwhealth/cd/westnile.asp
ATTACHMENTS
1. Technical Advisory Committee membership.
2. Program Response to Mosquito-Borne Arboviral Activity.
3. Power Point presentation.
ATTACHMENT 1
Attachment I
Technical Advisory Committee Membership
April 10, 2008
1. Boris Kondratieff, PhD — Entomologist, Colorado State University
2. Adrienne LeBailly, MD—Director, Larimer County Department of Health and
Environment
3. Eric Levine - Chair, Air Quality Advisory Board
4. Greg McMaster, PhD - Plant physiologist/ecologist, USDA; member Air Quality
Advisory Board
5. Chester G. Moore, PhD - Entomologist, Colorado State University
6. Roger S. Nasci, PhD - Entomologist, Centers for Disease Control and Prevention
. Former members:
7. Jackie Fields, MD - Physician specializing in treating people with chemical
sensitivities; resigned April 8, 2008 due to time constraints
8. Amy Dean— Ecologist; member Natural Resources Advisory Board; resigned March
4, 2008 due to time constraints.
Staff support:
Wendy Williams, Assistant City Manager
Mike Calhoon, Parks Crew Chief, contract administrator
Tess Heffernan, Policy and Project Manager, facilitator
•
ATTACHMENT
• City of Fort Collins
moo
Attachment 2
Program Response to Mosquito-Borne Arboviral Activity
April 2008
DRAFT—includes adulticide operations
Level I Off Season - November to April
Status: No human cases occurring; vector mosquito density none to very low;
mosquito infection rates 0, vector index 0.
Probability of Human Outbreak: None
Response:
1. Routine post-season analysis of previous season's data; assess response and
efficacy.
2. Preseason preparations for upcoming season's strategy and activities,
• including updating of public outreach plan with any new information (e.g. at-
risk populations).
3. Map previous season's surveillance data.
4. No mosquito testing.
Level II Late Season - September to October
Status: Sporadic human cases reported; transmission season apparently ending
due to declining numbers of Culex species mosquitoes in traps; mosquito
infection rate < 2 per thousand(0.2%) and decreasing(although spikes may be
observed due to low numbers of mosquitoes in positive pools); vector index < 0.5
and decreasing.
Probability of Human Outbreak: Remote
Response:
1. Mosquito surveillance concludes.
2. Limited testing of mosquito pools from areas with ongoing elevated activity.
• 3. Late season larval control (biological, chemical and habitat modification).
4. Continue public education emphasizing personal protection and "backyard"
mosquito control.
1
Level III Early Season — May to June
Status: No human cases reported; evidence of average or lower than average
Culex species mosquito populations (as compared to available historical
population data for the area); mosquito infection rates < 2 per thousand (0.2%);
vector index <0.5.
Probability of Human Outbreak: Low
Response:
1. Analyze and map data from prior years to develop surveillance strategy and
select mosquito-trapping sites. Initiate surveillance program.
2. Initiate larval control activities.
3. Brief City Manager on surveillance activities, mosquito-borne virus
epidemiology and trigger points for recommendation of emergency control
measures. Establish communication channels between appropriate City and
County staff.
4. Initiate public education program on mosquito source reduction and risk
reduction practices (e.g. elimination of domestic breeding sites, use of
repellants, etc.)
Level IV Peak Season — July to August — Low Level Activity
Status: Sporadic human cases are being reported; Culex mosquito populations
increasing, but below historical average for that time period; mosquito infection
rate < 2 per thousand (0.2%); vector index<0.5.
Probability of Human Outbreak: Low— Moderate
Response:
1. Analyze and map surveillance data to identify areas of increased risk.
2. Continue mosquito pool submissions from surveillance program for West Nile
virus testing with Center for Disease Control (CDC).
3. Notify local agencies, media and the public of positive findings. Continue and
increase prepared public information and education program (risk reduction
practices, elimination of domestic breeding habitat, etc.)
4. Brief City Manager on surveillance findings and need for quick action if
activity rapidly increases.
5. Increase larval monitoring and control where necessary.
6. Begin planning for adulticide control in the event that virus activity and Culex
populations rapidly rise.
2
Level V Peak Season — July to August— Rapidly Increasing Activity
Status: Human cases being reported daily in area; Culex mosquito populations
increasing and at or above historical average for that time period; sustained
mosquito infection rates of> 3.0 per thousand(0.3%) for two consecutive weeks;
vector index> 0.5 for two consecutive weeks.
Probability of Human Outbreak: High
Response:
1. Enhanced communications between City and County regarding positive
findings and anticipated response activities. City Manager apprised of threat
levels and activities on an ongoing basis.
2. Identify geographic areas, by mapping surveillance data, where virus
transmission appears most active.
3. Continue larviciding activities in an effort to stem the numbers of vector
competent species.
4. Coordinate press releases and a wide range of other activities to keep the
public informed of affected areas, focusing on exposure risk reduction
practices and public education of the disease threat.
5. In the event the Health Department recommends ground-based adulticide
• spraying and the City Manager decides to proceed, commence adulticide
operations.
6. Consider and plan for aerial adulticiding if significant human populations are
considered at risk to virus exposure.
7. Initiate public education/information on the adulticide program to include
pesticides used, toxicity, application times, target area, exposure reduction
suggestions,justification, FAQ's, etc.
8. Notify appropriate agricultural interests (i.e. bee keepers, organic growers,
etc.) and individuals on the Pesticide Sensitivity Registry of intended
adulticiding activities, times, affected areas, etc.
•
3
Level VI Peak Season —July to August — Epidemic Level
Status: Multiple neuroinvasive human cases being reported in area, deaths have
occurred; Culex mosquito population at or above historical average for that time
period; sustained mosquito infection rates of> 5.0 per thousand (0.5%) for two
consecutive weeks; anticipated vector index > -.75 for two consecutive weeks.
Probability of Human Outbreak: In progress
Response:
1. Focus resources on public education about prevention and on adult mosquito
control.
2. Expand mosquito surveillance activities (i.e. population densities, vector
index and infection rates) to direct mosquito control efforts where risk to
exposure is greatest and to monitor pre and post adulticide treatment
conditions.
3. In the event the Health Department recommends ground-based adulticide
spraying and the City Manager decides to proceed, commence (or continue)
spraying. The window for spraying to be effective in reducing human cases is
very narrow, thus if adulticide activities are going to be conducted they need
to be initiated immediately.
4. Consider aerial adult mosquito control in areas identified with extremely high
virus activity and risk of human exposures.
5. Where adult mosquito control is being conducted, provide extensive public
education and information on the program including pesticides to be used,
toxicity, application times, area of application, exposure reduction
suggestions,justification, FAQ's, etc. to residents of affected and adjacent
areas.
6. Notify appropriate agricultural interests (i.e. bee keepers, organic growers,
etc.)and pesticide sensitive residents of intended adulticiding activities, times,
affected areas, etc.
7. Initiate the buffer program for the individuals on the Pesticide Sensitivity
Registry. As part of this program notify residents in areas that will not be part
of the adulticide applications.
8. Increase activities to keep the public informed of affected areas, focusing on
exposure risk reduction practices and public education of the disease threat.
9. Secure any needed emergency funding and document costs associated with
outbreak control.
4
ile Virus
anageme icy Update
April 22 , 2008
• Update on work of the West Nile
Virus Technical Advisory Committee
— Overview of existing approach to
mitigating threat of West Nile virus
— Recommendations being discussed by
Committee
• Committee has not yet finalized
recommendations
1 . Is Council comfortable with the current
direction of the West Nile Virus
Technical Advisory Committee?
2 . Does Council have any questions or
additional direction for the Committee ?
ound
• West Nile virus first in Colorado in 2002
• City response : broad based , preventio
focused management plan
• Each year knowledge grows
• 2007 : severe outbreak , emergency use
of adulticides ; Technical Advisory
Committee formed in December
Technical Advisory CoffIl
itte
• Charge : review West Nile virus policy
and make recommendations regarding
possible revisions
TAC
Boris Kondratieff, Ph — ntomologis , CSU
Adrienne LeBailly , MD — Director , LCDHE
Eric Levine - Chair, Air Quality Advisory Board
Greg McMaster, PhD - Plant physiologist / ecologist ,
USDA ; member Air Quality Advisory Board
Chester G . Moore , PhD - Entomologist , CSU
Roger S . Nasci , PhD - Entomologist , CDC
Former members :
Jackie Fields , MD - Physician specializing in treating
people with chemical sensitivities
Amy Dean - Ecologist ; member Natural Resources
Advisory Board
ExiAtingmPoJjM & Program
• Disease prevention , not nuisance
control
• Basic program components :
. Public information and education
. Surveillance , trapping and testing
. Larva control
. At- risk employee training
• Adulticiding considered emergency
response to public health crisis
Roles
• Larimer County Department of Health and
Environment
— Local authority on health issues , recommends
actions
• City of Fort Collins
— Inform and educate citizens
— Participate in regional public education , outreach
— Administer, oversee contract
• Contractor
— Implement majority of program components
Progfmcmt_
• Contract with Colorado Mosquito Contr
— $ 44 , 700 surveillance and trapping
7 , 500 public education
178 , 400 larval site inspection and control
• Public education — direct and in - kind
— $ 61000 City communications dept
12 , 000 County DPHE
• Program administration , oversight
— $ 41900 City Parks Department
Mgr ued )
• Truck- based adulticiding operations
— $ 461300 - 2003
— $ 30 , 200 - 2004
— $ 727000 - 2007
• Reverse 9- 1 - 1 notifications
— $ 15 , 000 - 2003
— $ 21 , 400 - 2004
— $ 19 , 200 - 2007
TAC Revi
• Public Information and Education
— More public information and education
overall , expand methods
— Better , real -time information about findings
in mosquito traps ; readily available
— More efforts to reach people at higher risk
of contracting West Nile virus
— Pre -developed messages to be used when
risk escalates
— Emphasize approved alternatives to DEET
TAC Review Thus Far ( co
• Surveillance , Trapping & Testing
— Document current design of surveillance
program and trapping grid
— Collect data to determine if backyard larval
habitats are a significant source of infected
adult mosquitos
— Amend Code definition of public nuisance to
include stagnant water creating potential larval
habitats for disease -carrying mosquitos
• Surveillance , Trapping & Testing
- Conduct research to determine if there is a
benefit to extending the buffer zone around
some areas of the city
— Evaluate whether remote sensing technology
should be used to identify habitats
— Require that Quality Control become a
standard provision of the contract
— Appoint an ongoing TAC to annually review
prior season , and assist in interpreting data
during season
��► Far ( c
• Larva Control
— Expand public information and education ,
including locations of likely larval habitats
and alternatives for self protection
— Consider additional use of Altosid , as a
pre- hatch time release formulation
— Consider utilizing helicopters to apply
larvicide to larger sites
• Adulticiding
— Focus : understanding and balancing
Human health risks from West Nile virus
vs .
Human and ecological health risks from
pesticides used to reduce population of
disease-carrying adult mosquitoes
evie MQI Underway
• Adulticiding analysis
— Review of range of research
— Consultation with outside experts
• Bob Peterson , PhD — Department of
Entomology , Montana State University
• Theo Colborn , PhD & Lynn Carroll , Ph
TEDX / The Endocrine Disruption
Exchange
mMdIOihiPmdVmwes
• CDC testing services ending after 2008 ;
exploring options for cost-sharing with
surrounding cities/counties
• Northern Colorado Vector- borne Disease
Advisory Council (VDAG ) convening
municipalities to discuss long term , region -
wide approach ; led by Boulder , Weld and
Larimer county health department staff
• Exploring possibility of performance
contracting to increase efficacy of current
program
"' Aft "} Steps
• Finalize the recommendations of the
TAC
• Bring recommendations to Council
along with a resolution supporting any
modifications to the current policy
• For more information about West Nile
Virus
. www . fcgov . com/westnile
. www . larimer . org/health /cd /westnile . asp
1 . Is Council comfortable with the current
direction of the West Nile Virus
Technical Advisory Committee?
2 . Does Council have any questions or
additional direction for the Committee ?