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HomeMy WebLinkAboutCOUNCIL - AGENDA ITEM - 03/25/2014 - WEST NILE VIRUS MANAGEMENT POLICY & MANAGEMENT PLADATE: STAFF: March 25, 2014 Dan Weinheimer, Policy & Project Manager Mike Calhoon, Parks Supervisor WORK SESSION ITEM City Council SUBJECT FOR DISCUSSION West Nile Virus Management Policy & Management Plan. EXECUTIVE SUMMARY The City’s West Nile Virus (WNV) Management Policy was adopted July 1, 2008 and the Program Response Guidelines were last updated in March 2013. The purpose of this discussion is to review the input of the West Nile Virus Technical Advisory Committee (TAC) which evaluated the City's Program Response Guidelines, particularly focusing on the issue of adulticiding, as well as to receive guidance regarding proposed amendments to the WNV Management Plan. GENERAL DIRECTION SOUGHT AND SPECIFIC QUESTIONS TO BE ANSWERED 1. Which of the proposed enhancements does City Council wish to see included in the West Nile Virus Management Plan (Program Response Guidelines)? 2. Does City Council wish to formally reconsider the existing Council-adopted West Nile Virus Management Policy, which allows the use of adulticiding? BACKGROUND / DISCUSSION West Nile virus was first detected in Colorado in late 2002 and the first outbreak of the infection occurred in the Fort Collins area in 2003. Since its introduction to Larimer County, West Nile virus has become endemic. In order to combat the public health threat, City Council adopted a West Nile Virus Management Policy in July 2008. That policy states that West Nile virus is a public health issue and that the City’s “overall goal is to reduce the risk of human West Nile virus infection while limiting adverse human health and environmental impacts.” The 2008 policy articulated the City’s primary role in managing the threat of West Nile virus as (a) informing and educating citizens, (b) participating in regional educational and outreach efforts, and (c) administering a prevention-oriented mosquito management program. Fort Collins’ West Nile virus program uses the federal Environmental Protection Agency (EPA) and Centers for Disease Control (CDC) recommended Integrated Pest Management (IPM) approach. IPM consists of a series of pest management evaluations, decisions and controls. IPM is a comprehensive, systems-based approach to pest management with the goal of providing the safest, most effective, most economical, and sustained remedy. IPM reduces the risk from pests while also reducing the risk from the overuse or inappropriate use of hazardous chemical pest-control products. The City follows a five-step IPM approach that includes: 1. Inspection/monitoring Routine in-season examination is conducted to identify the presence of mosquitos. 2. Identification Using an extensive trap network, the City is able to identify types of mosquitos, the concentration of those mosquitos and the presence of West Nile virus through testing. March 25, 2014 Page 2 3. Establishment of threshold levels The program response guidelines established thresholds for the presence of West Nile virus that trigger specific actions. 4. Implementation of two or more control measures Fort Collins uses larval control (eliminating the larvae of the mosquitos) on the two mosquito varieties known to carry West Nile virus in Larimer County, surveillance aimed at reducing mosquito breeding habitat and community education. In the event of an active virus season adulticiding may be utilized per the Program Response Guidelines. 5. Measurement and evaluation Regular follow-up is necessary to determine whether treatments are successful and what should be done next. Evaluation is one of the most critical components of an IPM plan. Use of Adulticiding In accordance with IPM principles, broadcast spraying of a pesticide to control the adult mosquito population - also referred to as adulticide - is a last resort the City may use to break the disease transmission cycle and minimize the risk of human infection. The step of using adulticide was adopted as an emergency response in the 2008 policy. Application of adulticide is undertaken using the Program Response Guidelines, a set of criteria developed by a Technical Advisory Committee (TAC). The use of adulticiding has been controversial in Fort Collins, with divided public response. In 2013, hundreds of people joined a “No Spray Fort Collins” social media site, and many voiced their concern through letters and email to City Council, as well as via testimony at Council meetings. In fall 2013, the Health District of Northern Larimer County (“Health District”) completed a statistically valid Community Health Survey and included questions about West Nile virus. Residents were asked whether they would support the local health department’s decision to recommend spraying (adulticiding) for mosquitos to control West Nile virus and their concern of the risk of contracting the virus. Sixty-nine per cent (69%) of Fort Collins residents would support the health department’s recommendation to spray as opposed to 16% not supporting and 15% choosing “don’t know.” Respondents who are either “very” or “somewhat” concerned about contracting West Nile virus made up 27% of the survey while about 40% are “a little” concerned. Respondents’ level of support for a recommendation to spray for West Nile virus correlated with their age with younger residents less likely to support the health department’s recommendation to spray. Key Actions At its October 29, 2013 Work Session City Council asked that staff review the West Nile Virus Management Program. Specifically, Council asked for three key actions: Add new perspectives to the Technical Advisory Committee (TAC) o Representatives of urban agriculture and the pesticide sensitive registry were added for the 2013 review Recommend enhancements to the City’s program response guidelines Develop a program manual that articulates the West Nile virus management program In order to accomplish a thorough review of the existing program, staff developed a public input process which involved five TAC meetings - this has since been expanded to 7 meetings. TAC meetings are facilitated discussions lasting 2 hours and have so far focused on reviewing the existing program response guidelines and adulticiding. The TAC membership was expanded to include Meghan Williams, co-owner of Spring Kite Farms, and Dana Kunze, owner of the No Spray Fort Collins Facebook site. Other TAC members include Lars Eisen (Colorado State University (CSU) Department of Microbiology, Immunology and Pathology), Boris Kondratieff (CSU Professor of Entomology), Adrienne LeBailly (Larimer County Health & Environment Department Director), Eric March 25, 2014 Page 3 Levine (Air Quality Advisory Board), Greg McMaster (Air Quality Advisory Board), Chester G. Moore (CSU Professor of Medical Entomology), Roger Nasci (Centers for Disease Control and Prevention) and Elizabeth Pruessner (Natural Resources Advisory Board). Staff has developed a draft program manual similar to the City of Boulder manual which was shared during the October Work Session. This draft manual is attached for City Council review and feedback. The program manual will be finalized before the 2014 West Nile virus season. Technical Advisory Committee (TAC) Work Each year since the adoption of the 2008 West Nile Virus Management Policy, the City has used a Technical Advisory Committee (TAC) to review the previous season and make recommendations for process improvement. With the additional members and a focus on reviewing current operations and specifically addressing the use of adulticide the TAC developed some program modifications. The TAC reviewed the existing program response guidelines and tackled the issue of adulticiding. Overall the existing program provides a good foundation for the City. Fort Collins’ trapping network is more extensive than many states’ with 53 traps in the City. The one-week turnaround for data from the captured mosquitos is fast and is the result of a partnership with Colorado State University. The City works with its contractor to maintain a map of weekly changes in the disease activity based on its data network. These three factors combine to give a strong level of data for decision-makers. TAC members also support the use of the pesticide sensitive registry that limits those residents’ exposure to pesticide applications. Among the TAC suggestions to enhance the program are: Enhance the City’s communication efforts - in volume of material, focusing on specific at-risk populations and sites, and in emphasizing information about actions individuals can take to protect themselves from West Nile virus. Implement a Vector Control District which would expand beyond the City of Fort Collins city limits and provide regional mosquito control. This district, which would require voter approval, would be funded by a dedicated mill levy tax, similar to the weed district. Revise the program response guideline thresholds for implementing adulticide. This discussion focused on the use of human cases (a lagging indicator) in decision-making. Implement a zone approach that would utilize the City’s robust trap data to inform a more targeted use of adulticide. Develop an opt-out program through which residents would complete a voluntary education program and a self-inspection of their home in order to be able to opt out of the adulticide treatment. Implement a more aggressive larval control program that would include a longer season and a larger treatment boundary specifically on the east side of town. This boundary would be expanded at least two miles further into the County. Create a more weather-based season - a more flexible start and end date to trapping and other program elements. Add more gravid traps (which trap more Culex pipiens) in order to better speciate the data collection and response to the specific habits of mosquito species. There are several outstanding issues that have been contentious in the TAC discussions. These issues include: Appropriate zone size The TAC would support the use of zones in approaching adultidice applications. These zones would allow the City to limit its use of adulticide and permit a more aggressive response to “hot spots”. While the TAC would like to see zones that are as small as possible there has not been consensus on the appropriate adulticiding zone sizes in relation to the data collection sites. TAC members will meet with a CSU statistician to attempt to identify the optimal adulticiding zone size. Opt-out from adulticide applications o A TAC member provided a proposal for allowing residents to opt out of adulticide applications on their property. TAC members discussed this proposal and, while supporting the educational March 25, 2014 Page 4 components associated with the proposal, the majority of the TAC expressed feasibility and effectiveness concerns with allowing individual properties to opt out. These concerns focused on whether opting out would truly prevent/isolate a property from being sprayed, the appropriate distance from a home in order to prevent drift, and the possible reaction of neighbors if an adjacent property was not receiving adulticide and thus impacting control efforts on their property. There were also concerns around the impacts of an opt out program to the overall goal of the program of reducing the transmission of the virus. Amending the program response guidelines o Level III of the program response guidelines refers to several “status” criteria as thresholds for action. Many TAC members have expressed that the presence of the word “and” when referring to the presence of more than one human case and other criteria. This issue relates to use of human cases as a threshold as well as the use of other criteria listed in the Program Response Guidelines such as abundance, vector index or infection rates. Human cases are currently utilized as a leading indicator of virus activity but when reviewed after the season has completed they are shown as a lagging indicator. Advisory Panel role o Part of the City’s in-season program response guidelines is the use of a three-member advisory panel. The panel, made up of a doctor and members of the Air Quality Advisory Board (AQAB) and Natural Resources Advisory Board (NRAB), interprets seasonal data and provides its feedback to the City Manager as to whether to initiate a County recommended adulticiding application. Some members of the TAC believe adjustments to the functionality of the advisory panel may be warranted, depending on the outcome of the proposed recommendations. Beekeepers and Urban Farmers o Several TAC members keep bees and Meghan Williams was included to represent the urban agriculture community. Members have expressed concern about what to do to protect pollinators from adulticide applications. In other discussions the TAC also recommended focusing City resources on developing resources for beekeepers and farmers. The TAC has reached consensus regarding the following enhancements: - Communication - Larval Management - Source Reduction - Vector District Approach The cost to implement communication, larval management and source reduction enhancements is estimated at approximately $75,000. The TAC has come to a partial agreement but debate is still underway concerning: - Opt-out Program - Zones Additional TAC meetings have been scheduled to continue discussions regarding the outstanding issues. March 25, 2014 Page 5 ATTACHMENTS 1. Program Response Guidelines 2013 (PDF) 2. Triple Bottom Line Analysis (PDF) 3. TAC Program Response Guideline Comments (PDF) 4. West Nile Virus Management Policy - Resolution 2008-062 (PDF) 5. West Nile Virus overview 2013 Community Health Survey (PDF) 6. WNV Program Manual (Draft) (DOCX) 7. Powerpoint presentation (PDF) Page 1 of 6 Program Response Guidelines to Mosquito-Borne Arboviral Activity March 2013 Off Season Activities Status: • No human cases occurring • Mosquito activity none to very low • Mosquito infection rates 0 • Vector index 0 Operational Response: 1. Routine post-season analysis of previous season’s data; assess response and efficacy. 2. Analyze and map data from prior years to develop surveillance strategy and select mosquito-trapping sites. 3. No mosquito testing. Communication Activities: 1. Updating of public outreach plan with any new information (e.g. at-risk populations). 2. Update FAQ’s and other information that may be needed if spraying occurs. Page 2 of 6 Level I Early Season - 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 Operational Response: 1. Initiate surveillance program. 2. Initiate larval control activities June 1st. 3. Brief City Manager on surveillance activities, mosquito-borne virus epidemiology and trigger points for recommendation of emergency control measures. Communication Activities: 1. Establish communication channels between appropriate City and County staff. 2. Ensure online information is up to date and prepare for ongoing, timely updates. 3. Initiate public education program on mosquito source reduction and risk reduction practices Communication Topics: o West Nile Virus basics o Wear repellent o Eliminate breeding sites Page 3 of 6 Level II Peak Season – July thru August – Low West Nile Virus Activity Status: • Sporadic human cases are being reported • No infected human blood donors have been 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 Operational 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 Colorado State University. 3. Brief City Manager on surveillance findings and need for quick action if activity rapidly increases. 4. Increase larval monitoring and control where necessary. 5. Begin planning for adulticide control in the event that virus activity and Culex populations rapidly rise. Communication Activities: 1. Notify local agencies, media and the public of positive findings. 2. Increase public education activities 3. Continue to regularly update online information, including maps illustrating risk areas. 4. Optional: targeted outreach to high-risk areas including: a. Door hangers b. Online outreach via NextDoor c. Posters and signage d. Coordination with Poudre School District and Colorado State University Communication Topics Overall: o West Nile Virus Basics o Wear repellent o Eliminate breeding sites o WNV policy and spraying decision parameters o How to get notified of mosquito spraying Communication Topics To Targeted Areas: o West Nile Virus risks and symptoms o Wear repellent o WNV policy and spraying decision parameters o How to get notified of mosquito spraying Page 4 of 6 Level III Peak Season – July thru August – Increasing West Nile Virus Activity Status: • More than one human case being reported per week in Fort Collins – OR – • More than one positive human blood donor reported for the season. -AND- • Culex mosquito populations increasing and at or above historical average by 1 standard deviation for that time period– OR – • Mosquito infection rates of > 3.0 per thousand (0.3%) and increasing – OR – • Vector index > 0.75 and increasing Probability of Human Outbreak: High Operational 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. 4. In the event the Health Department recommends adulticide spraying and the City Manager decides to proceed, commence adulticide operations. Communication Activities: 1. 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. 2. Intensify existing public education activities and initiate public education/information on the adulticide program 3. Notify residents of affected and adjacent areas and people on the subscription notification list. 4. 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. Also notify residents in areas that will not be part of the adulticide applications. Communication Topics o West Nile Virus risks and symptoms o Wear repellent o WNV policy and spraying decision parameters o How to get notified of mosquito spraying Page 5 of 6 Level IV Peak Season – July thru August – Emergency Level Status: • Multiple neuroinvasive human cases being reported in Fort Collins - AND – • Culex mosquito populations increasing and at or above historical average by 1 standard deviation for that time period - AND – • Sustained mosquito infection rates of > 5.0 per thousand (0.5%) – OR – • Vector index > 0.75. Probability of Human Outbreak: In progress Operational Response: 1. 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. 2. In the event the Health Department recommends additional adulticide spraying and the City Manager decides to proceed, continue spraying. 3. Secure any needed emergency funding and document costs associated with outbreak control. Communication Activities: 1. Focus as many resources as possible on public education and information; intensify all activities and involve public officials as spokespersons. Consider emergency measures to restrict outdoor activities. 2. Continue public education and information on the adulticide program including pesticides to be used, toxicity, application times, area of application, exposure reduction suggestions, justification, FAQ’s, etc. Notify residents of affected and adjacent areas and people on the subscription notification list. 3. Notify appropriate agricultural interests (i.e. bee keepers, organic growers, etc.) and individuals on the Pesticide Sensitivity Registry of any continued adulticiding activities, times, affected areas, etc. Also notify residents in areas that will not be part of the adulticide applications Communication Topics: o West Nile Virus risks and symptoms o Wear repellent o WNV policy and spraying decision parameters o How to get notified of mosquito spraying Page 6 of 6 Spraying Communication Activities 1. Coordinate communication with Colorado State University and Poudre School District for assistance in communicating spraying activities. 2. Focus all available resources on spraying notification. Communication Topics: o Spraying details: where and when o High quality map (interactive?) o Chemical used o Precautions to take: people, pets, gardens o Opt-out ability o Future spray notifications o WNV policy and spraying decision parameters o Special event contact (i.e., if you are planning a special event outside, please contact PERSON to coordinate spraying activities) PENDING IDEAS UNDER FURTHER INVESTIGATION • GPS tracking and real-time mapping of spray trucks • Mobile app to notify of spraying activities • Interactive online map of searchable addresses and spray zones • Opt-in phone notification system • Advisory Panel Orientation and Communication Form Completed January, 10, 2014 This form is based on research by the City of Olympia and Evergreen State College Triple Bottom Line Analysis Map (TBLAM) Project or Decision: Existing West Nile Virus application guidelines, primarily with adulticide application City-wide. Informing staff recommendation to Council on mosquito. Reduce incidents of contracting WNV. Break transmission cycle at key times through risk index. Evaluated by: Multi-Departmental City team, Dan W. and Mike C. co-leads Social Environmental Economic Community STRENGTHS: Additional stakeholders on the review side adds more perspectives than prior to round out conversation Risk index provides an excellent threshold for measuring virus transmission. Data network is strong; more traps in our area than most places regionally or nationally; helps us verify actual need We have 10 years of baseline data to use to make decisions. Limited registry prevents start-stop and allows for continuity of application We spray less than some communities; i.e., Texas sprays for months on a regular basis without data. Product used is least-toxic product available by EPA standards. New plan now for targeted messaging instead of mass messaging. Historical data and highly-qualified TAC allow us to focus communication resources Discussion raises awareness before uninfected population is exposed to WNV or someone who has been infected STRENGTHS: Risk index provides an excellent threshold for measuring virus transmission. Fighting WNV will help reduce the impact on raptor species currently on the rise. We have 10 years of baseline data to use to make decisions. We spray less than some communities; i.e., Texas sprays for months on a regular basis without data. Product used is least-toxic product available by EPA standards. New plan now for targeted messaging instead of mass messaging will help us focus resources to areas of greatest impact Historical data and highly-qualified TAC allow us to focus product resources where they are most needed and effective Change in application will reduce impacts on habitat, food growing impacts, and human health impacts Can re-evaluate the balance between spreading toxins and reducing WNV health hazard spread STRENGTHS: Breaking transmission cycle cuts down on healthcare costs. Data network is strong; more traps in our area than most Form Completed January, 10, 2014 This form is based on research by the City of Olympia and Evergreen State College Change in application will reduce impacts on habitat, food growing impacts, and human health impacts Can re-evaluate the balance between spreading toxins and reducing WNV health hazard spread LIMITATIONS: Targeting all application to vector index, but not to the number of cases of WNV prevented without application. Cannot correlate spraying to how many people didn’t contract WNV. Few ways to start a control study without impacting people. Registry for pesticide-sensitive populations is stringent, and the number of people who can sign up is limited to registry criteria. HOAs go by mosquito numbers instead of WNV cases to make their local decisions; can spray outside City program at higher application rates. Product used is a broad-based insecticide and affects all small insects in area. Resource- expensive to provide adulticiding services; method of last resort. CBA concern about low rate of infection and high cost of application needs to be shared in perspective Discussions with the public involves private property spraying and property rights Discussions with the public must admit we are spreading a toxin city-wide Spraying will reduce the certifiable area for organic food growing Fossil Creek Reservoir cannot be effectively treated by spraying, and efforts in City areas may be counterproductive if critical areas are not treated Interaction with other political agencies is fractured and reduces effectiveness of application LIMITATIONS Targeting all application to vector index, but not to the number of cases of WNV prevented without application. HOAs go by mosquito numbers instead of WNV cases to make their local decisions; can spray outside City program at higher application rates Product used is a broad-based insecticide and affects all small insects in area. Warm weather in early spring disrupts June 1 spray commencement; allows for baseline population to explode before spraying starts and increases potential spread of WNV Discussions with the public involves private property spraying and property rights Discussions with the public must admit we are spreading a toxin city-wide Spraying will reduce the certifiable area for organic food growing Fossil Creek Reservoir cannot be effectively treated by spraying, and efforts in City areas may be counterproductive if critical areas are not treated Interaction with other political agencies is fractured and reduces effectiveness of application Form Completed January, 10, 2014 This form is based on research by the City of Olympia and Evergreen State College Urban environment with limited spraying still has an impact on the food chain; small bugs to birds to mammals…impact the entire life cycle of a broad group of insects, and everything they influence group of insects, and everything they influence counterproductive if critical areas are not treated Interaction with other political agencies is fractured and reduces effectiveness of application OPPORTUNITIES: Weather data can be incorporated into decisions in the future. HOAs go by mosquito numbers instead of WNV cases to make their local decisions; can spray outside City program at higher application rates – could ask them to incorporate their actions into City-wide program for continuity of application across FC. Spraying adds awareness of effectiveness of personal repellants and other self-mitigation measures. Former communication methods will be reevaluated for better participation, wider messaging, and more targeted communication methods. Personal impacts of WNV can be shared through CPIO to raise awareness and personal action Keeping reduced season of application will reduce potential for pesticide-resistant strains of WNV No lawsuit has been successful against spraying Could use this discussion as a chance to poll our residents on their perception of need and impact Discussion of WNV spraying will open dialogue to revisit County participation and funding and increase effectiveness regionally Cyclical nature of disease requires control vigilance; no pre-determined cycle associated with this disease – must be funded to make application effective Could consider a vector district to focus application to areas of most need and highest effectiveness OPPORTUNITIES: Weather data can be incorporated into decisions in the future HOAs go by mosquito numbers instead of WNV cases to make their local decisions; can spray outside City program at higher application rates – could ask them to incorporate their actions into City-wide program for continuity of product titration. Spraying adds awareness of effectiveness of personal repellants and other self-mitigation measures that would get away from broad-based spray applications and still potentially reduce WNV cases. Funding increases and widening application period would be more effective during warm spring seasons, allows earlier weather-reactive spraying to better effect Personal impacts of WNV can be shared through CPIO to raise awareness and personal action, and support city-wide efforts to reduce spread of WNV Keeping reduced season of application will reduce potential for pesticide-resistant strains of WNV Discussion of WNV spraying will open dialogue to Form Completed January, 10, 2014 This form is based on research by the City of Olympia and Evergreen State College Demographic needs and limitations create opps for Social Sustainability outreach efforts Crowdsourcing app available to raise awareness Patch available to disrupt CO2 we disseminate without chemicals design and maintenance Cyclical nature of disease requires control vigilance; no pre-determined cycle associated with this disease – must be funded to make application effective Could consider a vector district to focus application to areas of most need and highest effectiveness Patch available to disrupt CO2 we disseminate without any chemicals Patch available to disrupt CO2 we disseminate THREATS: If untreated, citizens in FC will get sick and die Virus is already here and is still on the rise in some years Homeless population or low income populations are most at-risk Homes without air condition are more at-risk THREATS: Long-term effectiveness of current chemical is unknown; future resistance to product applied is unknown Text THREATS: Text. NOTES: West Nile Virus TAC Program Response Guideline Comments Offseason: What works? 1. TAC process 2. Analysis of program and previous season 3. Review of program 4. Maintaining the pesticide sensitive registry 5. Mapping activity What Needs Improvement 1. Start larval control earlier 2. Program needs more money 3. When does season start? – Q 4. Look at storm drains (ex: Houston, TX which fogs its stormdrain system in offseason) 5. Expand larval control area to north and east of City 6. Consider adopting a vector district approach 7. Storm detention areas generate major activity – review those/standards 8. Involve planning and zoning on developments and impacts to WNV/mosquito production 9. Do agriculture outreach (perhaps through CSU extension) 10. Increase citizens’ backyard awareness 11. Ongoing public information and communication 12. Have more meetings of TAC (consider monthly) 13. Provide consistent information to urban farms Level 1: What works? 1. Thresholds a. Level 1 has no meaningful threat to human health What Needs Improvement 1. Weather monitoring data needs to be included in decision making 2. Consider early larvaciding 3. Add GDD info to data matrix in reviewing threat 4. Clearly describe program levels 5. Remove monthly reference (later discussion suggested keeping it but adjusting months) 6. Trap earlier based on environmental factors in specific locations (start in SE) 7. April – June = early season 8. Improve communication a. Outdoor patios b. Daycares (Dan addition) 9. Improve repellant options offered in town 10. Groceries and suppliers can stock more effective repellant intensities 11. Review historical info in making recommendations Parking Lot ideas: Council info and direction (we should focus on questions and details Council will want) Alternatives to adulticiding Gardens Children Environmental toxicology Larvaciding Fee for agricultural mitigation – a CA example Zones for evaluating status and treating Trap longer or later – we lose effective decision-making data late in the season based on the current schedule Communication strategies Level 2: What Works? Surveillance system o Trap layout o Trap mix Local testing site Speed of data analysis from traps What Needs Improvement? Vector/status – is this used to interpret all of the City or parts? Definitions needed for program response guidelines Enhance communication to hard to reach populations Start engagement earlier o Consider school years (end of term) for PSD and for CSU Engage all ages Maps ON fcgov.com site Simplify information – create graphics where possible Flexibility on budget (allow flexible allocation of budgeted resources based on environmental factors) Level 3: What Works? Catch basin control program What Needs Improvement? Status measurement changes and clarity How is response level interpreted? How is it used? “AND” on human cases negates the surveillance data Human cases lag from transmission Need to consider personal responsibility Remove reference to abundance of mosquitos Undervalues pipien mosquitoes in vector (LA study was mentioned) Target habitat based on the vector and type (use our data to target specific mitigation activities) Create registry of bees, local farms, sensitive populations Future Approaches: Zone approach Survey residents for communication effectiveness Utilize social media Keep older residents in mind Health marketing Repellant dispenser in high-risk/high-contact areas Contact youth sports and parks’ summer programs consistently Criteria interpretation – clarify use Pipien value/tarsalus value data Adjust response to current threat in season Create registry of bees, farms, gardens, and pesticide sensitive within City Parking Lot ideas: Analyze communication effectiveness o Reaching intended audience o Raise awareness o Evaluate Can we improve larval program? Speciated response Timing of adulticide and trigger Human cases indicator Date: February 20, 2014 Staff: Dan Sapienza Sue Hewitt Molly Gutilla DATA SUMMARY 2013 COMMUNITY HEALTH SURVEY DATA SUMMARY OF FORT COLLINS-SPECIFIC RESPONDENTS REGARDING WEST NILE VIRUS: SPRAYING FOR MOSQUITOES AND RISK OF CONTRACTING VIRUS. About the Community Health Survey Since 1995, every three years the Health District of Northern Larimer County has conducted a community health assessment to determine the health status and healthcare needs of Health District residents. This assessment is used to guide the planning, implementation, and evaluation of services that the Health District provides. This triennial process is used so that health status trends may be followed and heath service needs within the community can be understood on a regular basis. The assessment has three main components: 1. A written community health survey 2. A series of community discussion groups 3. A review of other local, state, and national health data and health trends 2,819 usable surveys were returned from across Larimer County, with a preliminary estimated response rate of about 40%. The data in this report includes only those responses from surveys sent to Fort Collins zip codes (zip codes 80521 through 80528). Data is statistically weighted by age and gender to the estimated population of Larimer County in 2013 from the Colorado Demography Office, to improve representation of underrepresented groups in the sample. Summary In the 2013 Community Health Survey conducted by the Health District of Northern Larimer County, respondents were asked two questions relating to West Nile Virus. The first was about supporting a local health department’s decision to recommend spraying for mosquitoes to control West Nile virus. The second was about respondents’ personal concern of the risk of contracting West Nile virus. Overall, respondents residing in Fort Collins supported the spraying for Mosquitoes if recommended by the local health department, with 69% supporting and 16% not supporting and 15% choosing “don’t know”. Support for spraying is linked with age of the respondents: older residents were significantly more likely to support and younger residents were more likely to oppose. Even with the differences, the majority (57%) of the youngest respondents, 18-29 year olds, would support spraying if recommended by the local health department. About 27% of Fort Collins residents are “very” or “somewhat” concerned about their risk of getting West Nile and about 40% are “a little” concerned. Approximately 30% of the city’s population is “not concerned at all” and another 3% reported having already contracted the virus. As was expected, an individual’s concern with the risk of contracting West Nile is associated with their likelihood of support for spraying for mosquitoes. However, even among those not concerned at all about their risk of getting West Nile, more than half would support spraying if recommended by the local health department. Date: February 20, 2014 2013 COMMUNITY HEALTH SURVEY DATA SUMMARY WEST NILE VIRUS SPRAYING/CONCERNS Page 2 Support for Spraying if Recommended by Local Health Department In the 2013 Community Health Survey conducted by the Health District of Northern Larimer County, households were asked, “If your local health department determined it was necessary to spray mosquitoes to control West Nile virus would you support their recommendation?” Respondents could answer “yes,” “no,” or “don’t know.” Of 1492 respondents identified as living in Fort Collins zip codes, twelve respondents did not answer. A significant majority of respondents indicated they would support the recommendation of a local health official that had determined it was necessary to spray mosquitoes to control West Nile Virus: 69% would support, 16% would not support, and 15% didn’t know. “If your local health department determined it was necessary to spray mosquitoes to control West Nile virus would you support their recommendation?”1 Support for spraying if recommended by a local health department is significantly related to age of respondents. Support was weakest among those aged 18-29 (57%) and strongest among those respondents 70 or more years of age (87%). Those respondents aged 30-49 were the most likely to not support spraying (21%; 62% supported) and those over age 70 were least likely to not support (7%; 87% supported). Support for Spraying with Health Department Recommendations by Age of Respondent2 Would Support 69% Would Not Support 16% Don't know 15% 57% 62% 78% 87% 20% 21% 12% 7% 23% 18% 10% 6% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 18-29 30-49 50-69 70+ Would Support Would Not Support Don't know Date: February 20, 2014 2013 COMMUNITY HEALTH SURVEY DATA SUMMARY WEST NILE VIRUS SPRAYING/CONCERNS Page 3 Personal Concern about Risk of Getting West Nile Virus In the 2013 Community Health Survey conducted by the Health District of Northern Larimer County, households were asked, “How concerned are you personally about the risk of getting sick from West Nile virus?” Response options were “very concerned,” “somewhat concerned,” “a little concerned,” “not concerned at all,” or “I already had a West Nile virus infection, so I am not concerned about it anymore.” Of 1492 respondents identified as living in Fort Collins zip codes, eleven respondents did not answer. A significant majority (67%) of respondents were at least a little concerned with getting the West Nile virus: 7% very concerned, 20% somewhat concerned, and 40% a little concerned. There were 4% of respondents who were not concerned because they had already had a West Nile infection, and another 29% who were not concerned at all. “How concerned are you personally about the risk of getting sick from West Nile virus?”3 Respondents’ reported concern with their personal risk of getting West Nile virus was strongly related to their likelihood of supporting a health department’s recommendation to spray for mosquitoes to control West Nile. Among those who are very concerned, nearly 95% would support a determination to spray, while more than half of those who are not concerned at all (57%) would support a determination to spray. Very concerned 7% Somewhat concerned 20% A little concerned 40% Not concerned at all 29% Already Infected 4% Date: February 20, 2014 2013 COMMUNITY HEALTH SURVEY DATA SUMMARY WEST NILE VIRUS SPRAYING/CONCERNS Page 4 Support for Spraying for Mosquitoes by Respondents’ Concern for Infection by the Virus4 About this Preliminary Data Summary This data summary was prepared by Health District of Northern Larimer County staff. The Health District is a special district of the northern two-thirds of Larimer County, Colorado, supported by local property tax dollars and governed by a publicly elected five-member board. The Health District provides medical, mental health, dental, preventive and health planning services to the communities it serves. For more information about this summary or the Health District, please contact Dan Sapienza, Policy Coordinator, at (970) 224-5209, or e-mail at dsapienza@healthdistrict.org. About the data included in this summary The Health District of Northern Larimer County (Health District) has conducted a survey of Larimer County residents every three years beginning in 1995. Our seventh and most recent survey, The 2013 Community Health Survey, was a written, 16-page, 83-question survey designed to collect data on a variety of health conditions and behaviors, healthcare affordability and coverage, access to healthcare and need for various services. The Health District has contracted with the Wyoming Survey & Analysis Center (WYSAC) to administer the survey, collect and clean the data and conduct preliminary data analysis. In the fall of 2013, a random-sample list of approximately 7,300 households with mailable addresses in Larimer County was obtained, with selected households contacted by mail up to five times. Mailed households were given the option of completing the survey on-line, and about one-third of completed surveys were completed this way. As of February 19, 2014 total 2,819 usable surveys were returned, with an estimated response rate of about 40%. 1 “If your local health department determined it was necessary to spray mosquitoes to control West Nile virus would you support their recommendation?” Q38_If your local health department determined it was necessary to spray mosquitoes to control West Nile virus would you support their recommendation? Valid Percent Valid Yes 69% No 16% Don't know 15% 94% 88% 73% 57% 62% 2% 3% 12% 26% 25% 4% 9% 15% 17% 13% 0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0% 80.0% 90.0% 100.0% Very concerned (7%) Somewhat concerned (20%) A little concerned (40%) Not concerned at Date: February 20, 2014 2013 COMMUNITY HEALTH SURVEY DATA SUMMARY WEST NILE VIRUS SPRAYING/CONCERNS Page 5 2 Support for Spraying with Health Department Recommendations by Age of Respondent Q38_If your local health department determined it was necessary to spray mosquitoes to control West Nile virus would you support their recommendation? * Age Group Age Group 18-29 30-49 50-69 70+ Total Q38_If your local health department determined it was necessary to spray mosquitoes to control West Nile virus would you support their recommendation? Yes % within Age Group 57% 62% 78% 87% 69% No % within Age Group 20% 20% 12% 7% 16% Don't know % within Age Group 23% 18% 10% 6% 15% 3 How concerned are you personally about the risk of getting sick from West Nile virus? Q39_How concerned are you personally about the risk of getting sick from West Nile virus? Valid Percent Valid Very concerned 7% Somewhat concerned 20% A little concerned 40% Not concerned at all 29% I already had a West Nile virus infection, so I am not conce 4% 4 Support for Spraying for Mosquitoes by Respondents’ Concern for Infection by the Virus Q39_How concerned are you personally about the risk of getting sick from West Nile virus? Total Very concerned Somewhat concerned A little concerned Not concerned at all I already had a West Nile virus infection, so I am not conce Q38_If your local health department determined it was necessary to spray mosquitoes to control West Nile virus would you support their recommendation? Yes % within Q39 95% 87% 69% 52% 60% 69% DRAFT West Nile Virus Program Manual March 2013 Parks & Recreation? 215 North Mason Street? Fort Collins, CO 80524? 970-221-6655 fcgov.com/WestNile For additional copies, please download from our website, or contact us using the information above. DRAFT WEST NILE PROGRAM MANUAL i Table of Contents EXECUTIVE SUMMARY ............................ 21 GOALS AND OBJECTIVES ......................... 12 BACKGROUND ..........................................3 HISTORY OF CITY OF FORT COLLINS WNV PROGRAM .......................................4 2003 ................................................................ 4 2004 ................................................................ 4 2005 & 2006 .................................................. 4 2007 ................................................................ 4 2008 ................................................................ 4 2009, 2010, 2011 ............................................ 5 2012 .............................................................. 56 2013 .............................................................. 56 Partners: Colorado Mosquito Control (CMC), CDC, Larimer County, CSU .......................... 6 PERSONAL PROTECTION ...........................7 EDUCATIONAL & COMMUNITY OUTREACH ...............................................9 City Staff Education ....................................... 9 Public Education – Print ................................ 9 Public Education – Video & Electronic ........................................ 9 Other Public Education/Media Relations .................................................... 910 PROGRAM GUIDELINES .......................... 11 Off Season ................................................... 11 Level 1 (Early Season) ................................. 11 Level 2 (Peak Season with Low Virus Activity) ..................................... 11 Level 3 (Peak Season with Increasing Virus Activity) ........................... 11 Level 4 (Peak Season- Emergency Level) ........................................ 12 WNV Advisory Panel .................................. 12 LARVAL MANAGEMENT ......................... 13 ADULT MOSQUITO MANAGEMENT ........ 15 Surveillance ................................................. 15 Testing ......................................................... 15 Adulticiding ................................................. 15 Individual Precautions ................................. 16 Pesticide Sensitive Registry ..................... 1617 CONTINUOUS IMPROVEMENT ............... 18 GLOSSARY ............................................. 19 ATTACHMENTS AND APPENDICES .......... 20 ii DRAFT WEST NILE PROGRAM MANUAL Table of Figures FIGURE 1 – AVERAGE ANNUAL INCIDENCE OF WEST NILE VIRUS NEUROINVASIVE DISEASE, 1999-2012. ................................................................... 1 FIGURE 2 – PRIMARY WEST NILE VIRUS VECTORS BY REGION ................................. 3 FIGURE 3 - FIGHT THE BITE CAMPAIGN .................................................................. 7 FIGURE 4 - CHOOSING A REPELLENT ...................................................................... 8 FIGURE 5 - DON’T GO NAKED ................................................................................ 9 FIGURE 6 - FCGOV.COM/WESTNILE ..................................................................... 10 FIGURE 7 - SPRAY MAP ...................................................................................... 16 FIGURE 8 - PESTICIDE SENSITIVE REGISTRY ......................................................... 17 FIGURE 9 - ANNUAL STEPS FOR PLAN, DO, CHECK & ACT .................................... 18 DRAFT WEST NILE PROGRAM MANUAL 1 Executive Summary West Nile virus (WNV) is a serious health threat to the residents of Fort Collins. The City of Fort Collins employs an Integrated Pest Management (IPM) approach in responding to the threat of WNV in the community. IPM is the recommended strategy for mitigating the risk of WNV by the Environmental Protection Agency (EPA) and the Centers for Disease Control (CDC). (Reference here) IPM is a common- sense approach that uses the least disruptive strategies initially, and then increase intensity as the virus amplifies. This strategy incorporates many tools for reducing the risk of WNV in the community. The tools available at this time are education, communication strategies, personal protection, source reduction, larval site inspection, mapping, larvaciding, adult trapping, adult testing and adulticiding. A key strategy used throughout the history of the program is leveraging local partnerships with individuals and organizations. Initially working with the Larimer County Department of Health and the Environment was a key first step in developing a comprehensive approach to a response to WNV response in the community. The proximity to the local Centers for Disease Control (CDC) office and Colorado State University (CSU) provides access to individuals who volunteer as private citizens, but are also content experts in the field of mosquito management. In 2007, the City Manager directed the formation of the Technical Advisory Committee (TAC) to assist with policy development and review of the WNV Management Program. This brought together many of these content experts and concerned citizens to vet the process. The TAC expanded in 2013 with the addition of two individuals who represent the urban farming community and No Spray Fort Collins Facebook page. FIGURE 1 – AVERAGE ANNUAL INCIDENCE OF WEST NILE VIRUS NEUROINVASIVE DISEASE, 1999-2012. Source: Center for Disease Control and Prevention 2 DRAFT WEST NILE PROGRAM MANUAL Goals and Objectives The goal of the WNV Management Program is to reduce the risk of human WNV infection while limiting adverse human health and environmental impacts. Along the Front Range the Culex varieties of mosquitoes are the vector for WNV. There are several other varieties of mosquitoes in the area, but with the goal of mitigating disease, the program’s focus is specifically on the Culex variety. The objective is to provide control of the Culex variety of mosquito in the most cost effective and efficient manner in order to reduce the threat of WNV transmission in the community. The primary method of control is source reduction and the use of larvacides in areas where the sites cannot be eliminated. The value of personal protection cannot be overstated as an effective tool in preventing the contraction of WNV. An example of a (type) mosquito, which carries and spreads the West Nile Virus disease. DRAFT WEST NILE PROGRAM MANUAL 3 Background WNV is a virus transmitted by infected mosquitoes. The virus can cause symptoms ranging from flu-like conditions to encephalitis (inflammation of the brain) or meningitis (inflammation of the lining of the brain and spinal cord), resulting in long-term effects up to and including death. The virus was first discovered in Uganda in 1937, but it did not appear in the United States until 1999. In 2003, the virus moved into Colorado and appeared in the Fort Collins area. That year, Colorado led the nation with 2,947 cases and 66 WNV-related deaths (CDPHE 2010). Even though there are 65 varieties of mosquitoes that can carry WNV in the United States, there are three varieties that drive the transmission of the virus to humans. In Fort Collins two of the three varieties thrive. These are the Culex tarsalis and Culex pipiens. Up until 2003, the City of Fort Collins did not provide mosquito control for the residents. The program philosophy is to reduce the risk of WNV and to that end there is no intention to provide nuisance control of mosquitoes. This strategy helps reduce the cost and negative impacts of pesticides to the environment and the community. FIGURE 2 – PRIMARY WEST NILE VIRUS VECTORS BY REGION Source: Center for Disease Control and Prevention 4 DRAFT WEST NILE PROGRAM MANUAL History of City of Fort Collins WNV Program 2003 The first human case of West Nile Virus in Fort Collins occurred in 2003. As a result of the arrival of the virus, the City responded under Council direction to mitigate its spread through control of the mosquitos that carried it. Council passed an emergency declaration, Resolution 2003-097.The emergency program in 2003 was composed of citywide adulticiding and select larvaciding in order to break the virus transmission cycle. The relationship with the CDC began as they provided adult mosquito testing free of charge to the City. The mission of the Fort Collins West Nile Virus program at its inception was, and still is, to reduce the human impact of West Nile Virus while balancing social and environmental impacts. Since 2003, the City has invested in outreach efforts to educate residents on the importance of personal protection. After the conclusion of the 2003 season, a comprehensive report assessing the program and its efficacy was published in early 2004. 2004 In 2004, WNV program guidelines were put into place via resolution 2004-082. This resolution focused on the relationship among the City, Board of Health and the WNV program response plan. During this year there was also an ad hoc group of concerned residents and representatives from the Air Quality Advisory Board and the Natural Resources Advisory Board that convened to provide feedback on the WNV response. 2005 & 2006 Both years were relatively quiet for WNV activity. There were mosquitoes that tested positive in both years but the virus did not amplify as in the previous two years. 2007 WNV was more active in 2007, creating the need for adulticide application in the City. As in previous years, residents were concerned about the impact of spraying on human and environmental health. At the conclusion of the 2007 season, the City Manager directed staff to form the citizen Technical Advisory Committee (TAC) made up of community members who are content experts and concerned citizens appointed by the City Manager. The review of the WNV program began in the fall of 2007. 2008 The TAC, formed in late 2007, was comprised of representatives from the Larimer County Department of Health and Enviroment, Colorado State University, an environmental consultant, members of the Natural Resources and Air Quality Advisory Boards, and the medical community of Larimer County medical community. There is a great depth of local knowledge in the area of infectious disease and integrated DRAFT WEST NILE PROGRAM MANUAL 5 Resolution 2008-062 became the WNV management policy, which still guides the program today. The resolution included program response guidelines for integrated pest management including thresholds and actions. One main program element is to meet regularly to ensure efficacy and to incorporate continuous improvement. Regardless of the West Nile Virus prevalence in any particular season, the TAC convenes every year to discuss the data. The committee examines what part of the season were most active, forecasts the next season, and explores new research and techniques. In the spring, the TAC studies weather patterns, arranges schedules and plans for the season. During the off-season, the committee reviews other parts of the program, such as public outreach and larvaciding. Another group created by the WNV Management policy is the WNV Advisory Panel. The panel consists of three members representing from the medical community, the Air Quality Advisory Board and the Natural Resources Advisory Board. They commit to stay current with all information shared during the season and to act as a conduit for this information to be disseminated to their groups. If the County Department of Health Director makes a recommendation to spray, the panel provides feedback regarding its level of agreement or disagreement, and its justification. In 2008, the CDC provided its last year of free adult mosquito control, which forced the program to plan for an alternative vendor to provide this service. 2009, 2010, 2011 These three years had relatively low virus activity. There was no need for adulticiding for three consecutive years. However, the TAC remained vigilant in conducting off-season reviews each year. In 2009, after much research, CSU was named the vendor to provide the adult mosquito testing. The cost of testing is defrayed partially by allowing Loveland to use the testing services on a “pay as you test” arrangement. 2009 CSU cost: $33,296 Loveland portion: $2,220 2010 CSU cost: $33,608 Loveland portion: $3,801 2011 CSU cost: $22,872 Loveland portion: $2,597 In 2011, CSU partnered with a second organization that tests mosquitoes for WNV, which decreased the cost of the testing program. There was also a budget reduction, which reduced early and late season testing. In the 2011-2012 budget cycle, there was a significant reduction in the WNV Management budget. The TAC created recommendations to address the budget shortfall, including shortening the season to simply cover June, July and August. The rigor of the program was not impacted but many outreach programs were eliminated to address the reduction. 2012 2012 was the first year adulticide was used by the City since the adoption of the 2008 WNV policy. Fulfilling 6 DRAFT WEST NILE PROGRAM MANUAL PARTNERS: COLORADO MOSQUITO CONTROL (CMC), CDC, LARIMER COUNTY, CSU Partnerships are a large component of Fort Collins’ WNV Management program. Larimer County is a very close partner in the administration of the City’s WNV program. A representative from the Department of Health and Environment sits on the TAC, provides advice on response protocol and options and is the conduit to state health department. When the City must do control measures and outreach, it coordinates with the County and shares information to assist with decision making. The CDC also has a presence in Fort Collins. For the first five??? years of the WNV program, the CDC conducted mosquito testing and created the risk index. CDC employees have served as TAC members, though they represent their individual views. CSU contributes to the WNV program in multiple ways. The university has provided mosquito testing services at a reduced cost since the CDC no longer performs the service free of charge. The City of Loveland also uses testing services provided by CSU. In addition, CSU faculty and researchers have participated on the TAC and provided data to aid in decision making. The City has a contract with Colorado Mosquito Control (CMC) to provide larvicide and adulticide operations. DRAFT WEST NILE PROGRAM MANUAL 7 Personal Protection Using the 4 D’s to prevent getting WNV is a strategy the City of Fort Collins employs. Drain – Larval source reduction is an effective way to reduce the areas that mosquitoes can breed. Any shallow water left unattended for more than a few days becomes a potential larval site for mosquitoes. Dusk & Dawn – Limit time outdoors during the periods when mosquitoes are most active. DEET – Any repellent approved by the EPA is effective if used according to the label. There are several choices of repellents available from local retail stores. Dress – Long sleeves and pants will deter mosquitoes from biting. If the material is light and tight the mosquitoes can bite right through. Using this technique in conjunction with repellant will increase effectiveness. Personal protection from being bitten by mosquitoes is one of the most effective ways to prevent contraction of WNV. Individuals who believe they have WNV symptoms should see a doctor as soon as possible. FIGURE 3 - FIGHT THE BITE CAMPAIGN Source: Tri-County Health Department 8 DRAFT WEST NILE PROGRAM MANUAL FIGURE 4 - CHOOSING A REPELLENT Source: City of Fort Collins DRAFT WEST NILE PROGRAM MANUAL 9 Educational & Community Outreach Communication and education play an important role in the prevention WNV. The City of Fort Collins is cooperating with Larimer County and other regional entities to conduct a multi-faceted public education campaign. The purpose of these outreach efforts is to encourage the following actions by the public and by City staff:  Take personal protection measures to minimize the risk of exposure to WNV, including limiting time spent outdoors at dawn and dusk, wearing appropriate clothing, and using effective insect repellent.  Reduce mosquito breeding sites by eliminating standing water.  Help health officials in tracking WNV by promptly reporting dead birds, infected horses or infected humans. A variety of communication tools and outreach methods will be employed to deliver this message: FIGURE 5 - DON’T GO NAKED Source: City of Fort Collins CITY STAFF EDUCATION  Training Sessions – live and videotaped  Employee newsletter and online articles  Updates to front-line staff and WNV liaison team PUBLIC EDUCATION – PRINT  Utility bill inserts Posters and brochures at City facilities Posters at Natural Areas and Parks facilities Newsletter articles Door hangers PUBLIC EDUCATION – VIDEO & ELECTRONIC  Cable 14 programs and bulletin board screens  City web site: fcgov.com/WestNile  Online notifications  Facebook, Twitter & NextDoor OTHER PUBLIC EDUCATION/MEDIA RELATIONS  Information provided at City-sponsored special events 10 DRAFT WEST NILE PROGRAM MANUAL  Staff responses to public concerns  News releases  Public service announcements (PSAs) Ongoing education will be the City’s number one priority in our effort to manage West Nile virus. FIGURE 6 - FCGOV.COM/WESTNILE Source: City of Fort Collins DRAFT WEST NILE PROGRAM MANUAL 11 Program Guidelines As part of the TAC recommendations the Program Response Guidelines were created. This is the operational document that drives the response to the threat of WNV in the community. There are four response levels outlined in the guidelines, with triggers and associated responses to those triggers. Based on the IPM practice, the least invasive measures are used early and often and when necessary as the risk increases more harsh tools are used to control the amplification of the virus. Please see the attached Program Response Guidelines. One of the main triggers developed by the CDC is the Vector Index. This index is the estimated average number of infected mosquitoes collected per trap night summed for the key vector species in the area. This index allows the surveillance program to feed data into the calculation to monitor the virus activity in the community. The sections of the Program Guidelines are summarized: OFF SEASON This time of the year is when the TAC reviews the previous season’s data and develops strategies for the next year’s program. The continuous improvement model would define this as the Check and Act segments. LEVEL 1 (EARLY SEASON) This time of the season has low WNV activity. While it will be present, it has not amplified to a level of more serious response. The main focus during this period is public outreach, source reduction, larval site inspections, larval site treatments, inter-agency communication and adult mosquito trapping and testing. This period begins in June and could continue through the entire season depending on the amplification of the virus. LEVEL 2 (PEAK SEASON WITH LOW VIRUS ACTIVITY) During this period of low virus activity the efforts are increased. Focusing again on enhanced outreach and control efforts, the program aims to prevent the amplification of the virus. There may be sporadic human cases, and the abundance and infection rates are on the rise, but the Vector Index remains at a lower threshold. Level 2 can begin as early as mid- June and continue throughout the season to the end of August. LEVEL 3 (PEAK SEASON WITH INCREASING VIRUS ACTIVITY) There are several triggers that are closely monitored and evaluated in this level. When the virus amplifies to this level response actions are intensified. Public outreach is critical to allow individuals to take preventative measures against the virus. All regular control efforts are continued to attempt to alleviate the amplification of the virus. Typically during this time, both temperatures and moisture availability for larval sites are excessive, 12 DRAFT WEST NILE PROGRAM MANUAL LEVEL 4 (PEAK SEASON - EMERGENCY LEVEL) Similar to Level 3, response actions intensify in frequency and intensity. Triggers are monitored, public outreach is increases, and operations move at the highest speed possible. If the County issues an adulticiding recommendation the same review process is initiated as in Level 3. In the event of an application of adulticides the same procedures are followed as in Level 3. This level is typically not reached until the end of July and may persist into September. WNV ADVISORY PANEL In 2008, the Advisory Panel was established with the adoption of the WNV Management Policy (2008-062). This panel is comprised of three individuals from three separate groups (Larimer County medical community, Natural Resources Advisory Board, Air Quality Advisory Board). The group was formed to monitor the WNV activity throughout the season, provide information back to their constituents and, when appropriate, provide feedback on all adulticiding recommendations received by the County. A comprehensive description is found in the attached appendices. Caption? DRAFT WEST NILE PROGRAM MANUAL 13 Larval Management Larval management is one of the cornerstones of the mitigation program. Site inspections and treatments are very effective mosquito control methods. Currently the larvae treatment season runs from June 1 – Aug. 31 each year. Ten years of data has shown that this is the most active portion of the year for mosquitoes. Technicians are trained to identify mosquito larva down to the species and apply the appropriate products to control the larva. The first consideration for any site is the option of source reduction. To date, there are 950 active larval mosquito habitats and 457 mandatory sites (weekly or twice per week inspections based on seasonal potential) included in the inspection and larviciding programs for the City of Fort Collins. There were 135 backyard sites included in the 2013 backyard public inspection program. There were 17 new larval sites added to the active larval inspection program and 13 new backyard sites found in the service area for Fort Collins in 2013. Since the inception of the program, 151 sites have been destroyed or physically modified and no longer pose the potential to produce mosquito larvae; 294 sites have been mapped and listed as not active due to the low potential to produce mosquito larvae. Source reduction is achieved by eliminating mosquito breeding sites by draining standing water where possible. There are many areas in town where source reduction has been achieved successfully. Working with the Storm Water Utility to maintain and improve storm water detention areas so they flow and/or absorb as quickly as possible is an example of source reduction. In other wetland areas source reduction would have a negative impact on desirable habitat. Each site is evaluated on an individual basis so the treatment is appropriate for each area. Caption? When the use of a larvicide is required to control the larva there are several factors that are taken into account so the appropriate product is used. The general philosophy is to use the product that will be as targeted and effective as possible while having the least impact to the environment and human health. The following is the list of products currently used in the program: Vectobac - Bacillus thuringiensis var. Israeli (Bti) This bacterial product is the preferred larvicide used in the program. The efficacy, targeted effects and the reduced environmental impacts make this product a good choice. These bacteria damage the gut of the mosquito larvae when they eat it, causing the larvae to starve to death. Vectolex - Bacillus sphaericus (Bs) This is closely related to Bti and has similar benefits but is considered a true biological control due to the fact that it persists through several broods of mosquitoes. Unfortunately it is cost prohibitive at three times the cost of Bti. Altosid-Methoprene is a synthetic copy of a juvenile growth hormone in mosquitoes. This keeps the 14 DRAFT WEST NILE PROGRAM MANUAL Bonide is a light mineral oil that is only used when pupa is found in the larval site. Once the larva reaches the pupa stage it will no longer feed, which eliminates the use of Bti or Bs products. This product is non- selective in nature as it will eliminate all air-breathing insects in the water until it dissipates. Typically this product is used on newly discovered sites or is an indicator that the reproductive cycles of the mosquitoes are increasing. Please refer to appendix ??? for the Material Safety Data Sheets and labels for each product. The contractor performs quality control inspections in the field from June through the first week of July. In 2013, there were a total of 46 sites inspected, with correct estimation of acreage, product selection and application rate, thoroughness of inspection and time spent inspecting occurring at 82.2 percent of the sites. In 2013, there were an estimated 7.012 billion mosquito larvae eliminated before emerging as biting adults by the larva control program. DRAFT WEST NILE PROGRAM MANUAL 15 Adult Mosquito Management SURVEILLANCE Adult mosquito management begins with a solid surveillance program. The surveillance program is the key to monitoring the WNV activity in the city. A network of fixed traps has been placed throughout the city and is used to develop a base of information that allows temporal and spatial evaluation of changes in the mosquito population. Mosquito traps provide an estimate of the number and kind of mosquitoes present within a geographical area. The subsequent testing regiment allows for monitoring viral infection rates in different mosquito species. Monitoring the presence and location of WNV in species can help to identify geographic areas of high risk, assess the need for and timing of intervention strategies and monitor the effectiveness of prevention and control measures. There are 43 light traps and 10 gravid traps currently in operation from June through August each year. Traps are located in a grid pattern throughout the city (Appendix-Map of Traps). These traps are set out one night per week during the season to collect adult mosquitoes. After collecting the traps, the mosquitoes are speciated and the Culex varieties are pooled in testing tubes for analysis by CSU. This is the most extensive municipal trapping network in the country. The data produced is invaluable in the decision making process. TESTING The second element of solid adult mosquito management is the testing procedure. The captured mosquitoes are identified down to the species. The Culex varieties are then pooled and sent to Colorado State University for WNV testing. In 2013 there were 1,082 pools comprised of 26,113 Culex mosquitoes tested for WNV. When WNV is found in the submitted pools the Vector Index is then calculated. This index is the estimated average number of infected mosquitoes collected per trap night summed for the key vector species in the area. The Vector Index is one of the main triggers in the Program Response Guidelines. It is monitored on a weekly basis throughout the season. In the years when the WNV activity is more active a recommendation to provide adult mosquito control may come from the Larimer County Department of Public Health and the Environment Director. ADULTICIDING The final element of adult mosquito management is adulticiding. Spraying for adult mosquitos is a controversial topic in Fort Collins. The goal of the current program is to reduce the risk of transmission of WNV to people while limiting the negative environmental and health impacts. Simply put, the use of adulticides is a decision based on risk management. The Program Response Guidelines are in place to 16 DRAFT WEST NILE PROGRAM MANUAL The following flow chart depicts the process following a recommendation from the County. Every application of adulticide is done on a two-night cycle three to five nights apart. This is required due to the life cycle of the mosquito in combination with the extremely low levels of pesticide applied in the control application. The female mosquito has already fed on a blood meal to produce the eggs. She has a metabolism rate, which is higher, and thus processes the poison more efficiently and is not controlled by the pesticide. These egg-laying mosquitoes must lay their eggs within three to five days. When their eggs are laid their metabolism slows down so that the pesticide will be effective when they come in contact with it on the second night of application. The permethrin-based product used in adulticiding is applied at a rate of .0035 pounds/acre. This is half the strength of what is allowed on the label. Monitoring and evaluation of effectiveness of the product has shown that this rate is sufficient in achieving positive results. The label also allows for 22 applications per season, which is substantially higher than has ever been initiated by the current program. Typically when adulticiding has been initiated, there have been no more than two cycles (four nights) of application performed in one season. FIGURE 7 - SPRAY MAP Source: City of Fort Collins INDIVIDUAL PRECAUTIONS To minimize pesticide exposure, residents should stay indoors and keep doors and windows closed for 30-60 minutes after spraying occurs. Bring pets indoors as well. A comprehensive list of frequently asked questions (FAQs) is available at fcgov.com/westnile/faq.php#4. PESTICIDE SENSITIVE REGISTRY The program makes accommodations for individuals on the Pesticide Sensitive Registry. The PSR is maintained by the Colorado Department of Agriculture and requires the endorsement of a Colorado licensed physician to verify the evidence of chemical sensitivity in an individual. The Department of Agriculture specifically exempts the use of the registry for mosquito control. The City of Fort Collins WNV Management Policy uses this registry to provide an DRAFT WEST NILE PROGRAM MANUAL 17 enhanced level of protection for individuals that have proven their sensitivity to pesticides. In the early years of the WNV response program an opt-out program was in place but it inhibited the effectiveness of the adulticide program so it was eliminated. FIGURE 8 - PESTICIDE SENSITIVE REGISTRY Source: Colorado Department of Agriculture 18 DRAFT WEST NILE PROGRAM MANUAL Continuous Improvement Per the City’s WNV Management Policy the TAC meets on a regular basis to ensure efficacy of the program. Following the precepts of continuous improvement the steps to Plan, Do Check and Act are initiated to assist with efficacy assurance. In years where adulticides have not been used, the review is fairly simple with a post- and pre-season meeting scheduled. In addition, there is a current Best Management Practice review being completed on four programs. These include studies from California, Washington, Florida and the Xerces Society. The intent is to review and use new ideas and/or procedures to enhance the current program. The greatest danger is complacency when the virus does not amplify during consecutive seasons. Since the virus is now endemic to the area it requires diligence in staying abreast of the intensity of the virus to prevent long-term effects to the residents. Recent studies (Long-Term Clinical ….) have begun to show adverse impacts to individuals who have contracted WNV, even in the less severe cases. FIGURE 9 - ANNUAL STEPS FOR PLAN, DO, CHECK & ACT Source: City of Fort Collins Response Guidlines Technical Advisory Comittee Advisory Panel = PLAN DO CHECK & ACT DRAFT WEST NILE PROGRAM MANUAL 19 Glossary Vector IPM Adulticide Larvicide Light Trap Gravid Trap 20 DRAFT WEST NILE PROGRAM MANUAL Attachments and Appendices  Program Response Guidelines  Yearly report(s) from CMC  Communication tools  Relative Risk Study-Peterson  Maps of Traps  Sample TAC documents (agenda, minutes)  Matrix of program response guidelines integrated with communication plan  NPIC information on chemicals.  Pesticide labels and MSDS’s  Contracts  WNV Advisory Panel Guidelines  Studies 1 West Nile Virus Management Policy & Plan March 25, 2014 2 Overview • Council Feedback Sought • Program Purpose and Focus • Background • Recommendations • Council discussion 3 Direction Sought • Which of the proposed enhancements does City Council wish to see included in the West Nile Virus (WNV) Management Plan (Program Response Guidelines)? • Does City Council wish to formally reconsider the existing Council-adopted WNV Management Policy, which allows the use of adulticiding? 4 West Nile Virus Program Purpose “Reduce the risk of human WNV infection while limiting adverse human health and environmental impacts.” -- West Nile Virus Management Policy Adopted July 1, 2008 5 Program Focus • Provide a wide range of public outreach and education • Extensive ongoing mosquito populations data collection and monitoring, including WNV testing • Aggressive larval control program focusing on Culex mosquitoes • Periodic review to ensure program efficacy 6 2013 Season Summary • 99 cases of WNV in the County • 60 cases in Fort Collins – 51 WNV Fever cases – 9 neuroinvasive cases – 3 blood donors • 84% cases contracted pre spray • 16% cases contracted the week of spraying or later 7 City Council Direction • October 29, 2013 Work Session feedback: – Reconvene Technical Advisory Committee (TAC) – Add new TAC representatives • Urban agriculture • Pesticide sensitive registry – Review Program Response Guidelines – Develop a program manual 8 Review Process • Reconvene the Technical Advisory Committee to review the adulticide operation of 2013 • Investigate Best Management Practices of other agencies: – City of Boulder – Fort Worth, Texas • Recommendations to Council in spring of 2014 9 Technical Advisory Committee • The WNV TAC is composed of City-appointed experts • TAC provides technical expertise and recommendations to City Council regarding the City’s WNV Management Policy • The WNV TAC has met five times to discuss the program operations and provide enhancement recommendations 10 TAC Recommendations • Communication • Larval Management • Source Reduction • Vector District Approach • Opt-out Program • Zones 11 Communication Recommendations: • Paid announcements • Educational video series • Posters, signs & banners • Event booths • Radio spots • Bus ads • Facebook ads • Billboards 12 Larval Management Recommendations: • Expand boundary of larval control program • Return to a weather based larval program 13 Source Reduction Recommendations: • Education of City employees: – Water auditors – Planning department – Parks and Natural Areas employees • County inspectors • CSU Extension-assistance with agricultural watering practices 14 Vector District Approach Recommendations: • Support the implementation of a mosquito control district • Funding generated by a dedicated mill levy tax similar to the current weed district 15 Opt-out Program Recommendations: • Voluntary opt-out program that has educational, inspection and mitigation components • Annual renewal process • Under discussion due to concerns over potential program efficacy issues 16 Zones Recommendation: • Utilize robust trap data to reduce size of adulticide area • Under discussion due pending additional research with CSU statistician 17 Direction Sought • Which of the proposed enhancements does City Council wish to see included in the West Nile Virus (WNV) Management Plan (Program Response Guidelines)? • Does City Council wish to formally reconsider the existing Council-adopted WNV Management Policy, which allows the use of adulticiding? 18 TAC Recommendations • Communication • Larval Management • Source Reduction • Vector District Approach • Opt-out Program • Zones ensure that the level of risk of transmission has elevated to an unacceptable point before the use of adulticides is approved The use of adulticides has been highly debated among the TAC since its inception. Several studies have been referenced to provide the rationale for their use when the risk of transmission has become too great. The topics covered include relative risk analysis (Peterson- Montana), endocrine disruption (find it), effectiveness of adulticiding (multiple on file) and environmental impacts (find). The intent of the WNV Mitigation Program has been to prevent any adulticide applications by performing myriad activities to control the mosquitoes before the virus can amplify. The program has been successful in half the years since WNV appeared in the area. Once a recommendation is received by the City, a 24- hour feedback period begins for the WNV Advisory Panel (Appendix-Advisory Panel Guidelines). Once the panel provides feedback, the decision rests with the City Manager whether to initiate control operations. mosquito larva from maturing into an adult. One positive result from this product is that the larva is still available as a food source for other organisms present that feed on larva. which makes controlling the larva a challenge. Inter-agency communications intensify and it is typically during this period that the County will issue a recommendation for adulticiding operations. Per the City’s policy, this triggers a 24 hour feedback period for the WNV Advisory Panel after which the City Manager will issue the decision for an application. If adulticiding is initiated the notification system is put into motion and route planning begins while taking into account a comprehensive list of activities that might conflict with the application. Typically this level is not seen until the beginning of July and can persist through August. the goal of continuous improvement, the TAC’s end- of-season review in 2012 resulted in several recommendations: enhance communication with schools, conduct more targeted outreach, increase the risk index, and reinstate backyard and stormwater drain inspections. The risk index was raised from .5 to .75 to increase the threshold that must be met to trigger the need for adulticiding. The City also expanded the trapping network in 2012. Five gravid traps were added, making for a total of 10 in the city. That addition, along with Fort Collins’ 43 light traps, makes the City’s trapping network among the most expansive in the country. 2013 In 2013, the prevalence of WNV was high enough to necessitate citywide adulticiding. The City sprayed on two nights to break the transmission cycle. These spraying activities contributed to the risk index decreasing from .85 to .29. mosquito management. Committee members also included employees of the CDC and US Department of Agriculture (USDA), though they were speaking as individuals and not as representatives of their employers. These individuals brought additional knowledge to the group, but were acting as private citizens. City Council charged the TAC with developing policy recommendations for a WNV mitigation policy. The committee’s recommendations were the foundation for comprehensive program guidelines for an Integrated Pest Management approach to preventing human cases of West Nile Virus. On July 1, 2008, the TAC’s policy recommendations were enacted by City Council. No % within Q39 2% 3% 15% 30% 25% 16% Don't know % within Q39 3% 11% 17% 18% 15% 15% all (29%) I already had a West Nile virus infection, so I am not concerned (4%) Support Not Support Don't know revisit County participation and funding and increase effectiveness regionally Change to development patterns could be added; impact to habitat and mosquito-breeding areas, effectiveness of current stormwater infrastructure OPPORTUNITIES: Weather data can be incorporated into decisions in the future. Spraying adds awareness of effectiveness of personal repellants and other self-mitigation measures and could help re-fund spray dissemination city-wide. Funding increases and widening application period would be more effective during warm spring seasons, allows earlier weather-reactive spraying to better effect Keeping reduced season of application will reduce potential for pesticide-resistant strains of WNV No lawsuit has been successful against spraying Could use this discussion as a chance to poll our residents on their perception of a need and impact Discussion of WNV spraying will open dialogue to revisit County participation and funding and increase effectiveness regionally Change to development patterns could be added; impact to habitat and mosquito-breeding areas, effectiveness of current stormwater infrastructure design and maintenance, Cyclical nature of disease requires control vigilance; no pre-determined cycle associated with this disease – must be funded to make application effective Could consider a vector district to focus application to areas of most need and highest effectiveness Long-term effectiveness of current chemical is unknown; future resistance to product applied is unknown Urban environment with limited spraying still has an impact on the food chain; small bugs to birds to mammals…impact the entire life cycle of a broad LIMITATIONS: Cannot correlate spraying to how many people didn’t contract WNV. Registry for pesticide-sensitive populations is stringent, and the number of people who can sign up is limited to registry criteria. Could increase costs of medical treatment. Product used is a broad-based insecticide and affects all small insects in area. Expensive to provide adulticiding services; method of last resort. Warm weather in early spring disrupts June 1 spray commencement; allows for baseline population to explode before spraying starts and increases total product needed to catch up Former communication methods will be reevaluated for better participation, wider messaging, and more targeted communication methods. CBA concern about low rate of infection and high cost of application needs to be shared in perspective Discussions with the public involves private property spraying and property rights Discussions with the public must admit we are spreading a toxin city-wide Spraying will reduce the certifiable area for organic food growing Fossil Creek Reservoir cannot be effectively treated by spraying, and efforts in City areas may be places regionally or nationally; helps us verify cost need Limited registry prevents start-stop and allows for continuity of application New plan now for targeted messaging instead of mass messaging will help us focus resources to areas of greatest impact Historical data and highly-qualified TAC allow us to focus fiscal resources Change in application will reduce impacts on habitat, food growing impacts, and human health impacts Can re-evaluate the balance between spreading toxins and reducing WNV health hazard spread