HomeMy WebLinkAboutCOUNCIL - AGENDA ITEM - 03/18/2014 - WEST NILE VIRUS MANAGEMENT POLICY PLAN (ITEM POSTPDATE:
STAFF:
March 18, 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 18, 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 18, 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 18, 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 18, 2014 Page 5
ATTACHMENTS
1. WNV Program Manual (Draft) (DOCX)
2. Program Response Guidelines 2013 (PDF)
3. West Nile Virus overview 2013 Community Health Survey (PDF)
4. Triple Bottom Line Analysis (PDF)
5. TAC Program Response Guideline Comments (PDF)
6. West Nile Virus Management Policy - Resolution 2008-062 (PDF)
7. Work Session 031814 (PPTX)
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
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
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%
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
1
West Nile Virus Management Policy
& Plan
March 18, 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
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 who provide technical expertise and
recommendations to City Council regarding the
City’s WNV Management Policy.
• The WNV TAC has met five times to discuss the
previous WNV season and provide
recommendations for future response guidelines.
• Two additional meetings have been added.
10
TAC Recommendations
• Communication
• Larval Management
• Source Reduction
• Vector District Approach
• Opt-out Program
• Zones
11
Communication
Recommendations:
• Paid advertisements
• 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.
• Yearly renewal process.
• Under debate due to concerns over potential
program efficacy issues.
16
Zones
Recommendation:
• Utilize robust trap data to reduce size of adulticide
area.
• Under debate due to further research with
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
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
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
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.