GIVE

One World: Hati, Dengue, Florida

The tragedy in Haiti due to the January 2010 earthquake is unfolding for the entire world to see. Though relief is being sent as quickly as possible from many sources, it is clear that the problems and devastation are overwhelming.

The people of Haiti face enormous difficulties. The destruction in Haiti, the plight of its people, the injured, the lack of basic necessities of shelter, food, water, health care, must be attended to as quickly as possible with the highest priority.

I call your attention to a lower priority at the moment that might prove significant over the next few months and could directly affect Florida and the U. S. Prior to the earthquake Haiti was endemic for dengue, with resident Aedes aegypti populations, though the extent is difficult to gauge due to the lack of reporting in Haiti prior to the earthquake. The earthquake caused huge damage to buildings and the infrastructure of this already poor country. The pictures of devastation are heartrending showing the enormity of a region reduced to rubble. What of Ae. aegypti and Ae. aegypti larval habitats? One might expect a likely increase in exposed artificial containers amid the debris, which with resulting greater exposure to biting Ae. aegypti due to the lack of housing will likely contribute to an increase in dengue in Haiti.

The presence of large numbers of aid workers from places outside Haiti with no history of dengue and therefore immunologically naïve to dengue virus, will also serve to increase the potential for increased transmission and spread of dengue when aid workers return to their home in regions where there are resident Ae. aegypti or Aedes albopictus populations. Florida and the southern U. S. should be concerned.

Is there something that can be done to help Haiti should dengue appear over the next few months, and to mitigate the impact of potential imported dengue and subsequent transmission in Florida and the U.S.? Actions taken in Haiti to reduce dengue will pay dividends if this prevents the spread of dengue to the U.S. What is the role for Florida mosquito control? Is Florida mosquito control prepared for dengue should it appear here?

The 2009 dengue outbreak in Key West demonstrates that Florida is at risk (Tabachnick, WJ. 2009. Dengue in Key West, 2009: Florida Keys Mosquito Control and the Florida Department of Health swing into action. Buzzwords ). The response to the outbreak by Florida Keys Mosquito Control (FKMC) was impressive. The FKMC has a history of aggressive control against Ae. aegypti in Key West. Their efforts were increased and focused to reduce Ae. aegypti populations once dengue cases were reported. Will other Florida districts be as well prepared? Was the state response to assist FKMC and increase their capacities adequate? Will the state response to provide assistance and support be adequate for other districts? What can we all learn from the Key West outbreak that will improve Florida’s capabilities to mitigate dengue in Florida?

I recommend that every Florida mosquito control district conduct an appraisal of their capabilities as preparation in the event they find themselves in a similar situation with cases of dengue. The appearance of dengue will require a planned response and significant resources to reduce cases.

What are some actions that Florida mosquito control districts should immediately take in preparation?

  1. Develop an appraisal of district capabilities to target Ae. aegypti and Ae. albopictus populations.
  2. Prepare operational plans using effective strategies for adulticiding, larviciding, source reduction, etc., for Ae. aegypti and Ae. albopictus.
  3. Consider if additional resources, training etc., will be needed by the District and its personnel to meet challenges to provide effective Ae aegypti and/or Ae. albopictus control to reduce transmission.
  4. Communicate with other Districts, Florida DACS and DOH colleagues to elicit and develop plans for their providing additional resources, people, and equipment to your District in case it is needed.
  5. Conduct an assessment of Ae. aegypti and Ae. albopictus populations in your district. Are there hot spots? Are there selected areas in the district with large populations that are likely higher priority for targeted control compared to other areas? Assign priorities for possible operations.
  6. Comprise the best available methods that will allow you to quickly identify hotspots for Ae. aegypti and Ae. albopictus habitats, i.e., GIS, larval sites, containers, bromeliads etc.

Now is the time for preparation to ensure that Florida mosquito control provides efficient, effective and environmentally proper methods against dengue. This is not the time for Florida to reduce its commitment to protect the health and well being of Florida’s citizens and visitors. There is great need for new methods and strategies to protect Florida against dengue, West Nile, St. Louis, Eastern equine, Chikungunya and malaria that requires new information, greater capability to share communications, and greater unified state responses where state capabilities can be marshaled quickly to mitigate outbreaks in specific regions.

At this very time when Florida is facing serious new challenges due to mosquito-borne pathogens, DACS is again recommending draconian reductions for the Florida state aid program for mosquito control. We all recognize that the Florida state budget is once again in dire straits. However, reducing Florida’s small commitment to mosquito control programs and mosquito control research is patently irresponsible in view of the consequences it will have to Florida’s future health. The Florida Coordinating Council on Mosquito Control, charged with advising DACS, unanimously advised DACS not to make any reductions to the state aid program at their Feb. 9, 2010 meeting. The DACS recommendation has essentially no support among Florida’s mosquito control and public health professionals. Mosquito control and public health professionals have a responsibility to provide correct accurate information to Florida’s legislators so they are fully aware of the grave consequences of making wrong decisions concerning state support for mosquito control. Doing otherwise would be negligent.

Remember to participate in the Florida Mosquito Control Association’s Tallahassee Days to make sure your views are heard by the State’s legislators.

 

walterWalter J. Tabachnick, Ph.D.
Florida Medical Entomology Laboratory
Professor, Department of Entomology and Nematology
University of Florida, IFAS, Vero Beach, FL