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A Workshop on Florida Mosquito Control and Reducing Florida's Risk From Dengue and Chikungunya

The chikungunya and dengue cases continue to pile up during 2014 in many regions of the Americas. More than 100,000 Chikungunya cases have occurred in the Caribbean region between December, 2013 and June 1, 2014, and the cases continue to climb. Dengue cases continue to pile up in Central and South America: Brazil with 35,000 cases, Venezuela with 22,000 cases and in Cuba, 3,500 cases in the same period to name a few. The situation is alarming for any country in the Americas with populations of Aedes aegypti and Aedes albopictusi. Florida and much of the southern US is no exception and remains at great risk. There have been focal epidemics of dengue in Florida in 2009, 2010 and 2013, demonstrating Florida's risk from mosquito-borne dengue virus (DENV). More than 25 imported dengue cases have been identified in Florida so far in 2014. Chikungunya virus (CHIKV) now also poses a great risk to Florida with more than 20 imported cases from the Caribbean region imported to Florida so far in 2014 and more imported cases being reported throughout Florida each week.

Those in Florida charged with protecting the public health from mosquito-borne diseases recognize the great danger facing Florida and the enormous challenges in reducing Florida's risk. In particular it is clear that reducing Florida's chance for a dengue or chikungunya epidemic will require effective, efficient and environmentally proper mosquito control to reduce the mosquito vector populations, as well as a strong partnership with government public health officials, mosquito control industry partners, and the academic university experts in mosquitoes and mosquito-borne disease.

 Leaders representing Florida mosquito control, Florida county public health, and the mosquito controlworkshop1 industry, and Florida university vector biologists from throughout Florida attended a Workshop entitled "Protecting Florida from Dengue and Chikungunya through Control of Aedes aegypti and Aedes albopictusi" at the University of Florida's Indian River Research and Education Center in Ft. Pierce, Florida on June 3-4, 2014. The workshop was organized and hosted by the Florida Medical Entomology Laboratory (FMEL, University of Florida) in nearby Vero Beach.

The workshop consisted of two intense days where participants divided into working groups to address the challenges and obstacles facing Florida mosquito control and public health in combating dengue and chikungunya. Over 120 participants representing 35 of Florida's counties attended. The participants came from counties with 75% of Florida's total population, and these counties spend more than 90% of Florida's total budgets directed at mosquito control. About 50% of the participants worked in Florida mosquito control; another 25% represented various county health departments in Florida. Mosquito control participants came from as far away as California and the Cayman Islands. After a plenary session with information provided by several presentations that included papers by Walter Tabachnick of the FMEL, Phil Lounibos, also of the FMEL, Gary Clark, of the Center for Medical, Agricultural and Veterinary Entomology (CMAVE) Lab, USDA, ARS and Dan Kline, also from CMAVE, participants met in different working groups to address a different specific topic. The workgroup topics were 1) surveillance for dengue, chikungunya, Ae. aegypti and Ae. albopictus, 2) source reduction, 3) larviciding against Ae. aegypti and Ae. albopictus, 4) adulticiding against Ae. aegypti and Ae. albopictus, 5) strategies to engage the public in dengue, chikungunya, Ae. aegypti and Ae. albopictus control.

Each working group focused on the same 3 primary issues for their topic. 1) What are the specific available methods to be employed? 2) What are the challenges in making the available methods successful? 3) What strategies will overcome the challenges? The workgroups each also provided 3-5 high priority recommendations intended to improve Florida's capabilities for their specific topic. On the final day all 120+ participants met together to review the major ideas developed by each of the workgroups, listen to the recommendations of each workgroup, add to the ideas and recommendations, and develop an overall consensus about Florida's capabilities and how to improve those capabilities to protect Florida's citizens and visitors.

Many different ideas, issues and ways to improve Florida's capability to control dengue and chikungunya were discussed. Readers can view the summaries of the various workgroups as well as some of the background information provided at the workshop at http://mosquito.ifas.ufl.edu/Workshop/. A document providing details of the workshop and the resulting information and recommendations is being prepared for publication.

The concluding wrap-up session of the workshop was focused on several key critical assessments of Florida's current situation. The workshop participants, representing a substantial portion of Florida's mosquito control and public health professionals unanimously agreed that break-bone fever or dengue, and contorted fever or chikungunya, represented an imminent danger to all of Florida. There was also widespread agreement that Florida must more effectively use available local mosquito control and public health resources. The workshop recognized that it was essential for mosquito control and local county Departments of Health to work work very closely, share information and develop joint strategies and efforts. In particular, it was deemed vital that county health notify mosquito control immediately of where there are even suspect dengue or chikungunya cases. Mosquito control must be so informed in order to immediately assess mosquito vector populations at the locations of such cases and to provide focal control to reduce those populations around suspect cases. Strategies to control the yellow fever and Asian tiger mosquito to reduce break bone and contorted fevers were reviewed and remain Florida's first line of defense.

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"It's Black and White: No Water, No Worries"
From Jim McNelly, Volusia Mosquito Control
District

Another vital recommendation of the workshop was the importance of engaging the public to change their behaviors including direct actions for source reduction to reduce the sites around their properties where Ae. aegypti and Ae. albopictus develop so that mosquito control has a greater chance at reducing mosquito vector populations. A host of strategies were recommended to elicit public concern and the active participation of all citizens in control efforts. These include better media coverage with messages geared to elicit changes in public behavior and greater reliance on ordinances including enforcement of F.S. 388 regulations identifying the illegality of a property owner allowing production of mosquitoes that endanger the public health. John Beidler, who some have called our Dean of Florida Mosquito Control, posed that the names dengue and chikungunya do not convey to the public the nature of these diseases. Mr. Beidler quipped that some use the term CHIK fever and he thought he has had this since he was 11 years old. Hence to get the message to the public the workshop recommended that "breakbone fever" for dengue, and "contorted fever" or "twisted-up fever" for chikungunya were far more appropriate in messages to inform the public of their serious nature.

The workshop showed there is much that is needed for Florida to be better protected against dengue and chikungunya. The participation and hard work of the workshop participants will be the basis for Florida being better prepared. As professionals charged with this great responsibility, we must continue making improvements.

wjt3Walter J. Tabachnick, Ph.D.
Florida Medical Entomology Laboratory
Professor, Department of Entomology and Nematology
University of Florida
Vero Beach, FL