Oklahoma City-County Health Department 2003 West Nile Virus Program

1. Oklahoma City-County Health Department2003 West Nile Virus Program Staci L. Myers, DVM Department of Epidemiology

2. West Nile virus is here to stay The primary transmission cycle is between birds & mosquitoes Can’t eliminate the virus without eliminating either vector or reservoir No vaccine for humans in the near future Mosquito control is the only way to reduce risk of infection

3. Why worry about WNV? Human cost Deaths Permanent debilitation in 50% of survivors Direct medical cost A Louisiana study showed an average cost of $51,826 per person Range from $2,000 - $242,000

4. Goals of OCCHD’s West Nile virus program for 2003 Examine countywide distribution of avian & human WNV cases in 2002 Provide education on WNV to the public Institute countywide mosquito trapping & testing Monitor distribution of avian WNV in 2003 Rapid investigation of human WNV cases Encourage development of municipality-level mosquito control programs

5. 2002 Avian WNV Distribution 53 positive birds in Oklahoma county OKC - 29 Edmond - 10 Midwest City - 5 Del City - 4 Bethany - 2 Choctaw - 1 Harrah - 1 Nichols Hills - 1 Blue jays & crows most frequently seen

7. 2002 Human Cases Only 3 human cases in Oklahoma County All in north OKC All > 50 years of age 1 death The oldest of the 3 individuals (78 years) Avid gardener; collected rainwater, but did not cover containers Environmental assessment found lots of mosquito larvae & adults in the garden area

9. Mosquito Surveillance/Testing - 2003 Conducted at sites around the county Trapped mosquitoes will be speciated Identify areas where WNV transmission could occur Mosquito pools will be tested for WNV Identify areas where WNV is already present Multiple types of traps will be used

11. Avian Surveillance/Testing The presence of WNV in local birds is the most reliable indicator of risk to humans OSDH will be testing birds from OK county OCCHD will report results to municipality officials Crows, blue jays & hawks/raptors only Deaths in other species will be tracked by OCCHD Contact Epidemiology Services at 425-4437 OCCHD & OSDH can not pick up birds Municipalities may wish to consider local drop-off points with daily delivery to OSDH to ensure testing of birds from their areas

12. Investigation of Human Cases Rapid initiation of investigation upon confirmation of human WNV infection Identification of environmental factors favorable to mosquito breeding Advise initiation of mosquito control measures to prevent further human infection Data from surveillance & investigation will be used to advise municipality pesticide use

13. Development of Municipality Mosquito Control Programs & the OSDH Grant Funds

14. Current Funding $14,000 is available to assist with mosquito abatement programs in this fiscal year OCCHD will use these funds to reimburse a portion of monies spent on pesticide purchase as part of a planned mosquito control program It has been decided to emphasize larvicide use at this point Additional funding is anticipated, but not guaranteed, in the next fiscal year (after July 1) Reimbursement program will be administered by ACOG

15. Reimbursement Limits No more than 50% of total spent The cap may be less than 50% Reimbursement caps will be set based on: Total number of participating municipalities 2002 Avian/Human WNV disease Areas with more 2002 WNV activity will be eligible for more funds than those with no recorded WNV activity All participating municipalities will receive some reimbursement

16. Reimbursement Cap Calculation Based on point totals Each participating municipality automatically receives 1 point 1 additional point for each avian WNV case in a municipality 1 additional point for each human WNV case in a municipality Total all points & divide into $14000 for share quantity Each municipality gets 1 share per point.

18. Requirements for Participation Designate 1 or more individuals to attend May 19 seminar & become certified in pesticide handling & application Designate a person or agency to respond to public nuisance complaints involving conditions favorable to mosquito breeding & provide OCCHD with contact # Submit a written program plan to ACOG Identify target areas for pesticide application Based on 2002 WNV surveillance and/or 2003 environmental/mosquito trapping data provided by OCCHD Identify which pesticides are to be purchased Purchase approved pesticides Submit purchase receipt & reimbursement request to ACOG based upon reimbursement criteria

19. Future Components of Mosquito Control Programs Not required for participation in this grant distribution, but highly recommended to maximize mosquito control & may be tied to future grants Public Education Elimination of mosquito breeding sites around homes Reduction of exposure to mosquito bites Mosquito trapping/testing by municipalities Increases the number of sites that can be monitored Identification of problem areas Evaluation of effectiveness of control programs Adulticides – spraying/fogging

20. Future Funding? Future federal grants are anticipated, but not guaranteed Available funds will be distributed based on: 2003 mosquito surveillance WNV positive mosquito pools Negative pools containing species of concern 2003 avian surveillance 2003 human case distribution As with the current grant monies, all participating municipalities will receive some funding, even if no WNV activity is found Suggestions for utilization of future funds are welcomed

21. QUESTIONS?