Trying To Control Zika’s Spread While Congress Dallies
Yesterday, I updated about Zika cases in Miami and new CDC travel warnings. Today’s focus is on efforts to control the spread of Zika given the lack of funding or concern from Congress.
Puerto Rico and some areas of Florida are now spraying pesticides to try to control the mosquito population. This will likely fail for several reasons. First, the Aedes aegypti vector lives in and around houses and is a daytime biter. If you don’t include door-to-door efforts to eradicate standing water in people’s homes, you will miss mosquito-breeding sites. We lack the personnel to do this and the will, as people here are more concerned about their privacy. Given the gun zealots and “Stand your ground” in Florida, what public health folks would want to risk going door to door there?
Dr. Fred Soper, who helped eradicate mosquitoes in Brazil in the 1930s, was reported to have said that mosquito eradication was impossible in a democracy.
Legal constraints of going into abandoned properties have slowed mosquito control efforts as well. Old tires, paint cans and neglected swimming pools all serve as mosquito breeding grounds. Given that even an empty bottle cap is large enough for a mozzie nursery, it’s clear what an intensive effort is needed to eradicate their habitats. A further hurdle is that the Aedes mosquito eggs can be dormant for a year, without any water, and later hatch when conditions are more favorable.
Pyrethroid (like Permethrin) sprays have been ineffective, including in the current area in Miami. As I noted in Mosquito Wars, mosquitoes are resistant to many of the commonly used pesticide sprays.
There is also a justifiable mistrust of pesticides, especially in Puerto Rico, where there is a history of unethical experiments. This is part of why I support the use of Oxitec’s GMO mosquito and of mosquitoes infected with Wolbachia. Puerto Rico recently rejected recommendations to allow aerial spraying of an organophosphate pesticide, Naled, which can have serious side effects.
Dr. Aileen Marty, professor of infectious diseases at Florida International University, recommended use of Bacillus thuringiensis israelensis, aka BTI. This bacteria is nontoxic and is an effective larvicide used to clear standing water of the mosquitoes.
Florida is not using Naled at this time. Marty said that, if needed, “doses would be minimal” and “We do our best to minimize effects.” She said that if conditions with Zika worsened, they would have to consider its use, analogously to using chemotherapy for a cancer.
To control the mosquitoes and protect vulnerable people, we need to focus on cleaning up the environment — the trash and standing water in all neighborhoods, decaying abandoned houses and to ensure access to decent housing with basic protective window screens. Dr. Peter Hotez, dean of the National School of Tropical Medicine, part of the Baylor College of Medicine, has stressed disparities and how poverty disproportionately puts people at risk of insect-borne infections, including Chagas, the mosquito-transmitted viruses and neglected tropical infections.
We need intensive education to ensure people clean up any standing water inside the home as well, to use mosquito repellents correctly and to provide all susceptible people (not just pregnant women) insecticide-treated bed nets. As Tanjim Hossain, a mosquito expert at the University of Miami notes despairingly, “in Miami some people still don’t know mosquitoes breed in standing water, among other ‘basic’ mosquito knowledge. We can and should do more to educate the public to make public health interventions more effective. Imagine if we had a short mosquito unit, even one day, in elementary schools. Or the budget to do flyers and ads every rainy season. ‘Drain and cover’ should be words every single resident knows.” “Aggressively pursuing an integrated vector management (IVM) approach is critical in the long run for both prevention and control,” he concluded.
Florida and the CDC are providing households at risk with Zika protection kits. Unfortunately and shockingly, mosquito nets are only being provided to families with pregnant women, and the funding for providing even these modest prevention kits is running out, according to Dr. Marty.
The SC Johnson company has just donated more than 500,000 OFF! Deep Woods® Towelettes to the CDC Foundation, and more than $7 million of OFF!® products and financial donations to help with mosquito control. Earlier contributions of DEET repellents have gone to the Red Cross, AmeriCares and FeedingAmerica food banks, among other.
Since many of the pregnancies, especially among teens, are unintended, we need to have accurate sex ed — not ineffective abstinence only — and ensure access to effective contraceptives. Congress failed funding Zika because the Republicans put in a poison pill clause attacking Planned Parenthood. The House Republicans also tried to strip funding from Title X Family Planning program, which provides sexual/reproductive “health services to about 4.1 million patients and prevents about 1 million unplanned pregnancies each year,” and to cut $108 million in teen pregnancy prevention grants.
Florida’s Rick Scott also signed a bill to remove any state funding for organizations even affiliated with a licensed abortion clinic. How is defunding Planned Parenthood—a primary source of medical care for many women, as well as contraceptives—going to help reduce microcephaly in Florida? Perhaps his current request for federal aid should be contingent on having rational plans to control the coming epidemic. Perhaps increasing funding for public health could be a start.
How can you protect yourself?
Again, the keys are controlling mosquitoes in your environment, including eliminating any standing water inside your home. If you can’t screen your home, use a bed net at night — but know that mosquitoes bite during the day as well. Use BTI for any standing water around your home to kill mosquito larvae. Spray your clothes (not skin) with Permethrin. This is very effective against ticks as well. Use an effective, EPA-registered insect repellent, on your skin. I explained the options for effective repellents here.
Finally, pray that our elected representatives will do their jobs to protect their constituents by funding public health efforts. Elections matter. Hold them responsible.
This article was written by Judy Stone from Forbes and was legally licensed through the NewsCred publisher network.
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