Managing ‘Mozziegeddon’, Media and Public Health Messages

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Beer, high tides, public holidays and blood thirsty mozzies. The perfect mix to set the media into a spin. How can you get the best public health messages out about mosquito bite protection?

It was almost as tricky managing the media this summer as it was the mozzies. Since late October, I’ve been interviewed on almost 50 occasions. A mix of pre-dawn calls from radio stations to live crossed to nationally broadcast breakfast televsion to taking talkback and dealing with mobile phone dropouts. It was a sweaty and stressful couple of months….and ‘mozzie season’ still isn’t over just yet.

The last few years have followed a pretty similar pattern. I get my first few calls around August/September. This is usually when we get our first blast of unseasonal heat and there are typically a few stories about people noticing bugs about their home and are worried about an early start to the mozzie season.

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Mozzie season kicked off early

This year we genuinely did have an early start to the mozzie season. The warmest spring on record kicked off the mozzie season early and one of the first big stories I did for Channel 9 News was almost derailed by swarms of mozzies! A few of the crew needed to retreat to the safety of their car. You can listen to me speaking with ABC New Radio here.

Following plenty of rain in early December, mosquito populations starting jumping up along the coast. Just in time for the Christmas holidays. During this period it is pretty common to respond to requests from media to talk about mozzies, particularly if there have been some public health alters from local health authorities.

Getting ready for a live cross to Weekend Today (Channel 9) but what you cannot see in this shot is the hundreds of mosquitoes that were swarming around me, standing in the middle of the mangroves for 20min getting ready for the segment attracted plenty of mozzie attention!

Getting ready for a live cross to Weekend Today (Channel 9) but what you cannot see in this shot is the hundreds of mosquitoes that were swarming around me, standing in the middle of the mangroves for 20min getting ready for the segment attracted plenty of mozzie attention!

A few things helped keep mozzies in the news. There were health warnings from local authorities after the detection of Ross River virus in southern Sydney. There were warnings about a new outbreak of dengue in Far North QLD. Flooding in central Australia also prompted warnings of outbreaks of mosquito-borne disease.

Then there was this piece I wrote on why mosquitoes bite some people more than others that attracted plenty of attention too….over 1.2 million readers in fact (thanks to republication by IFLS, SBS and Mamamia)!

Moztralia Day Mozziegeddon

As we headed towards our national holiday weekend and Australia Day celebrations, there were warnings that a big boost in mosquito populations were on their way. Yes, “mozziegeddon” was coming and the pesky little biters were set to turn our long weekend into a “moztralia day bloodbath“. Worse still, those taking part in the traditional Australia Day past time of beer drinking were being scared off the booze by fears of becoming “mozzie magnets“.

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“Mozzigeddon” turns Australia Day into Mozztralia Day! Great cartoon by Paul Zanetti accompanying a story at News.com

There is little surprise that stories about beer drinking and mozzies attract plenty of attention. It does almost every year. However, this year was a little different because health authorities were concerned about potential increases in mosquito populations and given recent detections of mosquito-borne pathogens such as Ross River virus, there was concern about public health risks. Those risks range from both the north coast of NSW to north-west of WA!

There was plenty of mosquito media coverage from SE QLD too. Local authorities were battling big mosquito populations and trying to control “3000 known mosquito breeding sites” the next generation of mosquitoes hatching following heavy rain and tidal flooding of local wetlands.

Local insect repellent manufacturers were also taking advantage of the boost in mosquito numbers. I’ve noticed an increase in tv and radio ads spruiking mosquito repellents and Aerogard also sent out “swat” teams to local parklands around Sydney on Australia Day promoting their “Mozzie Index“* website!

Aerogard "Bite Busters" hit the prime picnic spots around Sydney on Australia Day

Aerogard “Bite Busters” hit the prime picnic spots around Sydney on Australia Day

How could this media interest help spread the word on effectively stopping mosquito bites?

In the lead up to the long weekend I spoke with the breakfast show on 2UE (you can listen to the interview via link), Angela Catterns on 2UE, Chris Smith on 2GB as well as Robbie Buck and Linda Mottram on 702 Sydney. I provided a couple of brief grabs for news bulletins and even did my first live cross for the Sunrise breakfast program on Channel 7. You can also listen to interviews with 2SER, ABC Perth and ABC South East SA. [update 26 February 2015. There were a few more interviews, one fun one was with Richard Stubbs for 774 ABC Melbourne and you can listen in below, another was with Dom Knight on 702 ABC Sydney and you can read about that here. and I also chatted with Patricia Karvelas on Radio National Drive and you can listen here.]

It can be tricky getting good public health messages out during these very brief interviews, particularly for television. Radio can be pretty good as there is often plenty of time to get the message out (sometimes even time for talk back callers and questions) but for some of the commercial stations, time can be brief. Television is particularly challenging, I usually spend more time in the make up chair than being interviewed!

This summer I’ve been determined to ensure some key messages get out, particularly about choosing and using insect repellents most effectively. This is an issue I feel strongly about and I have an article coming out shortly in the Medical Journal of Australia on how local health authorities can do this a little better.

The two key messages were “if you’re using botanical based topical repellents, they need to be reapplied more frequently than the recommended DEET and picaridin based repellents” and “when using repellents, they must be applied as a thin coat over all exposed skin to get the best protection, not a dab here and there”.

Overall, I think I managed to get these two points into most radio and television interviews and I was happy to see that the general message got through in a lot of the print/online media too.

Below are some of my tips on getting a specific message out while dealing with the media.

1. Prepare. You would practice giving a conference presentation ahead of time so why not prepare for media? Think about the messages and how you can deliver them. What questions might you get asked? What will be the style of the presenter? Are there any questions you may be asked that you may want to avoid answering (e.g. questions of a political nature or something that could embarrass your employer)? How can you do that?

2. Learn from the professionals. If know you’re going to do some media in the coming weeks or months. Spend some time listening to talk back radio and reading newspapers. Take note of the number and length of quotes journalists use in articles. Make their job a little easier by providing concise quotes where possible. How do radio broadcasters conduct interviews? Listen to politicians and journalists being interviewed. How do they get their message across (or don’t in some circumstances). What makes you “switch off” from an interview – is it the topic or interviewee?

3. Create bridges between questions and your message. This is the thing I’ve found quick tricky but once you’ve got the hang of it, you can more effectively get the message out. There may not be a question asked that specifically relates to the message you need to get out. Learn how to transition from a brief response to the question asked onto the key messages you want to get out there. Don’t just launch off into your spiel at first chance, it is important to engage with presenter too, its a subtle art but like all things, it is only hard before it becomes easy.

4. Post-interview review. I’ll often take notes after an interview that help prepare for the next one. Things like the type of questions asked or how I answered questions, particularly if I feel my responses were clunky or I rambled a little! I’ve always found it interesting that slight differences in the way that questions are asked can often throw you off balance in an interview. If there are talkback callers, what questions were asked, especially if there was something out of left field! Making a note of these can help when preparing for the next batch of media.

5. Keep track of media activity. You never know when it may come in handy when applying for a promotion, grant or new job. I try to keep track of all media activities by recording the date, journalist, media outlet and brief description of topic. You can also speak to your local media and communications unit to see if they gather statistics on these things too. The team at the University of Sydney are great and it is fascinating to compare the analysis of different media activities, their reach and estimated value.

Perhaps the trickiest thing in all this is assessing whether this media activity actually helped the community prevent mosquito bites. It will be almost impossible to tell from human notification data on mosquito-borne disease given the numbers jump around so much from year to year anyway. What really need is some more attitudinal studies to see how people seek out and follow advice provided by local health authorities on mosquito-bone disease prevention strategies. Another thing for the “to do” list

Webb_NineNews_March2015[update 21 March 2015] Following the detection of Ross River virus amongst mosquitoes collected in NSW combined with a dramatic increase in human notifications of Ross River virus disease, there was another wave of interest by local media. You read a piece at the Sydney Morning Herald and watch a segment with me from Nine News.

Why not join the conversation on Twitter?

*A disclaimer: I provided some assistance to a local PR company back in 2012 that developed the “Mozzie Index” for Aerogard, particularly some info on the associations between mosquitoes and local environmental conditions.

Don’t let mozzie bites spoil your tropical “Schoolies” celebrations

With cheap international travel luring plenty of school leavers away from traditional “Schoolies” locations, concerns have been raised regarding a new set of health risks.

Traditionally, the Gold Coast in QLD was the main destination for “end of school” celebrations. Commonly known as “Schoolies”, these celebrations are generally portrayed in the media as pretty wild affairs. It is estimated that around 30,000 people will travel to the Gold Coast in 2013 (around 10,000 will celebrate an hour or so further south in Byron Bay). In recent years, there have also been discussions about alternatives to traditional “Schoolies” activities.

There are plenty of health concerns every year for those partying and this year, CSIRO has teamed up with local health authorities to create a tool to reduce the strain on hospitals. The software predicts how many patients will arrive at emergency, their medical needs and how many will be admitted or discharged. As the Brisbane Times reported:

The most common injuries among 17 to 19 year-olds are expected to include acute drunkenness from alcohol, grazes and cuts to feet, hands and heads, ankle and foot sprains, drug poisoning, asthma attacks, reaction to severe stress, lower abdominal pain and broken noses.  Intoxication is the single biggest reason schoolies turn up to hospitals or at medical tents for treatment, with the number of schoolies presenting for alcohol intoxication tripling between 2011 and 2012.

Lets hope that with a bit of help from some new technology, there is a downturn in injuries and hospitalisations this year. There has even been the suggestion that day-time naps could help prevent many injuries!

While the Gold Coast and Byron Bay continue to be popular destinations, cheap overseas holiday options in Bali are also attracting plenty of school leavers.

Don’t try to shake off that “Schoolies” hangover with a trip to McDonalds, try the local street food in Bali (Photo: Streetfood Blog)

Taking celebrations overseas

While there are many health risks associated with “Schoolies” celebrations across Australia, many are now looking to travel to Bali. Additional concerns are then thrown into the mix.

Health authorities have been issuing warnings about increased measles risks in Bali and encouraging travellers to ensure that they’re vaccinated. The Australian Government’s “Smart Traveller” website warns of measles, magic mushrooms and potentially poisoned drinks.

In addition, there are warnings on the risk of rabies and a range of mosquito-borne diseases (e.g. dengue, Chikunguya, Japanese encephalitis). In particular, there have been reports of surging dengue activity in Bali in recent years. Notwithstanding the risk to travellers, the burden of disease on local communities, particularly children, is significant.

Aedes aegypti (Photo: Stephen Doggett)

One of the key mosquitoes internationally that is responsible for the spread of dengue viruses, Aedes aegypti (Photo: Stephen Doggett)

From a mosquito perspective, the big difference between the Gold Coast and Bali is the presences of mosquitoes that can transmit dengue and Chikungunyna viruses. The risks are different, not only due to the activity of these pathogens but the mosquitoes display a different pattern of biting activity. They bite during the day as opposed to most “Aussie Mozzies” that bite in the late afternoon and evening. This has implications for the effectiveness of topical mosquito repellents against these mosquitoes/pathogens.

In the latest issue of the Broad Street Pump (Newsletter of the Centre for Infectious Diseases and Microbiology & Marie Bashir Institute of Infectious Diseases and Biosecurity), I wrote a piece titled “Are we providing the right advice on personal protection measures against endemic and exotic mosquito-borne diseases?”. The thrust of the paper is that we should be providing specific advice on how to choose and use repellents in these dengue-receptive regions.

The most important issue is that topical repellents should be applied in the morning, and reapplied during the day, to provide protection from mosquito bites. It is equally important that travellers aren’t complacent about the risks of mosquitoes in urban areas. While the preventative measures against malaria (i.e prophylaxis and bed nets) are well know, I suspect that they are mostly associated with travel to rural and “jungle” locations. The problem is, dengue is a disease of urban areas. Perhaps Australian travelers are being complacent?

Rather than being associated with wetlands or rice paddies, the mosquitoes that spread dengue and Chikungunya viruses are closely associated with “man made” water holding containers. Pot plant saucers, discarded tyres, rainwater tanks, uncovered water drums and, probably most importantly, discarded containers ranging from takeaway food containers to bottles and cans.

It isn’t just the parties, the wonderful surf in Bali is surf to attract a few extra Australian travellers to “Schoolies” celebrations (Photo: Aquabumps)

Australia has seen a steady rise in travellers returning with dengue and chikungunya infections. Dengue infection in returning travelers is not uncommon. The majority of dengue infections have occurred in Indonesia. This increase in imported cases may also be a risk to trigger local epidemics in QLD.  Even the movement of infected mosquitoes on aircraft have caused suspected cases of “airport dengue” in NT and WA.

It is important to note that there are some regions in Australia where mosquitoes responsible for the spread of dengue viruses are present. In particular, Far North Queensland experiences annual activity of dengue with occasional small clusters of locally acquired cases. Local mosquitoes typically pick up the virus by biting an infected traveller and then, subsequently, spreading to local residents. There have been about 30 cases of locally acquired dengue in FNQ since the start of the year.

Across Australia, according to the statistics provided by Australian National Notifiable Diseases Surveillance System, we are currently on track to record the highest number of dengue and Chikungunya cases. As of 16 November 2013, there had been 1563 cases of dengue reported and 121 cases of Chikungunya. Compared to the number of cases of dengue, Chikungunya may not seem so bad, until you realise that the highest number of cases previously was only 63 in 2010. The reasons for this increase are probably due to increasing movement of Australian travellers to dengue endemic regions as well as increasing activity of dengue and Chikungunya at these destinations.

What do you do?

Firstly, you head off to Bali to have a great time and, as well as celebrating the end of school with your friends, get a chance to experience another culture (and possibly some good waves). As they say, be alert but not alarmed.

Here are three tips on protecting yourself against mosquito-borne disease:

1. Protect yourself against day-biting mosquitoes. Apply a repellent before breakfast.

2. Take repellent with you. Australian repellents must be registered with the Australian Pesticides and Veterinary Medicines Authority who test for efficacy and safety. You may not be able to get a hold of similar products overseas. Use a repellent that contains either diethyltoluamide or picaridin. These two products are most effective.

3. Apply the repellent like sunscreen, not perfume. An even coating on exposed skin is required. Don’t bother applying it to clothing or “spraying it around the room”, that won’t protect you from bites.

Don’t forget to check out Smart Traveller before heading off to Bali…or anywhere else for that matter. Consult your GP before traveling regarding the appropriateness of anti-malarial drugs. This is particularly the case if you’re traveling to rural areas in Indonesia or heading off to another tropical location for celebrations.

The photo at the top of this post was taken from the 2012 piece “Sex, drugs, cheap beer and ignorance – schoolies completely lose it in Bali

Mosquitoes, Beer & Australia Day

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This Saturday, 26 January 2013, is Australia Day, the official national day and commemorates the arrival of the First Fleet at Sydney Cove in 1788. For many Australians, it is all about BBQs, ferry races, cricket and the Hottest 100. To say beer drinking is common is probably an understatement. Do beer drinkers attract more mosquitoes? Could there be a more perfect story for our local media on the eve of Australia Day?

Besides rain, about the only thing that can spoil the day is a swarm of mosquitoes. Unfortunately, late January is at the peak of the local mosquito season. This year, Australia Day falls about two weeks after some major tidal flooding of our coastal wetlands (particularly the east coast of Australia). This is a major trigger for mosquito activity. This summer has already been marked by ideal conditions for our major nuisance-biting pest and vector of Ross River virus, Aedes vigilax (the saltmarsh mosquito). Current mosquito numbers along the NSW coast are the highest they’ve been this summer and local authorities have issued health warnings.

While the idea that beer drinkers attract more mosquitoes is a quirky story and is bound to spark some media interest, the phenomenon is more than just folklore. There have been a couple of studies looking at the role of alcohol in influencing the attraction of mosquitoes. A Japanese study published in the Journal of the American Mosquito Control Association  demonstrated that drinking 350ml of beer increased the landing rates of mosquitoes.

One of the most recent, and perhaps well publicised, studies was by Lefèvre et al. (2010) “Beer Consumption Increases Human Attractiveness to Malaria Mosquitoes”. In their study, Anopheles gambiae (probably one of the world’s most important malaria vector) were used in Y tube-olfactometer tests to see if their host-seeking behaviour changed in the presence of beer drinking and non-beer drinking volunteers. The results showed that 15 minutes after drinking 2 pints of beer (a little less than 3 schooners by Australian standards), beer drinking volunteers attracted more mosquitoes. The reason for this result was unclear but it wasn’t due to either a change in the temperature of the volunteers or increases in exhaled breath (two factors that are generally thought to increase an individual’s attractiveness to mosquitoes).

There have been many studies over the years that have demonstrated a difference in the attraction of mosquitoes in response to humans. It is a subject that fascinates many people and has lead to many urban myths about mosquito attraction and repellency. While the exact reason why some people attract more mosquitoes than others hasn’t quite been nailed down, it is thought to have something to do with the “smell” of the chemical cocktail of microbes on our skin. There are thought to be over 300 different chemicals on our skin and that their “blend” influences how many more mosquitoes we attract compared to our friends. It is possible that drinking beer changes that blend and, consequently, beer drinkers end up attracting more mosquitoes. In reality, based on recent studies, after a few beers you’ll probably not notice the mozzies and you’ll be a little less effective in swatting them away.

The key issue here though is to remember that not all mosquitoes share the same tastes for humans. Just because Anopheles gambiae is more attracted to beer drinkers, it doesn’t mean that the Australian saltmarsh mosquito will be too. The difference in host-seeking behaviour may be most vividly demonstrated in studies that showed that Anopheles gambiae was attracted to Limburger cheese. This smelly cheese contains bacteria closely related to bacteria found on our feet. While this has been shown to attract mosquitoes with a preference for biting humans, mosquitoes with broader preferences, such as Aedes vigilax, are less likely to be attracted to the stinky cheese.

What does all this mean for beer-drinkers on Australia Day? To be honest, you couldn’t be certain that drinking beer will result in more mosquitoes being attracted to you. However, there is little doubt that there will be plenty of mosquitoes about over the weekend and unless you take precautions to avoid mosquito bites, you’ll end up with a few extra itchy bites on your return to work or school and, at worst, increase the risk of catching a mosquito-borne virus such as Ross River virus. You can find some tips on avoiding mosquitoes here.