Social media and blood suckers showcased at the International Congress of Entomology

instagram_wetlands_webb

Digital technology is changing a lot about how we undertake entomological research and communicate the results of that research to the community and policy makers.

This week in Orlando, Florida, is the International Congress of Entomology (ICE). A huge gathering of entomologists from around the world. While it was a great pleasure to be invited to participate, I couldn’t get over there this time.

I will, however, have a chance to present my work in the Symposium “Entomology in the Digital Age”  Friday, September 30, 2016 (01:30 PM – 04:45 PM), Convention Centre Room W222 A.

In the presentation I’ll share some of the reasoning behind my use of social media to engage the community with both entomological research and public health communication. Most importantly, it will focus on some of the metrics I’ve recorded alongside my use of social media, maintaining a blog of research and writing for outlets such as The Conversation.

I’ve written about my use of social media and how it can help extend the reach of public health messages and presented on the topic alongside a range of great speakers at the 2014 Entomological Society of America meeting in Portland.

This time around, technology is playing an even more direct role in my presentation! I’ve pre-recorded my presentation and it will be shown to the audience on the day among other presentations. I’ll also be checking into the session to answer questions. Despite the fact I’ll need to be up around 1:30am due to time differences, it should be fun.

See the abstract below…

Taking entomological research from the swamps to the suburbs with social media

Cameron E Webb

Connecting scientists and the community is critical. This is particularly the case for medical entomologists working in the field of mosquito-borne disease where the translation of entomological research into improved public health outcomes is a priority. While traditional media has been the mainstay of public health communications by local authorities, social media provides new avenues for disseminating information and engaging with the wider community. This presentation will share some insights into how the use of social media has connected new and old communications strategies to not only extend the reach of public health messages but also provide an opportunity to promote entomological research and wetland conservation. A range of social media platforms, including Twitter, Instagram, and WordPress, were employed to disseminate public health messages and engage the community and traditional media outlets. Engagement with the accounts of traditional media (e.g. radio, print, television, online) was found to be the main route to increased exposure and, subsequently, to increased access of public health information online. With the increasing accessibility of the community to online resources via smartphones, researchers and public health advocates must develop strategies to effectively use social media. Many people now turn to social media as a source of news and information and those in the field of public health, as well as entomological research more generally, must take advantage of these new opportunities. doi: 10.1603/ICE.2016.94611


If you’re at ICE, you can also catch up with my PhD student David Lilly who’ll be presenting our research into the development of insecticide resistance in bed bugs as part of the symposium “New Insights into Biology, Resistance Mechanisms, and the Management of the Modern Bed Bug” Friday, September 30, 2016, 01:30 PM – 04:45 PM, Convention Center, West Hall F4 (WF4).

Novel insecticide resistant mechanisms in the common bed bug, Cimex lectularius

David Lilly, Cameron E Webb and Stephen Doggett

Introduction: Research on field strains of Cimex lectularius from Australia has identified widespread resistance to pyrethroid insecticides, but variability in the magnitude expressed. To determine if differences in resistance mechanisms exist, collected strains were examined for the presence of metabolic detoxification and/or cuticle thickening. Methods: The presence and relative contribution of detoxifying esterases or cytochrome P450 monooxygenases were assessed. Bed bugs collected from Parramatta (NSW), Melbourne (VIC) – 2 strains, ‘No.2’ and ‘No.4’, and Alice Springs (NT) were exposed in topical bioassays employing deltamethrin and two pyrethroid synergists: piperonyl butoxide (PBO) and EN16/5-1. PBO inhibits both monooxygenases and esterases, whereas EN16/5-1 will inhibit esterases only. Thus in a comparative bioassay, the results can infer the dominant enzyme system. The Parramatta strain was then selected to study the potential presence of cuticle thickening. Nine-day-old male bed bugs were exposed to filter papers treated with the highest label rate of Demand Insecticide®(200mL/10L of 25g/L lambda-cyhalothrin) and were grouped according to time-to-knockdown (< 2 hours, ≥ 4 hours, and survivors at 24 hours). Measurements of mean cuticle thickness at the transverse midpoint of the second leg tarsus were taken under electron microscope. Results/Conclusion: All strains possessed resistance that was inhibited by the synergists, with the Parramatta and Melbourne No.2 indicating esterase-dominance, and Alice Springs and Melbourne No.4 indicating cytochrome P450 monooxygenase-dominance. Cuticular measurements demonstrated that bed bugs surviving deltamethrin exposure had significantly thicker cuticles, denoting a novel form of resistance in these insects. doi: 10.1603/ICE.2016.92553

 

You can also see Stephen Doggett (co-author and photographer of A Guide to Mosquitoes of Australia) speaking on photographing mosquitoes to in the symposium “Insect Photography Symposium: Bringing the Small to the World.


You can join the conversation on Twitter and keep an eye on all the fun in Orlando by keeping an eye on the tweet stream!

 

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Can social media help translate research to practice and promote informed public health messages?

I’m a Senior Investigator with the Centre for Infectious Diseases and Microbiology – Public Health. One of our primary focuses is translating research into improved public health outcomes. With NSW Population Health and Health Services Research Support Program assisting our work, we’re exploring new ways to achieve this objective. My experience of using social media was selected to be showcased among other case studies in 2015. 


Nuisance-biting mosquitoes and mosquito-borne disease are concerns for local authorities in Australia. 2015 saw the largest outbreak of mosquito-borne Ross River virus disease for more than 20 years with over 9,500 cases nationwide. In NSW, there were 1,633 cases compared to the annual average since 1993 of 742 cases per year. Notwithstanding the current outbreak, other endemic, as well as exotic, mosquito-borne pathogens represent future threats to public health.

As there is no large-scale mosquito control program in NSW, reducing the contact between mosquitoes and people is primarily achieved through the promotion of personal protection measures. NSW Health promotes the use of topical insect repellents in combination with behavioural change to avoid natural mosquito habitats and the creation of mosquito habitats around the home. This information is typically provided in the form of posters, brochures, online factsheets, and seasonal or outbreak-triggered public health messages issued by Local Health Districts or the NSW Ministry of Health.

With the emergence of new communications technologies, particularly the rise in popularity of social media, there are new opportunities for public health communications.

The aim of the current research was to determine the reach of public health messages through social media by tracking engagement, audience and relative value as assessed by media monitoring organisations and metrics provided by hosting services of social media platforms.

Assessing activities and processes

Dr Cameron Webb (CIDM-PH) has focused much attention on filling the gaps between current public health messages and findings from recent research into topical mosquito repellents.[1] For example, while public health messages provide accurate information on the insect repellents that provide the best protection, there is a paucity of information provided on how best these products should be used by individuals and those they care for.

Dr Webb’s engagement with mass media, online media (e.g. The Conversation), a personal blog (e.g. Mosquito Research and Management) and social media (e.g. Twitter) has resulted in substantial exposure of focused and informed public health messages. From mid-2014 through to the end of 2015, Dr Webb participated in over 80 mass media articles and interviews in print, online, radio and television media with public health information reaching an estimated audience of over 10 million people.[2] The focus of his messaging around mosquito-borne disease was to highlight the best way for the community to choose and use mosquito repellents; stressing the importance of active ingredients and application methods. This fills a gap in the current provision of public health information while also augmenting public health alerts and messages associated with the 2015 outbreak of Ross River virus disease.

Social media has become a “go to” source of information for much of the community. Information shared on Facebook, Twitter, Instagram, and YouTube has the potential to shape the habitats and behaviour of the community. Dr Webb is active on Twitter (currently followed by over 4,500 people); he uses the platform to engage with the social media accounts of journalists and broadcasters to establish a voice of authority in the field of mosquito-borne disease prevention and extend the reach and exposure of public health messages broadcast through mass media. Using Twitter to share links to informed articles following interviews reached hundreds of thousands of people by being shared by the social media accounts of journalists, media outlets, government organisations and community groups. During the 2014-2015 summer, tweets by Dr Webb reached an estimate 1.28 million people.[3]

Dr Webb regularly writes open access articles on his website, attracting around 250 daily visitors with over 117,000 article views.[4] In addition to his personal website, Dr Webb regularly contributes articles to The Conversation (a website for academics to share expert opinion and write about their latest research). His articles have attracted over 120,000 readers. However, one article “why mosquitoes seem to bite some people more” (published 26 January 2015) has alone been read by over 1.3 million people.[5] This “non-scholarly” writing not only establishes CIDM-PH scientists as authorities in public health matters but can also assist in directing the public to official health guidance provided on official websites and other sources.

Dr Webb’s activities provide a framework for how health authorities may engage with social media to extend public health messages. Organisations or individuals can connect health authority information with the community through media outlets. He has been invited to share his experiences in this field at local and international conferences and workshops including those coordinated by the Public Health Association of Australia, Australian Entomological Society and Entomological Society of America. In addition, Dr Webb has been invited to provide lectures on the benefits of social media for public health advocacy to undergraduate and post-graduate students at the University of Sydney.

While traditional messaging provided by health authorities will remain a staple in public health campaigns, social media provides a connection between traditional and emerging media and communication organisations. This increased connectivity between public health advocates, the media and community has the potential to greatly improve the awareness of mosquito-borne disease and increase the rate of uptake and application of strategic personal protection measures.

References

  1. Webb C.E. (2015). Are we doing enough to promote the effective use of mosquito repellents? Medical Journal of Australia, 202(3): 128-129.
  2. Estimated audience reported by Kobi Print, Media and Public Relations, University of Sydney, 23 April 2015, based on data provided by media monitoring organisation isentia.
  3. Estimated from total “tweet impressions” for the period October 2014 through April 2015 provided by Twitter Analytics (https://analytics.twitter.com/user/Mozziebites/home accessed 30 April 2015)
  4. Data provided by WordPress statistics (accessed 18 December 2015)
  5. Data provided by The Conversation metrics (accessed 18 December 2015)

This article was originally published by NSW Health showcasing some of the work within the NSW Population Health and Health Services Research Support Program. You can see the original article here.

Does Zika virus pose a threat to Australia?

They’re small, spindly insects but their threat never dwindles – the bites of mosquitoes threaten death and disease in many parts of the world. The emergence of a little-known virus, Zika, from an African forest, is the latest to alarm the public, politicians and health authorities because of its potential link to birth defects.

What is Zika virus?

Zika virus is a mosquito-borne virus closely related to dengue and Yellow Fever viruses. Discovered almost 70 years ago in a Ugandan forest, the virus generally only causes a mild illness. Symptoms include rash, fever, joint pain and conjunctivitis.

Severe symptoms aren’t common and the illness was never thought to be fatal.

Despite detection throughout Africa and Asia, the virus rarely entered the spotlight of scientific research. It was overshadowed by the spread and impact of dengue and chikungunya viruses, which infect millions of people across the regions.

In the last decade, Zika virus outbreaks have occurred in the Pacific, with reports of severe illness. But again, Zika was considered a lesser threat than dengue and chikungunya viruses.

Everything changed in 2015 when Zika virus reached the Americas.

New outbreaks and severe symptoms

Since the first local Zika virus infection, cases have been reported from at least 19 countries or territories in the Americas, with more than one million suspected cases.

Rapid spread of an emerging mosquito-borne pathogen is news enough but people are also panicked by reports of more serious consequences of Zika virus infections, including post-viral Guillain-Barré Syndrome, an autoimmune condition where there person’s nerves are attacked by their own body.

Of most concern has been the rapid rise in rates of microcephaly, a birth defect which causes babies to be born with unusually small heads, in regions where Zika virus has been circulating.

While the role of Zika virus as the cause of microcephaly has not yet been confirmed, there is growing evidence of a connection between the two where pregnant women have been infected with the virus.

Babies born with microcephaly, and those who died shortly after birth, have tested positive for the virus, and there are close regional associations between clusters of birth defects and Zika virus.

There is enough concern for the Centres for Disease Control to issue health warnings to pregnant women planning to travel to these regions. [This also includes the Australian Government] Some health authorities are even advising people to postpone pregnancies.

There is no vaccine for Zika virus. Stopping mosquito bites is the only way to prevent infection.

Is Australia at risk of a Zika virus outbreak?

There is little doubt the virus can make it to Australia. There have already been a number of infections reported in travellers arriving in Australia from the Cook Islands and Indonesia.

Mosquito-borne viruses generally aren’t spread from person to person. Only through the bite of an infected mosquito can the virus be transmitted.

In the case of Zika, there have been some unusual cases of transmission, including through sex and the bite of an infected monkey. Despite these unusual circumstances, mosquitoes will still play the most important role in any local transmission.

While dozens of mosquitoes are capable of spreading local mosquito-borne pathogens, such as Ross River virus, only one of the 300 or so mosquitoes found in Australia can transmit Zika virus: Aedes aegypti, the Yellow Fever Mosquito, which is only found in north Queensland.

The Yellow Fever mosquito, Aedes aegypti, is critical to the spread of Zika virus in many regions of the world, including Australia.

For local Aedes aegypti to spread Zika virus, they must bite an infected traveller shortly after they return from a country where the virus is circulating.

While the chances of this happening are small, there is then a risk of a local outbreak occurring as the infected mosquito bites people who’ve never left the country.

This is the process that occurs in outbreaks of dengue in Far North Queensland. If we can get outbreaks of dengue, there is no reason we cannot, or won’t, get an outbreak of Zika in the future.

How to reduce the risk of transmission

Fortunately, authorities are well placed to contain an outbreak of Zika virus, as the required strategies are the same as management of dengue outbreaks.

Perhaps the real message here for Australian authorities is that they need to work diligently to keep exotic mosquitoes out of the country.

While Aedes aegypti may not become established in southern cities, even with a changing climate, there is great potential that Aedes albopictus, better known as the Asian Tiger Mosquito, could become established in southern cities. As well as a vector of Zika virus, it can spread dengue and chikungunya viruses and be a significant nuisance-biting pest. Keeping this mosquito out of our cities is critical.

Australians planning travel to South and Central America, including the Rio Olympics, should take precautions to avoid mosquito bites. Irrespective of Zika virus, mosquito-borne dengue and chikungunya viruses have infected millions of people, causing thousands of deaths, in the last few years and are reason alone to pack mosquito repellents. Be prepared to cover up with long sleeved shorts and long pants if in regions where risk is high.

The ConversationThis article was originally published on The Conversation. Read the original article.

Perfume won’t protect you from mosquito bites

VictorissecretThe headlines have been awash with claims that a popular perfume may repel as many mosquitoes as those regularly recommended by health authorities. Could it be true?

In short, no. There is little surprise that the results of this recently published study in the Journal of Insect Science has attracted so much attention. Everyone loves the idea that some unexpected substance could be used as a mosquito repellent. Even better if it performs as well, or even better, than those such as DEET or picaridin that are widely recommended by health authorities.

The scientists tested a range of commercial insect repellents. Three formulations of DEET based repellent, an oil of lemon eucalyptus (aka PMD) based repellent, three botanical-based repellents, a mosquito repellent patch (Vitamin B), a product not specifically designed as a repellent but often quoted as being effective (Avon skin so soft) and the perfume. Why include the perfume at all?

The logic behind including the perfume was a good one. It is often said that floral perfumes and other cosmetics attract mosquitoes. I’ve never thought this is actually the case. I mean, there is stronger evidence that mosquitoes re attracted to smelly foot bacteria than pleasant smelling cosmetics! I always suspected that the idea comes from the fact the mosquitoes (mostly the non-biting males) will feed on plant sugars. However, it was worth including in this study. Always good to gather some quantitative evidence on the response of blood-seeking mosquitoes. It could be a good opportunity to bust (or perhaps confirm) some urban myths.

I’ve written before about how you can test mosquito repellents. While the “arm-in-cage” methodology typically provides the best indication of how a mosquito repellent will perform, there are other methods commonly employed. In this case, the researchers used a “Y-tube” setup. This system basically allows mosquitoes to make a choice as to whether they preferentially fly towards one or the other ends of the tube. If you insert a hand treated with a substance into one end and another untreated hand as a control into the other, it is possible to measure the overall repellent effect by tracking the movement of mosquitoes.

Firstly, it is interested to note that the researchers found that some mosquitoes were attracted to the hand treated with DEET. If I was conducting an “arm in cage” test. I would be very surprised if I had any mosquitoes biting a DEET-treated arm within 2h of application. In one study, I found an approximately 7% DEET-based repellent stopped bites for a little under 2h. It makes me wonder how many mosquitoes may fly up to tube towards the treated hand but, given the chance, would actually bite the hand?

Fewer mosquitoes were attracted to hands treated with oil of lemon eucalyptus, not surprising either given this product is regularly recommended as an effective repellent by health authorities.

The testing of the perfume provided the headline grabbing results! For the first couple of hours, there wasn’t much difference in the proportion of mosquitoes repelled by the perfume compared to the other repellents. Why? It may be related to the strength of the odour overpowering the sensory organs of the mosquito. I think this is how some strongly smelling essential oils can provide some protection. It masks the normal chemical cocktails of smells on our skin that attracts mosquitoes.

We all know how overpowering the smell of some cosmetics can be. In this case of this experiment, a relatively high dose of the products as used. The authors make note of this too when they state “It must be noted that the concentration of perfume we used in this test was rather high and that lower concentrations of the same fragrance might have different effects.”

Could this perfume be used as a repellent?

Studies like this provide some fun headlines but they can be misleading to the public. What “works” for a relatively short period in a small laboratory based study does not necessarily stand up the practicalities of real life.

Notwithstanding the expense (the perfume is about AUS$80 for 100ml compared to less than AUS$10 for about the same amount of DEET-based repellent) I must admit that for some of these products, the smell can be so overpowering that applying them to large areas of skin would probably be more unpleasant than the bites of mosquitoes!

When trying to help the public choose and use mosquito repellents more effectively, it is critical that health authorities stick to products that are currently registered for use as a mosquito repellent and that have been demonstrated to provide suitable protection from biting mosquitoes over extended periods of time.

Perhaps the most important finding of the paper is not that the perfume repelled some mosquitoes but that patches infused with Vitamin B provide absolutely no protection from mosquitoes. This is one urban myth that never really seems to go away!

We also know that Victoria’s Secret perfume doesn’t stop bed bugs invading lingerie stores!

[The image used at the top of this piece is taken from here.]

Asian tigers and shifting mosquito control from the swamps to the suburbs

aedes_albopictus_SteveDoggettOne of the world’s most troublesome nuisance-biting mosquitoes is perfectly adapted to summer life in southern cities in Australia. This is bad news for communities in temperate climate regions in Australia that would otherwise be immune from the threats of exotic mosquito vectors of dengue and chikungunya virus otherwise limited to tropical regions of the world.

I’ve been invited to speak in the “Managing Current & Future Exotic Mosquito Threats” symposium at the Australian Entomological Society conference to share some of the experiences in temperate Australia regarding exotic and endemic mosquito threats and how the threat of the Asian Tiger Mosquito is being addressed.

Australia has annual activity of mosquito-borne disease. Around 5,000 people a year fall ill following a mosquito bite each year in Australia, most commonly due to Ross River virus. These pathogens are generally spread by native “wetland” mosquitoes such as Aedes vigilax or Culex annulirositrs). Australia has also had major outbreaks of dengue in the past but the only mosquito in Australia able to spread the viruses, Aedes aegypti, is restricted to far north QLD. It is unlikely to spread to southern cities beyond Brisbane based on temperature change alone but there is another mosquito that may pose a threat of dengue or chikungunya virus transmission in southern regions.

The Asian Tiger Mosquito (Aedes albopictus), poses a significant threat to Australia. It was discovered in the Torres Strait in 2005, having thought to have hitchhiked on fishing boats from Indonesia. Although the mosquito hasn’t yet managed to set up home on mainland Australia, its a more likely a question of when, not if, this mosquito will make its way here.

The container-inhabiting (not wetland living) mosquito has already hitchhiked to Europe and North America with eggs carried with people and their belongings. Movement of people, not shifts in climate is the biggest risk. Should it reach one of our major southern cities, there is little doubt that mosquito could become a persistent summer pest and possible public health threat. The way we respond to water shortages in our cities, by increasing water storage around our homes, may set the scene for this mozzie to move in.

Once the mosquito is established in our cities, all we need are travellers to bring in the viruses. Travellers introduce dengue virus into Far North QLD every year. Last year Japan experienced its biggest outbreak of dengue in over 70 years thanks to a traveller introducing the virus to local mosquitoes in downtown Tokyo. This Tokyo outbreak of dengue has implications for local authorities in Australia.

In my presentation at the Australian Entomological Society conference, I’ll highlight some of the issues to consider when assessing the risks posed by exotic mosquitoes in New South Wales as well as outline some of the problems local authorities may have to face when dealing with these mosquitoes that differ from the current focus of mosquito and mosquito-borne disease surveillance and control strategies.

You can view my presentation slides and abstract below:

Developing a strategic response to exotic mosquito threats in NSW

Cameron E Webb (1,2), Jay Nicolson (3), Andrew van den Hurk (4) & Stephen L Doggett (1)

(1)Department of Medical Entomology, Pathology West – ICPMR Westmead, Level 3, ICPMR, Westmead Hospital, Westmead NSW 2145 Australia; (2) Marie Bashir Institute of Infectious Disease and Biosecurity, University of Sydney, NSW 2006, Australia; (3) School of Pathology and Laboratory Medicine, The University of Western Australia, Nedlands, WA 6009, Australia; (4) Virology, Public and Environmental Health, Forensic and Scientific Services, Department of Health, Queensland Government, Brisbane, QLD 4108, Australia.

Mosquito-borne disease management in Australia faces challenges on many fronts. Home growth threats posed by endemic mosquito-borne pathogens (e.g. Ross River virus (RRV)) may increase with a changing climate but exotic mosquitoes and pathogens are an emerging threat. In the absence of a national strategy to address these exotic threats, local authorities must develop regionally specific surveillance and response programs to identify and respond to exotic mosquito incursion. The Asian tiger mosquito, Aedes albopictus, poses the greatest risk to temperate regions of Australia due to their close ecological associations with urban habitats and ability to transmit exotic pathogens (e.g. dengue viruses (DENV) and chikungunya virus (CHIKV)). The mosquito is widespread in local regions, has been detected at international ports and, given the increasing frequency of local travellers to regions where this mosquito is abundant, it raises the potential that an incursion into metropolitan Sydney in the coming years is probable. When this happens, what is the likelihood that this mosquito becomes established? Laboratory studies have confirmed Ae. albopictus could survive in the egg stage under climatic conditions typical of a Sydney winter. Despite the endemic mosquito, Aedes notoscriptus, sharing the same ecological niche to Ae. albopictus, cohabitation studies demonstrated that no interspecies competition would act to limit the local spread of Ae. albopictus and the mosquito could proliferating in the summer. Critically, vector competence experiments have demonstrated the ability of Ae. albopictus to transmit endemic pathogens and, given their propensity to bite humans, could contribute to human-mosquito-human outbreaks of RRV in urban areas of NSW, complementing the enzootic vectors that currently limit transmission to the metropolitan fringe. Local authorities need to develop a multiagency strategic approach to surveillance concomitant with strategic response to reduce the pest and public health threats associated with exotic mosquitoes.

Make sure you check out the tweets from the Australian Entomological Society Annual Conference in Cairns, QLD, 27 September through 1 October 2015, by clicking on #AusEntoSoc15

Are mosquito coils making us sick?

coilWe burn them to beat the bite of mosquitoes but could they actually be making us sick? Is breathing the smoke from a smouldering mosquito coil really the same as smoking a pack of cigarettes?

In summary, should I use mosquito coils to protect my family from mosquito bites?

  • Only use commercial products that have been registered by local authorities
  • Products that contain pyrethroids will provide better protection from mosquitoes than those that contain only botanical extracts
  • The byproducts of combustion, not insecticides, associated with mosquito coils may pose a health risk in some circumstances
  • Best to limit use of coils to outdoor or well ventilated indoor areas
  • Don’t sleep next to a smouldering mosquito coil
  • Consider plug-in “smokeless” mosquito repellent devices
  • Sleeping under a mosquito net is the best non-chemical approach to overnight mosquito bite prevention
The Saltmarsh Mosquito (Aedes vigilax) (Photo: Stephen Doggett)

The Saltmarsh Mosquito (Aedes vigilax) (Photo: Stephen Doggett)

Here is the background…

For centuries we’ve burnt substances, particularly aromatic plants, to keep mosquitoes away. The clouds of smelly smoke can often ward off the swarms of blood sucking mosquitoes.

The use of pyrethrum in incense gained popularity and became common practice in Asia but it wasn’t until the early 1900s that the mosquito coil was born thanks to Japanese entrepreneurs Eiichiro and Yuki Ueyama and their katori senkō (mosquito-killing incense).

Modern mosquito coils, mostly containing the pyrethroid insecticides, are an almost permanent fixture at camp sites and backyard during summer. Millions of families across the tropics use them as their primary source of mosquito-borne disease prevention. They’re cheap and generally effective. We burn them to reduce the risks of mosquito-borne disease but could they actually be making us sick?

Health concerns of mosquito coils

There is growing concern about the adverse health impacts associated with the burning of mosquito coils and sticks indoors. A recently presentation to the 48th National Conference of Indian College of Allergy, Asthma and Applied Immunology has again raised the issue of potential health impacts associated with mosquito coils with media coverage given to Dr Sundeep Salvi in the lead up to the conference. He is quoted as saying “Burning one mosquito coil in a closed room amounts to smoking roughly 100 cigarettes”. The key point in Dr Salvi’s comment is “closed room”.

When assessing the real risks posed by mosquito coils, it is important to consider not just what is released by these smouldering products but actual likelihood it poses a serious health risk. How do you balance these potential health risks of burning coils with those posed by the bite of infected mosquitoes?

Total daily rainfall recorded at Sydney Olympic Park (Data source Bureau of Meteorology)

Do you really need to weigh up the risks of breathing in smoke from a mosquito coil with the risks of mosquito bites? (Image: Joel Sartore, National Geographic)

Who checks the safety of mosquito coils?

In Australia, all substances that purport to kill or repel mosquitoes must be registered by the Australian Pesticides and Veterinary Medicines Authority (APVMA). Similar regulatory authorities exist in other jurisdictions.

Mosquito repellents, whether they’re topical or spatial or whether they contain “chemical” or “natural” substances will need to be tested for efficacy and safety. Check the packaging for a registration number. There are dozens of different variations on “mosquito coils” including sticks, coils, candles and a variety of “plug in” devices. You’ll find the shelves of the local supermarket, camping and hardware store fully stocked almost all year round!

Despite the wide range of products available, the active ingredients (that is the mosquito repelling or killing products) don’t vary too much. There are either synthetic pyrethroids or botanical extracts (e.g. citronella oil, eucalytpus oil). You may be surprised to know that some contain a combination of the two. Just because “citronella” is written in bold on the packaging, it may still contain one of the synthetic pyrethroids. Check the label.

repellentrackDoes burning mosquito coils really make us sick?

A study of mosquito coils sold in the U.S. and found that some mosquito coils contain octachlorodipropyl ether (s-2) that, during the smouldering of the coils, produces an extremely potent lung carcinogen as a byproduct called (bis(chloromethyl)ether (BCME)). Fortunately, s-2 is banned in many countries. It is no longer used commercially in the U.S. and prompted by reports of the risks associated with mosquito coils, Hong Kong authorities released a statement in 2005 regarding the recall of mosquito coils containing s-2.

It is not listed as an active ingredient in mosquito coils registered for use in Australia. Given that in most circumstances, particularly in Australia, mosquito coils don’t contain s-2, it is the particulate matter that is of greatest concern.

An often quoted study published in 2003 titled “Mosquito coil emissions and health implications” analysed the components of commercially available mosquito coils from China and Malaysia and found that burning mosquito coils in an enclosed room may pose “significant acute and chronic health risks” with the fine and ultra fine particulate matter released from a single mosquito coil equaling that of up to 137 cigarettes!

In addition, they found that emission of formaldehyde (a by product of the combustion process) from burning one coil can be as high as that released from burning 51 cigarettes.

Doesn’t sound too good does it? The combustion of the coil itself is the main concern, not the insecticides used.

More recent studies have indicated that changing the base materials used in mosquito coils (i.e. switching to charcoal from other organic material) can reduce the volume of particulate matter substantially. Would these “smokeless” mosquitoes be more “healthy”? Probably.

Does what happens in the lab stays in the lab?

Billions of mosquito coils are sold across Asia every year. Millions of families use them as their primary mosquito bite prevention strategy. Why aren’t we seeing more substantial health impacts in local communities?

It is worth noting that two papers published in 2006 investigated the different methods used to assess the health risks associated with burning mosquito coils. The researchers tested different methods to expose laboratory rats to particulate matter from mosquito coils. They firstly reported that “protocols devised evaluate and assess the acute inhalation toxicity of mosquito coil smoke demonstrating that the nose-only mode of exposure of rats to the smoke of mosquito coils is suitable to assess the toxic potency of different coils.

The nose-only mode has clear advantages over the whole-body exposure mode.” Then, using the “nose-only” exposure method that they proposed, the researchers concluded that “overnight exposure to the smoke from burning mosquito coils (manufactured in Indonesia) is unlikely to be associated with any unreasonable health risk.” This is a noteworthy conclusion given that the level of exposure to those rats (6 h a day, 5 days a week for 13 weeks) was substantial.

What about “smokeless” mosquito coils?

There is a paucity of studies investigating the potential human health impacts of “smokeless” mosquito repellents. The few studies that do exist are inconclusive or use animals to test health impacts under conditions unlikely to occur in most circumstances.

A 2005 review of pyrethroid poisoning reported “Despite their extensive world-wide use, there are relatively few reports of human pyrethroid poisoning. Less than ten deaths have been reported from ingestion or following occupational exposure. Occupationally, the main route of pyrethroid absorption is through the skin. Inhalation is much less important but increases when pyrethroids are used in confined spaces.” Again, this highlights the critical issue here, exposure to insecticides in confined and/or enclosed situations.

It is worth remembering that pyrethroids are over 2000 times more toxic to insects than mammals. That means that the concentrations used to kill insects are unlikely to have adverse health impacts on humans, particularly if commercial formulations are used as recommended. Given the billions of people who use mosquito coils to prevent mosquito bites, perhaps the more important question to ask is, does burning mosquito coils actually prevent mosquito-borne disease? Perhaps that is a discussion for another time….

sp-breweries-mozzie-boxPerhaps one of the most interesting ideas this year was the “mosquito repellent beer carton”. More marketing than public health initiative but I like the idea. The carton is infused with citronella so that when you’re sitting about the campfire enjoying a few beers, you can toss bits of the carton into the fire and keep mosquitoes away. It is unlikely many mosquitoes will be actively repelled. However, I do like the idea of using the beer carton as an opportunity to raise awareness of mosquito-borne disease.

Perhaps it is this little bit of public health communication that will actually stop a few people becoming infected.

Do you use mosquito coils and sticks to prevent mosquito bites? Join the conversation on Twitter and let me know what you think.

Want to learn more about the amazing world of Australian mosquitoes? Check out “A Field Guide to Mosquitoes of Australia” out now through CSIRO Publishing. Over 200 pages containing a pictorial guide to almost 100 different mosquitoes along with tips on beating their bite and protecting your family from the health risks of mosquitoes. You can order online or through your favourite local bookstore or online retailer.

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.