A Guam visit to battle Zika virus and discover new mosquitoes

Guam2017_Beach

There are few places on earth where you can search in water-filled canoes for one of the most dangerous mosquitoes on the planet less than a stone’s throw from tourists posing for selfies alongside their inflatable novelty swans in the nearby lagoon.

Guam is the place to go if you need to tick that off your “to do” list!

I was fortunate to be invited to speak at the Pacific Island Health Officers Association (PIHOA) Regional Zika Summit and Vector Control Workshop in Guam 25-29 June 2017. The theme of the summit was “Break Down the Silos for Preparedness and Management of Emergencies and Disasters in United States Affiliated Islands” and had objectives to critical analyze the regional responses to recent mosquito-borne disease outbreaks while developing policies to strengthening public health emergency response and preparedness systems and capabilities within the region.

The tranquil lagoons of the Pacific Islands may seem a very long way from the hustle and bustle of the busy South American cities that held the 2016 Olympics but just as Zika virus was grabbing the attention of sports reporters everywhere, health authorities active in the Pacific were growing concerned too.

Guam2017_StormClouds

The Pacific has been far from free of mosquito-borne disease outbreaks. Previous outbreaks of dengue, chikungunya and even Ross River virus had struck numerous times. While sometimes widespread, at other times outbreaks were more sporadic or isolated. As is the case for many non-endemic countries, outbreaks are prompted by movement of infected travelers and the prevalence of local mosquitoes.

Across the region there are four mosquitoes of primary concern, Aedes aegypti, Aedes albopictus, Aedes polynesiensis and Aedes hensilli. The greatest concerns are associated with Aedes aegypti and in those countries where the mosquito is present, the risks of mosquito-borne disease outbreak are greatest. For this reason alone, it is imperative that good entomological surveillance data is collected to confirm the distribution of these mosquitoes but also to develop strategies to eradicate, where possible, Aedes aegypti should it be introduced to new jurisdictions.

With a growing interest in developing mosquito surveillance and control programs for exotic mosquitoes here in Australia, it was a perfect opportunity for me to get a closer look at how the threats of these mosquitoes and associated outbreaks of disease are managed.

On the third day of the meeting, vector control took centre stage. A brilliant day of talks from each of the jurisdictions on the disease outbreaks they’ve faced and how they’re preparing for future threats. There were presentations from the United States Affiliated Pacific Islands (USAPI) including Guam, the Federated States of Micronesia (Yap, Kosrea, Chuuk, Pohnpei), the Commonwealth of the Northern Marianas (CNMI), the Republic of Palau, the Republic of Marshall Islands (RMI), and American Samoa.

Hearing from these teams doing their best to protect their local communities from the threat of mosquito-borne disease, with only limited resources, was quite eye opening. There was passion and dedication but each territory faced unique challenges to ensure the burden of disease is minimised.

Guam2017_Canoe

Just outside the workshop venue were a series of water-filled canoes. Most contained larvae!

There is little doubt that climate variability will have a strong role to play in the impacts of mosquito-borne disease across the region in the future but there are so many other issues that could be contributing to increased risk too. One of the biggest problems is rubbish.

Time and time again, the issue of accumulated waste, especially car bodies and discarded tyres, was raised as a major problem. As many of the key pest mosquitoes love these objects that trap water, treatment of these increasing stockpiles becomes more of a concern. Community wide cleanups can help reduce the sources of many mosquitoes but the rubbish more often than not remains on the island and requires continued management to ensure is not becoming a home to millions of mosquitoes.

It is a reminder that successful mosquito control relies on much more than just insecticides. An integrated approach is critical.

There was a “hands on” session of surveillance and control. Coordinated by PIHOA’s Eileen Jefferies and Elodie Vajda, the workshop was a great success. It provided an opportunity for many to see how to prepare ovitraps and BGS traps (one of the most widely used mosquito traps) and discuss the various considerations for choosing and using the right insecticides to reduce mosquito-borne disease risk. Workshop attendees were also the luck recipients of a selection of cleaver public awareness material produced in Guam, from personal fans and anatomically incorrect plush mosquitoes to Frisbees and mosquito-themes Pokemon cards!

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Guam “mozzie” team: Elodie Vajda, Claire Baradi, Michelle Lastimoza, Eileen Jefferies and me

Following the summit, there was a chance to visit the new Guam “Mosquito Laboratory”, newly established as part of the Guam Environmental Public Health Laboratory (GEPHL). I’ll go out of my way to visit any mosquito laboratory but I was particularly keen to see this one as one of my previous students was playing a key role in establishing the mosquito rearing and identification laboratories. Elodie has been doing an amazing job and it was brilliant to geek out with her over some hard core mosquito taxomony as we tried to ID a couple of tricky specimens. [Make sure you check out our recent paper on the potential impact of climate change on malaria outbreaks in Ethiopia]

It actually turned out that one of their “tricky specimens” was a new species record for Guam – an exotic mosquito Wyeomyia mitchellii! The paper reporting this finding has just been published “New Record of Wyeomyia mitchellii (Diptera: Culicidae) on Guam, United States“.

Guam2017_SpeciesList

Mosquito-borne disease in the Pacific isn’t going anywhere and it’s important that once the focus fades from Zika virus, dengue and chikungunya viruses will again take centre stage and their potential impacts are significant. With the added risks that come with gaps in the understanding of local pest and vector species, the prevalence of insecticide resistance among local mosquitoes, climate variability and a struggle to secure adequate funding, challenges lay ahead in ensuring the burden of mosquito-borne disease doesn’t increase.

A modified version of this article appears in the latest issue (Winter 2017; 12(1)) of Mosquito Bites Magazine, (a publication of the Mosquito Control Association of Australia)

 

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Why do mosquitoes seem to bite some people more?

Back in 2015, I had an article published at The Conversation on why some people are more likely to be bitten by mosquitoes than others. It is one of the most commonly asked questions I get whenever I give public talks (or friends and family are quizzing me at summer BBQs).

This article was incredibly successful and has currently been read by approximately 1.4 million people. That is a lot of people. Hopefully the science of mosquito bites has got out there and actually helped a few people stop themselves or their family being bitten by mosquitoes!

The warm weather is starting to arrive here in Australia so I am sharing this once more for those wondering why they’re always the “mosquito magnet” among their friends…

Health Check: why mosquitoes seem to bite some people more

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There are up to 400 chemical compounds on human skin that could play a role in attracting mosquitoes.  sookie/Flickr, CC BY-SA

There’s always one in a crowd, a sort of harbinger of the oncoming mosquito onslaught: a person mosquitoes seem to target more than others. What is it about these unlucky chosen few that makes them mosquito magnets?

There are hundreds of mosquito species and they all have slightly different preferences when it comes to what or who they bite. But only females bite; they need a nutritional hit to develop eggs.

Finding someone to bite

Mosquitoes are stimulated by a number of factors when seeking out a blood meal. Initially, they’re attracted by the carbon dioxide we exhale. Body heat is probably important too, but once the mosquito gets closer, she will respond to the smell of a potential blood source’s skin.

Studies have suggested blood type (particularly type O), pregnancy and beer drinking all make you marginally more attractive to mosquitoes. But most of this research uses only one mosquito species. Switch to another species and the results are likely to be different.

There are up to 400 chemical compounds on human skin that could play a role in attracting (and perhaps repulsing) mosquitoes. This smelly mix, produced by bacteria living on our skin and exuded in sweat, varies from person to person and is likely to explain why there is substantial variation in how many mozzies we attract. Genetics probably plays the biggest role in this, but a little of it may be down to diet or physiology.

One of the best studied substances contained in sweat is lactic acid. Research shows it’s a key mosquito attractant, particularly for human-biting species such as Aedes aegypti. This should act as fair warning against exercising close to wetlands; a hot and sweaty body is probably the “pick of the bunch” for a hungry mosquito!

Probably the most famous study about their biting habits demonstrated that the mosquitoes that spread malaria (Anopheles gambiae) are attracted to Limburger cheese. The bacteria that gives this cheese its distinctive aroma is closely related to germs living between our toes. That explains why these mosquitoes are attracted to smelly feet.

But when another mosquito (such as Aedes aegypti) is exposed to the same cheese, the phenomenon is not repeated. This difference between mosquitoes highlights the difficulty of studying their biting behaviours. Even pathogens such as malaria may make us more attractive to mosquitoes once we’re infected.

Only females bite because they need a nutritional hit to develop eggs.
Sean McCann/Flickr, CC BY-NC-SA

Researchers are trying to unscramble the irresistible smelly cocktails on the skins of “mosquito magnets”. But the bad news is that if you’re one of these people, there isn’t much you can do about it other than wearing insect repellents.

The good news is that you may one day help isolate a substance, or mixes of substances, that will help them find the perfect lure to use in mosquito traps. We could all then possibly say goodbye to topical insect repellents altogether.

Attraction or reaction?

Sometimes, it’s not the bite as much as the reaction that raises concerns. Think of the last time the mosquito magnets in your circle of friends started complaining about being bitten after the event where the purported mosquito feast took place. At least, they appear to have attracted more than the “bite free” people who were also at the picnic, or concert or whatever.

But just because some people didn’t react to mosquito bites, doesn’t mean they weren’t bitten. Just as we do with a range of environmental, chemical or food allergens, we all differ in our reaction to the saliva mosquitoes spit while feeding.

People who don’t react badly to mosquito bites may think they haven’t been bitten when they’ve actually been bitten as much as their itchy friends. In fact, while some people attract more mosquito bites than others, there’s unlikely to be anyone who never, ever, gets bitten.

The problem is that people who don’t react to mosquito bites may all too easily become complacent. If you’re one of them, remember that it only takes one bite to contract a mosquito-borne disease.

Finally, there is no evidence from anywhere in the world that there is something you can eat or drink that will stop you being bitten by mosquitoes. No, not even eating garlic, or swallowing vitamin B supplements.

The ConversationPerhaps if we spent as much time thinking about how to choose and use mosquito repellents as we do about why mosquitoes bite our friends and family less than us, there’d be fewer bites all around.

Cameron Webb, Clinical Lecturer and Principal Hospital Scientist, University of Sydney

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

 

Talking wetlands, wildlife and mosquitoes at the 2017 Australian Entomological Society Meeting

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I’ll be in Terrigal, on the NSW Central Coast, for the 2017 Australian Entomological Society conference and taking the opportunity to present a summary of a number of collaborative projects undertaken in recent years, from working out how surrounding landuse influences the mosquito populations in urban mangroves to how important mosquitoes are to the diet of local bats.

Together with a range of colleagues, I’ve been undertaking research into the factors driving mosquito and mosquito-borne disease risk in urban wetlands. It is a complex puzzle to solve with more than just mosquitoes determining local pest and public health risks. However, with outbreaks of mosquito-borne Ross River virus on the rise in recent years, including urban areas of Australia, there is a need to better understand the factors at play.

There is a range of factors that may increase the risk of Ross River virus, they include suitable wetlands, wildlife reservoirs of the pathogen and mosquitoes. Understanding the mosquitoes associated with urban estuarine and freshwater wetlands is critical.

Investigating the role of surrounding landuse in determining the mosquito communities of urban mangroves, we found that industrial and residential areas tended to increase abundance of mosquitoes, perhaps due to direct or indirect impacts on the health of those mangroves. We’ve found previously that mosquitoes problems are often associated with estuarine wetlands suffering poor health, perhaps this is determining the increased mosquito risk we identified? You can read more in our publication here.

Expanding the investigation to look at urban freshwater wetlands, it was found that there was a high degree of variability in local mosquito populations and that each wetland needed to be assessed with consideration to be given to site-specific characteristics. You can read more about our work investigating mosquito assemblages associated with urban water bodies in our publication here.

More research is underway in this field and my PhD student, Jayne Hanford, has already started collecting some fascinating data on wetland biodiversity and local mosquito populations.

While the focus of our studies is often prompted by concern about Ross River virus, interestingly, in recent years we’ve found considerable activity of Stratford virus. This is not currently considered a major human health concern but given how widespread it is, it raises concerns about the suitability of local wildlife, even in Western Sydney, to represent important reservoirs of mosquito-borne pathogens. You can read more about Stratford virus in our publication here.

The final piece of the puzzle is to understand the ecological role of mosquitoes. Where their potential health threats are deemed significant, how could management of mosquito populations have unintended consequences for other wildlife. What about the animals that eat mosquitoes? A number of years ago we did some research to determine the importance of mosquitoes in the diet of coastal bats. While there was no indication that mosquitoes are a critical component of their diet, they are still being snacked on and mosquito control programs need to consider any local ecological impacts.

Now, how am I going to squeeze all this into 15 minutes….

The presentation abstract is below:

What drives mosquito-borne disease risk in urban wetlands?

Webb, C. (1, 2), J. Hanford (3), S. Claflin (4), W. Crocker (5), K. Maute (5), K. French (5), L. Gonsalves (6) & D. Hochuli (3)

(1) Department of Medical Entomology, NSW Health Pathology, Westmead Hospital, NSW 2145; (2) Marie Bashir Institute of Infectious Diseases and Biosecurity, University of Sydney, Camperdown, NSW 2006; (3) School of Life and Environmental Sciences, Faculty of Science, The University of Sydney, Camperdown, NSW, 2006; (4) Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, 7000; (5) Centre for Sustainable Ecosystem Solutions, Biological Sciences, Faculty of Science, Medicine & Health, University of Wollongong NSW, 2522; (6) School of Arts and Sciences, Australian Catholic University, North Sydney, NSW, 2060.

Managing pest and public health risks associated with constructed and rehabilitated urban wetlands is of increasing concern for local authorities. While strategic conservation of wetlands and wildlife is required to mitigate the impacts of urbanisation and climate change, concomitant increases in mosquitoes and mosquito-borne disease outbreak risk must be addressed. However, with gaps in our understanding of the ecological role of mosquitoes, could control strategies have unintended adverse impacts on vertebrate and invertebrate communities? A series of studies were undertaken in urban wetlands of greater Sydney to investigate the role of land use, wetland type and wetland aquatic biodiversity in driving the abundance and diversity of mosquito populations. A diverse range of mosquitoes, including key pest an vector species, were found in urban environments and mosquito-borne pathogens were detected in local populations, implicating local wildlife (e.g. water birds and macropods) as potential public health risk factors. Estuarine wetlands are locally important with the percentage of residential land and bushland surrounding wetlands having a negative effect on mosquito abundance and species richness while the amount of industrial land had a significant positive effect on species richness. Mosquito control in these habitats is required but insectivorous bats were identified as mosquito predators and the indirect implications of mosquito control should be considered. The aquatic biodiversity of urban freshwater wetlands influenced the species richness of local mosquito populations indicating vegetation plays an important role in determining local pest species. However, the matrix of wetland types also influences the abundance of mosquitoes in the local area. These results demonstrate the need for site-specific investigations of mosquito communities to assist local authorities develop policies for urban development and wetland rehabilitation that balance the need for conservation with reduced public health risks.

To keep up to date on what’s happening at the conference, check out the program online or follow the conversation on Twitter.

 

What do dogs and bird drawings have to do with conservation?

DogSavesBird_sign_June2017

Ask a dog owner why they let their pets chase shorebirds across the local mudflats and the response will usually be “Don’t worry, they never catch ‘em”. But dogs don’t have to catch the birds to have a serious impact on them, especially when they’re chasing them off wetlands full of mud dwelling invertebrates that the birds love munching on.

Perhaps if the community was more aware of how vulnerable the shorebirds are,  maybe they’d be more likely to keep their dogs on a leash, off the local mudflats and the birds could feed in peace. But how can we get the message across to local residents?

A global traveller and annual visitor to local wetlands

The Bar-tailed Godwit, Limosa lapponica, is a migratory bird that flies all the way from Alaska to feed in Australia’s coastal wetlands each summer. A medium sized brown and white bird with a distinctively long upturned bill, the Bar-tailed Godwits are commonly seen feeding on aquatic insects and molluscs along the muddy foreshore of Sydney’s Parramatta River. They’ve become an iconic bird of the region, even featuring as one of the “mascots” of the “Our Living River”, an initiative to improve the health of the  Parramatta River.

bartailedgowit_Dec2014HenChickenBay

Each spring they make the trip from the Arctic to Australia (non-stop flight around 11,000km has been recorded!) but to make the long flight back to Alaska, the Bar-tailed Godwits rely on finding enough food among the wetlands during their time along the river. The birds are commonly seen from spring to early autumn, often in flocks of a dozen or more, foraging in local mudflats. But their habitats are under constant threat from pollution and the encroachment of mangroves.

One location where the birds are commonly seen is Hen and Chicken Bay in the City of Canada Bay Council local government area. The suburbs of Abbotsford, Wareemba and Five Dock are nearby and the foreshore pathways and parklands are popular locations for exercise and recreation by both residents and visitors (please check out my favourite cafe, The Cove Dining Co, when you’re next visiting).

Unfortunately, the ever increasing human population, together with the easy access to the foreshore, brings threats to the Bar-tailed Godwits and their habitats.

People, pets and wildlife conservation

The Bar-tailed Godwits are quite tolerant of people. They’re happy to keep feeding while people and pets walk past. It provides a wonderful opportunity for the community to see these unique global travellers up close.

They have a tough time though when constantly chased by dogs or disturbed by people. Many times I’ve seen dogs running along the low tide shoreline, no doubt it is fun for both the pet and their owner. I have no doubt there is complete ignorance of the unintended consequences and that this may be a problem for the birds.

Awareness of shorebird conservation issues among those sharing habitats is a critical issue to address.

Reducing the impact of dogs on shorebirds is an issue faced by authorities around Australia as well as overseas. Beyond wetland habitats, studies have also shown dog walkers can have a negative impact on bushland birds too.

Putting a fence up around the wetlands isn’t a solution. The use of buffers is impractical and nobody wants to start setting traps or baits to stop the dogs. What else could be tried?

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Illustration and wildlife conservation

Inspired by a project in Ku-Ring-Gai Council where school students drew signs encouraging dog owners to pick up after their pets, a similar approach was proposed for Hen and Chicken Bay. Could signs featuring the artwork of local students help get the message across?

Jointly funded by the Abbotsford Public School Parents and Citizens Association, and City of Canada Bay Council (Council’s Bushcare Department contributed funds in additional to a Canada Bay Community Grant), a series of educational signs were installed along the foreshore pathway of Hen and Chicken Bay as well as nearby Henry Lawson Park and Halliday Park.

When trying to decide on the design of the signs, it was important that there was some community ownership of the messages, they were aesthetically pleasing and lacked a serious authoritarian tone.

A competition was launched among students at Abbotsford Public School to draw Bar-tailed Godwits, one illustration was selected from each grade to be showcased on the signs. While the student’s drawing may not have been taxonomically accurate, they certainly reflected the great enthusiasm for the birds and this conservation process.

The school itself was wonderful and a component of the curriculum involved the students learning about the Bar-tailed Godwits and the importance of local wetlands. A local author, Jeannie Baker, had recently published the wonderful children’s book “Circle”, and a copy was purchased for almost every classroom and became a reference point for learning about the birds and their amazing global migratory journal to the local wetlands each year. Directly involving the students not only yielded some wonderful illustrations to personalise the signs but it also engaged the broader school community and assisted raising the profile of the project.

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Along with an unique illustration on each sign, the key messages promoted were that the Bar-tailed Godwits visits the local mudflats from the Northern Hemisphere each year between August and April and to please don’t allow your dog onto the mudflats and please don’t allow off-leash dogs to chase birds. Dog owners were also directed towards to local off leash area in a nearby park.

An attitudinal study of dog owners in Victoria, Australia found that “Dog owners were more likely to feel obliged to leash their dog when they believed other people expected dogs to be leashed, and when they believed their dog was a threat to wildlife or people.” While this study was associated with beach-nesting birds, perhaps a similar attitude exists among those dog owners prone to allowing their dogs to run across bird-filled mudflat?

The signs were unveiled at an official launch in December 2016 by the Mayor of Canada Bay Council, Helen McCaffrey, and in attendance were representatives of Birdlife Australia, Our Living River and dozens of Abbotsford Public School students. Judy Harrington, Sydney Olympic Park Authority, kindly gave a talk to students on the day about the Bar-tailed Godwits and in the shadow of an approaching summer storm, a class alongside the local wetlands was a wonderful way to launch a novel and engaging project of environmental conservation.

Got any other ideas about how we can protect our local wetlands wildlife? Join the conversation on Twitter!

 

Ross River virus in Melbourne, how did that happen?

aedesnotoscriptus

Health authorities in Victoria have been warning of mosquito-borne Ross River virus for much of the summer. The state is experiencing one of its worst outbreaks of the disease but cases have mostly been across inland regions. Now it’s hit Melbourne. How has this happened?

Ross River virus is the most commonly reported mosquito-borne disease in Australia. There are usually about 5,000 cases across Australia. However, in 2015 there was a major spike in activity with around 9,000 cases reported. It is a common misconception that the disease is only found in northern regions of Australia. I’m often told “I heard the disease is moving south from QLD?” That’s not the case.

The virus is just as much a natural part of the Australian environment as the mosquitoes and the wildlife that maintain transmission cycles.

While there are generally more cases in northern Australia, nowhere is safe. Some of the largest outbreaks have occurred in southern regions of Western Australia, South Australia, Victoria and even Tasmania.

The virus is widespread but is generally associated with rural regions. A driving factor in determining the activity of Ross River virus is that more than just mosquitoes are involved in outbreaks. The virus is maintained in the environment in native wildlife, especially kangaroos and wallabies. Even when and where there are high numbers of mosquitoes, without wildlife, outbreak risk is low. This is the reason why any clusters of locally infected cases in metropolitan regions are typical in areas where there are wetlands, wildlife and mosquitoes occurring together. We’ve seen this on the urban fringe of Sydney and Perth in recent years.

The announcement of locally acquired cases in the suburbs of Frankston and Casey, in Melbourne’s south-east, has taken many by surprise. Should it have?

Victoria is no stranger to mosquitoes and outbreaks of mosquito-borne disease. There are mosquito surveillance and mosquito control programs in place in many regions and historically there have been major outbreaks of mosquito-borne disease. From freshwater flood plains of the inland to the tidally flooded estuarine wetlands of the coast, Victoria has diverse and often abundant mosquitoes. But cases in the metropolitan region are rare.

Victorian mosquitoes are not all bad but over a dozen different mosquito species can spread Ross River virus.

The region where these cases have been identified are in proximity to bushland and wetland areas. There is no doubt plenty of mosquitoes and suitable wildlife too. While this is the first time local transmission has been documented, that doesn’t mean the virus hasn’t circulated in the past, or even that cases may have occurred.

For individuals infected but only suffering mild symptoms, the illness can be easily discounted as nothing more than a mild case of the flu. Without appropriate blood tests, these cases never appear in official statistics. For this reason, many mosquito researchers believe that the number of notified cases across the country is just the tip of the iceberg with many milder infections going diagnosed.

But why in Melbourne now?

It is difficult to know for sure. The two most likely explanations are that either environmental conditions were ideal for mosquitoes and suitable populations of wildlife were present so that the virus was much more active in the local environment than previously. The second explanation is that the virus may have been introduced to the region by a traveller or movement of wildlife. In much the same way Zika virus made its way from SE Asia to South America in the last few years, mosquito-borne viruses move about in people and animals, much less so than mosquitoes themselves (but that isn’t impossible either).

Victoria (as well as inland NSW) is experiencing one of its largest outbreaks of Ross River virus on record following significant flooding of inland regions. With so much activity of the virus in the region, perhaps an infected bird or person travelling to the metropolitan region brought the virus with them. When bitten by local mosquitoes, the virus started circulated among local mosquitoes and wildlife.

Most people infected by Ross River virus are bitten by a mosquito that has previously fed on a kangaroo or wallaby.

Once it’s made its way to metropolitan regions, the virus can be spread from person to person by mosquitoes. Common backyard mosquitoes, especially Aedes notoscriptus, can transmit the virus but as these mosquitoes are not particularly abundant, don’t fly vary far and will just as likely bite animals as humans, they’re unlikely to drive major urban outbreaks of the disease. This mosquito doesn’t pack the same virus-spreading-punch as mosquitoes such as Aedes aegypti that spreads dengue, chikungunya and Zika viruses. Aedes aegypti isn’t in Victoria.

We’re unlikely to see significant spread of Ross River virus across Melbourne but that doesn’t mean Victorians should be complacent. As there is no cure for Ross River virus disease, the best approach is to avoid being infected in the first place. Preventing mosquito bites is the best approach. For my tips and tricks on avoiding mosquito bites see this recent paper in Public Health Research and Practice as well as my article for The Conversation.

Keep an eye on the website of Victoria Health for more information.

 

 

 

 

 

West Aussies versus the local mozzies

This is a special guest post from Dr Abbey Potter, Senior Scientific Officer, Environmental Health Hazards, WA Health. I’m currently mentoring Abbey as part of The Public Health Advocacy Institute of WA (PHAIWA) Mentoring Program. Its been a great experience as we navigate through some of the strategies to raise awareness of mosquito-borne disease and advocate for better approaches to addressing the public health risks associated with mosquitoes.

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Living in WA, we’re all too familiar with the pesky mosquito. We know they bite but what we often don’t consider is that they can transmit serious and sometimes deadly diseases. In fact, a recent survey of locals indicated that knowledge of mosquito-borne disease is pretty limited, particularly among younger adults aged 18-34 years and those living in the Perth Metro. It’s pretty important we’re aware of the risks posed by these pint-sized blood suckers and how you can avoid them… and here’s why!

The Facts

On average, more than 1,000 people will be infected with a mosquito-borne disease in WA every year. Our mossies can transmit Ross River virus, Barmah Forest virus, West Nile virus (Kunjin substrain) and Murray Valley encephalitis virus. All four cause diseases that are debilitating at best, causing weeks to months of symptoms. Murray Valley encephalitis is limited to the north of the State but is so serious it can result in seizures, coma, brain damage and even death.

Forget the bush, most people bitten in their own backyard. West Aussies are all very prone to getting eaten alive while socialising outdoors but if you’re up in the north of the State, you’ve also got a much higher likelihood of being bitten while boating, camping or fishing or working outside, compared to the rest of the state.

And don’t think you’re off the hook when you head off on holidays. A further 500 WA residents return from overseas travel with an exotic mosquito-borne disease every year. Heading to Bali? Beware of dengue, especially young adult males who return home with the illness more than others. There is limited mosquito management in many overseas countries where disease-transmitting mozzies can bite aggressively both indoors and throughout the day. This catches West Aussies off guard, as we are accustomed to mozzies biting outdoors, around dusk and dawn. When you’re in holiday mode it’s likely that you’ll be relaxing, having a couple of drinks and not thinking about applying repellent. Oddly enough, mosquitoes may actually be more attracted to people whose body temperature is higher. This happens naturally when you consume alcohol, so best pull out the repellent before you crack your first beer.

Despite our attractiveness to mosquitoes, we aren’t really aware of the most effective ways to avoid bites or how we can do our bit to reduce breeding in our own backyards. If you live by the mantra Cover Up. Repel. Clean Up you’ll have no problems!

mandurah_sep2014

Western Australia has some amazingly beautiful wetlands but these saltmarshes around Mandurah can produce large populations of nuisance-biting mosquitoes!

Cover Up

If you know you are going to be outdoors when mosquitoes are active, wear loose, long-fitting clothing that is light in colour. Believe it or not, mosquitoes can bite through tight pants as tough as jeans – I’ve witnessed it!

If you’re staying in accommodation that isn’t mosquito-proof, consider bed netting.

Try to keep children indoors when mosquitoes are most active. If exposure can’t be avoided, dress them appropriately and cover their feet with socks and shoes. Pram netting can also be really useful.

Admittedly, it’s not always practical to wear long sleeves during our warm summer nights, so there are going to be times when you need to use repellent. Choose a product that actually works and apply it appropriately so it does the job. Despite our best intentions, this is where we often go wrong. There are a few basic things to cover here, so stick with it!

Ingredient: Science tells us that the best active ingredient for repelling mosquitoes is diethyltoluamide (DEET for short) or picaridin. You need to look for either one of these names on the repellent label under the ‘active constituents’ section.

Unfortunately, natural repellents and anything wearable (e.g. bands, bracelets or patches) have very limited efficacy. Experts don’t recommend you use them and I consider this very wise advice. It only takes a single mosquito bite to become infected and chances are you will receive at least one if you rely solely on a product of this nature. It just isn’t worth the risk.

mosquito_repellent_wristband_october2015

Percentage: The next thing to consider is the percentage of the active ingredient. This can range anywhere from 7% to 80% which can make choosing a repellent confusing. Just remember, the higher the percentage, the LONGER the product will remain active for. It doesn’t mean it will repel mosquitoes better.

A repellent containing 16-20% DEET will provide around 4-6 hours of protection, and is a good place to start. Repellents labelled ‘tropical strength’ usually contain greater than 20% DEET – they are useful when you spend longer periods exposed to mosquitoes or if you are heading to a region where dengue, malaria or Zika is problematic. Kids repellents usually contain picaridin or <10% DEET.

Sometimes it can be tricky to work out the percentage of the active ingredient. You can see the Bushmans example below states this clearly, but the other bottles list the ingredient in grams per litre (g/L). No need for complex maths – just divide by 10 and you have the magic number! For example, the RID label below reports the product contains 160g/L of DEET. This would convert to 16% DEET – easy!

You can see a few examples here of effective repellents:

repellents_potterpaper

How to Apply: No doubt we would all prefer if repellents didn’t feel quite so gross on our skin or didn’t smell so bad. Even I have to admit that before I moved into this field, I was guilty of putting just a dab here and a dab there. Unfortunately, this is flawed logic that will only result in you being bitten!

Repellents must be applied correctly to be effective. That means reading the label and applying it evenly to all areas of exposed skin. Remember to reapply the product if you are exposed to mosquitoes for longer than the repellent protects you for. You’ll also have to reapply the repellent after sweaty activity or swimming.

For more information on repellent use in adults and children, click here.

Clean Up

Mosquitoes need water to breed, but only a very small amount. Water commonly collects in a range of things you may find in your backyard including pot plant drip trays, toys, old tyres, trailers and clogged up gutters. Mosquitoes also love breeding in pet water bowls, bird baths and pools if the water is not changed weekly or they are not well maintained. Rain water tanks can also be problematic so place some insect proof meshing over any outlets. When you’re holidaying, cover up or remove anything that may collect water.

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If you need more official info from WA Health about mosquito-borne disease or simple ways to prevent being bitten click here. And if you want to read more about how much West Aussies know (or don’t know) about mossies, check out Abbey’s excellent paper here! Joint the conversation too on Twitter by following Abbey and Cameron.

Do outbreaks of mosquito-borne disease always follow floods?

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Water, water everywhere…and mosquitoes soon to follow. It makes sense that with more water you’ll get more mosquitoes and with more mosquitoes you’ll get more mosquito-borne disease. Right? Well, not always.

With floods hitting parts of inland NSW, health authorities have issued warnings about mosquitoes and mosquito-borne disease.

Western NSW, has been substantially impacted by flooding this month and the region has been declared a natural disaster zone. The Lachlan River at Forbes has reached a level not seen for 25 years. There is a lot of water about. 35,000 mega litres of water has also been released from Wyangala dam resulting in further flooding. There could be more to come as “Superstorm 2016” continues to bring rain to south-east Australia. Evacuations continue.

The flooding has come at a time when the weather in warming up and there are already reports of mosquito numbers increasing. The biggest concern is that once the flood water recede, how long will pools of water remain, have mosquitoes got a “jump start”on the season?

On the other side of the world, Hurricane Matthew is threatening Florida. The Bahamas and Haiti have already been hit and more than 2 million people in the US have been told to evacuate their homes. Flooding is expected.

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Mosquitoes need water

There is no doubt that mosquito populations can increase rapidly following flood. There is even a group of mosquitoes commonly called “floodwater mosquitoes“. The desiccation resistant eggs of these mosquitoes are laying dormant in the cracks and crevices of flood plains, just waiting for the water to arrive. When it floods, the eggs hatch and in about a week or so, swarms of mosquitoes emerge.

For the most part, it isn’t immediately following the flooding, but in the weeks and even months following that can provide the most ideal conditions for mosquitoes. If temperatures aren’t high enough to drive rapid evaporation of ponding (or if additional rainfall keeps them topped up), mosquitoes can start building impressing population abundances. With more mosquitoes, the risk of mosquito-borne disease outbreak can increase.

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Rainfall records provided by the Bureau of Meteorology indicate that over the three months to September 2016, some regions of NT, QLD, NSW and Victoria received some of their highest rainfall on record for the period. (Bureau of Meterology)

A look back to floods and mosquito surveillance

In 2011-2012, QLD, NSW and Victoria saw incredible flooding. For those of us working in the field of mosquito-borne disease, we’re well aware of what that flooding can cause. Our attention was sparked when stories starting coming out from locals about this being the biggest flooding since the 1970s. Why was this important? Following flooding in the 1970s, we saw one of the biggest outbreaks of the potentially fatal Murray Valley encephalitis virus Australia has seen. This outbreak, and the response to the actual and potential health impacts, was essentially the genesis of many mosquito-borne disease surveillance programs across the country.

One of those programs was the NSW Arbovirus Surveillance and Mosquito Monitoring Program. Following the flooding in early 2012, there was a huge jump in mosquito populations in western NSW and one of the largest collections of mosquitoes in the history of the program was recorded with over 18,000 mosquitoes collected! Fortunately, we didn’t see any substantial activity of Muray Valley encephalitis virus but elsewhere in Australia, cases were reported.

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Mosquito-borne disease outbreaks need more than just mosquitoes

There is little doubt you need mosquitoes about for pathogen transmission. However, for many mosquito-borne diseases, the pathogens that cause the illness in people are naturally found in wildlife. Person to person transmission may occur but for pathogens such as West Nile virus, Ross River virus or Murray Valley encephalitis virus, the mosquitoes that inject their virus-filled saliva into people have bitten birds or mammals previously.

The role of wildlife is important to consider as the flooding may influence mosquito populations but they can also influence wildlife. While kangaroos and wallabies may be adversely impacted by floods, flood waters can provide a major boost for waterbirds.

In some instances, as is the case for Murray Valley encephalitis virus, floods provide ideal conditions for both mosquitoes and birds!

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Do floods really cause outbreaks of mosquito-borne disease?

There are few studies that have demonstrated that outbreaks of mosquito-borne disease always occur following floods.

Studies in North America had previously concluded that there wasn’t a direct link between hurricanes and flooding and mosquito-borne disease. But, that doesn’t mean there won’t potentially be a boost in nuisance-biting mosquitoes following flooding.There is often widespread spraying to control these pest mosquito populations.

Interestingly, after Hurricane Katrina hit New Orleans in 2005, there was an increase in mosquito-borne disease with more than a 2-fold increase in West Nile neuroinvasive disease. However, other reports noted no significant increase in cases of either West Nile or St. Louis encephalitis viruses. Surveillance for 6 weeks following the hurricane, authorities found no arboviruses circulating in local mosquito populations. These results highlight that much more than water and mosquitoes are required for outbreaks of disease.

In Australia, a recent review looked at the influence of flooding on cases of Ross River virus disease. They found that the evidence to support a positive association between flooding and RRV outbreaks is largely circumstantial. The trouble in predicting outbreaks of Ross River virus disease is that there can be complex biological, environmental and climatic drivers at work and, irrespective of local flooding, there may be other region-specific issues that either increase or decrease the potential for an outbreak.

What should we expect in Australia as summer approaches?

There is no doubt mosquito repellent will come in handy over the coming months. There are already reports of increased mosquito populations in some parts of the country. While nuisance-biting impacts will be a worry, if mosquito populations further increase following flooding, authorities need to remain mindful of a range of other health risks too.

The good news is that unless higher than normal mosquito populations persist into the warmer months, we may not see major outbreaks of disease. It typically isn’t until November-December that we start to see pathogens circulate more widely among wildlife and mosquitoes. Hopefully, if some hot weather arrives, the flood waters will quickly evaporate and abundant mosquitoes populations won’t continue.

Current outlooks suggest that between now and December 2016, south-eastern regions of Australia are likely to receive above average rainfall. Temperatures, though, are likely to be a little cooler than normal. We’re probably lucky that this cooler weather will keep the really big mosquito population increases that we saw a few years ago at bay.

On balance, we’re expecting plenty of mosquitoes to be about as summer starts, hopefully not “mozziegeddon” but enough to ensure the community should stay aware of the health risks associated with mosquito bites and how best to avoid their bites.

Have you seen mosquitoes about already this season? Join the conversation and tweet some shots of local mosquitoes!