3/2/2017 Mark Miller MD, MPH Co-director, Western States Pediatric Environmental Health Specialty Unit at No Disclosures UCSF PEHSU Funding from ATSDR and US EPA Director, Children’s Environmental Health Center, California EPA (comments do not represent the state of California) The findings and conclusions in this presentation have not been formally disseminated by the Agency for Toxic Substances and Disease Registry and should not be construed to represent an agency determination or policy. Acknowledgement: The U.S. Environmental Protection Agency (EPA) supports the PEHSU by providing partial funding to ATSDR under Inter-Agency Agreement number DW-75-95877701. Neither EPA nor Mosquito Control, Zika, and the ATSDR endorse the purchase of any commercial products or services mentioned in PEHSU publications Clinician Mosquito Control 101 Developmental Disabilities Conference UCSF March 2017 1
3/2/2017 Action at home Also Ae. albopictus • Breeds in very small containers of water � Remove standing water where mosquitoes could lay eggs • Multifaceted approach • Larvicide/ Adulticide • At least weekly, remove water from anything that • Eliminate standing contains even a small amount water • Tightly cover cisterns, etc. • “In the yard” • Home • Use larvicides on water containers that can’t be • Aerial spray thrown out. • AGO traps � Keep mosquitoes out with screens • Spray alone will not do • Don’t leave doors open the job � Use air conditioning when possible Zika, dengue, chikungunya � Consider use of indoor or outdoor insecticide as needed (not first option) Aerial Spraying Resistance to Pesticides Becoming a Problem https://www.cdc.gov/zika/vector/aerial-spraying.html � Most effective for quickly controlling population in a large area • Part of integrated plan including habitat elimination, screens, air conditioning use, larval control, community education (dress) • Requires on the ground workers � Naled – • 2 tablespoons/ football field (ultra low dose) • Used extensively since 1950s, short half life • Not carcinogen, correctly used should not impact asthma � Bt (larvacide) • Bacteria used on organic gardens CDC 2
3/2/2017 https://wwwnc.cdc.gov/travel/page/avoid-bug- epa.gov/insect-repellents/find-insect-repellent-right-you bites � Choose protective clothing (e.g., long sleeves) � DEET – AAP/CDC preferred for effectiveness and relative safety • 10-30% (above 2 mos) – higher concentration longer lasting • Canada – increases concentration and frequency by age • Under 2 months use mosquito netting with tight elastic fit for car seats, etc. � Picaridin � IR3535 � 2-undercanone (methyl nonyl ketone) � Oil of lemon eucalyptous / PMD (above 3 years) Biotec mosqito control - Oxitec � Genetically engineered males • Self limited – offspring of males who mate with wild females die • Reported 90% reduction in mosquitos • Studies in Brazil, Cayman Islands, Panama � Risks? (considered low) • Ecological niche replacement (Aedes albopictus) • Alteration of food chains • Possibility of insecticide tolerance and transfer to wild populations Autocidal Gravid Ovitrap Mosquito Mate – infection of males results in sterility which � is passed on to females (and other novel approaches) Beech et al. As Pac J Mol Biol Biotechnol 2009 3
3/2/2017 � General information for home: www.cdc.gov/zika/prevention/controlling-mosquitoes- at-home.html https://www.cdc.gov/zika/pdfs/larvicides-factsheet.pdf � Aerial Spraying www.cdc.gov/zika/vector/aerial-spraying.html � Insect repellants www.epa.gov/insect-repellents/find-insect-repellent- right-you 4
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