VECTOR SURVEILLANCE & CONTROL AT POINTS OF ENTRY CAPSCA 2016 12-13 October 2016 Budapest, Hungary Outline Why vector surveillance and control at PoEs matter? What is presumed under “vector surveillance and control” under the IHR (2005)? WHO Handbook on Vector Control at the Points of Entry Vector control . Vectors of focus . Required measures (Annex 5) Vector surveillance Types, plans, requirements, methods Why vector surveillance and control matter to IHR? . Vector-borne diseases (such as malaria, dengue, chikungunya, Zika virus, yellow fever) are reported in over 100 countries, and put up to 60% of the world’s population at risk of infection; more than 500 million cases are reported each year. The fast growing international travel and transport contribute to the dissemination and spread of vector borne diseases all over the world, including countries and populations previously not at risk. One of the areas requiring capacity building under the IHR 2005 is capacity building for vector surveillance and control at POE ECDC, Guidelines for the surveillance of invasive mosquitoes in Europe Legal provisions under the IHR Annex 5 – Parties shall establish programmes to control vectors that may transport an infectious agent that constitutes a public health risk to a minimum distance of 400 m from those areas of PoE facilities, with extension of the minimum distance if vectors with a greater range are present [incl. travelers, conveyances, containers, cargo, and postal parcels]. As per Arts. 22, 24, 27 & Annex 4 competent authorities are also required to ensure that facilities used by travellers at PoE are maintained in a sanitary condition and are kept free of source of infection and contamination, including vectors & reservoirs. Handbook “Vector surveillance and control at ports, airports, and ground crossings” (WHO, 2016) Handbook . Provides technical guidance to state parties with a view to meeting obligations of IHR (2005). Contains technical advice for developing a comprehensive programme for systemic monitoring of vectors and for integrated vector control at PoE. Reference material by Port Health Officers, Regulators, Port Operators and other competent authorities implementing these provisions under IHR (2005). Important vector borne diseases and target vector species • Mosquitoes - Malaria, Dengue, Chikungunya, Yellow fever, Plague, Leptospirosis • Fleas – Plague, Murine typhus, Tularaemia • Sandflies – Cutaneous & visceral leishmaniasis, bartonellosis, pappataci fever • Cockroaches – mechanical vectors for diarrhoeal diseases, typhoid fever, dysentery and also cause asthma • Triatomines – Chagas disease • Ticks - Tick-borne encephalitis, Lyme Disease Non mosquito vectors of disease • Rodents – Plague, murine typus, leptospirosis Species Rattus norvegicus Rattus rattus Mus musculus Common Brown Rat or Norway Rat Roof Rat or Black Rat House Mouse name Weight 500 g 250 g 20 g Length 45 cm 40 cm 18 cm Habitat Principally lives in sewers Under the roof of any type of Around supplies of grain, and holes and feeds on building. cereals, and flour. garbage. Animal and other wildlife regulations . Pets . Other exotic birds & animals Governed by the Convention on Biological Diversity (CBD), International Plant Protection Convention (IPPC), World Organization for Animal Health (OIE) & World Trade Organization (WTO). Types of surveillance I Routine Spot Checks Emergency surveillance Surveillance characteristics Areas of surveillance Within ports of entry area and up to a radius of 400 m around ports of entry (may need to be extended based on geographical location of PoE and flight range of vectors) Intensity of surveillance Depending on: importation/exportation risk due to prevailing disease burdens suspected or confirmed disease outbreaks/epidemics suspected presence or presence of exotic vector species Vector surveillance at PoE Vector Free Zone minimum 400m perimeter around these PoE Essential elements of surveillance Trained staff for field & lab work, infrastructure & equipment, reagents, chemicals, PPE & SOPs for surveillance Establishment of a surveillance plan Depending on epidemiological situation and risk of importation/exportation of vectors and their pathogens routine surveillance plan for normal circumstances emergency surveillance plan in case of outbreaks/epidemics Types of surveillance II Mosquito surveillance Larval surveillance Adult surveillance Surveillance for rodents (e.g. rats, mice) Runways & rub marks, tracks, gnawing, droppings, urine Use of traps for surveillance, calculation of Rodent Abundance Index Table: Listing potential breeding and resting places of mosquitoes at ports, ground crossings and in periphery Breeding Sites Resting Places Ponds Human dwellings/Rest rooms Puddles Sheds Ditches Indoor hanging objects Surface drains Crevices Grassy and marshy land Bushes/ Vegetation wild and in gardens Pits and depressions Furniture Scrap and water containing depressions in sheeting Curtains Containers of different varieties and shapes Underneath or on sides of Tanks Water Chambers Cargo Boxes Hydrants Work stations Tires including fenders Walls of the Buildings Ground and overhead water tanks Open luggage boxes Septic tanks Cartons Terraces/roof tops/ lintels Scrapped crafts, vehicles, vessels, etc. Curing waters in construction/development sites Wells Iron ore loader buckets Vector control . Vector control in conveyances . Vector control in containers, baggage & cargo . Vector control in the POE . Vector control in the surroundings of POE Specific Measures (Annex 5) . States Parties establish vector control programs, minimum distance of 400m from PoE facilities used by travellers, conveyances, etc. extended due to PoE geographical location range/type of vector . Every Conveyance leaving a PoE with recommended vector control should apply disinfection measures . Competent Authorities with capacity of next known port to be notified for vector control follow-up Specific Measures (Annex 5, cont.) Conveyances should be inspected: Possible vector borne disease or case on board Left affected area within period of continued transmission State Parties should NOT prevent suspected aircraft or ships from entering but may divert them to appropriate airports/ports with the capacity to apply control measures State parties may apply vector control measures to conveyances arriving from area affected by a vector borne disease Methods of vector control Environmental management • Biological control Source reduction – Biological larvicides Habitat modification & manipulation • Chemical control Mechanical control – Larviciding Screening – Adult control Drilling holes in tyre fenders Removal &/or appropriate storage of scrap Basic requirements for vector control . Trained staff in adequate numbers . Resources for procurement of equipment, PPE & supplies . Support of engineering department / contractors to implement physical, mechanical and environmental control measures . Routine surveillance plan with linkages to referral centres . Larval & adult bio assay kits . Impact assessment plan Disinsection of aircraft . Pre-flight – Applied by ground staff to flight deck, passenger cabin, toilets, open overhead & side wall lockers, coat lockers and crew rest areas, before passengers board and 1 hour before doors are closed (2% Permethrin) . Blocks away – following boarding of passengers and closure of cabin door, before flight take off. Done by crew members with 2% D-Phenothrin (0.7g a.i/100 m3) . Top-of-descent – when aircraft starts its descent with 2% D- Phenothrin Rodent prevention & control . Use of rat guards on tending lines, although not mandatory under IHR, excluding in countries where plague is endemic . Illumination . Traps (conventional, spring board, glue trap and electronic traps) Emergency control measures Recommended in the following situations: . Known disease outbreak at the source of conveyance . Known or suspected disease outbreak onboard a vessel . Outbreak around PoE THANK YOU .