species.

DOH WNV Surveillance, Prevention and Response
Objective: Continue implementation of effective surveillance, prevention, and control of WNVin Hawaii.
DOH continues to maintain and improve its current surveillance and prevention efforts, andestablish greater capacity for responding if WNV is detected, to prevent the establishment of thevirus in the State.
WNV poses a serious threat to Hawaii for several reasons. Given the tropical climate of theState, mosquito populations are present throughout all seasons, suggesting the potential for yearround transmission and prolonged human disease outbreak. Direct medical costs will besignificant. With regards to wildlife, WNV will probably extinguish several endangered andendemic bird species in Hawaii, and may cause irreversible damage to the ecosystem.
Additionally, Hawaii’s economy is dependent on tourism, and its beautiful and safe environmentis attractive to many visitors. Establishment of a mosquito-borne disease with no cure orprophylaxis currently available would have a negative impact on the state’s economy.
DOH focuses its efforts in various areas:
1.

Prevention activities continue to focus on source reduction, and source treatment withlarvicides. Hawaii’s mosquito species are container breeders, so reducing the number ofwater-collecting items from property reduces the breeding sites for the mosquitoes.
Public outreach is critical for source reduction, and is discussed below. In addition,
treatment of standing water with larvicides greatly enhances the reduction of the adultmosquito population, especially because standing water cannot be eliminated in many
areas. Mosquito suppression is targeted so that, if the virus is introduced, there will not
be a sufficient mosquito population to establish the disease cycle.

2.

Educating the public is another significant activity for prevention of WNV. DOH shared
WNV information through various venues, including health fairs, pet shows,neighborhood boards, association and group meetings, and the main public library. Other
outreach activities included radio public service announcements, production anddissemination of informational brochures. Outreach efforts will continue with the firstbasic concept of informing the public of the need for mosquito control. DOH seeks HISC
funds to maintain its level of effort.

3.

Source reduction. DOH's Vector Control Program continues to implement strategies of
reducing mosquito populations to a level of no more than 5 mosquitoes per trap per night,
with surveying for breeding sites triggered by higher counts. Maintaining low mosquito
counts has proven more difficult in some areas than others. Surveillance of an
approximate radius of two miles of all major ports of entry, to detect and reduce breeding11sites continues. As a significant focus on prevention, DOH seeks HISC funds to maintainits level of effort in the area of source reduction. Ports of entry, both air and sea, willcontinue to be the primary focus of DOH mosquito surveillance and reduction.
4.

Dead bird surveillance is accomplished through a contract established with Aloha United
Way to operate a public hotline, accessible statewide, to report dead birds. Birds
collected were tested by the RAMP (Rapid Analyte Measurement Platform) WNV Test,
which is a rapid antigen detection assay. This is treated as a screening test, providing
more rapid results. DOH needs the option to conduct live bird testing, and has developed
such capabilities. DOH seeks HISC funds to increase its level of effort in dead bird
surveillance, particularly in the area of RAMP WNV testing protocols.

5.

Detection of WNV in a timely manner is critical in preventing the establishment of WNVor, if it is established, minimizing the public health impact in humans and animal species.
Due to relative remoteness, efforts have been made to ensure that a full menu of WNV
testing is available within the State. Protocols for performing enzyme-linked
immunosorbent assays (ELISA) for WNV antibody in humans were established at theDOH's State Laboratory Division (SLD), and will continue to be used for the diagnosis ofWNV human infections. SLD will continue to perform Real Time RT-PCR tests for thedetection of WNV nucleic acid in human cerebral spinal fluid specimens, dead birdorgans, and mosquito pools. DOH seeks HISC funds to increase its level of effort,
primarily due to anticipated increasing requirements for dead bird and mosquito testing.

DOH WNV– Measures of Effectiveness
Vector Control Branch
Goal: Enhance capacity to identify WNV in mosquitoes and dead birds, prevent establishment of
WNV by maintaining a statewide integrated mosquito management (IMM) program, andmaintain and provide resources for a ground-based response to WNV introduction.

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Measures of Effectiveness:
Objective
Maintain gravid traps atmajor ports of entry
for collection ofmosquitoes
Sort and pool mosquitoes
for WNV testing
Necropsy dead birds
for WNV testing
Identify sources ofmosquito breeding within
2-mile radius of major
ports of entry

Remove or eliminate
sources of mosquito
breeding
Treat (larvicide) mosquito
breeding sources
Maintain database of
mosquito trap data, andmosquito breeding sources(location, inspection,treatment)
Report mosquito trap
results in a timely manner

MeasureDetailNumber of gravid traps at A total of 59 gravid traps areeach port of entry
maintained on the four major islands.
In addition, 122 New Jersey mosquito
light traps monitor the Culex andAedes vexans populations statewide.
Number of mosquitoes
194,903 mosquitoes were sorted.
sorted, number of
4,636 pools were submitted to SLD.
mosquito pools submitted
to SLD
Number of dead bird
207 birds were necropsied andnecropsies with tissues
submitted to SLD.
submitted to SLD
Number of new mosquito Oahu, Hawaii and Maui are
breeding sites identified
conducting surveys within a 2-mile
during surveys, total
radius of ports of entry at the present
number of mosquitotime. All new breeding sites are
breeding sites
documented, treated and added on tothe routine list of treatment sites.
Survey was last done in 2004.
Number of mosquitoThis data is unavailable. Eliminatedbreeding sites removed/sites are not archived as to date ofeliminatedremoval.
Number of mosquito
breeding sites treatedOngoing maintenance of
database

1,058 mosquito breeding sites weretreated 1,247 times.
Statewide maintenance of the Vector
Control Management System(VCMS) database is ongoing.

Mosquito trap results arereported to appropriate
personnel monthly.

See attached graph for mosquito trap
results.

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ov.

Dec
Ja .
n.
07Feb.
M
archAp
ri lM
ayJu
ne
July
Aug.
Sept.
Oct.
Nov.
Dec
Ja .
n.
08
Feb.
M
arch
Ap
ri l
M
ay
JuneJuly
Aug.

N

ct.

.06OSept

average no./trap/nightSe
pt.0
6Oct.
Nov
.
Dec
Ja .
n.
07
Feb.
M
arch
Ap
ri l
M
ayJu
ne
July
Aug.
Se
pt.
Oct.
Nov
.
Dec
Ja .
n.
08
Feb.
M
arch
Apri l
M
ayJu
ne
July
Aug.

average no./trap/night

Culex mosquito collection from gravid traps and NJ light traps
from September 2006 to August 2008 on Oahu

Gravid Trap Data80706050403020100Date

NJ Light Trap Data

6543210DATE14State Laboratories Division
Goal: Enhance laboratory capacity to identify WNV in humans and other species (dead birds,equine, live birds’ mosquitoes).

Measures of Effectiveness:
ObjectiveMeasure

Data

Maintain real-time RT-PCR
testing for avian samples
and mosquitoes
Maintain Blocking ELISA
test in support of live bird
surveillance
Maintain Plaque Reduction
Neutralization Test (PRNT)
for the confirmation of West
Nile Virus detection byELISA or MIA
Validate theMicroImmunoAssay(MIA) test in support oflive bird surveillance
activities
Establish MIA as part of thelive bird surveillance testingalgorithm
Maintain database of alllaboratory results(surveillance, diagnostictests)

Number of dead birds,
mosquito pools tested statewide

Dead bird tested from Jan. toAug. 2008 – 165; Mosquito pools
tested – 3,179

Number of Blocking ELISA
test performed
Number of Proficiency testing
performed and passed.
Number of PRNT testing
performed to rule-out West
Nile Virus (WNV).
Validation/verification studies
for the MIA performed within
the budget period

2,648
5 PT samples per year; 5/5
passed. 1 PRNT testing
performed (July 2008)
TBD – this is for the 2009 budget
periodNumber of MIA tests
performed on live birds sera

TBD – this is for the 2009 budget
periodSubmit monthly lab data andpost this on the DOH website.

MetPrevention Measures of Effectiveness
Number of new invasive species detected at ports of entry.
See Invasive Species Overview below.
Current measures in place to prevent invasive species arrival and establishment

HDOA implements a plant and animal quarantine facility and runs a whole team of biosecurityinspectors; this is in addition to standard federal measures at the border for international goods.
As regulations and logistics permit efforts are coordinated between, Homeland Security, USDA,

15