Transcript Title Layout - Pacific Island Health Officers Association

Guam
Mosquito Laboratory
D iv i sion o f E nv ironmen tal H e al t h
D e part m ent o f P ubli c H e al t h an d S o c i al
S e rv ices
Presentation Outline
• Threat of Mosquito-borne Diseases to Guam
• Introduction and Spread of Mosquito-borne
Disease
• Mission of the Mosquito Surveillance and
Control Program
• Guam Mosquito Laboratory
• BioSecurity Level
Threat of Mosquito-borne
Diseases to Guam
• Guam’s economy, U.S. military presence, tourism,
and geographic location have led to the entry of
millions of items and people into the island from all
over the world
• Many of these goods and travelers originate from
areas where mosquito-borne diseases are endemic
• Infected passengers and mosquitoes, and mosquito
carrying ships and planes, can enter Guam
• Hot and humid climate of Guam provides ideal
habitat for mosquitoes to breed and populate
• Thus, the risk of introducing and spreading mosquitoborne diseases on Guam is high
Threat of Mosquito-borne
Diseases to Guam (Cont.)
• Mosquito-borne diseases include:
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Dengue Fever: >100 million cases worldwide each year
Malaria: Kills about 660,000 people annually
Japanese Encephalitis: Causes inflammation of the brain membrane
Zika Virus and Chikungunya: Emerging mosquito-borne diseases
• Guam is free of endemic mosquito-borne diseases
• Most recent tests of captured mosquitoes showed no infection
• All documented cases post-WWII were imported
• Importation of infected mosquito
• Can enter island via ship or plane with imported goods and arriving
passengers
• Arrival of infected person
• Person infected elsewhere arrives to Guam
• Importation of certain mosquito species can increase
the threat to Guam
• Some mosquito species are more efficient than others in transmitting the
disease
Introduction and Spread of
Mosquito-Borne Diseases
• Outbreak from an infected mosquito
• Infected mosquito entering island can bite and transmit disease to local
resident or visitor
• Infected mosquito may transmit virus to its offspring
• Outbreak from an infected person
• Non-infected mosquito can bite an arriving visitor or returning resident who
is infected with the disease
• Now infected mosquito can subsequently bite another person to transmit
the disease
• Importation of certain mosquito species
• Aedes aegypti mosquito is an efficient transmitter of dengue fever
• Eradicated on Guam post WW-II by the military
• Can be imported into the island via ship or plane and become reestablished
• Establishment of the disease
• As more mosquitoes get infected, the greater the potential for the spread
of the disease in the population leading to an outbreak
• If infected mosquitoes are not eradicated, the disease may become
established
Mosquito Surveillance and
Control Program (MSCP)
• MSCP of the Division of Environmental Health, DPHSS
seeks to prevent the introduction and spread of
mosquito-borne disease on Guam
• MSCP will conduct mosquito surveillance
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Collect and identify mosquito species on Guam
Gather data on mosquito species, location and density
Establish monitoring sites (i.e., ports of entry)
Test mosquitoes for infection
• MSCP will conduct mosquito control
• Determine triggers to initiate investigation, control measures, etc.
• Conduct outbreak investigations and control activities
• Determine pesticide resistance
• MSCP will conduct mosquito education
• Promote mosquito education and awareness
• Conduct outreach and campaigns
Guam’s Need for a Mosquito
Laboratory
• To conduct mosquito surveillance, control, and
education activities, MSCP will require space,
equipment, personnel and community support
• DOI CIP grant ($3 million) to fund DEH Office
Expansion Project
• Additional office space
• House MSCP staff, store equipment and materials
• Mosquito lab
• Identify species, test for infection and determine pesticide
resistance
• Training room
• Provide onsite training and education on mosquito control
• Food screening lab
• Project to be constructed in Dededo, adjacent to the
Northern Community Health Center
Project Information
• The building will consist of 34 rooms total
• 15 rooms for mosquito laboratory
• Lab safety and security utmost importance
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Protecting staff and citizens from lab hazards
Limited access to building
Restricted access to lab
Internal and external security
Received assistance/guidance from CDC
• Constructed to meet certification standards for
structure
• Biosafety Level (BSL) of a lab describes the degree of
protection for containing biological agents
• BSL-4 > BSL-3 > BSL-2 > BSL-1
• Pathogens are identified by the CDC as to which biosafety
level they belong to
• Majority of our lab rooms will be BSL-2; few rooms will be BSL-3
Summary of Biosafety Levels 1-4
Agents
BSL-1
BSL-2
BSL-3
BSL-4
Practice
Primary Barriers and Safety
Equipment
Facilities (Secondary
Barriers)
Not known to consistently
cause diseases in healthy
adults
Standard
microbiological
practices
•No primary barriers required
•PPE; laboratory coats and gloves;
eye and face protection, as needed
Laboratory sink and bench required
•Agents associated with
human diseases and posts
moderate hazards
•Includes bacteria and
viruses that cause only
mild disease to humans, or
are difficult to contract via
aerosal in a lab setting
BSL-1 practice plus:
•Limited access
•Biohazard warning
signs
•“Sharps” precautions
•Biosafety manual
defining any needed
waste decontamination
or medical surveillance
policies
Primary Barriers:
•BSCs or other physical containment
devices used for all manipulations of
agents that cause splashes or
aerosols of infectious materials
•PPE: Laboratory coats, gloves, face
and eye protection, as needed
BSL-1 plus:
•Autoclave available
•Indigenous or exotic
agents that may cause
serious or potentially lethal
disease
•Includes various bacteria,
viruses, and parasites that
can cause severe to fatal
diseases in humans, but for
which treatment exists
BSL-2 practice plus:
•Controlled access
•Decontamination of
all waste
•Decontamination of
laboratory clothing
before laundering
Primary Barriers:
•BSCs or other physical containment
devices used for all open
manipulations of agents
•PPE: protective laboratory clothing,
gloves, face, eye, and respiratory
protection, as needed
BSL-2 plus:
•Physical separation from access
corridors
•Self-closing, double door access
•Exhausted air not recirculated
•Negative air flow into laboratory
•Entry through airlock or anteroom
•Hand washing sink near laboratory
exit
•Dangerous/exotic agents
which post high individual
risk of aerosol-transmitted
laboratory infections,
•Causes severe to fatal
disease in humans for
which vaccines or other
treatments are not
available
BSL-3 practice plus:
•Clothing change
before entering
•Shower on exit
•All material
decontamination on
exit from facility
Primary Barriers:
•All procedures conducted in Class III
BSCs or Class I or II BSCs in
combination with full-body, airsupplied, positive pressure suit
BSL-3 plus:
•Separate building or isolated zone
•Dedicated supply and exhaust,
vacuum, and decontamination
systems
•Other requirements outlined in text
BSL for specific Pathogens
Pathogens
BSL-2
BSL-3
Dengue fever virus
X
Chikungunya virus
X
(recommended)
Japanese encephalitis
virus
X
(recommended)
Malaria
X
West Nile virus
X
Yellow fever virus
X
Zika virus
X
Note: For Chikungunya and Japanese encephalitis viruses, a BSL-3 is recommended
but not required
Conclusion
• Guam’s economy, location, and climate may lead to
the importation and the establishment of mosquitoborne disease(s)
• MSCP seeks to prevent the introduction and spread
of mosquito-borne disease
• MSCP requires a dedicated laboratory to implement
mosquito surveillance, control, and education
• A mosquito lab can prevent and control mosquitoborne diseases on Guam
• Proposed mosquito lab will be constructed to meet
the physical standards to contain biohazards
THANK YOU!
ANY QUESTIONS?
Laboratory Information (Cont.)
• Table 3: Food Lab Pathogens and BSL Category
Pathogens
BSL-2
Bacillus cereus
X
BSL-3
X
If high concentrations or high production volumes are
used or when there is high potential for aerosol
production
Clostridium botulinum
X
If high concentrations or high production volumes are
used or when there is high potential for aerosol
production
Clostridium perfringens
X
E.coli 0157:H7
X
Hepatitis A
X
Listeria monocytogenes
X
Norwalk and Norwalk-like viral
agent
If used for research
work (co-cultivation,
replication studies, or
manipulation
involving
concentrated virus)
only
Salmonella
X
Shigella
X
Staphylococcus aureus
X
Campylobacter jejuni
If high concentrations or high production volumes are
used or when there is high potential for aerosol
production
If used for virus production activities
Laboratory Information (Cont.)
• Primary Barriers
• Biological Safety Cabinets (BSC) are enclosed, ventilated
laboratory workspace
• BSC Class II Type A2 will be used
• Vertical, laminar flow ventilated cabinets with an open-front
• Mass airflow is re-circulated within work space
• Uses HEPA-filter for both re-circulated air and exhaust air; HEPA filters are
effective for trapping particulates and infectious agents
• Provides personnel, environment, and product protection
• Insects will be contained in cages and placed inside
environmental chambers
BSC Class II Type A2
Environmental Chambers
Laboratory Information (Cont.)
• Secondary Barriers
• Laboratory Facilities Design
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Access is limited to lab staff
Double doors for main entrance/exits
Laboratory portion is separated by additional doors
Self-closing doors with locks are provided
BSL-3 rooms and insectaries are separated from unrestricted
traffic flow
An anteroom is provided for the insectary rooms
BSL-3 rooms have an anteroom and are equipped with a
negative airflow into the rooms; ducted air ventilation system
that circulates air from “clean” area to “potentially
contaminated” areas is also provided
No windows to the outside are provided for lab portion
Exhaust vents and vacuum lines are protected with HEPA
filters
Types of Tests/Procedures Performed
• Mosquito Sorting and Identifying
• Insecticide Chemical Preparations
• Insecticide Resistance Testing
• Polymerase Chain Reaction (PCR)
• Food and water screening and sampling
Disinfection and Decontamination
• Autoclaves
• An autoclave is a strong, pressurized, steam-heated vessel
used for sterilization
• Guam Mosquito Lab will have two (2):
• One (1) pass-thru autoclave from BSL-3 rooms to sterilization room
• One (1) back up autoclave
Pass-thru autoclave
Autoclave
Disinfection and Decontamination (Cont.)
• Facilities are designed to follow BSL-2 and BSL-3
specifications:
• Rooms sealable for decontamination
• Surfaces of walls, floors, and ceilings are smooth, impermeable
durable, chemical resistant, and easily cleanable and
decontaminated; all penetrations sealed
• Handwashing and eye wash stations are provided in each room and
located near exits
• Detailed protocols and strategies will be established regarding
disinfection and decontamination once laboratory is set up