Integrated Vector Management Programme Jamaica Sherine Huntley Jones Public Health Entomologist Manager, National Vector Control Programme

I have you under my control !

Presentation Outline Historical Background Current Situation Gaps in Programme Looking Ahead

Historical Perspective We have had Vector-borne Disease with us for a long time!. Outbreaks of mosquito-borne disease are NOT new

Endemic Diseases of the Past Yellow Fever Malaria Eastern Equine Encephalitis - EEE Dengue

History of Vector-borne Diseases in Jamaica Several outbreaks of dengue By 2007, all 4 serotypes have circulated in Jamaica 1970’s Discontinuation of eradication programme 2016 Introduction of Zika 1965 Certified by WHO as malaria free 1998 Outbreak of dengue Before 1961 Malaria Outbreaks Ongoing imported cases of malaria 1960’s Western hemisphere eradication programme 1977 Massive Dengue Outbreak 1962 Outbreak of Eastern Equine Encephalitis in Jamaica 2006 Reintroduction of Malaria. 2012 re-certified malaria free 1995 Outbreak of dengue 2013 Introduction of chikungunya virus Last case of yellow fever recorded in 1904

MOSQUITO VECTORS ENDEMIC Anopheles albimanus . Aedes aegypti Aedes sollicitans

Based on Eradication Principles Vector Management Based on Eradication Principles House to house Inspection with elements of treating/destroying breeding sites Application of pesticides Ownership Implementation owned by mostly government

Current Situation Supporting Environment persist! Outbreaks of mosquito-borne disease are still occurring We still have vector-borne diseases

Vector-borne Diseases Endemic Dengue Zika Chikungunya

Vector-borne Diseases At Risk For Yellow Fever West Nile Virus Mayaro Virus Malaria Oropouche

Dengue outbreaks Jamaica 1995 to 2018 Year Serotypes isolated 1995 DENV-2 1998 DENV-3 2007 DENV-1, DENV-2, DENV-4 2010 2012 DENV-1 2016 DENV-3, DENV-4 2018

Dengue in Jamaica

MOSQUITO VECTORS ENDEMIC Anopheles albimanus . Aedes aegypti Aedes albopictus Culex sp. Ochleratatus sollicitans

Dengue Epidemiology Outbreaks of dengue expected now every 2-3 years More severe clinical presentation projected with each outbreak Jamaica maybe at a hyper-endemic state

Contributing Factors Increase in global travel Climate Change Urbanization Solid Waste Management Piped Water Infrastructure Resistance to chemicals Resistance to drug - antimalarials

Integrated Vector Management Components of IVM Programme Legislation Vector Surveillance, Public Education (Community Participation Vector Control Interventions Intersectorial Collaboration Emergency Response Research

Integrated Vector Management (IVM) Legislation and Advocacy Nuisance Regulations Vector Surveillance Key Premises (tyre shops, garages and dump sites) Key Institutions (schools, infirmary, police stations, hospitals) Key Areas (markets, ports of entry, urban centres, high risk communities Public Education Media Campaign Distribution of educational material Vector Control Interventions Adulticiding Larviciding Emergency Response Hot spot Increase in response capacity Emergency intervention Inter-sectorial Collaboration Partnering with key stakeholders and other agencies Research Investigation into new and innovation intervention

Integrated Vector Management Vector Control Intervention Nuisance control Public Education Chemical application, source reduction Surveillance Aedes aegypti/albopictus sentinel System Daily House to House Inspection. Bi Annual Rapid Surveillance Programme Activities

Surveillance Information 45/55g drum tyres To determine main sources of mosquito breeding 511 High risk communities

202 permanent vector control staff Resources 202 permanent vector control staff 37 vehicles 9 ULV machines 162 handheld machines

GAPS IN PROGRAMME Enforcement of Legislation Inadequate Resources Population Behaviour Effective Tools for Intervention Operational Research

Looking Forward Supporting Environment minimized! Outbreaks of mosquito-borne disease reduced We will still have vector-borne diseases

Mosquito Control and Research Unit IVM - Research Mosquito Control and Research Unit Operational Research into innovative and novel tools for intervention to inform Ministry of Health programme

IVM – Research - (MCRU)

Looking Forward Continued collaboration under the MCRU as it relates to research Insecticide Resistance Monitoring Modelling for Vector-borne Diseases (establishment of an early warning system) Behaviour Change

IVM- Insecticide Resistance Monitoring

IVM - Research

Development of an Early Warning System for Arboviruses IVM-Research Development of an Early Warning System for Arboviruses Understanding the Impact of Climate Change Scenarios on Vector-borne Disease transmission

Looking Forward Strengthen Intersectorial Collaboration Review of Vector Control Programme - Development of the IVM Strategic Plan 2020-2025 - Increasing resources in the vector - Training and Certiification of staff in public health entomology

Looking Forward Enforcement of the Legislation