1. Personal protection strategies and communicating them Philippe Porigneaux Environmental Health Manager Hunter New England Population Health Arbovirus Mosquito Surveillance Workshop 2 - 3 December 2015

2. Overview Hunter New England Local Health District Arboviral notifications Regional Mosquito Strategy Personal Protection Strategies Insect repellents – active ingredients Lake Macquarie City Council participation Hunter New England Local Health District participation Communications/media

4. Hunter New England

5. HNE Recreational adventure playground

6. Ross River virus

7. Barmah Forest virus

8. Dengue

9. Field Deployment Consider –Engagement of LGA –Media in the field – protocols for dealing with media –Emergency deployment protocols (Incident Control System – ICS) –Non emergency deployment protocols

10. Personal Protection Strategies Include: Use of insect repellents or insecticides (topical repellents, mosquito coils) Source reduction (minimising opportunities for mosquitoes around dwellings by emptying or covering water-holding containers) Behavioural practices (avoiding mosquito habitats or times of the day when mosquitoes are most active) Physical barriers (bed nets, long- sleeved light coloured shirts/trousers, insect screened doors/windows, insect mesh tents)

12. Recommended repellents Products containing either: N,N-diethyl-3-methylbenzamide (DEET) or 2-(2-hydroxyethyl)-1-piperidinecarboxylic acid 1-methylpropyl ester (picaridin) These products are: Effective Pose no substantial adverse health effects to users Considered safe, although generally not recommended for children under 3 months of age Recommended for use by older children and/or adults to protect against mosquito bites

13. How to use/apply repellents Read and follow label directions Test/watch for any allergic reactions Apply to all areas of exposed skin (avoid applying to mouth, eyes, wounds, cut, sunburned or irritated skin) Applying large amounts of mosquito repellent does not result in longer periods of protection against mosquito bites Some mosquito repellents can be applied directly to clothing (label) but some for clothing are not suitable for application to skin When using pump spray, it is important to evenly cover the skin and this may be best done by first applying the mosquito repellent from the container and then spreading over skin using your hands/wipes Never allow children to apply repellents on their own

14. Lake Macquarie City Council

15. Council is part of NSW Health monitoring program Benefits: –information on mosquito numbers & virus presence (used to issue public health warning at times of high risk) –adds to local and statewide data that is being used by NSW Health to study and manage mosquito populations and mosquito borne disease –It underpins the mosquito information (used to respond to public inquiries as well as information on the Council’s web site)

16. Lake Macquarie City Council

18. Hunter New England Population Health Supports two Sentinel Chicken flocks: –Wee Waa –Moree Supports local coordination of Local Governments participation in adult trapping Monitors local conditions (rainfall, temperature, tides, arboviral notifications, sentinel chicken flock sero- conversion, adult trap results, Honey-Baited Trap virus detections) – Risk Assessment

19. Hunter New England Population Health Annual inspection of Newcastle Port in partnership with: –Department of Agriculture and Water Resources –Port of Newcastle –Newcastle City Council

20. Hunter New England Population Health Risk assessment for vulnerable populations and information provision: –Holiday makers (Christmas & Easter) –Residents –Major events (Tamworth Country Music Festival). –Institution inspections on complaint (Newcastle University) Communication –Website –Media releases & responses to media enquiries

21. Pre-Field Deployment Obtain information: –Pollution incident –Substance composition –Exposed people and exposure pathways –Maps/Satellite imagery –Identify key features –Meteorological conditions Prepare: –PPE –Electronic communications/recording equipment

23. Hunter New England

24. Ross River virus

26. Hunter Health: Beware of mosquitoes carrying Barmah Forest Virus By ASHLEIGH GLEESON Jan. 29, 2015, 12:30 p.m. THE Hunter health authority has issued a warning for residents to avoid getting bitten by mosquitoes after the Barmah Forest Virus was detected in the region. Public Health Physician Dr David Durrheim said recent warm weather teamed with good rainfall and king tides had resulted in excellent breeding conditions for mosquitoes responsible for spreading the Barmah Forest Virus and the Ross River Virus. He said most people infected would have a mild illness that would last a few days – however it could cause some people to feel lethargic and suffer pain in their joints for months. “The symptoms … include fever, skin rash, painful joints and tiredness,” he said. Dr Durrheim said the only way to prevent infection by the virus was to avoid being bitten by mosquitoes. “These viruses are spread by mosquitoes that feed on animals that have the infection, so prevention depends on avoiding mosquito bites especially in summer and autumn months when infections peak,” he said. “Good rainfall in coastal areas during the past few weeks has contributed to a rise in mosquito numbers while the warm weather allows mosquitoes to survive longer and transmit the virus to people. “The coastal high tides last week will provide an excellent breeding opportunity for saltmarsh mosquitoes.” Ways to avoid mozzie bites include: Avoiding being outside unprotected before dawn and after dusk. Avoiding known high-risk breeding sites, including marsh areas. Wearing loose fitting, light-coloured clothing that cover arms and legs. Using an insect repellent that contains the chemical DEET or picaridin on exposed skin. Fitting and maintaining fly screens to all windows and doors. Using a knockdown insecticide in bedrooms half an hour before going to bed according to instructions if mosquitoes are inside. The conditions are currently perfect for mosquitoes

27. Health warning as Hunter mozzies detected carrying Barmah Forest virus Posted 30 Jan 2015, 6:36am Fri Newcastle residents are being urged to take extra precautions to prevent mosquito bites, with king tides and good rain making conditions perfect for saltmarsh mozzies. The saltmarsh variety is responsible for spreading the debilitating Ross River and Barmah Forest viruses. Public health physician David Durrheim said conditions are currently ideal on the coast, and people need to start covering up and using repellent. "We've actually had catches now of mosquitoes in the greater Newcastle and Lake Macquarie areas, that are actually infected with Barmah Forest virus," he said. "So, the threat is there, and the warning really is that people need to take every measure possible to avoid being bitten by mosquitoes. “Dr Durrheim said symptoms include fever, skin rashes, as well as debilitating tiredness and joint pain. "At this time of year when we have king tides," he said. "And particularly with the wet weather we've had, we've got copious breeding sites for saltmarsh mosquitoes. "Unfortunately, with the saltmarsh mosquitoes, their flight range can be as far as 20 kilometres so it's almost impossible to really eradicate them." Photo: The saltmarsh variety is responsible for spreading the debilitating Ross River and Barmah Forest viruses.

28. Health experts warn locals to avoid mosquito bites Details Published: 17 November 2015 Hunter New England Health is urging people to take precautions against mosquitoes. Hunter New England Health Public Health Physician David Durrheim said the recent warm weather together with good rainfall has resulted in excellent breeding conditions for mosquitoes responsible for spreading Ross River virus and Barmah Forest virus. “Good rainfall particularly in coastal areas during the past few weeks has contributed to a rise in mosquito numbers while the warm weather allows mosquitoes to survive longer and transmit the viruses to people,” Dr Durrheim said. The only way to prevent infection is to avoid being bitten by mosquitoes. “These viruses are spread by mosquitoes that feed on animals that have the infection, so prevention depends on avoiding mosquito bites especially in summer and autumn months when infections peak,” Dr Durrheim said. “The symptoms of Ross River virus and Barmah Forest virus infection include fever, skin rash, painful joints and tiredness,” he said. “Most people affected will have a mild illness that lasts for a few days. However in some people joint aches and lethargy can last for months.” Methods for avoiding mosquito bites include: Avoid being outside unprotected before dawn and after dusk Avoid known high risk breeding sites, including marsh areas When outside wear loose fitting, light coloured clothing that cover your arms and legs Use an insect repellent that contains the chemical DEET or picaridin on exposed skin Fit and maintain fly screens to all windows and doors If mosquitoes are inside use a knockdown insecticide in bedrooms half an hour before going to bed according to instructions

29. Hunter New England Health warn virus-spreading mosquito number on the rise By Ellie-Marie Watts Nov. 19, 2015, 3:08 p.m. WARNING: Hunter New England Health is warning residents to avoid mosquitoes, which may carry the Ross River and Barmah Forest viruses. WARM weather mixed with spring showers has created excellent breeding conditions for virus- spreading mosquitoes Hunter New England Heath has warned. HNEH is urging resident to protect themselves against mosquitoes that spread the Ross River and Barmah Forest viruses. “Good rainfall particularly in coastal areas during the past few weeks has contributed to a rise in mosquito numbers while the warm weather allows mosquitoes to survive longer and transmit the viruses to people,” said HNEH public health physician David Durrheim. “These viruses are spread by mosquitoes that feed on animals that have the infection. “Prevention depends on avoiding mosquito bites.” The symptoms of Ross River and Barmah Forest virus infection include fever, skin rash, painful joints and tiredness.

30. Future Activity Exotic Mosquito Incursion –Port of Newcastle –Newcastle Airport –Risk Assessment –Beyond the 400 meter zone! –Community education/campaign