Updating Florida’s Vector-Borne Surveillance: Addressing the Growing Concern for Mosquito-Borne and Tick-Borne Illness

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Vector-borne diseases make up some of the more common infections throughout the globe. The Centers for Disease Control and Prevention acknowledges mosquito-borne denque mosqdiseases, such as West Nile Virus, and tick-borne infections, such as Lyme disease, have a great impact on the United States. These vectors have found favor in climate change as they continuing to breed and pose a public health risk; carrying infectious agents that may be transmitted to humans through a bloodmeal.

In 2014, the State of Florida Department of Health published their mosquito borne diseases surveillance guidebook. Within these guidelines, specific mosquito-borne infections were addressed in regards to both detecting and preventing such diseases. Unfortunately, since this publication, the Zika virus outbreak developed and was found to have recently reached Miami-Dade county in Florida, where locally transmitted cases were confirmed. Given these locally acquired infections in Florida, the surveillance guidelines should be updated accordingly.

FL Zika

Number of Florida Acquired Zika Virus (gray line: per million)

While the Northeastern regions of the US are known to have their “tick season” in the Spring and Summer, Florida’s climate allows for a year-long risk of contracting a tick-borne diease. The standard lab diauos in newsgnostic criteria for Lyme disease, the ELISA, detects antibodies against the bacterium, Borelia burgdorferi sensu stricto. However, it has continued to demonstrate poor sensitivity and overall reliability. Research from the University of North Florida has identified different strains of Borrelia that cause disease in humans. Thus, should one be infected with one of the different strains of Borrelia, one’s test is likely to be negative despite having actual disease. In recent years, Florida was found to have a 140% increase in Lyme disease cases since 1993 while reports of other tick-borne diseases have also increased. Hence, Florida researchers and public health professionals must partner together to revise and implement more up-to-date/accurate screening and awareness for vector-borne diseases.

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4 Responses to “Updating Florida’s Vector-Borne Surveillance: Addressing the Growing Concern for Mosquito-Borne and Tick-Borne Illness”

  1. Mosquito-Borne and Tick-Borne Illness in Florida: Importance of Surveillance | Tropical Health Matters Says:

    […] Here we are sharing the blog posted by “jleblan5jhmiedu“. read more on this and other SBFPHC blog posts by clicking here. This posting is particularly relevant today on World Mosquito […]

    • christypak Says:

      Thanks for sharing about the vector-borne disease situation in Florida! This is quite interesting and relevant, especially with Zika presence in the state.

      I agree that guidelines should be updated as needed, but also think 2014 is not so out of date that it requires revamping (outside of its normal update schedule) to account for a unique situation like the Zika outbreak. Though it looks like much of it has already been done, I would advocate for public health professionals at local, state and federal levels to use resources to publish comprehensive Zika-specific guidelines (a live document that is updated frequently) after taking into consideration the epidemiology and biology of the disease. Setting up a hotline, advertisements for clinic testing, spreading educational material for those at risk to know their levels of risk and where to get tested and seek care may be a more effective approach than updating a general guidebook. Another thing to look at is how widely this guidebook is currently used by private practitioners and public health staff across the state.

      In terms of tick-borne diseases, are there any current guidelines specific to Florida’s tick-borne disease “hot spots”? If not, that could certainly be a starting point; working with the counties and regions that report the greatest number of tick-borne illness and also taking into consideration infection outside of the state (travel-related, etc.).

      Guidelines and resources are great, but I believe knowledge should be disseminated strategically and appropriately to have the greatest impact on those who need it most.

  2. hanab_sbfblog Says:

    Thank you for sharing an important current issue regarding surveillance for vector borne diseases. Florida is a particularly interesting situation given the environment, climate, and also the human factor of travelers who enter the U.S. from areas with these diseases. In addition to WNV, Lyme, and Zika, there was also the chikungunya outbreak in which cases were initially reported among travelers. Eventually local transmission was confirmed in Florida. (Reference: http://www.cdc.gov/chikungunya/geo/united-states.html)

    Although publishing a surveillance guidebook would probably be the first step in addressing common and/or growing identified threats, it would also be useful for the department of health to reconsider their emergency health response and risk assessment of potential vector borne threats. Rather than creating a full list of vector borne diseases and exact public health responses, perhaps they can create a risk assessment flowchart to determine the realistic public health impact specific to the Floridian population and use that to justify their level of response. Of course, this must be supplemented by a flexible budget and political support, so there may be hesitation to dedicate money for unseen threats, but I believe there is growing evidence now that health departments (not just Florida) need to become better equipped with technical expertise and decision-making abilities in order to predict and prevent subsequent disease outbreaks.

    I also found this to be an interesting article about travel-related cases of disease: http://thenationshealth.aphapublications.org/content/40/7/1.2.full

  3. hasanalihali4 Says:

    Thank you for the post. If you were to pursue this interventional route, focusing on testing, how would you prioritize what illnesses to target and how would you measure the outcome/success of your measure? What about using those funds to target the vectors themselves and vector population reduction in vector-dense regions, which is a similar tactic employed by Brazil in favelas when addressing Zika? While a funding strategy geared towards the development of more sensitive and reliable tests is a potentially effective strategy, I may advocate for an alternative strategy oriented around increasing public awareness regarding the dangers of vector-borne illnesses. Working with community members and leaders within Florida to spread the word regarding the heterogeneity of both the illnesses and vectors themselves, early symptoms of the diseases, and the inability for medicine to reliably detect their presence should the main focus of the intervention.

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