Division of Environmental Health

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Guam Mosquito Laboratory

• Division of Environmental Health
• Department of Public Health and Social Services

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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

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Threat of Mosquito-borne Diseases to Guam

• Guams 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
  mosquito-borne diseases on Guam is high

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Threat of Mosquito-borne Diseases to Guam (Cont.)

• Mosquito-borne diseases include
• Dengue Fever gt100 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

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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 re-established
• 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

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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
• 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

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Guams 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

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Project Information

• The building will consist of 34 rooms total
• 15 rooms for mosquito laboratory
• Lab safety and security utmost importance
• 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 gt BSL-3 gt BSL-2 gt 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

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Summary of Biosafety Levels 1-4
Agents Practice Primary Barriers and Safety Equipment Facilities (Secondary Barriers)
BSL-1 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
BSL-2 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
BSL-3 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
BSL-4 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, air-supplied, positive pressure suit BSL-3 plus Separate building or isolated zone Dedicated supply and exhaust, vacuum, and decontamination systems Other requirements outlined in text
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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
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Conclusion

• Guams economy, location, and climate may lead to
  the importation and the establishment of
  mosquito-borne 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
  mosquito-borne diseases on Guam
• Proposed mosquito lab will be constructed to
  meet the physical standards to contain biohazards

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THANK YOU! ANY QUESTIONS?
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Laboratory Information (Cont.)

• Table 3 Food Lab Pathogens and BSL Category

Pathogens BSL-2 BSL-3
Bacillus cereus X
Campylobacter jejuni 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 0157H7 X
Hepatitis A X
Listeria monocytogenes X If high concentrations or high production volumes are used or when there is high potential for aerosol production
Norwalk and Norwalk-like viral agent If used for research work (co-cultivation, replication studies, or manipulation involving concentrated virus) only If used for virus production activities
Salmonella X
Shigella X
Staphylococcus aureus X
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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
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Laboratory Information (Cont.)

• Secondary Barriers
• Laboratory Facilities Design
• 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

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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

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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
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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