Organophosphate insecticides are widely used for adult mosquito control. Although proven effective in reducing mosquito populations and limiting arbovirus transmission, public concern exists regarding potential human health effects associated with organophosphate exposure. The aim of this scoping review was to describe any reported human health conditions associated with organophosphates during their use for adult mosquito control in the United States and Canada. Original peer-reviewed articles published in English language journals from 1 January 2000 to 22 May 2024, were obtained by searching from the databases MEDLINE, EMBASE, Agricultural & Environmental Science Collection, CAB Abstracts, and Scopus. The search identified 6,154 screened articles. Following an independent review, 10 studies were identified that described human health conditions associated with organophosphate exposure during adult mosquito control applications. Of the 10 included studies, only two articles were published within the last 11 years (2013 to 22 May 2024). Three types of study design were represented in the included studies: cohort (n = 5), case study (n = 1), and risk assessment (n = 4). The included studies could not determine causality between exposure to adulticides and development of illness or adverse impacts. Exposure to organophosphates did not contribute to an observed increase in metabolic toxicity, hospitalization rates, or self-reported symptoms and exposure. The available and limited evidence indicates that organophosphates can be used safely to control nuisance mosquitoes or mosquitoes that transmit arboviruses. Continued research regarding the human health effects associated with organophosphate applications for adult mosquito control could help evaluate the basis of the public's concerns and inform public health decision-making.

Oropouche virus has recently caused outbreaks in South America and the Caribbean, expanding into areas to which the virus was previously not endemic. This geographic range expansion, in conjunction with the identification of vertical transmission and reports of deaths, has raised concerns about the broader threat this virus represents to the Americas. We review information on Oropouche virus, factors influencing its spread, transmission risk in the United States, and current status of public health response tools. On the basis of available data, the risk for sustained local transmission in the continental United States is considered low because of differences in vector ecology and in human-vector interactions when compared with Oropouche virus-endemic areas. However, more information is needed about the drivers for the current outbreak to clarify the risk for further expansion of this virus. Timely detection and control of this emerging pathogen should be prioritized to mitigate disease burden and stop its spread.

Beginning in late 2023, Oropouche virus was identified as the cause of large outbreaks in Amazon regions with known endemic transmission and in new areas in South America and the Caribbean. The virus is spread to humans by infected biting midges and some mosquito species. Although infection typically causes a self-limited febrile illness, reports of two deaths in patients with Oropouche virus infection and vertical transmission associated with adverse pregnancy outcomes have raised concerns about the threat of this virus to human health. In addition to approximately 8,000 locally acquired cases in the Americas, travel-associated Oropouche virus disease cases have recently been identified in European travelers returning from Cuba and Brazil. As of August 16, 2024, a total of 21 Oropouche virus disease cases were identified among U.S. travelers returning from Cuba. Most patients initially experienced fever, myalgia, and headache, often with other symptoms including arthralgia, diarrhea, nausea or vomiting, and rash. At least three patients had recurrent symptoms after the initial illness, a common characteristic of Oropouche virus disease. Clinicians and public health jurisdictions should be aware of the occurrence of Oropouche virus disease in U.S. travelers and request testing for suspected cases. Travelers should prevent insect bites when traveling, and pregnant persons should consider deferring travel to areas experiencing outbreaks of Oropouche virus disease.

The recovery of a Haemaphysalis longicornis Neumann (Acari: Ixodidae) tick from a dog in Benton County, Arkansas, in 2018 triggered a significant environmental sampling effort in Hobbs State Park Conservation Area. The objective of the investigation was to assess the tick population density and diversity, as well as identify potential tick-borne pathogens that could pose a risk to public health. During a week-long sampling period in August of 2018, a total of 6,154 ticks were collected, with the majority identified as Amblyomma americanum (L), (Acari: Ixodidae) commonly known as the lone star tick. No H. longicornis ticks were found despite the initial detection of this species in the area. This discrepancy highlights the importance of continued monitoring efforts to understand the dynamics of tick populations and their movements. The investigation also focused on pathogen detection, with ticks being pooled by species, age, and sex before being processed with various bioassays. The results revealed the presence of several tick-borne pathogens, including agents associated with ehrlichiosis (n = 12), tularemia (n = 2), and Bourbon virus (BRBV) disease (n = 1), as well as nonpathogenic rickettsial and anaplasmosis organisms. These findings emphasize the importance of public health messaging to raise awareness of the risks associated with exposure to tick-borne pathogens. Prevention measures, such as wearing protective clothing, using insect repellent, and conducting regular tick checks, should be emphasized to reduce the risk of tick-borne diseases. Continued surveillance efforts and research are also essential to improve our understanding of tick-borne disease epidemiology and develop effective control strategies.

Background: La Crosse virus is an important endemic public health concern in the North Carolina Appalachian Mountains; however, human incidence is not commonly noted in this region on the South Carolina side of the mountain range border. No relevant studies have been performed in South Carolina evaluating mosquito vector populations for La Crosse virus (LACV) infection; thus, a pilot mosquito surveillance study was executed in summer 2020. Material and Methods: Vector surveillance occurred at five South Carolina state parks bordering neighboring state endemic counties from May to August 2020. Collections were approved by the state park authority, as noted in Permit No. N-8-20. Results: All three competent mosquito vectors were collected during the study duration; however, these vectors were collected in low abundance: Aedes triseriatus (4.5% of all collected mosquitos); Aedes albopictus (2.0%); Aedes japonicus (1.4%). Principal mosquito vector specimens, Ae. triseriatus, were sent to Centers for Disease Control and Prevention for testing of LACV by real-time reverse transcription PCR-all were negative. Discussion: While entomologic evidence suggests low transmission risk for this arbovirus in the South Carolina Appalachian Mountain region, further eco-epidemiologic investigations are warranted to understand this endemicity variance within a relatively small geographic area.

Control of mosquito vector populations is primarily intended to reduce the transmission of pathogens they transmit. Use of chemical controls, such as larvicides, can have unforeseen consequences on adult traits if not applied properly. The consequences of under application of larvicides are little studied, specifically the impacts on pathogen infection and transmission by the vectors that survive exposure to larvicides. We compared vector susceptibility of Aedes aegypti (L.) for dengue virus, serotype 1 (DENV-1) previously exposed as larvae to an LC50 of different classes of insecticides as formulated larvicides. Larval exposure to insect growth regulators (methoprene and pyriproxyfen) significantly increased susceptibility to infection of DENV-1 in Ae. aegypti adults but did not alter disseminated infection or transmission. Larval exposure to temephos, spinosad, and Bti did not increase infection, disseminated infection, or transmission of DENV-1. Our findings describe a previously under observed phenomenon, the latent effects of select larvicides on mosquito vector susceptibility for arboviruses. These data suggest that there are unintended consequences of sublethal exposure to select larvicides that can influence susceptibility of Ae. aegypti to DENV infection, and indicates the need for further investigation of sublethal effects of insecticides on other aspects of mosquito biology, especially those parameters relevant to a mosquitoes ability to transmit arboviruses (life span, biting behavior, extrinsic incubation period).

Geographic information systems (GIS) can be used to map mosquito larval and adult habitats and human populations at risk for mosquito exposure and possible arbovirus transmission. GIS can help simplify and target mosquito control efforts during routine surveillance and post-disaster (e.g., hurricane-related flooding) to protect emergency workers and public health. A practical method for prioritizing areas for emergency mosquito control has been developed and is described here. North Carolina (NC) One Map was used to identify state-level data layers of interest based on human population distribution and mosquito habitat in Brunswick, Columbus, Onslow, and Robeson Counties in eastern NC. Relevant data layers were included to create mosquito control treatment areas for targeted control and an 18-step protocol for map development is discussed. This protocol is expected to help state, territorial, tribal, and/or local public health officials and associated mosquito control programs efficiently create treatment area maps to improve strategic planning in advance of a disaster. This protocol may be applied to any NC county and beyond, thereby increasing local disaster preparedness. Copyright The copyright holder for this preprint is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. This article is a US Government work. It is not subject to copyright under 17 USC 105 and is also made available for use under a CC0 license.

Florence Anne Jones, known to all as “Flo,” passed away on January 21, 2023, in the care of hospice in Inverness, Florida. Her career in mosquito control began in 1975 and lasted until her retirement in 2006, although she remained involved in teaching about and advocating for mosquito control well beyond her retirement. During her career in mosquito control, Flo was a member of the American Mosquito Control Association, Florida Mosquito Control Association (FMCA), and Haiti Mosquito Control Association. She was also an active member of the Citrus County Historical Society, starting in 2017. Flo was a colleague, friend, biologist, teacher, author, pilot, philanthropist, friend to animals, and lover of nature and history.

On January 31, 2020, the U.S. Department of Health and Human Services (HHS) declared, under Section 319 of the Public Health Service Act, a U.S. public health emergency because of the emergence of a novel virus, SARS-CoV-2.* After 13 renewals, the public health emergency will expire on May 11, 2023. Authorizations to collect certain public health data will expire on that date as well. Monitoring the impact of COVID-19 and the effectiveness of prevention and control strategies remains a public health priority, and a number of surveillance indicators have been identified to facilitate ongoing monitoring. After expiration of the public health emergency, COVID-19-associated hospital admission levels will be the primary indicator of COVID-19 trends to help guide community and personal decisions related to risk and prevention behaviors; the percentage of COVID-19-associated deaths among all reported deaths, based on provisional death certificate data, will be the primary indicator used to monitor COVID-19 mortality. Emergency department (ED) visits with a COVID-19 diagnosis and the percentage of positive SARS-CoV-2 test results, derived from an established sentinel network, will help detect early changes in trends. National genomic surveillance will continue to be used to estimate SARS-CoV-2 variant proportions; wastewater surveillance and traveler-based genomic surveillance will also continue to be used to monitor SARS-CoV-2 variants. Disease severity and hospitalization-related outcomes are monitored via sentinel surveillance and large health care databases. Monitoring of COVID-19 vaccination coverage, vaccine effectiveness (VE), and vaccine safety will also continue. Integrated strategies for surveillance of COVID-19 and other respiratory viruses can further guide prevention efforts. COVID-19-associated hospitalizations and deaths are largely preventable through receipt of updated vaccines and timely administration of therapeutics (1-4).

Geographic information systems (GIS) can be used to map mosquito larval and adult habitats and human populations at risk for mosquito exposure and possible arbovirus transmission. Along with traditional methods of surveillance-based targeted mosquito control, GIS can help simplify and target efforts during routine surveillance and post-disaster (e.g., hurricane-related flooding) to protect emergency workers and public health. A practical method for prioritizing areas for emergency mosquito control has been developed and is described here. North Carolina (NC) One Map was used to identify state-level data layers of interest based on human population distribution and mosquito habitat in Brunswick, Columbus, Onslow, and Robeson Counties in eastern NC. Relevant data layers were included to create mosquito control treatment areas for targeted control and an 18-step protocol for map development is discussed. This protocol is expected to help state, territorial, tribal, and/or local public health officials and associated mosquito control programs efficiently create treatment area maps to improve strategic planning in advance of a disaster. This protocol may be applied to any NC county and beyond, thereby increasing local disaster preparedness.

Chemical control of vectors depends on the effective application of formulated insecticides. In this study we evaluated formulated larvicides using a larval bioassay against susceptible Aedes aegypti. The estimated larvicide lethal concentrations for 50% mortality (LC50s) were 25.7 μg/liter (Natular 2EC), 3.13 μg/liter (Abate 4E), 0.43 μg/liter (Altosid), 0.03 μg/liter (Nyguard), and 500.6 ITU/liter (VectoBac12AS containing Bacillus thuringiensis israelensis). Sublethal effects were identified and documented from adults that survived exposure to these estimated LC50s (body size and sex proportion). We observed changes in net growth as measured by adult wing lengths. For those larvae exposed to estimated LC50s, the average size of adults was between 0.1% and 10.6% smaller for males and between 1.1% and 13.6% smaller for females compared to controls. Sex proportions varied between larvicides, but some were significantly different from the control, favoring greater survival of females than males.

Among disease vectors, Aedes aegypti (L.) (Diptera: Culicidae) is one of the most insidious species in the world. The disease burden created by this species has dramatically increased in the past 50 years, and during this time countries have relied on pesticides for control and prevention of viruses borne by Ae. aegypti. The small number of available insecticides with different modes of action had led to increases in insecticide resistance, thus, strategies, like the "Incompatible Insect Technique" using Wolbachia's cytoplasmic incompatibility are desirable. We evaluated the effect of releases of Wolbachia infected Ae. aegypti males on populations of wild Ae. aegypti in the metropolitan area of Houston, TX. Releases were conducted by the company MosquitoMate, Inc. To estimate mosquito population reduction, we used a mosquito abundance Bayesian hierarchical estimator that accounted for inefficient trapping. MosquitoMate previously reported a reduction of 78% for an intervention conducted in Miami, FL. In this experiment we found a reduction of 93% with 95% credibility intervals of 86% and 96% after six weeks of continual releases. A similar result was reported by Verily Life Sciences, 96% [94%, 97%], in releases made in Fresno, CA.

Aedes aegypti (Linnaeus) is an invasive mosquito species and notable vector of several pathogens in the USA. Their cryptic and anthropophilic nature puts this species in close association with humans, where they can also be a nuisance. Mosquito control programs are the front line of defense for protecting the community from nuisance-biting and disease. However, the occurrence and prevalence of insecticide resistance in mosquitoes is a well-documented phenomenon that directly impacts the efficacy of insecticide applications. In Florida specifically, widespread resistance in Ae. aegypti has created a need for operational strategies that combat and, ideally, reverse resistance. Laboratory studies and the association between fitness costs and insecticide resistance indicate that this reversion is possible under the right conditions. For a 2.5-year period, the impact of varying operational treatment regimens on insecticide resistance in Ae. aegypti is evaluated using kdr genotyping and the CDC bottle bioassay. In an organophosphate treatment area, a decrease in frequency of a double homozygous resistant genotype was observed. CDC bottle bioassays did not reveal any clear trends in the data to indicate a reversion to insecticide susceptibility. However, the changes in genotype could indicate the first step back to insecticide susceptibility. This study provides preliminary data that has implications for resistance management in mosquito control operations. Article Highlights: Presented study represents the first field study to evaluate how changing insecticide pressures on resistant mosquitoes affects insecticide resistance.A decrease in the double homozygous resistance genotype was observed in Ae. aegypti from the organophosphate treatment area after a change in use patterns.Identifiable trends in phenotypic resistance as a result of the treatment regimens were not observed. © 2022, The Author(s).

Preparation for post-hurricane mosquito control is essential for an effective emergency response to protect public health and promote recovery efforts. Effective pre-hurricane planning includes laying the groundwork for a successful reimbursement application to the Federal Emergency Management Agency. The critical and overlapping need to sustain funding for mosquito control programs is highlighted here in the context of both normal and emergency responses. Community support is an integral component of an effective integrated pest management program and is established over time with appropriate communication and engagement. Experienced mosquito control operators who are familiar with treatment areas are an essential component of successful operations. Here, practical advice is provided to plan, prepare, and implement a successful ground- and aerial-based mosquito control response.

Mosquitoes are both a nuisance and public health threat. In recent decades, outbreaks of dengue, chikungunya, and Zika in Florida have raised awareness of the importance of domestic and peri-domestic container mosquitoes, Aedes aegypti and Aedes albopictus. The synanthropic nature of these species, coupled with their preference for human bloodmeals, makes them a concern of and target for mosquito control. However, mosquito control programs (MCPs) often struggle to sustainably manage these mosquitoes because of the cryptic and abundant nature of their larval habitats, and negative public opinion towards MCPs and the use of insecticides. Fortunately, mosquito control can be improved by the actions of homeowners and residents as they have regular access to their own property and containers. School-based education programs can provide a means to community-wide education regarding mosquito control. We developed and delivered a mosquito education program to elementary, middle, and high school students. Knowledge of mosquitoes significantly improved in participating elementary and middle/ high school students. This knowledge was partially retained according to a follow-up test that was administered. Additionally, attitudes towards mosquito control and at-home control methods significantly improved following the instruction. The improvements in knowledge and attitudes observed in students suggest they can and should be targeted for mosquito education campaigns by mosquito control programs and educators.

The United States experienced local transmission of West Nile Virus (WNV) for the first time in 1999, and Zika Virus (ZIKV) in 2016. These introductions captured the public’s attention in varying degrees. The research presented here analyzes the disproportional perception of ZIKV risk compared to WNV transmission risk, by the public and vector control personnel. The risk perception of vector control was measured through purposive sampled interviews (24 interviews in 13 states; May 2020–June 2021), while the public’s perception was estimated from news publications (January 2000–December 2020), and Google searches (January 2004–December 2020). Over time, we observed a decrease in the frequency of press reporting and Google searches of both viruses with decreasing annual peaks in the summer. The highest peak of ZIKV news, and searches, surpassed that of WNV. We observed clear differences in the contents of the headlines for both viruses. We propose that the main reason in risk perception differences between the viruses were psychological. Zika infections (mosquito-borne and sexually transmitted) can result in devastating symptoms in fetuses and newborns, observations that frequently appeared in ZIKV-related headlines. Our results highlight the likely influence the news media has on risk perception and the need for public health agencies to play active roles in the conversation, helping disseminate timely and accurate information. Understanding the factors that shape risk perceptions of vector-borne diseases will hopefully lead to better use of resources by providing better guidance. © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/).

Temperature plays a significant role in the vector competence, extrinsic incubation period, and intensity of infection of arboviruses within mosquito vectors. Most laboratory infection studies use static incubation temperatures that may not accurately reflect daily temperature ranges (DTR) to which mosquitoes are exposed. This could potentially compromise the application of results to real world scenarios. We evaluated the effect of fluctuating DTR versus static temperature treatments on the infection, dissemination, and transmission rates and viral titers of Culex tarsalis and Culex quinquefasciatus mosquitoes for West Nile virus. Two DTR regimens were tested including an 11 and 15◦C range, both fluctuating around an average temperature of 28◦C. Overall, no significant differences were found between DTR and static treatments for infection, dissemination, or transmission rates for either species. However, significant treatment differences were identified for both Cx. tarsalis and Cx. quinquefasciatus viral titers. These effects were species-specific and most prominent later in the infection. These results indicate that future studies on WNV infections in Culex mosquitoes should consider employing realistic DTRs to reflect interactions most accurately between the virus, vector, and environment. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.

The vector competence of mosquitoes for pathogens has been shown to be influenced by the status of insecticide resistance in the mosquito population. However, to date, only two studies has explored the impact of insecticide resistance on arbovirus transmission. The global and widespread use of pyrethroids has led to the development of insecticide resistance in many mosquito species, including Aedes aegypti (Linnaeus) (Diptera: Culicidae), the primary vector of Zika virus. Strains of Ae. aegypti that were genetically similar, but responded differently to pyrethroid exposure, were developed using backcrossing techniques. These populations were orally infected with Zika virus and susceptibility to infection, disseminated infection, and transmission potential were evaluated. Analyses revealed differences in susceptibility to infection and disseminated infection between the pyrethroid susceptible and resistant strains of Ae. aegypti during the infection period. Here, we identify an additional challenge to that of widespread pyrethroid resistance. Specifically, resistance is associated with altered phenotypic traits that influence susceptibility to arbovirus infection and progression of infection in the mosquito, factors which ultimately influence risk of arbovirus transmission. These findings support the need to 1) consider insecticide resistance status during times of arbovirus transmission and 2) to implement insecticide resistance management/ mitigation strategies in vector control programs.

Oropouche virus (OROV), a vector-borne Orthobunyavirus circulating in South and Central America, causes a febrile illness with high rates of morbidity but with no documented fatalities. Oropouche virus is transmitted by numerous vectors, including multiple genera of mosquitoes and Culicoides biting midges in South America. This study investigated the vector competence of three North American vectors, Culex tarsalis, Culex quinquefasciatus, and Culicoides sonorensis, for OROV. Cohorts of each species were fed an infectious blood meal containing 6.5 log(10) PFU/mL OROV and incubated for 10 or 14 days. Culex tarsalis demonstrated infection (3.13%) but not dissemination or transmission potential at 10 days post infection (DPI). At 10 and 14 DPI, Cx. quinquefasciatus demonstrated 9.71% and 19.3% infection, 2.91% and 1.23% dissemination, and 0.97% and 0.82% transmission potential, respectively. Culicoides sonorensis demonstrated 86.63% infection, 83.14% dissemination, and 19.77% transmission potential at 14 DPI. Based on these data, Cx. tarsalis is unlikely to be a competent vector for OROV. Culex quinquefasciatus demonstrated infection, dissemination, and transmission potential, although at relatively low rates. Culicoides sonorensis demonstrated high infection and dissemination but may have a salivary gland barrier to the virus. These data have implications for the spread of OROV in the event of a North American introduction.

On February 9, 2019, the Bipartisan Budget Act of 2018 was signed into law and appropriated $200M in hurricane funding to the Centers for Disease Control and Prevention (CDC) for preparation, response, recovery, mitigation, and other expenses related to the consequences of Hurricanes Harvey, Irma, and Maria. The CDC then awarded, through CDC-RFA-TP18-1802 Cooperative Agreement for Emergency Response: Public Health Crisis Response notice of funding opportunity, $51,136,347 in extramural funding. Funding specific to vector-borne diseases, including intramural and extramural (partners and jurisdictions), was $37,628,235 to Florida, Georgia, Louisiana, Mississippi, Texas, Puerto Rico, and US Virgin Islands. State and territorial funding supported the implementation of conventional and novel mosquito control techniques, training for public health pest control applicators, replacement of mosquito surveillance and control supplies utilized in the aftermath of the 2017 hurricanes, insecticide resistance testing and training, and source reduction. Additionally, the CDC hurricane funding supported this special issue of the Journal of the American Mosquito Control Association (JAMCA) focused on mosquito control response in the wake of natural disasters. We invited hurricane relief funding grantees, mosquito control programs, academics, manufacturers, product distributors, and applicators to submit response plans or descriptive articles related to their experience with mosquito control after natural disasters. The objective of this special issue of JAMCA is to provide a comprehensive volume that includes resources to help guide mosquito control in areas affected by natural disasters. The shared experiences should serve to assist others involved in mosquito control in planning for and responding to natural disasters.

In the last 2 decades, many new Florida county mosquito records have been discovered. The intent of this report is to establish unpublished county records to update the known distribution of mosquito species in Florida. We report 92 new county records from 5 major sources collected during 1989-2019.

Aedes aegypti (L) is an anthropophilic mosquito involved in the transmission of a variety of viral pathogens worldwide including dengue, chikungunya, yellow fever, and Zika viruses. This species, native to Africa, is well established in the continental U.S. (CONUS) and occasionally contributes to localized outbreaks of viral diseases. In the last seven decades, mosquito control programs in the CONUS have been focused on vectors of eastern equine encephalitis, St. Louis encephalitis, and West Nile viruses, as well as nuisance species. Aedes aegypti receives little control focus except during outbreak periods, which has led to a lack of information on appropriate and effective control options targeting Ae. aegypti in the CONUS. As such, in the event of an Ae. aegypti-borne arboviral outbreak in the CONUS, there are limited evidence-based control recommendations or protocols in place. Autochthonous outbreaks of Ae. aegypti-borne pathogens have occurred recently in the CONUS, including dengue outbreaks in 2010 and 2013, a chikungunya outbreak in 2014, and the 2016 outbreak of Zika virus. The increasing frequency of Ae. aegypti-borne outbreaks necessitates increased attention and research on control of this species to prevent and mitigate future outbreaks. This review consolidates and synthesizes the available literature on control of Ae. aegypti, specifically within the CONUS, focusing on data generated through operational applications as well as field and semifield experiments. The purpose of this review is to identify and highlight areas where additional research is needed. The review covers chemical control and insecticide resistance, biological control, source reduction, trapping, and alternative techniques.

Mosquitoborne disease outbreaks occur every year in the United States from one or more of the arboviral diseases dengue, West Nile, LaCrosse, Eastern equine encephalitis, and Zika (1). Public opinion communicated through traditional and social media and the Internet, competing public health and resource priorities, and local conditions can impede the ability of vector control organizations to prevent and respond to outbreaks of mosquitoborne disease. The Environmental Protection Agency (EPA) and CDC performed a coordinated review of the concerns and challenges associated with continuation of mosquito surveillance and control during public health emergencies and disasters. This report highlights the first joint recommendation from EPA and CDC. Mosquito surveillance and control should be maintained by state and local mosquito control organizations to the extent that local conditions and resources will allow during public health emergencies and natural disasters. Integrated pest management (IPM) is the best approach for mosquito control (2). IPM uses a combination of methods, including both physical and chemical means of control (3). For chemical means of control, CDC and EPA recommend the use of larvicides and adulticides following the EPA label. It is imperative that public health recommendations be followed to ensure the safety of the pesticide applicator and the public.

In 2016, four clusters of local mosquitoborne Zika virus transmission were identified in Miami-Dade County, Florida, USA, generating "red zones" (areas into which pregnant women were advised against traveling). The Miami-Dade County Mosquito Control Division initiated intensive control activities, including property inspections, community education, and handheld sprayer applications of larvicides and adulticides. For the first time, the Mosquito Control Division used a combination of areawide ultralow-volume adulticide and low-volume larvicide spraying to effectively control Aedes aegypti mosquitoes, the primary Zika virus vector within the county. The number of mosquitoes rapidly decreased, and Zika virus transmission was interrupted within the red zones immediately after the combination of adulticide and larvicide spraying.

Aedes aegypti and Aedes albopictus are invasive mosquito species with geographic ranges that have oscillated within Florida since their presence was first documented. Local transmission of dengue, chikungunya, and Zika viruses serves as evidence of the public health importance of these two species. It is important to have detailed knowledge of their distribution to aid in mosquito control efforts and understand the risk of arbovirus transmission to humans. Through a partnership involving the University of Florida Institute of Food and Agricultural Sciences Cooperative Extension Service and the Florida Medical Entomology Laboratory; the Florida Department of Health; and mosquito control agencies throughout Florida, a container mosquito surveillance program involving all life stages was launched in the summer of 2016 to detect the presence of Ae. aegypti and Ae. albopictus. Results from this survey were mapped to provide a picture of the current known distribution of Ae. aegypti and Ae. albopictus in Florida. Aedes aegypti and/or Ae. albopictus were detected in the 56 counties that were part of the survey. Only Aedes albopictus was detected in 26 counties, primarily in the panhandle region of Florida. The results of this work underscore the importance of maintaining container mosquito surveillance in a state where chikungunya, dengue, and Zika viruses are present and where there is continued risk for exotic arbovirus introductions.

The theme of the 2018 Entomological Society of America, Entomological Society of Canada, and Entomological Society of British Columbia Joint Annual Meeting was Crossing Borders: Entomology in a Changing World. Following the theme of the meeting, papers selected for the 2018 'Highlights of Medical Entomology' included reports of expanded ranges for Aedes albopictus (Skuse) (Diptera: Culicidae), Aedes japonicus japonicus (Theobald) (Diptera: Culicidae), Culex coronator Dyar and Knab (Diptera: Culicidae), Mansonia titillans (Walker) (Diptera: Culicidae), and Wyeomyia mitchellii (Theobald) (Diptera: Culicidae); a first report of mosquito feeding on earthworms and leeches; Cache Valley virus detection in Ae. j. japonicus; surveillance in high-risk areas of Canada for Lyme Disease; and increasing lone-star tick detections in Connecticut. The selection of papers served as a reminder of the increasingly difficult challenge of sustaining vector surveillance programs. Fluctuating funding and a decline in vector taxonomists and identification expertise contribute to the erosion of vector surveillance.

OBJECTIVE: Limited English proficiency can be a barrier to asthma care and is associated with poor outcomes. This study examines whether pediatric patients in Ohio with limited English proficiency experience lower asthma care quality or higher morbidity. METHODS: We used electronic health records for asthma patients aged 2-17 years from a regional, urban, children's hospital in Ohio during 2011-2015. Community-level demographics were included from U.S. Census data. By using chi-square and t-tests, patients with limited English proficiency and bilingual English-speaking patients were compared with English-only patients. Five asthma outcomes-two quality and three morbidity measures-were modeled using generalized estimating equations with a logit link function. RESULTS: The study included 15 352 (84%) English-only patients, 1744 (10%) patients with limited English proficiency, and 1147 (6%) bilingual patients. Recommended pulmonary function testing (quality measure) and multiple exacerbation visits (morbidity measure) did not differ by language group. Compared with English-only patients, bilingual patients had higher odds of ever having an exacerbation visit (morbidity measure) (adjusted odds ratio [aOR], 1.4; 95% confidence interval [CI], 1.2-1.6) but lower odds of admission to intensive care (morbidity measure) (aOR, 0.3; 95% CI, 0.2-0.7), while patients with limited English proficiency did not differ on either factor. Recommended follow-up after exacerbation (quality measure) was higher for limited English proficiency (aOR, 1.8; 95% CI, 1.4-2.3) and bilingual patients (aOR, 1.6; 95% CI, 1.3-2.1), compared with English-only patients. CONCLUSIONS: In this urban, pediatric population with reliable interpreter services, limited English proficiency was not associated with worse asthma care quality or morbidity.

Hurricane Maria made landfall in Puerto Rico on September 20, 2017, causing major damage to infrastructure and severely limiting access to potable water, electric power, transportation, and communications. Public services that were affected included operations of the Puerto Rico Department of Health (PRDOH), which provides critical laboratory testing and surveillance for diseases and other health hazards. PRDOH requested assistance from CDC for the restoration of laboratory infrastructure, surveillance capacity, and diagnostic testing for selected priority diseases, including influenza, rabies, leptospirosis, salmonellosis, and tuberculosis. PRDOH, CDC, and the Association of Public Health Laboratories (APHL) collaborated to conduct rapid needs assessments and, with assistance from the CDC Foundation, implement a temporary transport system for shipping samples from Puerto Rico to the continental United States for surveillance and diagnostic and confirmatory testing. This report describes the initial laboratory emergency response and engagement efforts among federal, state, and nongovernmental partners to reestablish public health laboratory services severely affected by Hurricane Maria. The implementation of a sample transport system allowed Puerto Rico to reinitiate priority infectious disease surveillance and laboratory testing for patient and public health interventions, while awaiting the rebuilding and reinstatement of PRDOH laboratory services.

Background: Enterovirus D68 (EV-D68) caused a widespread outbreak of respiratory illness in the United States in 2014, predominantly affecting children. We describe EV-D68 rates, spectrum of illness and risk factors from prospective, population-based acute respiratory illness (ARI) surveillance at a large U.S. pediatric hospital. Methods: Children <13 years of age with ARI and residence in Hamilton County, Ohio were enrolled from the inpatient and emergency department (ED) settings at a children's hospital in Cincinnati, Ohio, from July 1-October 31, 2014. For each participant, we interviewed parents, reviewed medical records, and tested nasal and throat swabs for EV-D68 using real-time RT-PCR assay. Results: EV-D68 infection was detected in 51/207 (25%) inpatients and 58/505 (11%) ED patients. Rates of EV-D68 hospitalization and ED visit were 1.3 (95% CI: 1.0-1.6) and 8.4 per 1,000 children <13 years of age, respectively. Pre-existing asthma was associated with EV-D68 infection (aOR 3.2; 95 %CI 2.0-5.1). Compared with other ARI, children with EV-D68 were more likely to be admitted from the ED (p=<0.001), receive supplemental oxygen (p=0.001), and require ICU admission (p=0.04); however, mechanical ventilation was uncommon (2/51 inpatients, p=0.64), and no deaths occurred. Conclusions: During the 2014 EV-D68 epidemic, high rates of pediatric hospitalizations and ED visits were observed. Children with asthma were at increased risk for medically attended EV-D68 illness. Preparedness planning for a high-activity EV-D68 season in the U.S. should take into account increased healthcare utilization, particularly among children with asthma, during the late summer and early fall.

BACKGROUND AND AIMS: Alaska Native peoples have an increased rate of hepatocellular carcinoma compared to the United States population. Viral hepatitis is a risk factor for malignancy and the leading cause of hepatocellular carcinoma in Alaska. With the introduction of hepatitis B immunization in 1982, as well as the emergence of hepatitis C virus in this population, the epidemiology and etiology of hepatocellular carcinoma in Alaska have changed. METHODS: Using the Alaska Native Tumor Registry, all cases of viral and non-viral hepatocellular carcinoma occurring from 1969 through 2013 were identified and reviewed. Incidence rates per 100,000 population were calculated for hepatocellular carcinoma overall and by etiologic category. RESULTS: 152 cases of hepatocellular carcinoma were identified in 148 Alaska Native persons. Overall tumor rate was 3.82 per 100,000 and did not change significantly over the study period. Hepatitis B associated cases decreased significantly over the study period (p=0.048) and were eliminated in persons under the age of 20. Hepatitis C associated cases increased significantly (P<0.001). Undetermined hepatocellular carcinoma rates also decreased. (p=0.034) CONCLUSIONS: Overall hepatocellular carcinoma rates in Alaska Native peoples remained stable over the study period, but the epidemiology and etiology are changing. Two decades after routine hepatitis B immunization, the hepatocellular carcinoma age distribution has shifted to cases presenting later in life. This is consistent with an aging hepatitis B infected population with no new infected young persons coming into the population, as well as the emergence of hepatitis C in adults. This article is protected by copyright. All rights reserved.