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Vector Control - Reference
Vector Control - Reference
VECTOR CONTROL
Description
This section is a supplement to the Environmental Health chapter. It gives an overview of the unique factors
that influence the spread of vector-borne diseases in disasters. It also includes the appropriate vector control
strategies for humanitarian emergency situations. It focuses on vectors that cause major problems in
emergency situations (mosquitoes, non-biting flies, rodents, and fleas). Readers interested in vectors that
cause less common problems are referred to additional sources of information. The characteristics, biology,
and ecology of the major vectors are described and then applied to the appropriate vector-control strategies.
In addition, a word of caution on safe pesticide use is included. Emphasis is placed on the proper management
techniques of vector control programs, including monitoring.
Note: For details on the clinical features and management of common vector-borne diseases, refer to the Control
of Communicable Disease chapter. For details on the investigation of an outbreak of vector-borne disease,
refer to the Disaster Epidemiology chapter.
Learning Objectives
To describe the public health importance of vector-borne diseases among large displaced populations.
To characterise the major vectors commonly encountered in humanitarian emergencies.
To define a logical approach to developing vector control strategies.
To define the safe use of pesticides.
To describe the methods used to monitor and evaluate vector control programs.
Key Competencies
Vector Control
5a-1
TABLE OF CONTENTS
PART I
Public Health Importance of Vector-Borne Diseases ............................................. 5a-3
Transmission of Vector-Borne Diseases .................................................... 5a-3
Risk Factors for Vector-Borne Diseases .................................................... 5a-4
Common Vectors in Emergencies ............................................................................. 5a-5
Mosquitoes ...................................................................................................... 5a-5
Non-Biting Flies .............................................................................................. 5a-7
Biting Flies ....................................................................................................... 5a-8
Rodents and Fleas ......................................................................................... 5a-9
Other Vectors and Pests.............................................................................5a-10
Designing a Vector Control Program ......................................................................5a-10
Vector Control Strategies ............................................................................5a-11
Linking with Other Sectors ..........................................................................5a-12
PART II
Vector-Specific Control Strategies...........................................................................5a-13
Mosquito Control..........................................................................................5a-13
Fly Control .....................................................................................................5a-15
Flea Control...................................................................................................5a-18
Rodent Control..............................................................................................5a-18
Summary of Vector Control Measures......................................................5a-19
Controlling Other Vectors and Pests.........................................................5a-19
Safe Use of Pesticides ..............................................................................................5a-20
Monitoring and Evaluating Vector Control Programs ...........................................5a-20
Strategies for Monitoring.............................................................................5a-20
Evaluating Vector Control Programs.........................................................5a-22
Appendix......................................................................................................................5a-25
References and Suggested Readings ....................................................................5a-26
5a-2
The Johns Hopkins and IFRC Public Health Guide for Emergencies
Person or other animal in which a parasite reaches maturity or passes through its sexual stage.
Ecology
Habitat
Infectious Agent
An organism (virus, bacteria, fungus, protozoa, helminth) that is capable of producing infection
or infectious disease.
Larvicide
(noun): pesticide used to kill arthropod larvae; (verb): killing of arthropod larvae
Pathogen
Pesticide
Any substance used to kill or control organisms which are considered to be pests.
Repellent
A chemical applied to the skin, clothing or other places to discourage arthropods and other
disease agents from landing on or attacking an individual.
Reservoir
Any person, animal, arthropod, etc. on which an infectious agent depends for its survival where
it reproduces itself for transmission to a susceptible host.
Indoor Residual
Spraying (IRS)
Rodenticide
Transmission
Any mechanism by which an infectious agent is spread from a source or reservoir to a host.
Vector
Any animal or arthropod capable of carrying disease pathogens from one host to another either
mechanically or through its body functions.
(mechanical)
RESERVOIR
pathogen
SUSCEPTIBLE
HOST
VECTOR
(biological
transformation)
DEFINITIVE
HOST
Each emergency situation may be characterised by different types of vectors and vector-borne diseases. In
addition to transmitting diseases, some vectors may also be considered a nuisance because of their painful
bites, e.g. mosquitoes, biting flies, fleas, and lice. The most troublesome vectors in evacuation sites and
refugee camps are the non-biting flies. The following table summarises the vectors and vector-borne diseases
that are common among displaced populations.
Vector Control
5a-3
DISEASE TRANSMITTED
Mosquitoes
Anopheles
Malaria, filariasis
Culex
Aedes
Lice
Fleas
Ticks
Rodents
5a-4
Mosquito populations can multiply in great numbers in poorly drained water distribution points.
There may be and increased number of breeding sites, either due to more pools of water or more
domestic water containers. This can significantly increase the incidence of mosquito-borne diseases,
as follows:
- More water-storage containers increase breeding of the dengue fever vector Aedes aegypti.
- More water-filled pit latrines increase breeding of the encephalitis vector Culex quinquefasciatus.
- More groundwater pits, ponds, and footprints increase breeding of the malaria vector
Anopheles gambiae.
The Johns Hopkins and IFRC Public Health Guide for Emergencies
While evacuation sites and newly established camps may have severe problems with flies, lice, and
mosquitoes, problems with rodent populations usually takes some time to build up. Poor storage or
disposal of food will increase the rodent population. These rodents bring fleas and possibly diseases.
Flies are attracted to areas with food and wastewater disposal problems, especially around feeding
centres. Fly problems are often severe at the very beginning of the camp, before sanitation systems
can be established.
Natural disasters (e.g., El-Nino floods and hurricanes in 1997-98) may change the environment and
increase the breeding sites of other vectors of less urgent concern, e.g. ticks, tsetse flies, etc., resulting
in less common disease outbreaks including viral haemorrhagic fevers.
Epidemics can occur amongst vulnerable displaced and host populations in complex emergencies due to
poor access to effective treatment. In complex emergencies, a general break down of the health
infrastructure is common, possibly compounded by gradual deterioration over many years. In the case of
displaced populations, health services often become overwhelmed and many cases simply go undetected
and untreated.
A. Mosquito-Borne Diseases
There are many different species of mosquitoes, each living in a specific habitat and capable of
transmitting a variety of diseases. Fortunately, there are just a few mosquito species that need to be
studied to determine the most essential vector control measures. In this section, the most common species
will be reviewed, namely:
the Anopheles mosquito that is a vector for malaria and filariasis
the Aedes mosquito that is a vector for yellow fever and dengue
the nuisance Culex mosquito that may also be a vector of filariasis and the encephalitis virus is
generally not a critical vector control issue in complex emergencies
Vector Control
5a-5
It is important to understand the differences among mosquito species when planning a mosquito control
program. The three species, Anopheles, Aedes, and Culex, can easily be distinguished from each other as
shown in the following table and illustration:
Table 5a-3: Characteristics and Ecology of Different Mosquito Species
Feature
Anopheles
Aedes
Culex
Species of Public
Health Importance
Anopheles gambiae,
Anopheles funestus
Aedes aegypti
Culex quinquefasciatus
Egg Deposit
Flight Range
Biting Time
* Note: Aedes aegypti glue their eggs just above the water surface on the sides of containers where they can remain
dry for 6 months. The next time the container is filled with water, the eggs are flooded and two days later the larvae
hatch out of the egg.
5a-6
The Johns Hopkins and IFRC Public Health Guide for Emergencies
Figure 5a-3: The Main Characteristics for Differentiating Anopheles, Aedes, and Culex Mosquitoes (WHOii )
The non-biting flies of medical interest in refugee camps are the synanthrophic flies: housefly, blow fly,
and flesh fly. These flies usually hover around food, carrion, garbage, and human and animal waste.
When they land, they may either transfer or carry disease pathogens that attach on their legs and other
parts of their bodies. These pathogens may then be mechanically transported or transferred to humans,
animals. Even though they can also be transmitted via fly faeces, pathogens do not undergo biological
transformation in the flies. In unhygienic conditions, flies have more opportunities to cause the following:
Flies of the Musca and Chrysomyia genera are known mechanical vectors of intestinal infections such
as dysentery and typhoid.
Flies can transmit poliomyelitis and certain eye infections, such as trachoma.
Large fly populations can be extremely bothersome, interfering with human comfort. In fact, some
people think that the word bother is derived from a cattle fly known as Bot Fly.
Note: Flies are not usually associated with cholera. A larger dose of cholera bacteria is required for cholera
transmission than the flies can carry.
Vector Control
5a-7
There are four stages in the fly life cycle: egg, larvae (or maggot), pupa, and adult (see illustration
below). A single female housefly, Musca domestica, can lay up to 2,000 eggs a month. Eggs are deposited
in various habitats, especially in garbage and human and animal wastes. Depending on the temperature,
the life cycle may extend anywhere from 6 days to 6 weeks before the adult emerges. This can result in
enormously dense fly populations developing in a short period of time. In warmer climates, the adult fly
may live for only 2-3 weeks, whereas, in cooler climates, they can live up to 3 months.
Figure 5a-4: Life Cycle of a Fly (WHOiii )
The key to fly control is to identify and eliminate their breeding sites. The main breeding sites of the
non-biting fly species are listed in the following table:
Table 5a-4: Breeding Sites of Non-Biting Fly Species
Common Name
Scientific Name
Breeding Sites
House fly
Musca domestica
Filth fly
M. sorbens
Human faeces
Bush fly
M. vestutissima
Cattle droppings
Blow fly
Chrysomya spp.
Blue Bottle,
Green Bottle flies
Calliphora spp.
Lucilia spp.
Flesh fly
Sarcophaga spp.
Fannia spp.
Animal faeces
Stable fly
Stomoxys calcitrans
5a-8
The Johns Hopkins and IFRC Public Health Guide for Emergencies
Tsetse flies: where known to transmit sleeping sickness (trypanosomiasis), tsetse flies must be
considered a serious threat to life. Sleeping sickness is 100% fatal without complete treatment,
which is often very hard to access in emergencies (costs $500-1000, depending on the stage of
disease). There are an estimated 250,000 cases in total in just Southern Sudan, DRC and Angola.
Refugees can be infected with sleeping sickness in different ecological habitats including both
forest and scrub/river areas.
Sandflies: sandflies can transmit two types of leishmaniasis: cutaneous and visceral. Visceral
leishmaniasis is highly fatal and is reported in IDP and refugee areas of Southern Sudan.
blindness).
Rodents and rodent-borne diseases may become serious problems in displaced population camps that
have existed for some time. These problems may result from uncontrolled and accumulating solid waste,
which greatly increases rat breeding. Increased rat populations discourage other efforts on environmental
health improvement and also leads to an increase in diseases transmitted by rats, including the following:
Rats cause disease through their fleas, especially Xenopsylla cheopis, which can transmit plague (Yersinia
pestis) and murine typhus (Rickettsia mooseri). Studies in refugee camps in Asia have shown murine
typhus to be a major cause of Fever of Unknown Origin (FUO).
Rats can spread diseases such as salmonelloses, leptospirosis, hanta virus and lassa fever through their
excreta.
Rat bites can transmit pathogens that can cause fever and rabies.
People can contract leptospirosis from handling the dead bodies of infected rats, or get trichinosis from
eating undercooked meat from pigs that have eaten the dead bodies of infected rats.
The multi-mammate rat (Mastomys natalensis) is the natural reservoir of the lassa fever virus. Outbreaks
of lassa fever have been reported among refugee populations in Sierra Leone and Liberia.iv
Finally, rats can cause enormous economic damage by destroying or contaminating food stores and
damaging other materials around the house.
NORWAY RAT
(Brown or sewer rat)
Rodent Species
Rattus norvegicus
(Norway rat)
Small eyes and ears,
thick tail
Appearance
Weight
Common
Habitat
Up to 500 g
Hole in ground, piles
of refuse,
warehouses, sewers
Geographic
Distribution
Vector Control
ROOF RAT
HOUSE MOUSE
MULTI-MAMMATE
RAT
Rattus rattus
Mus musculus
Mastomys natalensis
No more than 25 cm
from tip to tip
Throughout Africa
except desert and
semi-desert areas
Small
Less domestic than
others
Africa, south of
Sahara
5a-9
2. Mites mites commonly cause scabies and other skin infections in displaced populations,
particularly children. Overcrowding and poor personal hygiene favour the spread of mites within a
refugee population.
3. Ticks ticks are usually not a problem in camp settings. But they can transmit several diseases,
(e.g., Q-fever, hemorrhaegic fever, and tick-borne relapsing fever).
4. Bedbugs bedbugs can become a great nuisance after displaced population camps have been
established for several months. Bedbug bites cause significant discomfort and loss of sleep. In
heavily infested areas, young children may show signs of anemia.
5. Cockroaches cockroaches contaminate unprotected food and may transmit various pathogens
including poliomyelitis virus, amoebae and intestinal viruses.
6. Snails snails are intermediary hosts for the schistosoma flukes that cause urinary schistosomiasis
and intestinal schistosomiasis.
5a-10
The Johns Hopkins and IFRC Public Health Guide for Emergencies
The control of vector-borne diseases requires efforts of several sectors, including relief, water/sanitation,
health services and food and nutrition. To ensure the displaced community shares the responsibility of
determining their health care, representative members should be involved in all phases of vector control.
Otherwise, it may be difficult to convince displaced people to use the simple, inexpensive and effective
method of self-protection or home improvement, if they are not greatly bothered by bites from the vectors
present. (See the Environmental Health chapter Planning Environmental Health Programs for more details
on assessment and defining priorities and objectives.)
environmental control: alter breeding sites by draining or filling sites, regular disposal of refuse,
mechanical control: use screens or bednets, traps, food covers, lids or polystyrene beads in latrines
biological management: use living organisms or products against vector larvae, such as fish that eat
larvae (e.g., tilapia, carp, guppies), bacteria (Bacillus thuringiensis israelensis) that produce toxins against
larvae, free-floating ferns that prevent breeding, etc.
chemical control: use chemicals for personal and household protection and treatment or for
environmental control. There are many forms including repellents, insecticides for residual spraying,
adulticides, or larvicides that minimise risk of infections. Previous data on resistance to insecticides will
be useful in helping to ensure the best one is chosen.
The objectives of the vector control program can only be achieved by implementing appropriate vector
control measures. Each emergency situation is different, and may require different vector-control options. A
vector control measure that is appropriate for one disease may not be appropriate for another disease or vector
species. Vector control experts (national and international) should be consulted to give advice about
the most appropriate vector control measures and chemicals to use . All measures should be based on
the national and international protocols. The following criteria may be used to select the most suitable vector
control measure:
Table 5a-6: Criteria for Selecting Vector Control Measures
Criteria for Selecting Vector Control Measures
appropriate for controlling the specific vector species, given its breeding,
flight and resting, behavior
Vector Control
acceptable and compatible with local customs and practices (postemergency phase)
safe for the user and the environment
5a-11
Note that the WHO Roll Back Malaria (RBM) Technical Support Network for Complex Emergencies was formed
officially in April 1999 and is producing, technical guidelines and training materials, and providing direct technical
support for malaria control in complex emergencies
ii
WHO. "Vector Control - Methods for use by individuals and communities", by Jan A Rozendaal 1997 ISBN q2 4.
Permission to use this diagram is needed as it is copyright protected by WHO
iii
Ibid
iv
Allan et al, (1998) The progression from endemic to epidemic Lassa fever in war-torn West Africa, Emergence and
Control of Rodent-Borne Viral Haemorrhagic Diseases, Fondation Marcel Merieux - Elservier, p 197-205. Based on
personal experience managing the 1997 Lassa epidemic in Sierra Leone and all SL lassa services until Feb 2000 with
Merlin, prior to joining WHO.
5a-12
The Johns Hopkins and IFRC Public Health Guide for Emergencies
Anopheles malaria
There are various strategies to control the Anopheles mosquito:
a.
Site selection: From a malaria control perspective, any displaced population camp or evacuation site
should be located one to two kilometers upwind from potential vector breeding sites (some natural
water sources) whenever an additional clean water source (pumps, tanks, or capped wells) can be
provided for the camp population. In this case they have less direct need to be sited close to natural
water sources.
Environmental control: If the Anopheles breeding sites are limited and circumscribed (a rare
circumstance), then larval control may be possible through drainingi or applying a larvicide.
However, in most rural situations in Africa, larval control for malaria prevention is not usually
practical or possible as common vectors breed in a variety of water sources. Anopheles gambiae
breeds in temporary water bodies without vegetation and in open sunlight, where as Anopheles
funestus breeds in permanent water bodies with vegetation, including ponds and swamps.
Chemical and biological control: If larviciding is chosen, there are only two main larvicides that can
be safely applied on water that is used for drinking. Dosing and precautions can be found in a number
of manuals.ii ,iii
temephos (an organophosphate insecticide better known as Abate) widely used in control
of dengue, onchocerciasis, and guinea worm
Bacillus thuringiensis israelensis (a biological insecticide)
b. To Minimise Transmission:
For control against the adult Anopheles mosquito, it is important to remember that in Africa this
species generally bites late in the nightiv . Therefore, if repellents (including soaps that contain
repellents), coils, fumigants, and aerosol sprays are applied in the early evening, the protection they
provide may not last long enough to have a significant impact. Where available, repellants and coils
may be in use on an individual basis and their use should be encouraged
The malaria -control methods of choice are indoor residual spraying (IRS) within the inside surface of
houses or tentsv and insecticide treated materialsvi (ITMs, e.g., mosquito nets or curtains). Both are
about equally effective against any mosquito species that feed and rest indoors at night. In acute
emergencies, agencies normally depend on IRS initially as this can be implemented over a wide area
quickly, requires less community education (as it is done by trained teams and not the community
themselves) and ITMs are rarely available on the ground in less than two months. Once they become
available, prevention programs should sensitize displaced communities and distribute ITMs. Once
distribution is complete, the IRS program can cease in ITM protected communities, but may need to
be maintained for refugee transit accommodation and other community structures where groups may
continue to sleep without netsvii
In areas with year-round malaria transmission, re-treatment of nets as well as residual spraying should
be done once every six months. All shelters (tents, huts, mud houses) should be sprayed to give a
mass protective effect rather than spraying only a single shelter which gives little personal protection
since mosquitoes rest on walls after feeding.
Vector Control
5a-13
Note: Shelters made of plastic sheeting cannot effectively be treated with insecticides. Therefore, treated tents
rather than plastic sheeting should be distributed fo r shelter in malaria endemic regions.
In the long run, ITMs are cheaper and more readily accepted by the population than IRS. viii The
community needs to be sensitised before distribution to ensure that:
nets are used by the most vulnerable,
they sleep under them and use them correctly,
the education used to reinforce good practice also reinforces treatment seeking behavior,
the need for re-impregnation, times and methods.
Mosquito nets are available from a variety of sources.ix For details about the recommended
specifications for mosquito nets, refer to the Appendix.
Figure 5a-6: Benefits of an Insecticide-Treated Mosquito Net (WHO Vector Controlx)
Insects cannot find
holes or other
openings
There are six pyrethroid insecticides approved for treating mosquito nets or curtains:xi
Permethrin
Deltamethrin
Lamda-cyhalothrin
Etofenprox
Alphacypermethrin
Cyfluthrin
These are available in the form of litre bottles for communal net treatment, or in the form of
individual tablets or sachets for individual treatments.
Note: There are now "long lasting" insecticide treated bed nets under WHOPES testing that will last up to 24
washes, and possibly longer. These are commercially available and may reduce the need for frequent reimpregnation, or eliminate it altogether, if impregnation is confirmed to last as long as the bed net itself
5a-14
The Johns Hopkins and IFRC Public Health Guide for Emergencies
2.
a.
b.
3.
Culex quinquefasciatus
Culex mosquitoes are more often nuisance biters and are less easily controlled by insecticide-treated
mosquito nets or residual house spraying. Larval control can be achie ved through environmental
sanitation, improved latrines, and applying insecticides, oils, and polystyrene beads on the surface of
pit latrines and cesspools.
c.
Dead animals and wastes from slaughter houses should be buried as soon as possible.
Vector Control
5a-15
Figure 5a-7: Market with Large Amounts of Food and Piles of Refuse (WHO Vector Controlxii)
To Prevent Transmission:
a. Traps and Screens: Large numbers of flies can be caught with non-poisonous traps and screens,
for example:
A simple trap can be made by cutting off the upper third of a plastic bottle and placing it upsidedown inside the lower portion of the bottle which is half-filled with bait. Ripe mango waste and
fish flour mixed with water make excellent bait. The traps are suspended above the ground near
breeding sites. Flies entering the trap will not be able to leave and soon die. The traps become
active in 2-3 days and can last 2-4 weeks. xiii (Refer to Figure 5a-8.). Traps can be efficient only if
well maintained, or simply become additional breeding sites for flies, as commonly seen.
Note: Poison baits should never be used in refugee camps.
Figure 5a-8: Diagram of a Fly Trap Made from a Plastic Bottle (UNHCR)
Bait
5a-16
Sticky strings and sticks suspended in latrines and around food preparation areas also help reduce
fly populations.
Putting screens on doors and windows may not be practical in most refugee situations. However,
food and utensils can be protected by placing netting over them or keeping them in fly-proof
containers or cupboards.
The Johns Hopkins and IFRC Public Health Guide for Emergencies
b.
Chemical Control: Environmental sanitation is the basis of long-term fly control. Insecticides should
be used only during outbreaks of vector-borne diseases and as a supplement to sanitation. Because
flies can develop resistance to insecticides very quickly, chemical control should be used for only a
short period of time and only when absolutely necessary. Specialised manuals should be consulted
before beginning any insecticide applications.xiv xv
Sticky strings are not very practical in emergency situations and not commonly used. Residual spraying
of the inside of pit latrine shelters to control adult insects, and use of floating polystyrene beads on the pit
latrine fluid to discourage vectors from breeding in the fluid surface are more common and effective
approaches in emergencies.
Traps: The biconical trap, pyramidal trap and vavoua trap are made up of blue and black cloths and
mosquito netting. Flies get attracted to the brightly colored mosquito netting over the traps and are
unable to escape after entering. Traps are cheap, easy to transport, completely safe for the user and
very effective means for control of biting flies. Because they do not require any specific training to
use, they are ideal for use by individuals or communities.
b.
Insecticide Treated Targets: these consist of impregnated traps and screens, which are more effective
since they kill any flies that land on them. They may be impregnated by the same pyrethroids used
for impregnating mosquito nets (may be effective for upto 3 months).
c.
Insecticide Spraying: Aerial and ground spraying of insecticides may be the preferable method of
control during acute epidemics of sleeping sickness, river blindness or leishmaniasis. Daytime resting
places such as tree trunks, twigs and roots should be target, Because of its high cost, need for special
equipment and trained workers, spraying is not recommended as a routine control measure.
Traps attract more flies than screens and require less handling. Screens are much cheaper than traps and
can cover a larger area. However, traps continue to be effective in catching flies once the insectide wears
out, screens are only effective as long as the insecticide is active.
Sandflies - leishmaniasis
The infection and spread of leishmaniasis may be controlled in the following ways:
2.
Personal Protection: avoid being bitten by keeping away from areas that sandflies are known to breed
or rest, and by using bednets, repellents, clothing.
Residual Spraying: although spraying the interior and exterior sides of doorways and windows, and
the inner walls is effective against indoor-resting sandflies, malaria control is the primary reason for
spraying wherever leishmaniasis is a problem.
Control of animal reservoir: controlling the animal reservoir population (e.g. rock hyrax in Ethiopia,
dogs or other domestic animals) may reduce the incidence of leishmaniasis.
Vector Control
5a-17
IV FLEA CONTROL
When controlling flea-borne diseases such as plague and murine typhus, never attack the rodents before
first getting rid of the fleas. Otherwise, when the rats are gone, the fleas will attack humans. There are two
effective ways to get rid of fleas:
a. Chemical control: dusting rodent footpaths with insecticide dust/powder is effective for large scale flea
control (during outbreaks of typhus or plague). When the rats groom themselver, the dust spreads on their
fur, thus killing the fleas. Resistance to pyrethroid insecticides is common.
b. Rat Control: see below
Note: Where fleas are a biting nuisance, simple hygiene measures may be effective, such as taking bedding outside
to air in the sun weekly.
V RODENT CONTROL
There are various ways of controlling rodents:
a. Mechanical Protection and Sanitation: These are the only permanent methods for reducing rodent
populations in refugee camps. Efforts should be made to store all food in rat-proof containers. The
final disposal of solid waste should be done in a location and manner that does not encourage rat
breeding or create other environmental health risks. Burial or incineration may be used to finally
dispose of household waste and refuse from markets and slaughtering areas.
b. Traps: Trapping rats is good for publicity but generally catches only the sick and the stupid rodents.
As long as there is enough food and nesting places, the rodent population will grow and quickly reach
its former population levels. In one camp in Thailand, offering rewards for children to bring in rat
tails resulted in children breeding rats!
c. Poisons: Rodenticides are generally not recommended for refugee camps. The large number of
children, having little to do and few things to play with, make it risky to place poison bait traps
around the camp environment. Documents on rodent control are available from WHOxvi, and the
following poisons can be used:
Multiple dose anti-coagulants are the safest to use. They generally interfere with the Vitamin K
cycle, thus inhibiting blood coagulation. This causes the rodent to die by internal bleeding within
3 to 5 weeks. Examples of commonly used anti-coagulants include Warfarine, Rozol, Fumarine,
Difenacoum, and Bromadiolone.
Acute rodenticides such as zinc phosphate and arsenic oxide, while used in some industrial
applications (e.g., on ships), are too toxic to be considered for use in refugee camps.
d. Caution to Rodent Trapping/ safe handling: Lassa fever is common in Sierra Leone and Liberia. It
causes several hundred cases of severe disease a year (in 1997 = 553 severe cases) and three
expatriates have died this year from Lassa fever in eastern Sierra Leone. The virus is spread through
the urine of rats. If trapped, these rats have to be disposed of without direct contact between the
human and the rat corps as they urinate wildly and their bodies become covered in the virus. Rodent
trapping campaigns could cause outbreaks of Lassa fever if this inadvertently increases host virus
contact through normal handling and disposal of the corpse.xvii This might also include safe handling
of rodents in regards to rabies risk, especially with live animals.
5a-18
The Johns Hopkins and IFRC Public Health Guide for Emergencies
VECTOR
Source Reduction
Prevent Transmission
INDIVIDUAL PROTECTION
Mosquitoes
Anopheles
Culex
Aedes
Space spraying
Flies
Refuse disposal,
Waste water disposal,
Latrine covers
Fleas
Environmental
sanitation and dusting,
Rat control immediately
after flea control
Rodents
Lice
Mites
mass laundering; supply adequate water for washing and distribute soap for
the community
Ticks
Bedbugs
Black Flies
Cockroaches
Snails
Vector Control
5a-19
5a-20
The Johns Hopkins and IFRC Public Health Guide for Emergencies
Mosquitoes
Monitoring mosquito populations is essential for guiding insecticide spray operation. Often huge
sums of money are wasted on insecticide applications without any idea of the impact on the mosquito
population.
Anopheles are most easily monitored in their adult form through the following methods: nighttime capture on human bait, morning indoor pyrethrum spray collections, or alternatively battery
powered light trap collections.
Culex are better monitored and controlled through larval surveys of heavily organic drains and
pit latrines because they often breed in enormous numbers.
Aedes are also better monitored through larval surveys of domestic water containers. For
example, in larval surveys for yellow fever and dengue control, the results are expressed in terms
of standard indices of Aedes aegypti (the House Index, the Container Index and the Breteau
Index) to predict the chances of disease transmission in a population. xx
Vector Control
5a-21
II
Flies
It is more difficult to monitor non-biting fly populations than mosquito populations. Rather than
counting the number of flies collected over time per sticky trap, monitoring of fly populations is best
carried out as part of larval control and sanitation inspections, especially around feeding centres,
hospitals, latrines, and refuse disposal areas.
III Rodents and Fleas
Rodent and flea surveys can be conducted through periodic trapping and chloroforming of the
rodents (and their fleas), followed by combing the rodents hair over a white basin and counting the
number of fleas that drop off.
IV Other Vectors
Techniques for monitoring for less common vectors can be found in many of the references listed at
the end of the chapter.
The following indicators may be used to assess whether the displaced people have the means to
protect themselves from disease vectors and nuisance pests that are considered to be a significant risk
to health or well-being:
a. Control of human body lice is carried out to an agreed standard where louse-borne typhus or
relapsing fever are a threat.
b. All populations at risk of vector-borne diseases have access to shelters that are equipped with
insect control.
Other indicators that may be used evaluate individual and family protection include:
Number of households with ITMs
Number of households timely sprayed with appropriate, effective and safe insecticide
Number of households using chemical repellants, coils etc.
Number of households placing bedding in the sun daily
Number of households with access to sufficient water and soap
5a-22
The Johns Hopkins and IFRC Public Health Guide for Emergencies
2.
The following indicators may be used to assess whether the number of disease-bearing vectors and
nuisance pests are kept to an acceptable level:
Number of displaced communities that have their camps established in areas of minimal
disease vector breeding site risk (relative to the region)
Number of infective malaria mosquitoes reduced
Number of water supply points effectively managed to ensure minimal risk of creating
temporary breeding sites
Number of natural vector breeding sites are reduced by land fill (or larvicide)
Number of other vectors, including rats, biting and non-biting flies, and other mechanical
vectors and nuisance pests, effectively reduced and maintained at low levels
Number of intensive vector control interventions carried out in communities with high risk of
disease outbreaks
3.
The following indicators may be used to assess whether the people have an environment that is free of
solid waste contamination:
a. Domestic refuse is removed from the settlement or buried on site before it becomes a nuisance or
a health risk.
b. There are refuse pits, bins or specified areas at markets and slaughtering areas, with a daily
collection system.
c. Final disposal of solid waste is carried out in such a place and in such a way as to avoid creating
health and environmental problems.
4.
The following indicators may be used to assess whether people have an environment that is
acceptably free from risk of water erosion and from standing water:
a. There is no standing wastewater around water points or elsewhere in the settlement.
b. Storm water flows away.
c. Shelter, paths and water and sanitation facilities are not flooded or eroded by water.
5. Indicators for Evaluating the Safe Use of Chemical Vector Control Methods
The following indicators may be used to assess whether the use of pesticides is carried out according
to international standards:
a. Personnel are protected by providing training, protective clothing, supervision, and a restriction
on the number of hours handling pesticides.
b. The purchase, transport, storage, and disposal of pesticides and application equipment follows
international norms and can be accounted for at all times.
c. People are informed about the potential risks of pesticides and about the schedule for
application. They are protected during and after the application of pesticides according
to internationally agreed procedures.
d. The choice of pesticide and application method conform to national and international protocols.
e. The quality of pesticide and of treated bednets conform to international norms.
Vector Control
5a-23
The following indicators may be used to assess whether the affected population is aware of priority
hygiene practices that create the greatest risk to health and able to change them:
a. Bedding and clothing is aired and washed regularly.
b. In areas where malaria is endemic: people with mosquito nets keep, use and retreat them
correctly; people avoid exposure to mosquitoes during biting times, using the means available to
them; containers which may be mosquito breeding sites are removed, emptied of water regularly
or covered.
c. Waste is put in containers daily for collection, or buried in a specified refuse pit.
7.
The following indicators may be used to assess whether the correct vector and parasite are being
targeted for control:
a. Changes in parasite susceptibility to drug treatments this is essential to maintain
effective treatment.
b. The susceptibility of the vector to insecticides this is necessary to estimate resource needs
(chemicals, equipment, personnel).
c. Identifying vector species and characteristics this is necessary for planning
vector control.
Note : All indicators in lower case alphabet bullets, except those for measuring hygiene promotion, are from the
Sphere Projectxxi.
5a-24
The Johns Hopkins and IFRC Public Health Guide for Emergencies
APPENDIX
Polyester netting
Fabrication:
Fibre analysis:
Filaments:
multifilament, 36 filaments
Mesh size:
Minimum 156
Denier:
Weight:
Dimensional stability:
Bursting strength:
Fire safety:
16 (CFR 1610)
Vector Control
Size in cm (L,l,H)
Water absorption in ml per net
Washing 30C
No bleaching
No drying machine
No ironing
No dry cleaning
5a-25
14. WHO. Outline Strategy for Malaria Control in Emergencies. WHO Roll Back Malaria: Emergency
and Humanitarian Action, Geneva 1999.
15. WHO. Vector Control - Methods for use by individuals and communities, by Jan A Rozendaal 1997
ISBN q2 4.
5a-26
The Johns Hopkins and IFRC Public Health Guide for Emergencies
World Health Organisation. (1982) Manual on Environmental Management for Mosquito Control
Bruce-Chwatt LJ (1985) Essential Malariology John Wiley and Sons New York
iii
UNHCR (1997) Vector and Pest Control in Refugee Situations.
iv
Maxwell, CA, J Wakibara, S. Tho and CF Curtis. (1998) Malaria-infective biting at different hours of the night Med.
and Vet. Entom. 12(3):325-327
v
Bouma, MJ, Parves, SD, Nesbit, R. and Winkler, AM (1996) Malaria Control using permethrin applied to tents of
nomadic Afghan refugees in northern Pakistan. Bull WHO 74(4):413-421
vi
Lengler, C. Jcattani and D. de Savigny (1996) NetGain, a new method for the control of malaria. World Health
Organisation, Geneva/ International Development Research Centre, Ottawa. 1996
vii
For more details about residual insecticide spraying, refer to WHO/CDS/WHOPES/GCDPP/2000.3 publication;
Manual for Indoor Residual Spraying
viii
Curtis CF, CA Maxell, RJ Finch and KJ Njunwa (1998) A Comparison of use of a pyrethroid either for house
spraying or for bednet treatment against malaria vectors. Trop. Med. Int. Health. 3(8):619-631.
ix
Insecticide-treated nets for malaria control: a directory of suppliers of insecticides and mosquito nets for sub-Saharan
Africa PATH Canada. Available on the internet at http://www.synapse.net/~path/direct.html
x
World Health Organisation (WHO) publication "Vector Control - Methods for use by individuals and communities", by
Jan A Rozendaal 1997 ISBN q2 4. Use of figure requires permission from WHO and the artist, Lois Robertson
xi
Insecticides listed under here are WHOPES tested and approved as active ingredients in one or more commercially
available formulations. WHOPES hold a database of all approved products and formulations. For further information,
contact the WHO Pesticide Evaluation Scheme, 20 Avenue Appia, CH-1211 Geneva 27, Switzerland
xii
World Health Organisation (WHO) publication "Vector Control - Methods for use by individuals and communities",
by Jan A Rozendaal 1997 ISBN q2 4. Use of figure requires permis sion from WHO and the artist, Lois Robertson
xiii
UNHCR (1997) Vector and Pest Control in Refugee Situations
xiv
Chavasse, DC and HH Yap (1997) Chemical Methods for the control of vectors and pests of public health
importance. WHO/CTD/WHOPES/97.2
xv
WHO Pesticide Evaluation Scheme (WHOPES) Guidelines for the purchase of pesticides for use in Public Health.
CTD/WHOPES/98.5
xvi
World Health Organisation (1987) Commensal rodent control. WHO/VBC/87.949
xvii
Allan et all, (1998) The progression from endemic to epidemic Lassa fever in war-torn West Africa, Emergence and
Control of Rodent-Borne Viral Haemorrhagic Diseases, Fondation Marcel Merieux - Elservier, p 197-205. Based on
personal experience managing the 1997 Lassa epidemic in Sierra Leone and all SL lassa services until Feb 2000 with
Merlin, prior to joining WHO
xviii
Contact World Health Organization
Communicable Disease Control
Prevention and Eradication
WHO Pesticide Evaluation Scheme
20 Avenue Appia
CH-1211 Geneva 27
Switzerland
ii
xix
Dambo small valley wetland commonly found on the plateau savanna regions of eastern and southern Africa.
Dambos are a multi-purpose land and water resource used for water supply, grazing, and cultivation
xx
WHO book
xxi
Sphere Project: The Humanitarian Charter and Minimum Standards in Disaster Response. Oxfam Publishing, Oxford,
2000
Vector Control
5a-27