US: Bug board convenes experts for advice
BY KATIE ATKINS From FLKEYSNEWS
When it comes to zapping the population of disease-carrying bugs in the Florida Keys, mosquito control officials have several options.
So on Feb. 20, a panel of experts will talk about those options at a workshop in front of the Florida Keys Mosquito Control Board.
Presenters will include David Hoel, assistant director of Lee County Mosquito Control, talking about sterilized mosquitoes through irradiation; Stephen Dobson of MosquitoMate, speaking about Wolbachia-infected bugs; Derric Nimmo of Oxitec talking about its genetically modified mosquitoes; Dr. John Norris of Key West; and Dr. Carlos Espinal, director of Florida International University’s Global Health Consortium.
Last month, a delayed conversation began about the potential for British biotec company Oxitec to release its genetically modified mosquitoes in the Florida Keys this year.
According to its website, Oxitec’s male mosquitoes are reared with a self-limiting gene, so when the males are released into the wild to mate with females, that gene is passed on and the offspring never survive to adulthood. This results in a smaller population of Aedes aegypti bugs, officials say, which carry Zika and other viruses.
The trial needs approval from the U.S. Environmental Protection Agency.
Norris is part of a group of Lower Keys doctors on a quest to get a sample of Oxitec’s mosquitoes to see what kind of bacteria is on them. He told commissioners he visited with officials in the Cayman Islands where Oxitec started releases in summer 2016. He wants data about antibiotic resistance seen in people living in the trial site, which he will talk about Feb. 20.
Dobson will talk about a different a trial that happened last year to drive down Aedes aegypti bugs on Stock Island. Thousands of mosquitoes infected with the natural bacteria Wolbachia were released there from April to October and the goal was to have them mate with wild bugs so their eggs wouldn’t hatch, driving down the wild population.
Results from the Wolbachia trial have not yet been released.
The workshop will start at 1 p.m. at Mosquito Control’s building at 503 107th St., Marathon.
Keys physicians petitioned for bacterial safety cultures on the Oxitec antibiotic dependent mosquito in 2016. Physicians embrace technology and have ample experience nothing is completely safe. Petitioners want risk benefit analysis and accept reasonable imperfection but are not prone to blind acceptance. The cultures requested would not delay any trial, but would address the physician safety concern. The request was declined by the company with release now being planned in an middle or upper Keys location not as yet identified.
Petitioners worry about the spreading of antibiotic resistant bacteria into the homes of immunologically incompetent patients we treat; ie those with diabetes, asthma, on chemotherapy, etc. Petitioners know it is only a matter of time before mosquito borne illnesses return to the Keys. Keys physicians want testing now and an end to delays.
Physicians petitioned for data as to bacteria identification and sensitivity to antibiotics carried by the Oxitec antibiotic dependent insects. Cultures very similar to throat or urine cultures. These antibiotic dependent mosquitoes are raised in baths of the antibiotic tetracycline. This antibiotic is classified by the World Health Organization as a ‘highly important’ antibiotic. The mass use of any antibiotic promotes resistant bacteria to that and possibly other antibiotics. The mosquito being used is meant to get where spraying cannot reach, such as inside of homes and businesses. It is here physicians concerns arise. What risk is there of humans infection from any antibiotic resistant bacteria left behind on surfaces by these antibiotic dependent mosquitoes?
Keys physicians petitioned to have that culture data factored into any release and to delay the release if the data was not provided. Excuses for denial were received and felt weak. Gaining physician support just required data and appropriate risk benefit analysis.
Data denied, Keys physicians turned to the Cayman Islands were these antibiotic dependent insects are deployed now. The Cayman Ministry of Health was battling actively 3 mosquito borne illnesses (Zika, Dengue, and Chikungunya) and turned to all options for control. Keys physician would likely have done the same under the same circumstances, but our circumstances were different. Keys physicians were screening for mosquito borne illnesses, but luckily not battling those diseases actively. Keys physicians were and are battling actively daily antibiotic resistant bacteria here. Cayman Island physicians were battling these bacteria as well. They had data on this concern as well. Some of the Cayman data is linked below. It demonstrates an anomaly Keys physicians expected. Cayman Island Ministry of Health data demonstrates an anomaly in the antibiotic tetracycline resistance that stands out in human Staph aureus infections.
Our islands have an issue with Staph aureus infections. Where all other antibiotics of significant resistance in this Staph are dropping by an impressive percentage in resistance during an aggressive Pan American Health Organization (PAHO) guided Cayman campaign, tetracycline did not decline in Staph aureus. Cayman data does not place blame on the Oxitec insects as other factors could be responsible, but it was predicted by the petitioners. This remembering there have been releases with pauses since 2009 in the Caymans. Now we await data divided between release area and rest of the Caymans to see if the release area is a resistance cluster. We are very grateful to the Mosquito Research and Control Unit of the Cayman Ministry of Health for their hospitality during a site visit and freely sharing their data. More data to come.
Antibiotic resistance is as significant a threat to human health as mosquito borne illnesses. Keys physicians do not accept a key statement by Dr Nimmo the Oxitec Spokesperson related to not providing the data. We do not accept the United States government would refuse the cultures physicians seek. These cultures are safety testing. Also, we are working with the goal of submitting the Cayman data to publication, to the EPA and to The National Antibiotic Resistance Monitoring System (NARMS) arm of the FDA. FDA and EPA have rules for data. Antibiotic dependent insects are new technology and FDA admitted it was not the most appropriate place for oversight. The data will be submitted whether it demonstrates an issue or does not demonstrate any problem.
Please take the time to review and share the video linked. I will be presenting the concern and this data at the Sterile Insect Training of the Florida Keys Mosquito Control District on February 20th. This to clarify our desire for risk benefit analysis on this subject. Please freely comment back.
https://view.knowledgevision.com/presentation/f685f26257334969aae998765ae6a8a9
John W Norris III MD FACP
508 Southard Street, Suite 103
Key West, Fl 33040
305-296-1022
[email protected]