Letter to Thomas R. Frieden, MD, MPH Director Centers for Disease Control and Prevention

Letter

Today, standing at the Manlius Swan Pond, U.S. Senator Charles E. Schumer unveiled a new, three point plan to have the federal government help Central New York and counties across the state combat the Eastern Equine Encephalitis (EEE) virus, and other mosquito-borne illnesses like West Nile virus. Schumer announced his push to support federal funding for New York from two programs within the Centers for Disease Control and Prevention (CDC). The funds will be used to expand the state's Epidemiology and Laboratory Capacity (ELC) and the Emerging Infections Program (EIP), both of which can fight back against EEE and West Nile. Additionally, Schumer called on officials from the CDC, state Department of Environmental Conservation, and other agencies to meet with state and county health officials from Central New York and throughout the state ahead of next year's mosquito season to map out an aggressive and proactive regional response to mosquito-borne illnesses. Additionally, Schumer is seeking new opportunities to unleash SUNY's research capabilities and to engage New York science students in efforts to stop the spread of EEE mosquitoes. Finally, Schumer announced that he is urging local universities to produce a public service announcement television commercial with tips on avoiding EEE-infected mosquitoes, and alerting local families to their dangers. Mosquitoes capable of transmitting EEE were recently discovered in Rockland County, sparking fears that the potentially fatal disease could spread to new parts of the state. Schumer hopes that a proactive plan will save local governments funding in the long run, by preventing the need to spray in the event of an outbreak.

"We learned this summer of the tragic consequences of letting EEE go unchecked," said Schumer. "Our local and state health departments have done a great job tracking and fighting EEE where they can, but they need the federal government's help. We need CDC funding for a groundbreaking study, a summit to help local governments understand how best to battle mosquito breeding grounds, and to increase public awareness over the airwaves. I'm going to fight as hard as I can to get this done, so that EEE doesn't hover like a dark cloud over Central New York summers."

"The county's fight against EEE and other mosquito borne illnesses begins with public awareness and education," said Onondaga County Health Commissioner Dr. Cynthia Morrow. "Senator Schumer's plan builds off that premise by supporting specific funding, utilizing our university researchers and engaging the general public. That's why it makes so much sense. A summit, where regional stakeholders join state and federal partners, will cost nothing yet return much. While Onondaga County can and does do as much as it can to prevent illnesses like EEE from impacting residents, we need partners who will carry our message and engage the public in a way that attracts measurable results, but never the mosquitoes."

"The State Health Department works closely with municipalities across the state to identify, track and control mosquitoes that pose a health risk to humans," said State Health Commissioner Nirav R. Shah, M.D., M.P.H. "We appreciate Senator Schumer's strong support in helping us obtain federal funding for a research project that will provide critical information to protect local residents from Eastern Equine Encephalitis."

EEE is a rare disease that is caused by a virus spread by infected mosquitoes. EEE is one of a group of mosquito-transmitted viruses that can cause inflammation of the brain (encephalitis). In August, four-year-old Maggie Wilcox, from New Haven, died after contracting Eastern Equine Encephalitis (EEE). Schumer's office has been working with local officials to establish a comprehensive plan for the federal government to help prevent EEE cases or fatalities in future mosquito seasons. Schumer was joined by Onondaga County Health Commissioner Dr. Cynthia Morrow, a SUNY ESF Phd candidate and researcher, Manlius School District Superintendent, and Fayetteville Manlius High School Principal Ray Kilmer as he unveiled his new, three point plan to help Central New York combat EEE.

Schumer is putting his support behind The New York State Department of Health's (NYSDOH) application for two funding programs to support the fight against EEE, and urging the CDC to accept those applications. The funds will be used to expand the state's Epidemiology and Laboratory Capacity (ELC) and the Emerging Infections Program (EIP). Schumer noted that the NYSDOH application for funding includes specific proposals to help the state combat EEE and West Nile. Specifically, the Department would perform a serosurvey of long-time residents of the 4-county area surrounding Oneida Lake (Madison, Oneida, Onondaga, and Oswego counties), which comprise the current geographic focus of this disease in New York. The project will help to determine the percentage of residents who have been exposed to EEE and have been mildly symptomatic or asymptomatic. The village of Central Square will be the primary target of the serosurvey. Individuals above age 18 that have lived in the town for a minimum of 10 years will be requested to participate in the serosurvey.

Recruitment will be done through a number of means, including local advertising, local media, and recruitment via county health department services. County health department staff nurses and phlebotomists will be utilized to perform collection of samples from participants, and counties would be reimbursed for these services. Participants would also fill out questionnaires regarding their history in the area near Oneida Lake. All of these results would then be sent to NYSDOH laboratories for specialized testing to determine antibody status and potential previous exposure. This would ultimately help NYSDOH officials to catalog the possible occurrence of the illness, its potential movement and the types of people infected, symptomatic or not. This invaluable information would be used to beef up the state's defense against mosquitoes while shedding light on how and where they spread illness.

The Epidemiology and Lab Capacity (ELC) funding would allow the NYSDOH to continue to build its public health capacity, specifically through the purchase of laboratory equipment and supplies for diagnosing emerging pathogens, and investing in critical information technology to improve disease reporting and monitoring.

Schumer is also planning to develop the first-ever summit to discuss EEE and the best ways to fight this deadly virus. The summit will join officials from the CDC, state Department of Environmental Conservation, SUNY and other agencies to meet with state and county health officials from Central New York and throughout the state ahead of next year's mosquito season to map out an aggressive and proactive regional response to mosquito-borne illnesses. For instance, Schumer will push for this summit to establish new opportunities to unleash SUNY's research capabilities and to engage New York science students in efforts to stop the spread of EEE mosquitoes. This would put young minds to work exploring new avenues and resources to aid local communities, all while providing first-hand experience to Central New York students in science fields. SUNY officials have expressed a desire to conduct some of the analysis work when mosquitoes have been discovered in Central New York ponds.

This Schumer-proposed summit will occur before EEE season begins in April 2012, and will focus on being proactive, not reactive, in the fight against mosquito-borne illnesses. The summit will also help local governments develop a plan to combat what Onondaga County Health Director Cynthia Morrow has described as a lack of village and town preparedness when it comes to drainage practices. Whether it's the local baseball field that collects stagnant water or local parks where effective drainage measures aren't in place, the summit will educate suburban leaders on how best to prevent water from becoming a suitable breeding ground that helps catalyze the spread of more mosquito disease. Officials at the summit will also discuss any further mitigation measures that can be taken at the Cicero swamp, where EEE both thrives and incubates. This 'hot bed' is one of the constant challenges that Onondaga County Health officials face and continue to work to address.

Finally, Schumer is pushing for a local university to produce a Public Service Announcement (PSA) in order to increase awareness of EEE, and to alert local families of EEE-related dangers. Once produced, PSAs will air on local television for free and would be an economical and effective way to disseminate information and provide tips to parents, teachers and other viewers regarding EEE and mosquito-borne illnesses. That information would include simplified tips on removing standing water from your property, wearing pants or long sleeves at dusk and responsibly using insect repellents. The PSA would also serve as a reminder to parents who encourage their children to play outside, reiterating how best their children can avoid the bite of mosquitoes. Any unfolding EEE-related dangers could also be included.

According to NYSDOH, Eastern Equine Encephalitis (EEE) is a rare but serious viral disease spread by mosquitoes that can affect people, horses and other animals. EEE is transmitted by the bite of an infected mosquito, which become infected by feeding on infected birds. Infected mosquitoes will then occasionally feed on horses, humans and other mammals. The virus that causes EEE is spread only by mosquitoes. People and horses do not directly spread the disease to other horses or people. While most people bitten by an infected mosquito will not develop any symptoms, severe cases of EEE infection, involve encephalitis (an inflammation of the brain) and begin with the sudden onset of headache, high fever, chills, and vomiting. The illness may then progress into disorientation, seizures and coma. Approximately a third of patients who develop EEE die, and many of those who survive have mild to severe brain damage. Five human cases have been reported in New York State: one each in 1971, 1983, 2009, 2010 and 2011, with a clear uptick in recent years, and all have been fatal. Schumer is also pushing for his three-pronged plan to address other mosquito-borne illnesses such as West Nile Virus, which can cause serious illness such as high fever, muscle weakness, paralysis, coma and in some cases death.

A copy of Senator Schumer's letter to Dr. Frieden, Director of the Centers for Disease Control and Prevention appears below:

September 28, 2011

Thomas R. Frieden, MD, MPH
Director

Centers for Disease Control and Prevention

1600 Clifton Rd
Atlanta, GA 30333

Dear Director Frieden,

I am pleased to write in support of the applications submitted by the New York State Department of Health (NYSDOH) for ongoing funding through the Centers for Disease Control and Prevention (CDC) Epidemiology and Lab Capacity (ELC) and the Emerging Infections Program (EIP).

As you know, the EIP is a collaborative public health effort of the NYSDOH Wadsworth Center laboratories, Division of Epidemiology, Office of Science and Public Health, and the Center for Rochester's Health. The program spans 34 counties and directly covers an area with a population base in excess of 4.3 million. Each EIP surveillance area conducts core, population-based activities, and over its more than nine year history has promoted longstanding and professional relationships with the Local Health Departments, laboratories, Infection Control Practitioners (ICPs), and NYSDOH Regional and Central Office staff. The benefits of this collaboration are felt throughout the state of New York.

The ELC funding has allowed the NYSDOH tobuild its public health capacity, specifically through the purchase of laboratory equipment and supplies for diagnosing emerging pathogens, and investing in critical information technology to improve disease reporting and monitoring.

These federal funds also enable NYSDOH to facilitate enhanced surveillance, testing, and studies of Arboviruses such as Eastern Equine Encephalitis and West Nile Virus. These are two emerging illnesses that have required significant resources and efforts by New York State local authorities. It is only with the help of the federal government that we can assist NYSDOH in their research and activities to combat these deadly diseases. Specifically, these funds will enable NYSDOH to implement a plan to perform a survey of long-time residents of a 4-county area surrounding Oneida Lake, which comprise the current geographic focus of this disease in New York. Outside of questionnaires, blood specimens will be collected and undergo specialized testing to determine antibody status and the potential previous exposure of the participants. This plan will go a long way in our collective fight to eradicate EEE and other arboviruses.

I hope you will fully consider NYSDOH's EIP and ELC applications for the upcoming funding cycle. Thank you again for your consideration. If you need additional information, please to do not hesitate to contact me or my Washington office at 202.224.6542.

Sincerely,

Charles E. Schumer

United States Senator

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