Municipal Government of São Paulo Health Department Environmental Health Surveillance SÃO PAULO LEPTOSPIROSIS AND RODENT CONTROL PROGRAM: METHODS AND SUPPORTED STUDIES Dr. Eduardo de Masi Biologist and Public Health Researcher Presentation conducted during the International Workshop of the Oswaldo Cruz Institute/FIOCRUZ for Leptospirosis Research Based on Country Needs & the 5 th Global Leptospirosis Environmental Action Network (GLEAN) Meeting on November 10-12, 2015, in Rio de Janeiro, Brazil.
SÃO PAULO RODENT CONTROL PROGRAM HISTORY: Rodent actions exist since 1972; Leptospirosis and rodent control program since 1987; First revision in 2005; Last revision 2011-2013; In July 2013 the Leptospirosis and Rodent Control was published as a guideline;
Available at http://pesquisa.bvsalud.org/sms/resource/pt/sus-27536
SÃO PAULO LEPTOSPIROSIS AND RODENT CONTROL MANUAL Three sections: Section 1 Urban rodent Section 2 - Leptospirosis Section 3 - Rodent control Strategies
RODENT CONTROL STRATEGIES: a) Actions in Leptospirosis Risk Areas; b) Actions micro-watersheds of the Leptospirosis Risk Areas c) Actions in areas with notified leptospirosis cases; d) To pay attention to citizen complaints; e) Other activities.
DEFINITION OF LEPTOSPIROSIS RISK AREAS Higher probability to leptospirsosis transmission; Programed strategy to rodent control by Pulsed baiting (presented in GLEAN of 2013); Selected by geostatistical methodology (AHP - Analytic Hierarchy Process); Map of areas to programed rodent control.
LEPTOSPIROSIS RISK MAP CONSIDERED FROM THE ENVIRONMENT (sufficient causes)
LEPTOSPIROSIS RISK AREAS DEFINED FROM THE GEOGRAPHICAL FEATURES Population density Precarious housing conditions Flooded areas
LEPTOSPIROSIS RISK AREAS DEFINED FROM THE GEOGRAPHICAL FEATURES Geo Statistical Methods Precarious housing conditions Flooded areas Population density AHP LEPTOSPIROSIS RISK MAPS
LEPTOSPIROSIS RISK MAP Risk Map in numeric model Risk Map in stratum model Designed by AHP methods - Analytic Hierarchy Process, (Saaty, 1978)
GEOGRAPHICAL CASES DISTRIBUTION VS RISK AREAS Validated Program Areas Map Kernel density of leptospirosis cases, 2007 to 2015
LEPTOSPIROSIS RISK AREAS: EPIDEMIOLOGICAL FEATURES Defined 425 Leptospirosis Risk Areas in 24 Health District
LEPTOSPIROSIS RISK AREAS: EPIDEMIOLOGICAL FEATURES 425 risk areas recorded Area Area(km²) Cases Population Cases Density (cases/km²) Accumulated Incidence 2010-2015 (100.000 hab.) Density ratio (DR) Incidence Ratio (RR) Risk Areas SP General 14 158 233,557 11.3 67,6 1,513 1,325 19,976,116 0.9 12,1 12.9 (10.8-15.2) 5.6 (4.7 6.6)
LEPTOSPIROSIS RISK AREAS: RODENT CONTROL STRATEGY WORK FRONTS Three rodent control blocks per year (Between March to November) In each work fronts are three intervention per block a) Houses b) River/streams c) Manholes/Sewers d) Public areas
LEPTOSPIROSIS RISK AREAS: RODENT CONTROL STRATEGY Control Action Synchronized According to micro-watershed Watershed 1 Watershed 2
LEPTOSPIROSIS RISK AREAS: RODENT CONTROL STRATEGY RODENTICIDES SELECTION Place Formulation Generation Active ingredient Techniques Rat Burrow Contact dust First Coumatetralil Sprinkling Houses Pellets Bait Second Brodifacoum or bromadiolone Pulse Sewers extruded blocks Second Brodifacoum or bromadiolone Pulse
In all control blocks Rodent control in houses: SÃO PAULO LEPTOSPIROSIS AND RODENT CONTROL PROGRAM: SOPPORTED STUDIES LEPTOSPIROSIS RISK AREAS: RODENT CONTROL STRATEGY Inspection on 100% of the houses 1 st intervention Rodent control in the infested (first pulse) Measures of initial infestation level Health information to households 2 nd e 3 rd intervention 4 nd Intervention Inspection only in the infested houses Replacement of consumed baits (second and third pulses) Removal of the remaining baits, if the infestation has been eliminated Removal of the remaining baits Measures of residual infestation level
LEPTOSPIROSIS RISK AREAS: RODENT CONTROL STRATEGY Rodent control in houses: SÃO PAULO LEPTOSPIROSIS AND RODENT CONTROL PROGRAM: SOPPORTED STUDIES
In all control blocks Rodent control in sewers: SÃO PAULO LEPTOSPIROSIS AND RODENT CONTROL PROGRAM: SOPPORTED STUDIES LEPTOSPIROSIS RISK AREAS: RODENT CONTROL STRATEGY 1st intervention Extruded rodenticides blocks are placed on 100% of the sewer (first pulse) Replaced consumed baits (second pulse) 2nd intervention Removal of the remaining baits, if there were no consumption Reuse not consumed baits 3rd intervention Replaced consumed baits (second pulse) Reuse not consumed baits
LEPTOSPIROSIS RISK AREAS: RODENT CONTROL STRATEGY Rodent control in sewers: SÃO PAULO LEPTOSPIROSIS AND RODENT CONTROL PROGRAM: SOPPORTED STUDIES
In all control blocks SÃO PAULO LEPTOSPIROSIS AND RODENT CONTROL PROGRAM: SOPPORTED STUDIES LEPTOSPIROSIS RISK AREAS: RODENT CONTROL STRATEGY Rodent control in streams: dusting burrows Walk along the banks of the stream and find 1st intervention the rat burrows Dusting rodenticide in all burrows Pluging all burrows 2nd intervention 3rd intervention Walk again along the banks of the stream and find the rat burrows Plug all holes that have been opened Walk again along the banks of the stream and find the rat burrows Dusting rodenticide in all burrows that have been opened
LEPTOSPIROSIS RISK AREAS: RODENT CONTROL STRATEGY Rodent control in streams: SÃO PAULO LEPTOSPIROSIS AND RODENT CONTROL PROGRAM: SOPPORTED STUDIES
In all control blocks SÃO PAULO LEPTOSPIROSIS AND RODENT CONTROL PROGRAM: SOPPORTED STUDIES LEPTOSPIROSIS RISK AREAS: RODENT CONTROL STRATEGY Rodent control in streams: bait points 1 st intervention Walk along the banks of the stream and to find the rat marks and tracks Bait close to marks (bait points) 2 nd intervention Walk again along the banks of the stream and find the bait points Replacement of consumed baits (second pulses) 3 rd intervention Walk again along the banks of the stream and to find the bait points Replacement of consumed baits (third pulses)
LEPTOSPIROSIS RISK AREAS: RODENT CONTROL STRATEGY Rodent control in streams: bait points
SUPPORTED STUDIES
Conclusion: In water samples of a.i it was not detected, during the 10 weeks. It was concluded that the a.i. stays in the environment for at least 10 weeks, but it doesn t reach the underground water in the type of used soil. SÃO PAULO LEPTOSPIROSIS AND RODENT CONTROL PROGRAM: SOPPORTED STUDIES SÃO PAULO RODENT CONTROL PROGRAM SUPPORTED STUDIES: Study 1: Papini et al. Environmental behaviour of coumatetralyl rodenticide in contact powder. Pesticidas: r. ecotoxicol. e meio ambiente, 18, 2008 Dissipation of a.i cumatetralil in soil Pluviosity
SÃO PAULO RODENT CONTROL PROGRAM SUPPORTED STUDIES: Study 2:
SÃO PAULO RODENT CONTROL PROGRAM SUPPORTED STUDIES: Study 2: Palatability and efficacy of bromadiolone rodenticide block bait previously exposed to environmental conditions Consumed rodenticide baits Days to death
SÃO PAULO RODENT CONTROL PROGRAM SUPPORTED STUDIES: Study 3 (In submission): PALATABILITY AND EFFICACY OF RODENT BAITS TO WILD URBAN NORWAY RATS OF SÃO PAULO, BRAZIL. NAKAGAWA, LE; MASI, E; ARRUDA, A; OLIVEIRA, JCB; PAPINI, S TABLE 1. Average amount of bait (g) consumed per unit animal weight in T zero, T30, T60 and T90. 30 days Days of exposition Average block amount consumed per kg rat IC 95 % Tzero 24.6 22.3 FIGURE 1: No exposed (left, above) and exposed blocks by 30, 60 and 90 days. 60 days 90 days T30 108.4 41.4 T60 114.8 30.2 T90 90.0 55.5 Mortality rate = 92%
SÃO PAULO RODENT CONTROL PROGRAM SUPPORTED STUDIES: Study 4 (In preparation): SNPS SCREENING OF VKORC1 COFACTOR GENE IN Rattus Norvegicus in Brazil: a specific panmitic strain Wagner Narciso de Campos, Solange Papini, Lia Emi Nakagawa, André Arruda, Ana Eugênia de C. Campos, Eduardo de Masi, Ricardo Harakava. In R. norvegicus were found 32 mutated nucleotides. Specific strain of rodents were reported, when compared to references sequences databases (NCBI and Ensembl). No mutation association was found with rodenticide pressure area. A series of specific SNPs characterizing a unique and panmitic rat stain was found
SÃO PAULO RODENT CONTROL PROGRAM SUPPORTED STUDIES: Study 4: SNPS SCREENING OF VKORC1 COFACTOR GENE IN Rattus Norvegicus in Brazil: a specific panmitic strain
SÃO PAULO RODENT CONTROL PROGRAM SUPPORTED STUDIES: Study 5: Constructive characteristics of the Norway rats burrows Masi et al. Vetores e Pragas, 39; 2015.
Thanks! EDUARDO DE MASI Contact e-mail: emasi@prefeitura.sp.gov.br