APPENDIX I-1B: E-Mail from John Pape Epidemiologist, State of Colorado, July 5, 2007.
Date: Thu, 05 Jul 2007 17:57:18 ‑0600
From: John Pape <firstname.lastname@example.org>
To: MAZIAR ANNE LEE <Anne.Maziar@Colorado.EDU>, walter@Colorado.EDU,
Cc: Heath Harmon <email@example.com>,
Joe Malinowski <firstname.lastname@example.org>
Subject: Re: report on meeting with state health today (fwd)
Ms. Maziar and colleagues,
I read with interest the 32 emails that Ms. Maziar forwarded to me regarding
the recent meetings with the Longmont City Council and Boulder County
Commissioners. I usually don't respond to such blast emails as I find this
accomplishes little with groups in which to paraphrase Mr. Walters statement
"Predetermined assumptions guides [their] whole program".
However since I was personally attacked in the string of discussions, I felt
a need to respond to clarify some points that were made. I don't have the
time to address the numerous inaccuracies and errors in these email
strings, but would offer the following comments for consideration.
First, the reason for which both of these meetings were held was to discuss
trigger points and issues to consider when deciding if adult mosquito
control (spraying) should be conducted during a WNV outbreak. This was a
very narrow focus, not a discussion on mosquito control 101. However by
leaving out this important context, it makes statements like "Larviciding
was not mentioned..." or the "best approach to control ... is aerial
spraying" sound much more sinister and ominous. Maybe the persons attending
this meeting were unaware of the purpose of the discussion?
However, I have observed over my years in public health that using quotes or
statements out of context or attributing statements to a person they did not
make is a common tactic with groups advocating a specific agenda. I would
be like to hear the tape where I used the term "wall to wall spraying" that
is mentioned several times in these emails. A comment attributed to me
included "Pape implicitly dismissed larviciding", again used out of context
and contrary to written information we have been promoting for years ( i.e
one of the prevention 4 D's ‑‑ drain standing water). Even the email string
contradicted this statement as in the Longmont City Council notes it states
" He confirmed for Mayor Pirnack that the larvicide's control in City limits
is very effective."
We have been using surveillance data to determine the best ways to prevent
human WNV infections. One pattern that has occurred several times is the
initiation of spraying well after the peak of the transmission season, when
it has limited impact on preventing human illness. The spraying in Longmont
at the end of August last year is a good example of this. Our goal is to
limit the times when spraying is used and if used that it has the most
impact on preventing infections based on surveillance data we have been
collecting for 5 years.
To that end our data has shown approximately 85% of WNV cases are infected
between July 1 and the second week of August. But due to reporting delays,
most human cases are reported in August and September. Culex populations
tend to peak in mid to late July. Thus, based on available surveillance
data, the most effective time to do adult control would be in July at the
front end of the mosquito population and infection curves. But at this
point few human cases will have been reported.
I have been discussing these findings with local decision makers to insure
that if spraying is being done for disease control purposes it is most
effective and to not spray when there would be no public health benefit. Our
mosquito‑borne arbovirus response plans was revised to reflect this with the
inclusion of the statement: "Based on epidemiological data from Colorado,
adulticiding after the third week of August will have a minimal impact on
human case totals. " The plan also discusses trigger points as to when
spraying should be considered, so despite inferences in the email strings to
the contrary, I only recommend spraying when indicators are showing
significant human risk. As a case in point, no spraying for disease control
was needed or recommended in Boulder County during the 2004 or 2005 seasons
based on surveillance data.
However, I cannot support this groups main position, that spraying should
not be done under any circumstance. We have logged nearly 4,000 human
cases, many with permanent sequelae, and 76 deaths over the past 4 years
(514 cases; 8 deaths in Boulder County). Adult mosquito control is one tool
that can lower this impact. I have not received one report of a physician
diagnosed illness or death related to emergency ultra low volume (ULV)
This brings me to my final point regarding statements :" Mr. Poppy added
that there have not been any conclusive studies that link
spraying to illnesses. Either he is totally incompetent, or he is
deliberately misrepresenting the truth. "
I have asked no spray groups repeatedly over the years to provide a
reference of a scientific article in the peer‑reviewed literature showing a
causal link between human morbidity and ULV mosquito spraying. I have yet
to be provided with such a reference.
However, this should be easy to document. My sister lives in a Midwest town
that conducts ground based ULV spraying for nuisance mosquitoes from May ‑
September; the truck goes down her street 1‑2 per week. This is a common
practice in the eastern and southern U.S. so the doom predicted in these
email strings should be evident in such areas.
I'm well aware of studies showing illness with high doses fed to mice, long
term chronic exposures or acute intoxications due to mishandling or improper
application and have read the MSDS sheets for adulticide products. I'm also
aware of the attempts to extrapolate such data into predictions of wide
spread human illness due to ULV applications without any supporting data.
These studies do not change my view that targeted, appropriately timed adult
mosquito control as one component of an integrated mosquito control program
can significantly reduce human morbidity and mortality. This view appears
to be held by the majority of the CO citizens.
I actually receive more complaints from citizen about why there is no
mosquito control in their area. Every public vote to expand or fund
mosquito control districts in Colorado since 2003 has passed by large
margins. One way to prohibit spraying, is to start a petition, get it on the
ballot and put it to a community vote. I suspect though it wouldn't be
successful based on a 2004 state‑wide population based survey. When asked
the question "If testing showed there were lots of West Nile Virus infected
mosquitoes in your community, would you support spraying to reduce the
number of mosquitoes?" responses were YES 84.6% (95% confidence interval
81.5 ‑ 87.3%); NO 8.5% (CI 5.9 ‑ 11.1%); DO NOT KNOW 6.8% (CI 4.8 ‑ 8.8%);
My position of trust requires me to consider the views of all Colorado
citizens. This includes the concerns of pesticide exposure that your group
voices along with the concerns of thousands of Coloradoans and their
families who have been adversely impacted by WNV. While I hope most years
we do not have to resort to mosquito adulticiding, there are times when the
public health benefit of adult mosquito control will outweigh the risks
associated with spraying.
I appreciate the opportunity to provide the context in which my comments
were made at these public meetings. Please feel free to forward this to
other members in your email group. JP
John Pape, Epidemiologist
Colorado Department of Public Health & Environment
4300 Cherry Creek Drive South
Denver, CO 80246