TheFinalControlPlanforDoyleViralEncephalitis

By:ParniaBehinaein,RachelBowen,SoohyunOh,NathanielShearerandChelseaVargas
Introduction
Our CDC team mapped out the emergingvectorbornediseaseinNewMexicooverthepastfew
months and has now made a plan to end it. The pathogen that causes Doyle Viral Encephalitis
(DVE) is
Roseolovirus albuquerquii
. The disease agent is vectored by a species of kissing bug,
Triatoma recurva and is carried in the wild by squirrels. Given that such a deadly disease is
spread by a flying insect, the posed control plan had to bring a quickresolutiontotheoutbreak.
The plan starts with informing the people about the disease and gathering funding. Once the
public is aware and the money is flowing, a vaccine and specialized insecticide can start to be
developed. In the meantime, people need to be vigilant to avoid exposure to the pathogen,
reservoir and vector. After a period of time, the vaccine will be given out to prevent infection
among the people. Once the insecticide has been approved, the bugs habitat will be sprayed
untilthediseaseisvanquished.Allalongthisprocess,theCDCwillbedoingsurveys totrackthe
progressionofthediseaseandseethecontrolplanoutuntiltheend.
ControlPlan
Public Awareness.
The first initiative to preventing disease states in general, and specifically
Doyle viral encephalitis, is to raise awareness among communities. Awareness is the most
effective way of sending a message, capturing attention, and getting people to discuss the
disease. This is done by spreading details of the disease on media outlets, such as television,
radio, newspaper, and social media. Such details should include which areas to avoid, what
insects to be cautious of, and how to quickly identify symptoms of the disease. Additionally,
details of the seriousness of the disease state should be communicated tothepublic.Doyleviral
encephalitis has a 99% mortality rate everypersonwhohascomeintocontactwiththis disease
has died. If death is associated as a result of contracting Doyle viral encephalitis,peopleshould
be increasingly likely to accept a mandatory statewide vaccination. The more the public knows
aboutthisdiseasestate,themoretheywillbecomeconcernedfortheirsafety.
Vaccine Production.
Viral vaccines protect people from disease by eliciting an immune
response. The immune system remembers how to deal with the antigen in the vaccine so if the
person is subsequently infected by the virus, they should be fine. There are three types of viral
vaccines. These types are subunit, killedandliveattenuated.Themosteffectiveoneisthelatter.
Liveattenuated vaccines are made by preparing an abundant supply of cell media. A cheap
supply of cells can come from embryonated eggs. The cells will then be infected with
Roseolovirus albuquerquii
.Theprocessofattenuation islaidoutinareview(McGheeetal.) that
is better explained by the scientists. The weakened virus would then be extracted from the egg

medium. The attenuated virus can no longer cause symptomatic DVE. Lastly, the virus ismade
into a vaccine. It isdilutedwithsterilewaterwhilestabilizersandpreservativesextendshelflife.
An adjuvant will be added to increase the level of immune response to the vaccine for greater
effect. The vaccine is then placed into syringes and packaged for shipping. Production of this
vaccineshouldoccurabout6to9monthspriortothestartofdistribution.
Pesticide Production.
In addition to a liveattenuated vaccine, a pesticide targeting
Triatomine
bugs willbeproducedinordertopreventdisruptiontotheaffectedareasorsurroundingecology.
In general, pesticides are used to control pests in the different spheres of public health,
agriculture, and horticulture (World Health Organization 2010). The pesticide designed to kill
our target organism, the
Triatomine
kissing bug, will be exposed to certain areas within New
Mexicobythepreparationanduseofsprays.
Avoidance of Exposure.
While the vaccine and insecticideareindevelopment,thepeopleneed
to take steps to distance themselves from the vector and reservoir. This is easiersaidthandone,
however. Because of urban sprawl, squirrels live in cities around people. Some can even infest
homes by living in attics and spaces in the walls. ThereservoirforDVEcanbepotentiallyright
abovetheplace wherelittleTimmysleepsatnight.
Triatomarecurvaisusuallyasylvaticspecies
but the CDCteamhascaughtitinresidentialareasofAlbuquerque.Thebugsliketoliveinnests
and burrows of small rodents like pack rats and squirrels. This putsthereservoir,thevectorand
people in the same place which is a bad concoction when you throw in
Roseolovirus
albuquerquii
. A book about controlling insects (Tvedten 2007) recommends the following. To
decrease the risk of exposure, exterminators can remove nesting materialsinattics,burrowsand
trees within 100 yards of each house and seal the cracks in old buildings. Diatomaceous earth
(DE) can be spread around the home to dessicate insects. The DE destroys their waxy coating
anddriesthemout.
Vaccine Administration.
As Doyle Viral Encephalitis is most prevalent in the late summer
months, the distribution of the vaccination should occur from approximately March to July.
While a primary series of vaccinations is required for infants and throughout childhood, the
vaccination for Doyle viral encephalitis will be developed and recommended foradolescentand
adult populations in New Mexico. In order for distribution to occur, access to the vaccine is
usually ordered by a physician, orprovider,fromprivatemanufacturersordistributors.Basedon
the daily administration rate, each provider isgivenadailydemand,and orders accordingtothis
figure on a weekly basis. It is important to note that CentersforDiseaseControlandPrevention
(CDC) assigns vaccinations to each stateaccordingtotheirpopulationneeds.AlthoughtheCDC
and Department of Health and Human Services work to increaseproduction capacity and
improvestabilityofvaccines,theseservicesdonothavetheabilitytocontroldistribution.Thisis
achievedintheprivatesector.

Spraying Insecticides.
The insecticidethatwas createdtokillourvectorwillbesprayedweekly
in the summer months at the peak times of triatomine levels. Areas to be sprayed are the
potential habitats for
T. recurva all across NewMexico.TheCDC willsprayrockcrevices,tree
holes, burrows andbuildingcracks amonth afterthelastinfectiousorganismhasbeentrappedto
ensureeradication.
Surveillance.
During this entire operation, the CDC will keep tabs on theT.recurvapopulation
in the state. Trapping methods agreed upon earlier (Noireau et al. 2002) will still be ineffectto
observe if and where the pathogen spreads. Other statistics that will be measured are new cases
of the disease, any potential mutations of the DVE virus, areas of high levels of contamination
andclearedzones.
Conclusion
Eradicating a disease is not an easy feat. It takes a carefully thought out plan that attacks from
multiple angles. If this plan is put into place, everyone including government agencies, private
companies andcitizensmust workhardtoachievesuccess.Oneoverlookeddetailaboutthisplan
can cause a resurgence in disease and take out half of New Mexico.Withthepropermeticulous
mindsetgoingin,thepeoplecanriseaboveDVE.
WorksCited
CDC.(2016).
"Vaccines."CentersforDiseaseControlandPrevention.CentersforDisease
ControlandPrevention.Web.
McGhee,JerryR.(1992)
,etal."Themucosalimmunesystem:fromfundamentalconceptsto
vaccinedevelopment."Vaccine10.2:7588.
Noireau,Franois,etal.(2002).
"TrappingTriatominaeinsilvatichabitats."Memriasdo
InstitutoOswaldoCruz97.1:6163.
Tvedten,Stephen.(2007).

TheBestControl
.Vol.2.Text.
WorldHealthOrganization.(2010).
ExposuretoHighlyHazardousPesticides:AMajor
PublicHealthConcern.WorldHealthOrganization:PreventingDiseaseThrough
HealthyEnvironments
.
Web.