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Pests of Public Health Importance in Schools

Richard J. Pollack, PhD

New England School Nurses5 May 2018

Plymouth, MA

Richard J. Pollack, PhD• Harvard University &• Harvard T.H. Chan School

of Public Health• IdentifyUS LLC

Mention of any product name or image is for illustrative purposes only and does not indicate endorsement of any product or service. Opinions are those of the

presenter and do not necessarily reflect those of his employers. The presenter declares that he owns and operates IdentifyUS LLC that offers

some products and services discussed during this presentation. Images are copyright protected by their respective owners.

3https://www.cdc.gov/media/releases/2018/p0501-vs-vector-borne.html

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How do pests pose risk to the school community?

• Bite / sting / infest / irritate

• Damage / foul infrastructure

• Contaminate food / service items

• Instill fear (real and imagined)

• Stimulate unjustified / costly interventions

• Harm reputation of school & community

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morbidity

conc

ern

Ticks

Head lice

Bedbugs

Mosquitoes

Fear vs. realitySpiders

Scabies

RodentsFleas

Cockroaches

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• Reduce risks!• Develop / adopt IPM program

• Keep pests out• Stop them from spreading• Eliminate them• Monitor for pests & damage• Action plans

IPM Integrated Pest ManagementIPM Integrated Pest Management

https://www.epa.gov/managing-pests-schools/introduction-integrated-pest-management

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Exercise restraint

It is rarely possible to identify the cause of an insect or tick bite merely by

examining the appearance of the lesion.

What bit me?

https://identify.us.com/whats-biting-me.html

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Eat & Run

Flea

Bed bug

Deer fly

No-see-umBlack fly

Mosquito

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Center of Expertise for School IPM

• Minor annoyance• Quality of life• Illness• Death

Mosquitoes

http://curacaochronicle.com/wp-content/uploads/2014/09/Chikungunya1.jpg

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• Stagnant water• Small containers ponds• Some breed indoors

• Eliminate sources• Contact regional mosquito

control district• Install / repair screens• Keep doors closed• Consider use of EPA-

registered repellents

Mosquitoes

https://www.epa.gov/mosquitocontrol10

Bed bugs and their cousins

Bed bug Tropical bed bug

Bat bug Swallow bug

http://bugguide.net/node/view/478887

Ken Walker (2012) Tropical Bed bug (Cimex hemipterus) Updated on 2/10/2012 5:04:06 PM Available online: PaDIL -http://www.padil.gov.au.

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• Generally night active• Bugs hide in dark

recesses• Blood feeding only

(minutes)• Bites painless• Survive for months

between feedings

Bed bugs

https://www.epa.gov/sites/production/files/styles/large/public/2014-02/bed-bug-ctual-size.jpg 12

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Fecal spots

Cast skins

13© 2016 IdentifyUS, LLC

• Wingless, but may hitch rides on clothing & belongings

• Contract services of licensed pest management professional

• Manage information carefully to protect confidentiality of students & families

Bed bugs

https://www.epa.gov/bedbugs

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Contemplate & savor

Engorging ticks

Bot fly larva

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Deer or black-leggedLone star

Dog or wood

Adult non-fed female ticks

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Deer ticks

American dog ticks

Lone star ticks

Three common

female ticks

Engorgement sequences

http://www.tickinfo.com

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larva

nymph

male

female

Deer (black legged) ticks

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Non-fed & engorged nymph

Spreading rash

site of feeding

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Tick check & removal

https://www.epa.gov/insect-repellents/tips-prevent-tick-bites

Larva

Nymph

20https://www.cdc.gov/ticks/avoid/on_people.html

Find and remove ticks promptly!

Time matters: Risk of pathogen transfer increases with duration of attachment

https://www.cdc.gov/ticks/removing_a_tick.html 21

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Tick feeding video

http://nyti.ms/1gZ7dez

Diners in residence

https://upload.wikimedia.org/wikipedia/commons/1/10/Scabies-burrow.jpg

burrow

Head louse

Pubiclouse

Scabies mite

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'Super Lice’ Plague Kids and Parents

http://www.kmbz.com/-Super-Lice-Plague-Kids-and-Parents/17596851

Reality… or a good example of marketing excesses?

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• a person or home is unclean• jump, fly & survive long off a host• infest buildings• readily shared on combs, brushes and hats• burrow into skin or transmit infections• resistant to all treatments• should prevent a child from attending school

Myths about head lice

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• infest only people (usually children), not pets

• occur solely on the scalp hair• feed only on blood• do not burrow into skin

EGG 1st nymph 2nd nymph 3rd nymph ADULTS

Head lice

https://www.epa.gov/managing-pests-schools/previous-webinars-about-integrated-pest-management-schools#Oct2015

Egg

Head louse

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Rumors spread far faster than do head lice!

Are ‘Selfies’ spreading head lice among teens?

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The overly-maligned comb

How could a louse – even if alive - grasp this situation?

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Probably not from these or other fomites

Transmission?

29© 2016 IdentifyUS, LLC

Most likely by direct head-to-head contact as children engage in

otherwise wholesome activities.

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Not all bugs on the scalp are head lice

Head louse

Booklouse

Aphid

https://identify.us.com31

Head louse eggs (‘nits’)

…and imposters

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Recommended responses ✔

• Confirm specimen ID

• Notify parent / guardian at the end of the day

• Provide educational information on the biology & management of head lice

• Respect confidentiality!

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IPM for Head Lice

Head lice are obligate parasites & are notfree living. They do not infest the school or buses.

Hence, head lice are a medical issue, not a pest control problem.

IPM efforts should be restricted to the scalp hair.

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Head lice: Patient management

Anti-louse treatments

OTC & Rx

Habitat modification 35

Mechanical removal

Symptomatic treatmentAntihistamines

Don’t touch me !

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Waiter, there’s a person in my soup !

http://lancaster.unl.edu/pest/resources/itchmites.shtml

http://www.scielo.br/img/revistas/ne/v35n4/31340f1b.jpg

Itch mites

ThripsMites of animals37

Cockroaches• Sanitation & plumbing

issues• Foul foodstuffs• Exacerbate allergies• Cause some panic &

overreliance on frequent pesticide use

Uninvited guests American cockroaches

German cockroaches

University of Nebraska-Lincoln Extension http://lancaster.unl.edu 38

Cockroaches

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Imagined pests

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Pests in the schools

• Rodents & insects common outdoors

• Some flourish indoors• Odors of food & trash are highly

attractive• Rodents can chew through

some walls, and damage wires & pipes

• Pests can foul & contaminate foods & food preparation surfaces

• Pests can upset, bite & pose risk of allergy or infection

• Cause health code violations41

Allergens & asthma• Asthma: most prevalent chronic health issue of

children in US• Triggered by allergens

• Contact & inhalation of dusts containing excrement, hairs & body parts of cockroaches & rodents

• IPM can reduce pests & secondary health burdens

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https://www.epa.gov/sites/production/files/2016-04/documents/preventing-pests-for-healthier-schools.pdf

https://www.nhlbi.nih.gov/sites/www.nhlbi.nih.gov/files/images_234

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• Keep pests out

• Stop them from spreading

• Eliminate them

• Monitor pests and report sightings / damage

You can help meet important goals:You can help meet important goals:

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• Keep doors closed at all times

• A mouse can easily pass through a space as thin as a pencil

• Repair doors & windows, add rodent-resistant sweeps, seal penetrations in walls / floors / ceilings

• Keep doors closed at all times

• A mouse can easily pass through a space as thin as a pencil

• Repair doors & windows, add rodent-resistant sweeps, seal penetrations in walls / floors / ceilings

Keep pests out

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• Cardboard boxes & plastic bags won’t stop rodents or many insects

• Discard contaminated foods

• Protect food by using secondary containment

• Cardboard boxes & plastic bags won’t stop rodents or many insects

• Discard contaminated foods

• Protect food by using secondary containment

Protect food

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• Crumbs, grease, wrappers attract and feed pests

• Rodent droppings and urine serve as attractants and signposts for other rodents

• Sweep & wash floors at least daily

• Crumbs, grease, wrappers attract and feed pests

• Rodent droppings and urine serve as attractants and signposts for other rodents

• Sweep & wash floors at least daily

Food sanitation

https://centuryproductsllc.com/wp-content/uploads/FLoor-cleaning.png 46

• Many pests breed in organic muck in drains of sinks, floors & soda machines

• Clean drain strainers & baskets daily

• Drains clogged or producing flies call a plumber (don’t pour caustic substances into drains)

• Many pests breed in organic muck in drains of sinks, floors & soda machines

• Clean drain strainers & baskets daily

• Drains clogged or producing flies call a plumber (don’t pour caustic substances into drains)

Drains

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• Secure food wastes in closedbags & closed bins or dumpsters

• Keep clean receptacles & areas where these are stored

• Secure food wastes in closedbags & closed bins or dumpsters

• Keep clean receptacles & areas where these are stored

Wastes attract pests!

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• Often not healthy• Encourages animals to depend upon hand-outs• Poses risk (bites, scratches, damage, disease)

• Often not healthy• Encourages animals to depend upon hand-outs• Poses risk (bites, scratches, damage, disease)

Don’t feed wildlife!

http://www.dec.ny.gov/animals/94709.html

Bread for birds (and rats)

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Feathered friends and fiends

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Rodent excreta (droppings and urine):• attract other rodents• may contain pathogens

Contaminated areas should be cleansed and sanitized• avoid creating dusts & aerosols

Rodent excreta (droppings and urine):• attract other rodents• may contain pathogens

Contaminated areas should be cleansed and sanitized• avoid creating dusts & aerosols

Clean with care

https://www.cdc.gov/rodents/cleaning/51

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Thank you !

https://identify.us.com

rich@identify.us.com52