Blowing Up the Death Star
In its natural life cycle, Escherichia father, commonly known as Darth Vader, is transmitted from its reservoir, pack rats, to its vector,Triatoma recurva, and back again. Humans are an incidental host of Escherichia father, only occuring in humans when they come in contact withTriatoma recurva. In fact human contact with Triatoma recurva is not terribly common on a day to day basis and is generally confined to the hours before dawn and after dusk. Most often contact occurs in nature, and Triatoma recurva does not often invade homes, although they are known to live in dog houses or chicken coops.
As an incidental host, the human body is destroyed as Darth Vader causes a deep tissue infection, triggering Luke Syndrome. The survival rate of an Darth Vader infection is essentially zero. There is no known treatment for Luke Syndrome and there is no known antibacterial used to combat Darth Vader. Essentially once infected, there is nothing a hospital can do to increase your odds of survival other than supportive treatment.
The reservoir, pack rats, live almost anywhere dark; including forests; under thick vegetation; in cellars; and under houses. They do not generally come out during the day unless their nests have been disturbed and thus do not often come in contact with humans. It is not known if the disease can be directly transmitted from the pack rat to the human, and although that is yet to be examined, it is the general case for the vector, Triatoma recurva, to be necessary in the transmission of Darth Vader to humans.
After consideration of the interactions of Darth Vader with its vector, its reservoir, and humans and the interactions of these groups with one another, it was decided that the link between Triatoma recurva (vector) and humans (incidental host) would be the best starting point in the interruption of Darth Vader's infection of humans. This was primarily decided due to the fact that no medical headway is guaranteed and that the prevention of illness seems to be more justified than attempting to combat the illness from within the body. Essentially it was reasoned that the scope of impact would be lessoned if prevention was focused on initially.
Because there was little interaction between the reservoir and humans, and there is no evidence to suggest that the reservoir can directly infect humans. However, precautions should also be taken against the reservoir (pack rats) since they particularly favor human environments for potential feeding habitats. In order to control of pack rats in the community, exclusion and trapping are environmentally safe control methods for pack rats. Exclusion method: Cracks and openings in building foundations, and any openings for water pipes, electric wires, sewer pipes, drain spouts, and vents must be sealed. Also check for openings in attic vents, broken roof shingles, or other gaps next to the eaves. No hole larger than 1/2 inch (1.3 cm) should be left unsealed. Make sure doors, windows, and screens fit tightly. If gnawing is a problem, edges can be covered with sheet metal. Coarse steel wool, wire screen, and lightweight sheet metal are excellent materials for plugging gaps and holes. Plastic sheeting, wood, or other less sturdy materials will likely be gnawed away. When rodent-proof-ing, be sure the woodrat is not trapped inside the building. One way to accomplish this is to install a temporary gravity door made of sheet metal or rigid mesh wire, hinged at the top, over entrance holes. The woodrats can push it open to exit but cannot reenter. Trapping methods: pack rats show little fear of new objects in their environment and are easily trapped. The standard rat snap trap is quite effective for woodrats. Trap bait should be wedged into or tied to the treadle. Good baits include nut meats, bacon rind, peanut butter and oatmeal, prunes, raisins and other dried fruit, and biscuits. Cage traps, using the same baits as above, can be used for woodrats. Release of trapped animals is not recommended and may be against local fish and game regulations. Also, many studies have shown that animals released into new areas often die from exposure, predation, or competition with resident animals. Glue boards are also effective for trapping packrats. These work on the same principle as flypaper; when a rat attempts to cross a glue board, it gets stuck. Glue boards tend to lose their effectiveness in dusty areas, and temperature extremes may affect the tackiness of the adhesive. In many cases, packrats trapped on glue boards will not die immediately. If they don’t, they can be euthanized by placing the board in a plastic bag and adding carbon dioxide gas.
To further integrate our plan into all aspects of the pathogen life cycle, there will be a focal point on reservoir control. The primary focus on the reservoir control is to significantly decrease packrat- human interaction. Packrats are nocturnal, living in holes, cacti, basements, dog houses, chicken pens and cellars. To prevent their habitation in these places, seal off the outside of houses, filling in any crevices or cracks in the foundation with cock. This will prevent rat access into the house. Cleaning of trash and litter is also imperative. The rats are attracted to the food left by people and forage through their trash. Without the trash, the rats will have little draw to civilization.
The link between vector and human is the main target of initial treatment. This plan involved a survey, testing of related Triatoma spp. for potential vector capabilities, pesticide use in localized and known Triatoma recurva habitats, public awareness, and education campaigns. Hopefully this plan will reduce human-Triatoma recurva interactions, thus reducing the number of people infected by Darth Vader, ultimately reducing the quantity of human deaths and the number of people impacted by the disease.
The first step in our initial efforts to combat Darth Vader was to survey El Paso, Texas, Deming, New Mexico, Hatch, New Mexico, the Ciabola National Forest, Hobbies Mountain Ranch, and the surrounding areas. An emphasis was be placed on areas near rocks, heavy vegetation near hiking trails, and local chicken coops. Carbon Dioxide and Malaise traps were placed in craggy and wooded areas, and the homes of victims were investigated around and near the above places (Creekmore 2013). These traps were chosen specifically because they appeal to Triatoma recurva by use of attractants such as carbon dioxide and heat. These attract more than our desired vector, but it increases their affinity for the trap. Surveys would provide localized knowledge of where the vectors are present and are coming in contact with the victims. It will also reduce costs that would stem from spraying randomly. A collection will be made of the specimens found, and the locations of Triatoma spp. will be noted for spraying.
WhenTriatoma recurva is found, the location will be sprayed with pyrethroid spray, specifically allethrin and permethrin. These insecticides have low toxicity in mammals and birds, are fast-acting, and are known to be effective as an insecticide in small quantities (2014). It also binds very well to organic matter and soil, so that it won't easily wear away with time (2014). The plan called for an aerial spray of known areas of pack rat habitats (in prairies and those indicated by the surveys) and the less broad and more direct spraying on foot of houses and running trials that are near places indicated to harbor the vector. These places included Ciabola National Forest, Hobbies Mountain Ranch, and rocky areas. The direct spraying of the insecticide in water was not permitted, for pyrethroid, especially allethrin and permethrin, are known to cause adverse affects in fish. This however is not a set back because true bugs do not have a primarily aquatic life stage. Furthermore, kissing bugs have an incomplete life cycle meaning they do not pupate. This was fantastic for our purposes because most often this is the phase that insects are most resiliant. It is also important to note that all nymphal stages of Tritoma recurva blood feed, which means that they could vector Darth Vader anytime after their first nymphal stage. If another specimen of Tritoma was recovered, it was tested for Darth Vader through pyrosequencing of bacteria found in its gut as a means to confirm that there is not another vector available to Darth Vader. If another vector is found, it was to be investigated in the same way as Tritoma recurva. (It should be noted that after several applications of pyrethroid spray, a different insecticide, such as a synergist like MGK- 264 or piperonyl butoxide, was intended for use as a method of preventing vector resiliance. Initially though, pyrethroid spray should be efficient (2013).)
The initial plan also called for educational propaganda to promote public awareness. This would include cooperation from news stations, papers, and radio. The information provided would inform the public on what Tritoma recurva is, what it looks like, and what its bite looks like. Furthermore it will encourage people not to go on early morning or late night hikes or other ventures into or around the forest. It would then incite the public to seek immediate medical attention if they have a kissing bug bite and exhibit any of these symptom. It encouraged people to make sure that all cracks and openings which bugs can utilize to get into the home are sealed as completely as possible, to use weather stripping, caulk, or silicone seal, to make sure that all windows and vents should be properly screened, and that dog and cat entrances insect proofed. Any unused fireplace flues were encouraged to be kept shut, and lights should be moved away from door or windows where they may attract insects, especially during early and late hours. An outside perimeter treatment using a broad spectrum insecticide was encouraged. In addition, an interior crack and cervice application of insecticide was suggested to be made in bedrooms and bathrooms. These measures were designed based on the fact that Triatoma recurva is a nocturnal insect of which take part in large dispersal flights during the first hour of dark. It is during these dispersal flights that the vector looks for any visual cues to hone in to their next potential habitat or feeding opportunities. Among these are visible lights in or outside our homes. They can make their way into your home through any crevices or openings in your home. Part of the control plan, tackling the vector, are some simple but effective, home improvements to keep T. recurva outside your home during dispersal flights or any single one that may be straying from their habitat looking for a blood meal. In a study done by Maria Carlota Monroy, she found that covering up any openings with cement plastering and using lime-colored paint on your home caused a 92% reduction in the Reduviidae population the following year. Although this may not be entirely true for T. recurva we will conduct extensive testing with different colors and also using cement plastering methods to attempt to replicate these results or at least obtain reasonable success for T. recurva specifically. This would be an excellent strategy to implement into our control which could be promising to minimize the population at risk at least in the confines of their own home during the hours of the dark.
The rationale behind this measurement, is that although there is only one known survivor of Darth Vader, no one has been admitted to the hospital during the earlier stages of Luke Syndrome. There is not a known cure, and supportive treatment is the best hospitals have been able to provide. It is possible that early detection may change this, but this is inconclusive. It is also aimed to reduce Triatoma recurva- human interaction, thus reducing the number of incidences of Darth Vader in humans. In summation, the expected outcome of this plan was to reduce the Triatoma recurva population, inform and educate the public, and reduce the human-vector interaction. In accomplishing this, the incidence for potential infection of Darth Vadar would decrease. Although this method may not be the most desirable because of the use pesticides, precautions were implemented to ensure that they were not used excessively or in a manner harmful to humans (or mammals in general).
Although there was a 51% drop in the amount of Triatoma recurva found in the traps, indicating a decrease in the overall vector population due to our efforts, the public was not impressed. There were allegations of pesticide poisoning, and all around protest to our decision to neglect the public opinion. A petition was signed to end the use of pesticides. Also there were concerns expressed for the state of tourism in the community. The projected income loss from the projected decrease in tourism was quite significant.
To address these complaints, another plan was developed. This new plan focuses on home control, for the kissing bug is generally a rural insect. Home control is probably the best place to combat exposure. It encourages installations of free-range guinea fowl, a natural predator of the Triatoma recurva, around the home (2014). Also regular vacuuming and steam cleaning, as well as the light application of a non-volatile desiccating dust with talcum powder, boric acid or food-grade diatomaceous earth in nest areas or areas of repeat infection to kill bugs that may hatch out later (2012). Light spraying, in three week intervals, of pyrethrins around camping grounds and trails will continue, although sparingly. As before the education campaign will continue, focusing on early detection of the disease and symptoms, avoidance of the vector, and preventative measures to avoid contact with the vector. This plan would be presented as an alternative to the first plan, and a vote would be rushed at a community meeting. The plan chosen will be the plan implemented, and its implementation will take place at the beginnning of the new year. Until then the original plan will remain in place. Regardless it will be stressed that something must be done. With a 100% mortality rate, it is necessary to take measures, even if those measures result in a less than ideal situation. Essentially, the people will be informed of the statistics and hopefully they see that the alleged pesticide poisoning is nothing compared to death.
To address the tourism issue and the subsequent loss of income, it is being made public that the CDC employees in the town are buying from and residing at locally run entities. We also brought in an economist to help the community diversify its economy base and marketing personnel to develop better strategies in appealing to tourist. One idea was to publicize the significant decrease in vector presence in the community and surrounding area. Another was to appeal to the curiosity in humanity and exploit the outbreak as a sort of interesting quirk to the community. It should be stressed that the situation is under control and that the rate of incidence has dropped. Also a facebook page with a donation page to help the town's economy may be made.
The expected outcome on this plan is focused primarily on limiting the human-vector interaction. Triatoma recurva is rurally found and are not often associated with human homes. If their household presence is prevented, then the human-vector interaction should decrease. Through the educational methods people should be informed of what a Triatoma recurva bite looks like and the early symptoms of Luke Syndrome. They will also know the preventative techniques to avoid contact when in nature. Beyond this light pesticide use will be implemented-applied once every three weeks to trails and campgrounds). This is targeted and should reduce the human-vector interaction in the wilderness, as well as decrease the Triatoma recurva population (by a small quantity, but a quantity nonetheless).
Public opinion should improve as well as the community’s economy.
In order to combat Escherichia father at the molecular level, several different courses of action are currently taking place. Firstly, we must insure that the local hospitals and CDC are able to detect the presence of this disease at the earliest possible moment. This will be accomplished through several public service announcements and debriefings about the current virility and pathogenicity at a given time with local health officials and community leaders. Secondly, with the partnership of the Bill and Malinda Gates Foundation and many other donors, we have begun work on antibiotic derivatives of penicillin G, aminoglycoside, and clindamycin all of which show promising results when used in tandem of treating the onset of E. father before luke syndrome begins to take ahold of the given patient. While the original parent compounds of the aforementioned antibiotics have had positive results, through the use of protein sequencing and recombinant DNA therapy, we can accurately manufacture an individualized drug for our novel strain of Escherichia. For those patients who have moved beyond the first stages of the disease and have begun to have necrotizing dermal tissues, treatment with the monitored use of a hyperbaric chamber has also shown positive results. Due to the anaerobic nature of this bacteria, hyperbaric oxygen treatment inhibits anaerobic and some other bacteria from replicating, spreading, and releasing damaging toxins. By limiting the release of these toxic cells, local hospitals have shown increased results concerning the effectiveness of the current antibiotic treatment being administered. Unfortunately, before more effective derivatives of the needed antibiotics reach the effected towns the most common form of treatment once luke syndrome has onset is surgical intervention of the infected site. While this treatment is both costly and very traumatic on the patient, it is currently the most effective treatment to insure the infected area is removed and has had the best survival rate amongst infected individuals.
In regards to the success of the above mentioned treatment plans our team has partnered with a local PR corporation familiar with the local community to help launch a campaign and bring a positive light to the previous discord between the community and health officials. Our campaign is centered on the foundation that the local population’s best interests are in mind. Based on previous history with the local community, the local health officials have been briefed on the most effective methods in determining an individual who may have been exposed to a large amount of insecticide. Local health officials have also been informed that as patients’ cycle into the hospital; they will be provided with the most updated versions of antibiotics on a 2-4 week cycle. The CDC has also been briefed on the necessity to retrieve tissue samples from all positive testing individuals throughout their treatment plan as to monitor the effect of our antibiotic derivatives and the possibility that a bacterial resistant response may occur. In the event that a possible resistant strain is becoming present in the community, the above derivative process will immediately begin again. While full control of the disease by the health officials and the CDC will take several months to effectively implement, we expect to see a dramatic increase in the survival of individuals following the first antibiotic derivatives being delivered and used in treatment in tandem with other known Escherichia combatants.
Outline of Strategy:
(1) Currently Instated Program (as of December 2014)
(a) Surveillance Protocol
- Trap Type: Carbon Dioxide Trap (Creekmore 2013).
Materials needed:
~1 cup of water
~1/4 cup of brown sugar
~1 gram of yeast
~1 2-liter bottle
Implementation:
1) Cut the plastic bottle in half.
2) Mix brown sugar with hot water. Let cool. When cold, pour in the bottom half of the bottle.
3) Add the yeast. No need to mix. It creates carbon dioxide, which attracts kissing bugs.
4) Place the funnel part, upside down, into the other half of the bottle, taping them together if desired.
- Trap Type: Malaise Trap (2014).
Materials needed:
~jar
~Solid or evaporating Killing agent
~Net sheet enough to build 3 walls on your trap (for our purposes black mesh)
~ 6 Wooden poles (Five should be 4 ft. and the sixth 5 ft.)
~ A canopy (white)
~ Some rope for extra structural support
~Attractant (heat and carbon dioxide)
a) Carbon dioxide either from sugar and yeast or dry ice
b) heat- thermal blanket to insulate jar
Implementation:
1) locations will be picked based upon victim localization and around known Triatoma recurva habitats
(discussed above)
2) Begin by placing the wooden poles (4 ft. long) in the ground 4 ft. apart for the front and back wall of the trap. The distance of the side walls will be 6 ft. In the center designated back wall the last 4 foot wooden pole will be place, on the opposing side (front wall) we will place the longest wooden pole for the sloping canopy.
3) Use the mesh sheet to make our designated front and back walls, and a wall that runs through the center all the way up to where the collecting jar will be. We will attach the canopy the wooden poles with the sloping end leading up to the tallest pole. As the insects fly up they will funnel their way up into the attached kill/collecting jar at the end of the canopy.
4)To make this trap more efficient in collecting Triatoma recurva, we will an attractant consisting of Carbon Dioxide, which our suspected vector is highly attracted to, so it will make it's way up to the attractant and into the collecting jar for us to test for the agent.
5)A battery operated thermal blanket will wrap around the jar as a means to apply heat. This is also an attractant to Triatoma recurva.
(b)-Spraying Protocal:
- Materials:
~pyrethroid spray (allethrin and permethrin- approved to be the safest for humans (2014).)
~air sprayer/ air plane
~hand sprayer/ pump
~ man power and protective gear
*** Precaution will be set to make sure that the spray is not directly applied to water, for it may cause some adverse effects in fish (2014).
- Methods:
~pyrethroid spray will be sprayed over large areas indicated to harbor Darth Vadar via aerial means; this would include areas of known pack rat habitation and forest edges
~professional fumigators will be called upon to spray basements and cellars of indicated areas as well as dog houses and chicken coops
a) fill sprayer with pyrethroid spray
b) direct sprayer at Triatoma recurva infested area
c) apply spray
- Locations:
~those indicated by the surveillance results
~Ciabola National Forest
~Hobbies Mountain Ranch
~ outside of houses in high risk areas (next to woods/cliffs ect)
*** It should be noted that after several applications of pyrethroid spray, a different insecticide, such as a synergist like MGK- 264 or piperonyl butoxide, would be used as a method of preventing vector resiliance. Initially though, pyrethroid spray should be efficient (2013).
(c)- Surveillance of Potential Vectors: Testing Protocol
Samples of bacteria found in Triatoma spp. will be sent to a lab for pyrosquencing.
A battery operated thermal blanket will wrap around the jar as a means to apply heat. This is also an attractant to Triatoma recurva.
(d) Educational Program
-new realeases
-propagation posters
-pamphlets
-vector exposure preventatives
(1b) Proposed Alternative Plan (plan to be instated January 2015 if voted on, if not above plan will be continued)
(a) Domestic Control (1-2/15)
-free range guinea fowl
-non-volatile desicatting dust and Talcum powder/boric acid treatment
(b) Outdoor Control (1/15)
-light pyrethroid spraying around trails and camping grounds
-encouragement not to go out at dawn or dusk and if one must, to be aware of surroundings and utilize a topical pesticide
(c) Public
- town meeting/vote (mid- December 2014)
- CDC employee encouragement to buy locally
- education continued- headed by a publicist/marketer (late 12/14)
-economist hired to help with financial issue/ fb donation page (1/14)
(2) Reservoir Plan (begin December 2014)
-clean up litter around houses
-cock cracks and crevices in foundation
-clear of brush around paths and houses
-Consistent reapplication of the above listed processes ( maintained monthly)
(3) Pathogen Plan (begin December 2014)
(a) Define suspectible- look at more cases and study interaction with cellular biology (beginning in January 2015)
(b) Vaccine - will be distribution ready probably 4 or 5 years after development
- pyrosequence (January 2015)
- research into E. father antibody--- are there any (hopefuly by 6 months (June 2015)- but maybe longer depending on progess)
- trials
-focus on suspetible host- not mandatory but suggested
a.respiratory ailment/ weakness?
b. arthritisis/ joint pain?
c. alcohol abuse associated?
d. not age specific
(c) Treatment
- early detection and empiric application of supportive antibiotics
- penicillin G and an aminoglycoside (January 2015)
-clindamycin
-hydrobaric chamber (January 2015)
-antibiotics research based on the above listed antibiotics, which are typical of treating Necotizing Fasciitis, a similar syndrome to Luke Syndrome (depends on research timing, but hopefully before 6 months there will be a breakthrough)
References
Creekmore, M. D. 2013. A Homemade Mosquito Trap that Really Works. (http://www.thesurvivalistblog.net/homemade-mosquito-trap/)
Edlich, R. F. 2014. Necrotizing Fasciitis Treatment & Management. (http://emedicine.medscape.com/article/2051157-treatment)
Inglis-Arkell, E. 2011. How to Use a Hyperbaric Chamber to Treat Flesh Eating Bacteria. (http://io9.com/5792905/how-to-use-a-hyperbaric-chamber-to-treat-flesh-eating-bacteria)
Mississippi Entomological Museum. 2014. Malaise Trap (http://mississippientomologicalmuseum.org.msstate.edu/collecting.preparation.methods/Malaise.traps.html)
(TAMUAE) Texas A&M AgriLife Extension. 2014. Insects in the City. TAMUAE, College Station, TX.
(USDA) U.S. Department of Agriculture. 1986. Collecting and Preserving Insects and Mites. USDA, Washington D.C.
(USEPA) U.S. Environmental Protection Agency. 2013. Pyrethroids and Pyrethrins. USEPA, Washington, D.C.
Van der Berg, H., and W. Takken. 2009. Evaluation of Integrated Vector Management. Cell. 25: 71-75.
