August 4, 2006

Dear Emergency Department Director:

The purpose of this letter is to ask for your assistance in an important public health surveillance effort related to planned aerial spraying of a pesticide in your area. This aerial application is being conducted to reduce the high level of human risk from eastern equine encephalitis (EEE) virus infection from mosquito bites. As you may be aware, the Massachusetts Department of Public Health (MDPH) has determined that a high risk of eastern equine encephalitis in humans presently exists in certain areas of the Commonwealth (i.e., southeastern Massachusetts). As a result, the Commonwealth has determined that aerial spraying should be conducted in southeastern Massachusetts (see attached map of area) to reduce the risk of human disease. It is expected that this aerial spraying will occur during the week of August 7, 2006. We are providing this letter and attachments to all hospitals, however, in the event that other areas of the state could become at higher risk as the summer season continues.

As part of the MDPH planning process for possible aerial spraying during the summer 2006 season, the MDPH Center for Environmental Health developed a protocol (attached) for monitoring possible pesticide-related illnesses that may result from the aerial spraying. The pesticide being used is called Anvil. We have attached a question and answer fact sheet on Anvil for your information. The active ingredient is sumithrin, a synthetic form of the pesticide that occurs naturally in chrysanthemums. The application will be done at night and exposures/health effects are not expected. However, to monitor whether any pesticide-related illnesses may be reported, we are asking that emergency departments at hospitals in high-risk areas as well as the Poison Control Center assist MDPH by completing a short, one-page abstract form on any cases that appear to be related to the aerial spraying event. As noted in the protocol, symptoms that may be reported if there have been unanticipated exposures include dizziness, headache, nausea, twitching, reduced energy, or changes in awareness.

As stated, we have enclosed a copy of the pesticide illness surveillance protocol (including the one-page abstract form) and a copy of a question and answer fact sheet on the use of Anvil in aerial spraying to reduce the risk of EEE for your information. If aerial spraying is to occur in your area, a Homeland and Health Alert Network (HHAN) message will be sent to all the emergency departments in the areas scheduled for spraying, as well as to the Poison Control Center. We would appreciate your assistance in completing the abstract forms on any suspected cases of pesticide-related illnesses and faxing completed forms to the Center for Environmental Health at 617-624-5777, care of Emily Backman, Environmental Analyst. If you have any questions, please feel free to contact either Ms. Backman or me at 617-624-5757. The Department has also established a toll free hotline (866-627-7968) for general information regarding EEE and related issues.

We thank you in advance for your assistance.

Sincerely,
Suzanne K. Condon, Associate Commissioner
Center for Environmental Health


This information is provided by the Environmental Toxicology Program within the Department of Public Health.