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June 24, 2003 Agenda ORDERS OF THE DA Y FOR TUESDA \': JUNE 24. 2003 - 9:00 A.M. PAGE# ORDER 1 st Meeting Called to Order 2nd Adoption of Minutes - meeting of June 10, 2003 3rd Disclosure of Pecuniary Interest and the General Nature Thereof 4th Presenting Petitions, Presentations and Delegations PRESENTATIONS: 1 9:00 a.m. Employee Recognition (ATTACHED) DELEGATION: 9:15 a.m. Earl Moore, Noble Tufford and Ian Raven, Elgin Military Museum, and Mary Clutterbuck and Georgia Sitton, Elgin County Pioneer Museum - concerns regarding Elgin County Pioneer Museum 9:45 a.m. Donna Lunn, "Elgin Connects" Update and Broadband Update (see Correspondence for Consideration Item #1) Motion to Move Into^"Committee Of The Whole Council" Reports of Council, Outside Boards and Staff Council Correspondence - see attached 1) Items for Consideration 2) Items for Information (Consent Agenda) OTHER BUSINESS 1) Statements/Inquiries by Members 2) Notice of Motion 3) Matters of Urgency 9th In-Camera Items (see separate agenda) 1 Oth Recess 11th Motion to Rise and Report 12th Motion to Adopt Recommendations from the Committee Of The Whole 13th Consideration of By-Laws 14th ADJOURNMENT 5th 2-10 6th 7th 11-13 14-41 8th - -~---_..._----_..._- LUNCH WILL BE PROVIDED EMPLOYEE SERVICE RECOGNITION/RETIREMENT PRESENTATION - JUNE 24.2003 RETIREMENT RECOGNITION Joanne Bolt Georgina Ousterhout YEARS OF SERVICE HOMES Sylvia Underhill ShannelTaggart Julie Acre Jacoba Pennings Barbara Pressey Julie Taylor Robin Fleming Jill Hindley Tammy Jackson Lois Ashton-Diniz Jeff Casey Linda Pinkerton LIBRARY SERVICE / Katherine Comeil Janice Nicholson Cheryl Campbell Lorelei Gloor 17 years (full-time) 17 years (part-time) 20 years (full-time) 20 years (part-time) 15 years (full-time) 15 years (full-time) 15 years (full-time) 15 years (full-time) 15 years (part-time) 15 years (part-time) 15 years (part-time) 10 years (full-time) 10 years (full-time) 10 years (part-time) 20 years (part-time) 20 years (part-time) 15 years (part-time) 10 years (part-time) INFORMATION TECHNOLOGY Suzanne Edwards 15 years (full-time) ADMINISTRATIVE SERVICES Mark McDonald 10 years (full-time) Elgin Manor Terrace Lodge Terrace Lodge Elgin Manor Terrace Lodge Bobier Villa Elgin Manor Terrace Lodge Elgin Manor Elgin Manor Terrace Lodge Terrace Lodge Elgin Manor Terrace Lodge DuttonlDunwich Library Port Stanley Library Aylmer Library Port Stanley and Shedden Library 1 The Elgin Military Museum Presentation to the Council of the Corporation Of the County of Elgin Regarding the Elgin County Pioneer Museum Over the past twenty-one years, both Museums have worked together for the benefit of the community. In the mid 1990's, our Board recommended the adoption of a joint admission fee, to address the public perception that there was one Museum, with a Military section and a Pioneer section. The success of this joint admission led to the adoption of a single entrance, again resolving the confusion caused to the public, due to their view of both operations as one Museum. A joint committee was formed to assist in the coordination of operations between the two Museums. This committee reports to both Executives, and deals with issues of admission fees, and ensures each Museum is aware of the others activities, such as avoiding both Museums scheduling major events on the same day. During the unfortunate incident of the fire at the Elgin County Pioneer Museum on Sunday, April 29, 2001, our Museum immediately called in its staff to assist in the rescue of the Pioneer Museum artifacts. Our Curator, a trained conservator, took the lead role in advising the St. Thomas Fire Department on the best practices to minimize damage ,to your collection, and, most, if not all of the artifacts removed from the fire area were brought into our Museum for temporary safekeeping. In fact, our Curator was later retained by your Insurance adjusters to advise on the best methods and techniques to clean and restore the items in your collection. The Elgin Military Museum believes that it is clear, through our words and deeds, that we have always worked to the benefit of both operations in identifying, developing and implementing the most cost effective and efficient methods and techniques. In this view, we had approached the Executive Committee of the Pioneer Museum last summer with a document we had titled "The Future of History". This presentation outlined the results of a study we had undertaken looking for methods to improve efficiencies and/or reduce costs for both operations. For example, were you aware that the two operations, sharing the one site as they were at the time of the study, had 2 large photocopiers, 2 fax machines, 5 telephone lines, and 7 computers for the use of 1 full time and 1 part time staff member at each location. It appeared that there must ,be some savings to be found. The presentation was made to the Pioneer Museum Executive in this very Council Chamber on Monday, September 16, 2002. The Pioneer Museum Executive Committee, quite understandably, asked for some time to study our presentation. The reply we received from the Pioneer Museum was brief, and stated their preference to leave the situation unchanged. A further request regarding the plans for the Museum xenovations received a similarly brief reply informing our Museum that the plans were 'on hold, as the County of Elgin has not reached a decision on the future of the Museum'. Our board then decided that we should speak directly with the Council regarding the Pioneer Museum, which brings us to this meeting today. Museums are not a business in the traditional sense, but they do need to be businesslike if they are to succeed. Unlike the Pioneer Museum, the Elgin Military Museum receives no municipal funding, and is dependant on our own fundraising efforts for our success. The only regular funding received by the Museum is the Provincial Community ~"""-~- Museum Operating Grant, which has declined substantially in recent years, and in 2002 amounted to only about 12% of our operating costs. Yet, despite this burden of having to raise close of 90% of our budget each and every year, the Elgin Military Museum has been able to amass considerable reserves (sufficient to operate the Museum for up to two years with no outside funding), and in 1998, opened ai, 1 00 square foot addition at a cost of $150,000, fully paid for on the day it opened to the public. In actual fact, very few Museums receive municipal funding in Elgin County, and certainly none at the level provided to the Pioneer Museum. Of the four largest Museums in the County, only the Pioneer Museum receives substantial municipal funding. The Aylmer and District Museum only receives limited funding from Aylmer and Malahide, while neither the Elgin County Railway Museum or the Elgin Military Museum, both very successful operations, receive any municipal funding. We do not appear here before you 'cap in hand' hoping to receive some level of funding from the County's taxpayers. , Instead, we appear here as a successful Museum operator ready to offer you our assistance and expertise in the operation of your Museum. We believe we may have the 'Tylenol' for your Museum 'headache'. Would it surprise you to learn that we believe that we could operate the Elgin County Pioneer Museum for less than you are currently paying now? Offering the same programs, "same exhibit schedule, same collection conditions, as well .:as increasing the hours the Museum is open to the public. 'Our research has identified a number of areas where we believe costs can be reduced, efficiencies increased and new revenues generated. How would this be achieved? By contracting out the operation of the Elgin County Pioneer Museum to the Elgin Military Museum, a number of direct costs could be reduced or eliminated. Through a single operations staff, further efficiencies and savings can be achieved, as staff can be given the time and resources to be more specialized, rather than a 'jacks of all trades'. Exhibit ~i"",....=--, .,-""'.·.._,_,ò..·,'"""'-c_...;.._.:..~-'---'----'-_~ schedules, advertising and marketing can all be focused to produce the maximum impact and return. Over a five-year period, we project that we can reducè costs and increase revenues sufficiently to reduce the County's direct input to support the Pioneer Museum operation by up to 30%. How would this benefit the Elgin Military Museum? We would gain from the same savings and efficiencies as the Pioneer Museum. As well, the Military Museum would receive a management fee for our services to the County - remember, we are businesslike, and there is no such thing as a free lunch! If there were no benefit to the Military Museum, we would not be here today. What would make the County believe that we can produce the results we claim? The biggest single proof we can offer you is our 21 years of successful operation - with no municipal funding. We have been very careful over the years to plan our progress. Our 1998 addition was designed to meet the needs of our Museum for the foreseeable future, and included a number of improvements to meet upcoming changes in the Standards for Community Museums. For ,example, all exhibit areas are now fully accessible to visitors, and the full building now has HEPA air filtration, a Ministry recommendation for new construction starting, we believe, in 2005. In fact, our main exhibit room is cited by the Ministry museum advisor, Dr. John Carter, for those Museums considering renovations and additions. Our Board has viewed, with growing concern, the operation of the Elgin County Pioneer Museum and the current plans for renovation, relocation, or something - nO,body really seems to know. We are concerned as neighbours, as your partner in the Talbot Street location, and as taxpayers in the County of Elgin, as many of us are. Throughout the history of the Elgin County Pioneer Museum, one singular aspect has been touted above all others - the location of the Museum "housed in the 1848 historic home of early physician Dr. Elijah E. Duncombe. . .", and has been featured prominently on your letterhead, envelopes and advertising for many years. An Ontario Historical Society plaque marks the location and notes that Duncombe also co- founded the provinces first medical school, also here in St. Thomas. The 32 Talbot Street location of the Pioneer Museum is much more than just a place to store the artifacts of your collection, the home is itself an artifact, the largest in your collection. Only a few years ago, significant effort was made to locate and import proper period wallpapers to redecorate and refurbish the interior of the home, and to ensure that the colours used were correct for the age of the home. Early plans of the home were proudly displayed in the front hallway. These actions are hardly required if the location is simply a receptacle to house and exhibit your collection. Indeed, reference to your recent, now apparently rejected, plans to renovate the location required the successful bidder to ensure "all existing construction, finishes, fixtures, etc. within original residence to remain undisturbed. Contractor to provide an air tight seal between construction area and original residence". Yet, it seems from the information available to the public, the preference seems to be new construction at another location. This is another point of great interest to us. What will happen to the current museum building should you decide to relocate? Please do not forget that your decisions will have a very real impact on us, whether you stay or go. When the Pioneer Museum moved out in September, 2002, and we first saw your original renovation plans, the Elgin Military Museum, as a good neighbour, relocated our hydro service at a cost of close to $2,000. This work was done to save you money, as we realized the cost of the contractor installing a temporary service for our Museum, and later removing it, would have far exceeded our costs to move the service permanently. :Returning to any decision you may make to relocate the Pioneer Museum to another location, it is our belief that any such decision should be delayed until all of the aspects, impacts and needs have been fully studied. If, as is our contention, the house itself constitutes an artifact worthy of preservation, then this factor must also be considered. Certainly exhibit and other public access areas could be moved to accessible areas of the site, and offices, storage and other areas moved into the less accessible areas, for this is what we ourselves have done. The inaccessible aspects of the home may well be considered worthy of preservation for future generations to graphically illustrate how accessibility concerns have changed things today. -~.~-~...- The City of St. Thomas has identified the area of the Museum as one of their Community Improvement areas. The Elgin Military Museum has b.een an active partner in the process relating to this area. The Museum has also been an active partner with the group seeking to develop a 'Jumbo parkette'. Both of these initiatives offer great potential to develop more visitors, programs and, ultimately, more revenue. These programs may also provide the possibility of funding of upgrades, etc. through grants, loans or subsidies. Have these been fully explored by the County? Ladies and Gentlemen, you have admitted in the press that you have a problem with your Museum. We offer our assistance and expertise to correct the problems and provide the community with the first class operation it deserves. We hope that you are interested. -:;----- EIAin County Pioneer Museum 32 Talbot Street, St. Thomas, Ontario N5P 1 A3, (519) 631-6537 June 24, 2003 The Warden and Council, Corporation of the County of Elgin 450 Sunset Dr. St. Thomas, Ontario N5R 5V1 Warden Wilson and Members of Council; I have prepared a chronology of communication with the Elgin Military Museum. Chronology of Communication · June 29, 2002- Letter informing the EMM of upcoming construction. · August 2, 2002- Letter informing the EMM that we will provide signage during construction, so their guests know they are still open. · October 4, 2002- Letter informing the EMM that our construction project is on hold, waiting for a working group to examine for barrier free access, as required in the Disabilities Act. · February 21, 2003- Letter to EMM informing them that we have decided to go with OPTION 1, of their "Method of Understanding Proposal" presented in September 2002. This issue was not addressed earlier as it wasn't feasible then and still isn't now, as we are at 449 Talbot St. · April 17, 2003- Letter to the EMM informing them that our plans are on hold while the County explores other options, such as a Cultural Centre. · May 21, 2003- Letter to the EMM informing them that we would be staying at 449 Talbot St. until August 31,2003. El~in County Pioneer Museum 32 Talbot Street, St. Thomas, Ontario N5P 1A3, (519) 631-6537 Chronology of Elgin Military Museum's attempts to communicate with us, should the above correspondence not have been sufficient. · Letter sent in January 2003, asking of our decision regarding the Method of Understanding, replied to in February 2003, after an Executive Committee decision. . · Attempts to discuss issues with our Executive Committee, none. . Phone calls, none. · Joint Committee Meetings requested, none. · Visits to the Museum to discuss issues, none. I have been on staff at the Elgin County Pioneer Museum since November, 2000. The above information should address any concerns regarding our "lack" of communication with the Elgin Military Museum. I would like to remind County Council that you have a standing invitation to drop by the Museum to tour our temporary location at 449 Talbot St., and see what we do. Our hours are 9-5, Tuesday to Saturday. Tomorrow Wednesday June 24th is our Strawberry Social, 1 :30 -4:00pm. ~\4 Georgia Sitton Acting Manager 99 Edward Street, St. Thomas, ON N5P 1Y8 (519) 631-9900, ex!. 202 - telephone (519) 633-0468 -fax Elgin-St. Thomas Health Unit Memo To: Council Members, County of Elgin Cynthia St. John, Chief Administrative Officer, Elgin St. Thomas Health Unit June 24, 2003 West Nile Virus From: Date: Re: Based on the announcement by the Ministry of Health and Long Term Care last month and subsequent meetings with them, the Health Unit has learned that control measures related to west nile virus will be cost shared between the Ministry of Health and Long Term Care and Municipalities on a 50/50 cost shared basis. The Ministry has asked us to submit revised west nile virus budgets based on the new regulation (199/03) received using information obtained from Municipalities. Municipalities are asked to develop a west nile virus budget that includes control measures such as larviciding and adulticiding. Once the budget is complete, please forward the budget to the Health Unit to then submit to the Ministry for approval. It should be noted that the Ministry of Health will pay 100% of the chemical cost of larviciding or adulticiding but the application portion is cost shared. Please use the two pages attached to determine your budgets. These pages come from the Ministry of Health and Long Term Care West Nile Virus Operational Plan. You will want to include all costs associated with larviciding and adulticiding. You may never get to the stage that requires this control measure (as outlined in the regulation) but this planning is necessary in case you do. Completed budgets must be sent no later than July 4, 2003. Please send them to the attention of: Cynthia St. John Chief Administrative Officer Elgin St. Thomas Health Unit 99 Edward Street St. Thomas, ON N5P 1Y8 519-631-9900, ext. 202 - telephone 519-633-0468 - fax cstiohn(â)elqinhealth.on.ca - email 1 Objectives of the WHv Vector Control Plan · to cover a certain geographic area or type of infrastructure (e.g., catch basins) · to reduce mosquito populations (adult or larval) by a certain percentage in the treated area(s) · to prevent or reduce the number of human WNv cases in treated areas (before vs. after, or compared to non-treated areas) · to be used only when public education efforts have proved inadequate · to follow "integrated pest management" (IPM) principles or practices · to minimize unintended adverse effects on human health and non-target organisms. Planned Advance Preparatory Work for Vector Control Examples · Mapping of known or potential mosquito breeding sites · Larval mosquito surveillance (by Health Unit staff or a private sector company) · Adult mosquito surveillance (by Health Unit staff or a private sector company) · Private company is contracted to do the mosquito control (larviciding or adulticiding) · Another municipal or regional agency agrees, or is contracted, to do the mosquito control · . Training of staff in general knowledge of vector control measures · Training of staff in actually applying larvicide or adulticide · Securing a supply of pesticide(s) and the application equipment/vehicles · Acquisition of licenses or pennits (MOE) to apply larvicide or adulticide · Public notification requirements (print or broadcast materials) Costs of the 2003 WHv Vector Control Plan or Program Please use the attached spreadsheet to state the planned (bud£eted) or estimated costs of your WNv vector control plan/program for the 2003 season. The costs are broken down as follows: a) by Category (salaries (positions), benefits, and other costs); b) by Program Activity (costs for planning/training, mapping, otherìpreparatory work, larviciding, adulticiding, and other activities); West Nile Virus - Cost Estimates COST BY CATEGORY Total Cost by Activity Total $ , $ Pest Control Companies 1. Abell Pest Control, Inc. 246 Attwell Drive Etobicoke, Ontario M9W 5B4 Phone: (416) 675-3305 Fax: (416) 675-6727 www.abellqrouP.com 2. Pestalto Environmental Products Inc. 400 Elizabeth Street, Unit 1 Guelph, Ontario N1 E 2Y1 Phone: (519) 837-4470 Fax: (519) 837-4471 www.pestalto.com 3. Garry F. Keating Licensed Mosquito/Biting fly Exterminator St. Thomas Phone: (519) 637-2475 E-mail: keatinqcoco®aol.com June 24, 2003 Permit Applicant Guide: Controlling Mosquito Larvae for Prevention and/or Control of West Nile Virus April 2003 Ontario Ministry of the Environment ® Ontario Table of Contents 1.0 Introduction 2.0 Mosquito Vectors 3.0 Pesticide Regulations 4.0 Municipal WNV Prevention and/or Control Programs 4.1 Surveillance 4.2 Licensing Requirements 4.3 Permit Application Submission A. Catch basins/storm drains B. Ditches and Temporary Pools or Permanent Pools including storm water management ponds C. Sewage and sludge storage lagoons D. Wetlands 4.4 Permit Submission Checklist 5.0 MOE Permit Requirements for Monitoring A. Catch basins/storm drains B. Ditches and Temporary Pools or Permanent Pools including storm water management ponds C. Sewage and sludge storage lagoons D. Wetlands 6.0 MOE Recommendations for Monitoring A. Catch basins/storm drains B. Ditches and Temporary Pools or Permanent Pools including storm water management ponds C. Sewage and sludge storage lagoons D. Wetlands 7.0 Permit Conditions Table 1 Ontario Ministry of Environment Pesticides Control Specialists Appendix 1 - Permit Application Form 7 Appendix 2 - Public Notification of a Water Extermination for the Control of Immature Stages of Mosquitoes (Larviciding Programs for West Nile Virus) Appendix 3 - Larvicides Currently Federally Registered and Classified for Commercial Use in Ontario under permit for WNV Appendix 4 - Guidance for Bti Efficacy Monitoring Appendix 5 - Guidance for Methoprene Efficacy Monitoring Appendix 6 - Sensitive Area Definitions Appendix 7 - Assessing Catch Basins to Determine Application Rate -1- Page No. 2 2 3 4 4 4 5 6 8 9 10 13 15 19 23 25 27 29 31 1.0 Introduction This permit applicant guide outlines the requirements for requesting a permit (See Appendix 1) to purchase and use a pesticide (i.e., larvicide to control mosquito larvae) for the prevention or control of West Nile Virus (WNV). Public notification requirements for WNV larvicide programs are included in this guide (See Appendix 2). NOTE: This guide does not include mosquito larvicide programs intended for nuisance control. Regulation 914 under the Pesticides Act requires: · a person to obtain a permit approved by the Director under the Act, authorizing that person to apply a pesticide to a water body to control a pest (referred to as a water extermination). · a licensed exterminator holding a Mosquito/Biting Flies or Aerial licence to obtain a permit approved by the Director under the Act, authorizing that exterminator to apply a pesticide to a water body. · a person who owns a property, or a full-time employee of the property owner, to obtain a permit approved by the Director under the Act, authorizing that person to purchase a pesticide. (Note: a permit is not required if the water body which the ., person intends to treat is wholly located within the boundaries of his or her property and has no direct or indirect outflow, other than by percolation, beyond his or her property boundary). Completed permit application forms and support documentation must be submitted to the Regional Pesticides Specialist (See Table 1 for office locations) responsible for the county in which the pesticide application will take place. 2.0 MOSQuito Vectors The proper identification of mosquito species is very important in deciding if a larviciding program should be initiated, and for determining the location and timing of the larvicide applications, in order to disrupt the transmission cycle of WNV. WNV is spread from bird to bird by Culex pipiens or C. restuans - mosquito species that feed predominately on birds but will occasionally bite humans and other mammals. In early spring, pre-mated females disperse from overwintering sites in sewers, outbuildings, subterranean enclosures and basements to feed on birds (especially nestlings). Feeding occurs mainly at night when the birds are nesting or roosting high -2- up in the trees. Female C. pipiens or C. restuans lay their eggs in containers, catch basins, grassy roadside ditches, tire ruts, rain barrels, swimming pool covers, stored boats or other containers that hold stagnant water. Several overlapping generations of C. pipiens or restuans may be present from April to early August depending on temperature and rainfall abundance. Female adults that develop in mid to late August do not blood feed before mating and seeking overwintering sites (winter diapause). WNV appears to be lethal to many birds in the family Corvidae (e.g., American crows and jays) and the presence of WNV-positive dead birds is the first sign that WNV is present and spreading through the local bird population (this is known as epizootic amplification). Larviciding programs conducted through early spring to mid summer in catch basins and other stagnant water bodies prevent C. pipiens and C. restuans larvae from developing into adults. This should reduce the number of adult mosquitoes that would otherwise amplify WNV in the bird population. If birds are dying (e.g., entire families of crows in a single roosting site), it is an indication that WNV is well established in the bird population and, at this point, there is an increased risk that human cases may occur. There is a probability that Aedes vexans, an aggressive summer biter of humans, birds and other animals, and other summer mosquito species, could act as "bridge" mosquitoes transmitting WNV from birds to humans. A. vexans breeds predominately in temporary pools created by rainfall (e.g., roadside ditches, flooded pastures). Adult mosquitoes are present from May to first frost. . Larviciding programs conducted through late spring to early fall for the treatment of temporary pools, created by rainfall, prevent A. vexans larvae from developing into adult mosquitoes. This should reduce the number of adult mosquitoes and lower the risk of humans developing WNV from biting mosquitoes. 3.0 Pesticide Reaulations The management of pesticides is a joint responsibility of the federal and provincial governments. Health Canada's Pest Management Regulatory Agency (PMRA) is responsible for assessing pesticides to determine if they are acceptable in terms of safety, merit and value. Pesticides approved by PMRA are granted registration which allows them to be sold and used in Canada. The Ministry of the Environment (MOE) regulates the sale, use, transportation, storage and disposal of federally registered pesticides in Ontario under the Pesticides Act and Regulation 914. Pest control products are classified into one of six different classes or "schedules". The schedule determines who can sell or use the pesticide product and ·3- what restrictions (e.g., requires a licence and/or permit) are placed on its use. For current information on classified products, consult the Ontario Pesticides Advisory Committee web site and link to the PEPSIS data base at www.opac.qov.on.ca. Appendix 3 provides a list of currently classified larvicides for commercial use under permit for WNV. 4.0 Municipal WNV Prevention and/or Control Proqrams A municipality has the authority to conduct a larviciding program onlv on municipal- owned land or on land where an easement exists for the purpose of drainage management. These control programs would likely be initiated under an MOH directive or request for preventative mosquito control. In order to expand the larviciding program onto private land, the municipality must obtain written permission of the private land owner or a health hazard order must be issued, covering private land, by the local Medical Officer of Health under Section 13 of the Health Protection and Promotion Act. A permit application that is supported by a health hazard order, issued by the local MOH, will be considered as a very high priority. Apermit application may be submitted by an agency (e.g., municipality, parks commission) or a licensed exterminator contracted by an agency with the written support of, or order from the Local Medical Officer of Health. MOE encourages early (preventative) submission of completed permit forms and supporting documentation by either a municipality or licensed exterminator on behalf of the municipality. Submissions will be reviewed and 'considered for approval subject to appropriate conditions appended to the permit. 4.1 Surveillance Dead bird surveillance, adult mosquito trapping, larvae surveys and mapping are very important for determining the need for larviciding programs. Municipal Health Units are encouraged to conduct surveillance and monitoring programs. If not already done in the previous year, municipal Health Units should begin in early spring to conduct dead bird and adult mosquito trap surveillance and larvae mapping to determine if a larviciding program is warranted. 4.2 Licensina Reauirements A pest management company requires an Operator's licence in order to run a business that uses pesticides to control pests. A pest management company that provides a service to control mosquito larvae is conducting a water extermination. This requires at least $1 million in third-party liability insurance and the company must ensure that its -4- insurance policy allows for the use of pesticides in water (i.e., the policy has no exclusion for water exterminations). An Operator must hire appropriately licenced exterminators to carry out the larviciding program. A municipality or other agency that intends to use a larvicide on its own property is not required to obtain an Operator's licence if full-time employees are appropriately licensed for the use of larvicides. A WNV larviciding program must be conducted by an appropriately licensed exterminator holding one of the following valid licenses: · Mosquito/Biting Flies (a Water Class 2 or Water Class 3 is equivalent) for ground equipment application of a larvicide · Aerial (a Land Class 7 is equivalent) for aircraft application of a larvicide 4.3 Permit Application Submission Municipalities (or other jurisdictions) may decide to submit a permit application in order to conduct larviciding programs based upon dead bird and mosquito surveillance activities. Permit applications and support documents for larviciding should be submitted seDaratelv for any of the following four types larviciding programs in urban areas: A. Catch basins/storm drains: Methoprene products will be considered for application to catch basins/storm drains since these are high in organic content and suspended silt and it is unlikely that non-target aquatic organisms will be present (Note: BU has limited efficacy in water bodies with high organic and silt content). . Label rate for methoprene pellets is 0.7 g per catch basin (equivalent to a broadcast application rate of 11.2 kg/ha in water with a high organic matter content) based on an average surface water area of 0.6 m2. Catch basins with an average surface water area greater than 0.6 m2 would receive proportionately more of the methoprene pellets. A greater amount of methoprene pellets per catch basin is consistent with label directions if drainage from the catch basin is impeded and the water in the catch basin is backed up, above the level of the outlet pipe, on standing water in the sewer. This would be determined by a pre-treatment inspection (see Appendix 7). A review of best practices indicates that an amount of up to 3.5 g of methoprene pellets may be applied in such situations and is consistent with label directions. . See Appendix 7 for detailed information on determining application rates. B. Ditches and Temporary Pools or Permanent Pools including storm water management ponds Bacil/us thuringiensis var. israe/iensis (BtJ) products will be considered for application in ditches and temporary pools or permanent pools including storm -5- water management ponds since these water bodies may support non-target aquatic organisms (methoprene may have an impact on these organisms whereas Bti is very specific to mosquito larvae). The rate of application will be determined by the larval instar stage, target species etc. as indicated on product labels. · C. Sewage and sludge storage lagoons · Methoprene products will be considered for application in sewage and sludge lagoons since these water bodies are high in organic content and it is unlikely that non-target aquatic organisms will be present (Note: Bti has limited efficacy in water bodies with high organic content). · A label rate for methoprene products of 11.2 kg/ha for broadcast application of pellets and 22.4 kg/ha of granules is in accordance with label directions for water with a high organic content. D. Wetlands: · Bacillus thuringiensis var. israeliensis (Bti) products will be considered for permit approval in wetlands since these water bodies support non-target aquatic organisms (methoprene may have an impact on these organisms whereas Bti is very specific to mosquito larvae). · The rate of application will be determined by the larval instar stage, target species, etc., as indicated on product labels. 4;4 Permit Submission Checklist þ-h application for a permit to use a larvicide for the control of mosquito larvae as a preventative or control action against WNV must include the following information as support documentation: o A completed permit application form (see Appendix 1). If it is not possible to provide the name, licence number and business information (including the Operator's licence number if applicable) of the licensed exterminator responsible for carrying out the larviciding program (i.e., water extermination), this may be submitted seven (7) days prior to the initiation of larviciding. o A copy of a letter from a representative of a town, city, etc., within the jurisdiction of a Regional Municipality authorizing the use of a larvicide in that town, city, etc. by the Regional Municipality. o A copy of an order under the Health Protection and Promotion Act or a letter of support from the Local Medical Officer of Health (MOH) indicating: o A mosquito larviciding program is considered necessary or appropriate to reduce Culex pipiens larvae and prevent the epizootic amplification of WNV, based upon data obtained from the previous year's WNV-positive dead bird and/or mosquito surveillance programs in that jurisdiction or a neighbouring -6- jurisdiction and/or o A mosquito larviciding program is considered necessary to reduce Aedes vexans or other mosquito species that may act as a bridge species for WNV from birds to humans based on data obtained from the current year's WNV- positive dead bird/animal/human and/or mosquito surveillance programs. o Letters of permission from private property owners authorizing the use of a larvicide on their property (for example: if a catch basin or ditch is on private land and no municipal easement allowance is in place). o Standard municipal CAD/GIS maps or Ontario Base maps (1:10,000 scale is recommended for Southern Ontario - 1 cm on the map represents 100 metres and 1 :20,000 scale for Northern Ontario - are available at htto:/lwww.maos.mnr.aov.on.ca/cataloalindex.htm ) showing: o The approximate number, average size and location of water bodies (e.g., catch basins, ditches, ponds, lagoons, wetlands, etc.) to be treated with a larvicide. (NOTE: if a municipality does not have sufficient mapping information to show exact map locations of all catch basins, ditches or pools that are proposed for treatment with a larvicide then MOE will accept a statement that "x" number of catch basins, ditches, pools, etc., are planned to be treated within a marked boundary location on the maps submitted - the approved permit conditions will require that the exact location of all treated catch basins be provided with the final report). o The location of all nearbv Sensitive Areas (see Appendix 6 for definitions) that may be impacted by the larvicide in the event of off site movement. For catch basins - Sensitive areas include: · fish bearing waters, including hatchery areas, sanctuaries and critical fish habitat and fish farms adjacent or downstream of the discharge For ditches and temporary or permanent pools - Sensitive areas include: · fish bearing waters, including hatchery areas, sanctuaries and critical fish habitat and fish farms · marshes, bogs, swamps, fens or other wetlands · aquatic species at risk (e.g., endangered or threatened) · headwater areas · irrigation water sources · potable and livestock water supplies · areas where human recreational water activities may occur For sewage and sludge lagoons - Sensitive areas not applicable For wetlands - Sensitive areas include: · fish bearing waters, including hatchery areas, sanctuaries and critical fish habitat and fish farms · marshes, bogs, swamps, fens or other wetlands · susceptible crops/organic farms or crops grown in marsh areas (e.g., cranberries, wild rice, etc.) -7- · aquatic species at risk (e.g., endangered or threatened) · headwater areas · irrigation water sources · potable and livestock water supplies · areas where human recreational water activities may occur o A description of measures that will be used to protect Sensitive areas from potential impact due to movement of the larvicide from the target area. o Monitoring data - See 5.0 below for reauired pre and post larviciding monitoring data and 6.0 for recommended monitoring procedures. 5.0 MOE Permit Reauirements for Monitorina A textual description of the methods that will be used to comply with the MOE requirements listed below must be included with the permit application support documentation. A. Catch basins/storm drains using methoprene: .' No monitoring requirements - See section 6.0 below for monitoring recommendations. B: Ditches and Temporary or Permanent pools (including storm water management ponds) using Bt;: MOE requires that: Ii': Pre-Iarviciding monitoring be conducted to determine organic matter content (e.g., presence of algae on water surface indicates high organic content and requires higher label rate) and larval instar stage (e.g., lower label rate for 1st and 2nd instars; higher label rate for 3rd and 4th instars) in order to apply Bti at the proper label rate. Appendix 4 provides a guidance for Bti. efficacy monitoring for pre and post larviciding. C. Sewage or Sludge lagoons using methoprene: · No efficacy monitoring requirements - See section 6.0 below for efficacy monitoring recommendations. D. Wetlands using Bt;: MOE requires that: · Pre-Iarviciding monitoring be conducted to determine degree of organic material content and larval instar stage in order to apply the proper label rate of Bti. . Post-Iarviciding monitoring of 10 typical sites (minimum) to determine larvae dead -8- vs. alive within 24 - 48 hours after treatment. Appendix 4 provides a guidance for Bti. efficacy monitoring for pre and post larviciding. 6.0 MOE Recommendations for Monitorinq MOE recommendations listed below are at the discretion of the permit holder. A. Catch basins/storm drains using methoprene: MOE recommends that: · Pre-Iarviciding monitoring be conducted in catch basins to determine larvae counts and evaluate a need to apply methoprene. · Post-Iarviciding monitoring be conducted in catch basins to determine pupal development to adult (refer to the methoprene product guide literature or the guidance for methoprene efficacy monitoring provided in Appendix 5). MOE suggests that a minimum of 30 catch basins proposed for treatment with a larvicide be randomly selected and monitored for methoprene efficacy. B. Ditches and Temporary or Permanent pools (including storm water management ponds) using Bti: MOE recommends that: · Post-Iarviciding monitoring be conducted in ditches and temporary or permanent pool to determine dead vs. live larva counts within 24 - 48 hours after treatment with Bti. MOE suggests that post-Iarviciding monitoring should include at a minimum, several ditches, temporary pools and permanent pools, sampled around the margins at several points. C. Sewage or Sludge lagoons using methoprene: MOE recommends that: · Pre-Iarviciding monitoring at 10 points around the perimeter be conducted in sewage or sludge lagoons to determine larva counts and evaluate a need to apply methoprene. · Post-Iarviciding monitoring at 10 points around the perimeter be conducted in sewage or sludge lagoons to determine pupal development to adult (refer to the methoprene product guide literature or the guidance for methoprene efficacy monitoring provided in Appendix 5). -9- D. Wetlands using Bt!: See requirements in section 5.0 above. 7.0 Permit Conditions Permit applications will be reviewed by the Regional Pesticide Specialists in the Regional Pesticides Office. A permit appiication that is complete and provides all of the required support documentation will be processed within five days of receipt. The following conditions may be placed on approved permits: · Larvicide purchase is limited to a licenced exterminator (Mosquito/Biting Flies for ground-based application or Aerial for aircraft appiication) who must store the larvicide in accordance with Sections 119 - 122 of Regulation 914 under the Pesticides Act. · The transportation of larvicide in vehicles must be in accordance with Sections 126 and 127 of Regulation 914 under the Pesticides Act. · Larvicide use is iimited to a iicenced exterminator (Mosquito/Biting Flies for ground-based application or Aerial for aircraft application), or a trained Technician under the supervision of a Mosquito/Biting Fiies licence holder (in accordance with Sections 20.1 and 20.2 of Regulation 914 under the Pesticides Act) or a iicensed exterminator who is considered a Technician in accordance with Section 20.1 (1.1) of Regulation 914 under the Pesticides Act. · The licensed exterminator, who supervises a Technician, must: · provide his or her name and licence number to the Technician as the person responsible for supervising the Technician · visit the Technician at least once every seven days at the job site to observe the use of the larvicide by the Technician and sign off (signature, licence number and date) in the Technician's log book and/or written instruction documentation for that extermination · ensure the Technician has received appropriate training for the larviciding program and that this training is documented at the supervising iicensed exterminator's place of business · ensure the Technician carries out the extermination according to Regulation 914 and the Pesticides Act · A Technician who appiies a larvicide under the supervision of a Mosquito/Biting Flies iicence holder must: · have at the job site a valid Technician certificate issued by Ridgetown College - University of Guelph, Pesticide Industry Council or Pesticide Industry Regulatory Council, or be the holder of another exterminator's iicence · have at the job site a document of written instructions with details on how to perform the extermination, safety instructions, etc., and information on the -10- pesticide being used, the PCP No. and target pest . the name and licence number of his or her supervisor who holds a Mosquito/Biting Flies licence . maintain a log book or other documentation that provides a record of the once every 7 days site visits by the supervising licensed exterminator over the past 30 days . This permit is approved for 2003 only. · Larvicide must be applied according to label directions. · Larvicide must be placed into catch basins through the grate and must not be applied to catch basins if there is sufficient water flow, such as during heavy rainfall that does not allow for the proper settlement of the larvicide in the bottom of each catch basin. · The Spills Action Centre (SAC) must be notified by telephone [1-800-268-6060] at least 48 hours before the 2003 larviciding program begins, and immediately if there is any change in the information that was provided, advising SAC of the name of: o the contact person and his or her telephone number who is responsible at the municipal level for the larviciding program and who can provide specific details about the location and timing of larvicide applications when contacted o the licensed exterminator (and licence number) who is responsible for applying the larvicide o the Operator, his/her licence number and telephone number · Public notification must be provided as set out in the document "Public Notification of a Water Extermination for the Control of Immature Stages of Mosquitoes (Larviciding Programs for West Nile Virus)" [see Appendix 2] as follows: A. Catch Basins - Option 1 or 2 must be used B. Ditches, temporary or permanent pools including storm water management ponds - Option 3 and either 1 or 2 C. Sewage or sludge lagoons - Option 3 and either 1 or 2 D. Wetlands - Option 3 and either 1 or 2 · The licensed exterminator responsible for the use of the larvicide must immediately report any situations involving health or environmental effects or damage to property resulting from the application of the pesticide to the local Ministry of the Environment District Office (telephone number will be provided on the approved permit), or if a pesticide spill occurs, to the Spills Action Centre at 1-800-268-6060. · A summary report must be provided by December 1st of the year to the Regional Pesticides Specialist that includes: . a map indicating the locations of all treated catch basins and their discharge points, and specific location of all applications of a larvicide to ditches and temporary or permanent pools including storm water management ponds or wetlands. -11- > the total number of treated catch basins, ditches and temporary or permanent pools including storm water management ponds or wetlands and dates of all treatments. > letters of permission from private property owners who were not included with the support documentation. > the name of the pesticide used, PCP number, rate of application and quantities used in each water body. > copies of the actual newspaper or written notices used for public notification. > reference to any incidents or situations involving the use of the pesticide during the larvicide program that was reported to the District MOE office or SAC. > Completed pre and post larviciding efficacy monitoring forms [see Appendix 4 and 5] for each water body if reauired - see section 5.0 above for MOE requirements. · Additional conditions may be provided on a case by case basis. -12- Table 1 Ontario Ministry of Environment - Regional Pesticide Specialists REGION PESTICIDE SPECIALlST(S) TelephonelTolI Countv/TownshiD Mailina Address Free/Fax Central Region Cathy Wright (416) 326-3477 Toronto, Halton, Peel 5775 Y onge St, 8th Floor Toll Free York and Durham Toronto, Ontario 1-800-810-8048 M2M 4J1 Fax (416) 325-6347 West-Central Region Charlie Roland (905) 521-7658 Haldimand, Norfolk, Niagara, Suzanne Howe (905) 521-7551 Hamilton-Wentworth, Dufferin, 119 King SI. West, 12th Floor Toll Free Wellin9ton, Waterloo, Brant Hamilton, Ontario 1-800-668-4557 L8P 4Y7 Fax (905) 521-7820 Eastern R",gion Roberto Sacilotto (613) 549-4000 ex Frontenac, Hastin9s, Lennox & 133 Dalton Avenue 2684 Addington, Prince Edward, Leeds & Kingston, Ontario Toll Free Grenville, Prescott & Russell, K7L 4X6 1-800-267-0974 Stormont/Dundas & Glengarry (In Eastern Region Peterborough, Victoria, only) Northumberland, Renfrew, Ottawa- Fax (613)548-6908 Carleton, Lanark, District of Nipissin9 (Twsps. of Airy, Murchison, Dickens, Lyell and Sabine), Haliburton Southwestern Region Gary Roberts (519) 873-5047 Elgin, Middlesex, Oxford, 733 Exeter Rd., Toll Free Essex, Kent, Lambton, Bruce, Grey, London, Ontario N6E 1 L3 1-800-265-7672 Huron, Perth, Muskoka, Simcoe Fax (519) 873-5020 Northern Region (east) John Negusanti (705) 564-3249 Manitoulin, Nlpissing, Parry Sound, 199 Larch Street, Ste 1101 Toll Free Sudbury, Algoma (East), Sudbury, Ontario 1-800-890-8516 Timiskaming, Sault Ste. Marie P3E 5P9 Fax (705) 564-4180 Northern Region (west) Don Mitchell (807) 475-1712 Algoma (West), Cochrane, Kenora, 435 James SI. S., Suite 331 Toll Free Rainy River, Timmins, Thunder Bay Thunder Bay, Ontario 1-800-875-7772 P7E 6S7 Fax (807) 475-1754 Spills Action Centre -1-800-268-6060 -13- Appendix 1 Permit Application Form 7 MOE requests that the permit application be completed and signed by an appropriately licensed exterminator who is responsible for the larviciding program. Complete all parts of the application form except those sections which are shaded: -15- ® Ontario Ministry Ministère of the de Environment 'Environnement Pesticides Act - Form 7 I Loi sur les pesticides - Formulaire no 7 Application For A Permit To Purchase A Pesticide And/Or Perform A Water Extermination Demande de permis d'achat d'un pesticide au de destruction de parasites aquatiques Person31 information requested on this form is collected under the authority of the Pesticides Act. RSO, 1990, Ontario Regulation 914. It is used to evaluate applications for pennits to use restricted pesticides according to the requirements of the Pesticides Act. Questions should be directed to your nearest Ministry of the Environment Regional Office. I L.as renseignements personnels demandés dans Ie présent formu]alre sont recuelllls en vertu du RègJement 914 de l'Ontario pris an application de fa Lol sur ¡as pesticIdes, loR.O. 1990. lis serviront à évaluer les demandes de permis d'utilisation de pesticides à usage restreint salon les exlgances de la Loi. VeuilJez adresser toute question au bureau regional ou au bureau de destrict de ministère da 'Environnement de votre région. Annlicant Information / Renseignements sur I'auteur de la demande Name of property owner / Nom du propriétaire Home tel. no./ Tél. dom. Business tel. no./ Tél. bur. Mailing address / Adresse postale Postal code / Code postal Pesticide and Site Information / Données sur les Desticides et la zone à traiter Name of pest / Nom du parasite Area to be treated (attach a map and indicate access route) If for blackfly treatment Zone à traiter üoindre une carte et y indiquer la route Lutte contre les mouches noires d'accès) Name of pesticide / Nom du pesticide Stream flow [=::J Length (frontage) / Longueur (façade) [=:J Débit du cours d'eau Pest Control Products Act No./ No Width / Largeur [=:J Current speed [=::J d'enregistrement Vitesse du Depth (average) / Profondeur (moyenne) [=:J courant Active ingredient{s) /Ingrédient{s) actif(s) Name of body of water / Nom de I'étendue d'eau I Lot I Concession Township / Canton District/County/Municipality / District/comté/municipalité . Water in the vicinity ofthe treated area is to be used for / Utilisations de I'eau aux alentours de la zone traitée D Swimming / Natation Fishing (specify) /Pêche (préciser) D ~ Drinking / Eau potable Type of application'/ Méthode d'applicatìon Crop irrigation /Irrigation des cuffÜi"ës···Öth....C.........:iÇ)"iÄ...¡...(·· .. ) § Ground;! terrestre Livestock watering / Bétail er specl u re preclser D Air / aérienne Boating / Navigation de plaisance ............................................... Both / combinée ..... Rate Requested / Taxu demandé Have all adjacent owners, lessees or organizations been notified of the proposed treatment and have they all agreed, realizing use of the water may be temporarily restricted? / Tous les Quantity requested / Quantité demandée propriétaires, locataires ou organismes adjacents ont-Us été avisés du traitement proposé et ont-ils donné leur accord, sachant que I'utilisation de I'eau pourrait être temporairement limitée? Date of treatment / Date de traitement D No / Non No. of treatments / Nbre de traitements D Yes, specify who notified them? / Qui les a avisés? ........................................................................................ Date of notification / Date de notification No. of properties to be treated / Nbrede ........................................................................................ propriétés à traiter Has a permit been issued p'reviously?/ Is the treatment to be done by an exterminator? / Le traitement doit-iI être fait par un destructeur de Un permis a-t-il déjà été delibré? parasites? D Yes/Qui No /Non D D No / Non Yes, indicate below:/ Qui, préciser D Last permit no./ N" du dernier permis Name of exterminator / Nom du destructeur Tel. no./ Tél. Amount of pesticide left over from last Address / Adresse Exterminatorrs licence noJ treatment/ N° du permis du destructeur de Quantité de pesticide qui reste du dernier Postal Code / Code postal parasites traitement Signature -17- Signature of property owner or exterminator I Signature du propriétaire ou du destructeur Date For Ministry Use Only I Réservé au Ministère Permission is hereby granted under the Pesticides Act and Regulations to perform a water extermination: ILa Permit no. I N° de permis présente autorise aux termes de la Lai sur les pesticides et des règlemerits établis en vertue de celle~i la destruction de parasites aquatiques: 0 with the attached amendments! in accordance with the above application I 0 Expiry date J Date d'expiration avec les modifications ci-jointes conformément à la demande ci-dessus Signature of Director under the Pesticides Act I Signature du dîrecteur désîgné en vertu de la Loi sur les pesticides Date MaE regional contact J Représentant(e) du bureau de régional du MaE Ministry of Natural Resources District contact J Représentant(e) du bureau de district - min. des Richesses naturelles -18- Appendix 2 Public Notification of a Water Extermination for the Control of Immature Stages of Mosquitoes (Larviciding Programs for West Nile Virus) The following public notification options must be used: A. Catch Basins - Option 1 or 2. B. Ditches, temporary or permanent pools including storm water management ponds - Option 3 and either 1 or 2 C. Sewage or sludge lagoons - Option 3 and either 1 or 2 D. Wetlands - Option 3 and either 1 or 2. Option 1 Publication of a notice in a newspaper of general circulation in the vicinity of the proposed water extermination at least 48 hours before performing the water extermination and, if necessary, repeated monthly and printed such that it is not less than 10 cm in width or the nearest equivalent in column layout. Option 2 Distribution of a written notice at least 48 hours before ,performing the water extermination and, if necessary, repeated monthly to all land owners or occupiers or persons in charge of land that is contiguous to and within the application area. The notice in Option 1 and 2 above must include the following: . The details of the larviciding program including: · the pest to be controlled (i.e., mosquito larvae) and purpose for control (i.e., West Nile Virus). · proposed date(s) the water extermination is to take place. · the location of the larviciding program (e.g., name of the water body, street boundaries, all catch basins on a specific street, etc.). · the name of the larvicide and the registration number assigned to the product under the Pest Control Products Act (Canada). · the formulation (e.g., pellet, granular). · a telephone number (indicating collect calls will be accepted) that provides the public with information regarding the larviciding program and includes updates on the street location and dates of larviciding. A web site may be used in addition to a telephone number. See the Sample notice below. Option 3 The posting of a public area sign (rectangular and at least 51 cm high and 38 cm wide) every 100 metres along the perimeter of the treatment area immediately before the -19- application of the larvicide and remaining for 48 hours. The public area sign must include the following on the front of the sign: · red lettering with the words "WARNING" and "PESTICIDE USE" · a red circle and red bar over a single black silhouette of an adult person · black lettering with the words "FOR INFORMATION CONTACT" and "CALL COLLECT" and a telephone number provided in 1.5 cm high numerals (indicating collect calls will be accepted) that provides the public with information regarding the larviciding program and includes updates on the street location and dates of larviciding · black lettering with the words "DATE POSTED" and "DATE SPRAYED" (these dates will be the same since the sign must be posted immediately before larviciding -lettering and numerals must be 1.5 cm high) The public area sign must include the following on the back of the sign: · black lettering with the words "PESTICIDE" and 1.5 cm high lettering to indicate the name of the pesticide used (e.g., Methoprene) · black lettering with the words "REGISTRATION NUMBER" and 1.5 cm high numerals to indicate the Pest Control Products Act Number of the product · black lettering with the words "TO CONTROL" and 1.5 cm high lettering to indicate the pest (e.g., Larva Mosquitoes) · A web site may be provided in the bottom 5 cm of the sign See example and format requirements below. Sample Notice for Catch basins: NOTICE OF PESTICIDE USE Between April 1 to April 30, 2003 the Town of Pleasantville will be conducting a larviciding program under the authority of the Local Medical Officer of Health to control larval mosquitoes In order to prevent their development into vectors of West Nile Virus. The pellet formulation of the larvicide methoprene [provide Product Name and re9istration number under the Pest Control Products Act (Canada)] will be placed into catch basins of storm drains in the following area [provide street boundaries]. All larvicide will be applied by Ministry of the Environment licensed applicators or trained technicians. For details on the exact locations and dates of treatment please call [1-800------ if not a toll- free number indicate collect calls will be accepted] or atthe following web site: www.------- -20- I Example: Public Area Sign - NOT TO SIZE I WARNING STtCJDE U E FOR INFORMATION CONTACT.................... . CALL COLLECT............ DATE POSTED............. DATE SPRAyED.......... -21- Public Area Sign Si¡¡n to be 51 em x 38cm (minimum) rain resistant, sturdy to be reused "'Capital Red letters 5cm (minimum) "'Black 1inQle silhouette of an adu t person on white background. Red circle (outer edge a minimum of 21.5cm in diameter and width one tenth of the diameter) and oblique red bar "'Capital Red letters 5cm (minimum) "'Capitai Black letters 1.5cm (minimum) and telephone number of representative or person performing the land extermination; numbers to be 1.5cm in height (minimum) "'Capital Black letters 1.5cm (minimum) and long distance telephone number, if applicable; numbers to be 1.5cm in height (minimum) "'Capitai Black letters 1.5cm (minimum) and, day/month/year of posting, anâlor preposting (if applicable) and day/ month/year of pesticide application; numbers to be 1.5cm in height (minimum) "'Words or markings that identify the employer of the person performin9 the land extermination or that identify the owner/ . occupIer or person In charge and that do not detract from the sign; not to occu~v more than bottom em ot the sl9n J=>E::~-¡-IC:;I£:)E::............................. RE::GI~-¡-RA -¡-ION N U M B E:: R. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . -¡-O c:;ON-¡-ROL....................... . -22- -. -+Capital Black letters 1.5cm (minimum) and pesticide name; letters to be 1.5cm in height (minimum) -+Capital Black letters 1.5cm (minimum) and Pest Control Products Act No. (PCP No.) or Fertilizers Act No. (FA No.); numbers to be 1.5cm in height (minimum) -+Capital Black letters 1.5cm (minimum) and name of pest; letters to be 1.5cm in hei9ht (minimum) -+Words or markings that identify the employer of the person performing the land extermination or that identify the ownerl occupier or person in charge and do not detract from the sign, or additional words or markings that have been approved in writing by the Director under the Act, not to occupv more than bottom 5cm of the sign Appendix 3 Mosquito Larvicides Currently Federally Registered and Classified for Commercial Use In Ontario under permit for WNV PCP PRODUCT NAME AERIAL' REGISTRANT/AGENT ADDRESS ONT. No. ACTIVE INGREDIENT (Yes/ No) SCH. 18158 Vectobac 200G Bioro~car Larvicide Y Valent Biosciences Canada Ltd. 2100-40 King St. 2 Bacillus thuringiensis erotype H-14 W. Scotia Plaza Toronto, ON, M5H 3C2 (0.2 ITUlL) 19239 Teknar Granules Larvicide for Y Thermo TriloßY Co~oratjon 175~9145 Guilford Rd. 2 MOS~jtoes BacjJIus thuringiensis Columbia, M 210 6-1883 Sero pe H-14 (260 AAU/mg) 19241 T eknar Hp·D Larvicide for Mosquitoes! Y Thermo TrilOBY Co~oratjon 175-9145 Guilford Rd. 2 Black-fly control 8th 3000 AUlmg Columbia, M 210 6-1883 19455 Vectobac BOOL Biological Larvicide Y Valent Biosciences Canada Ltd. 2100-40 King St.W. 2 Bacillus thuringiensis Serotype H-14 Scotia Plaza Toronto, ON M5H 3C2 (0,6 ITUlL) 19466 Vectobac-200g Biological Larvicide N Valent Biosciences Canada Ltd. 2100-40 King St. 3 Bth 200 ITUlmg W. Scotia Plaza Toronto, ON M5H 3C2 21062 Vectobac 1200L Biolo~cal Insecticide Y Valent Biosciences Canada Ltd. 2100-40 King St. 2 Bt Serotype H-14 (1.2 IU/Kg) W. Scotia Plaza Toronto, ON M5H 3C2 21809 Altosid Pellets y WeUmark Int. P.O Box 20040, Woodlawn Postal 2 Methoprene 4.25% Outlet Guelph, ON N1 H BH6 22676 Altosid Granules y Wellmark In1. P.O Box 20040, Woodlawn Postal 2 Methoprene 1.5% Outlet Guelph, ON N1 H BH6 26860 Aquabac xt y AFA Environmental Inc. 1100 Rene Levesque Blvd_ 2 Bt Serotype H-14 (1200 ITUlmg) West, 25th Floor Montreal, QC H3B 5C9 26862 Aquabac 200G N AFA Environmental Inc. 1100 Rene Levesque Blvd. 3 Bt Serotype H-14 (200 ITUlmg) West, 25th Floor Montreal, QC H3B 5C9 26863 Aquabac 200G y AFA Environmental Inc. 1100 Rene Levesque Blvd. 2 Bt Serotype H-14 (200 ITUlmg) West, 25th Floor Montreal, QC H3B 5C9 Consult with the PMRA at 1-800-267-6315 to ensure current registration status. . A pesticide may only be applied by aircraft if the label directions specify this method of application. -23- Appendix 4 MOE Permit Number GUIDANCE FOR BACILLUS THURINGIENSIS vaT. ISRAELlENSIS (Bti) EFFICACY MONITORING COLLECTION DATA I Date: ì Location No.: I Collector's Name: Location Description (if no location no.): BREEDING SITE DESCRIPTION II Site Type (Check one): Roadside Ditch Right-of-Way Ditch _ Woodland Pool_ Field Pool - Dugout _ Culvert - Slough _ Pond Rock Pool - Tree Hole - Marsh _ Swamp_ Fen _ Bog _ Storm Management Pond _ Other Type of Suñace water Site Organic level of water: low _ moderate _ high_ III Water Temperature: _ Pool Length (m): Width (m): Depth (m): Emergent Vegetation: NiI_ Low - Mod. - High_ I PRE·LARVICIDING SEQUENTIAL SAMPLING I Pool rating*: Nil - Low _ Moderate _ High _ (sBebelow) Dio No. No. of Larvae Cumulative No. Dio No. No. of Larvae Cumulative No. 1 6 2 7 3 8 4 9 5 10 * Pool Rating · Ifoo larvae are collected, the site is ratedas"nil", · 'fonly 1.or 2 larvae are collected in 10 dips, this,site.is rated as "low". · 1f.7~30 larvae are collected in 10dips; thissiteisratedasnmoderate'~. · If>31 larvae are collected in-10 dips"this site is rated as "high". · If the number of larvae collected in at least 5 dips is 51 or more, the site is rated as "high". Note: if the surface area of the site is greater than 50 m by 50 m (2500mZ), then the number of dips taken must be doubled. SPECIES IDENTIFICATION I Culex pipiens CP, Culex restuans CR, Culex salinarius CS, Aedes vexans AV, Coquil/ettidia pertubans CP, Anopheles punctipennis AP,Ochlerotatus triseriatus OT, Ochlerotatus cantator OC, Ochlerotatus trivattatusOTR. Snecies Code larva Instar (1-4) No. Identified SDecies Code larva Instar (1-41 No. Identified I POST·LARVICIDING SEQUENTIAL SAMPLING II Pool rating*: Nil Low Moderate High I DiD No. No. of larvae Cumulative No. DioNa. No. of larvae Cumulative No. 1 6 2 7 3 8 4 9 5 10 -25- Appendix 5 MOE Permit Number GUIDANCE FOR METHOPRENE EFFICACY MONITORING COLLECTION DATA Date: Location Description (if no location no.): I Location No.: I Collector's Name: BREEDING SITE DESCRIPTION II Site Type (Check one): Catch Basin/Storm Drain - Sewage Lagoon _ Sludge Lagoon _ Organic level of water: low _ moderate _ high_ III Water Temperature: _ Lagoon length (m): Width (m): Depth (m): Emergent Vegetation: Nil - Low - Mod. - High_ I PRE·LARVICIDlNG SEQUENTIAL SAMPLING I Pool rating"': Nil - Low _ Moderate _ High _ (see below) DiDNa. No. of Larvae Cumulative No. Dip No. No. of larvae Cumulative No. 1 6 2 7 3 8 4 9 5 10 '" Pool Rating · If no larvae are collected, the site is rated as "nil". · If only 1 or 2 larvae are collected in 10 dips, this site is rated as "low". · If 7-30 larvae are collected in 10 dips, this site is rated as "moderate". · If >31 larvae are collected in 10 dips, this site is rated as "high". · If the number of larvae collected in at least 5 dips is 51 or more, the site is rated as "high". Note: iUhe surface area of the site is greater than 50 m by 50 m (2500 m2), then the number of dips taken must be doubled. SPECIES IDENTIFICATION I Culex C/Piens CP, Culex restuans CR, Culex salinarius CS, Aedes vexans AV, cogui Jettidia pertubans CP, Anopheles punctipennis AP, Ochlerotatus triseriatus OT, Oc /erotatus cantatar OC, Och/erotatus trivattatus OTR. SDecies Code Larva Instar 11-4\ No. Identified Snecies Code Larva Instar {1-4\ No. Identified I POST·LARVICIDING MONITORING FOR METHOPRENE EFFICACY 1. Collect pupae once a week from a treated catch basin and from a nearby untreated catch basin (if available) 2. Place t~e pupae in a covered syrofoam coffee cup or soup container (half-filled with distilled water) and cover with netting or screening. 3. Check for emergence after two days. 4. Count the number of dead pupae (DP), dead adults (DA) and alive adults (AA). 5. Use the following formula to determine the % control = (DP+DA) -;'(DP+DA+AA) x 100 6. Record results in an Excel spreadsheet format to facilitate calculations (see example below) Most catch basins should show >95% control for up to 30 days using methoprene pellets. Some may show less control (perhaps due to flushina,laraer than normal size catch basin or storm drain, or some other reason} and should be retreated. -27- . Recording Results: Treated Site No. of DP DA AA % Control Control No. of DP DA AA % Control Pupae Site Pupae Sample 1 Sample 1 Sample 2 Sample 2 Sample 3 Sample 3 Sample 4 . Sample 4 Sample 5 Sample 5 Sample 6 Sample 6 Sample 7 Sample 7 Sample a Sample 8 Sample 9 Sample 9 Sample 10 Sample 10 -28~ Appendix 6 Sensitive Areas Definitions SENSITIVE AREA is defined as a critical fish habitat, e.g., spawning areas, wetlands, headwaters, migration areas, nursery areas, intermittent streams that provide spawning habitat for fish; fish sanctuaries; fish hatcheries; stocked lakes and rivers; endangered species habitat; patented land. SENSITIVE AREAS REQUIRING PROTECTION - DEFINITIONS CRITICAL FISH HABITAT: Is habitat judged to be of critical importance to the maintenance of a healthy fish population (includes: feeding areas, migration areas; nursery areas; spawning areas). WETLANDS: Are lands that are seasonally or permanently covered by shallow water as well as lands where the water table is close to, or at the surface; in either case, the presence of abundant water has caused the formation of hydric soils and has favoured the dominance of either hydrophytic or water tolerant plants. The general term wetlands, includes specific land types that are known as marshes, bogs, swamps; fens, etc. HEADWATER AREA: Is the area starting at the lake highest up in the watershed which requires prote.ction under the guidelines (either greater than 10 ha or with a known fisheries value) and continues up each inflow to this lake until the top of the stream occurs, or there is a wetland, lake or beaver pond with significant retention capacity. FISH SANCTUARY: Is a water body (or a portion of a water body) in which fishing for all species is prohibited for a specified period of time and is identified in the annual Ontario Sport Fishing Regulations, which is published by the Ministry of Natural Resources at httD:/ /www.mnr.qov.on.ca/MNR/fishinq/qen.html. FISH HATCHERY: Is a designated area offish rearing. ENDANGERED SPECIES HABITAT: Is the sum total of environmental conditions of a specific place occupied or potentially occupied by an endangered species (as designated in Regulations of the Ontario Endangered Species Act) or a population of such species. HUMAN HABITATION: Areas of human habitation such as day care centres, schools, senior citizen homes, hospitals, etc. -29- Appendix 7 Assessing Catch Basins to Determine Application Rate Most modern catch basins are cylindricai, have 900 mm diameter (0.9 m diameter or 0.45 m radius), are 2.3-2.4 m deep in total (including ring spacers and cover), have a water depth below the outlet pipe of 600 mm (when there is no flow), and a water surface area of 0.636 m'. However, older catch basins may be of different sizes, shapes, and have different surface areas. Thus, it is important that mosquito control workers consult local public works officials on the dimensions of the catch basins in any particular area of the jurisdiction. Catch basins in newer suburban areas may differ in size from those in older downtown areas and along hi9hways within a municipality. Public Work officiais may be able to provide computer-based maps and a numbering system for the catch basins within their jurisdiction. Some databases may also include information on the size of individual catch basins. Drainage from some catch basins may be partialiy blocked, increasing the total water volume associated with that catch basin and others 'upstream' from it. Local water en9ineers may be able to advise on what percentage of the catch basins fali into this category and where they are most likely to be located. Calculations showing how much methoprene peliets to apply to a standard modern catch basin have been provided (see below). it may be necessary to inspect a representative sample of catch basins (e.g., 1%) and base the application rate on the average surface area of the catch basins in an area. Sample Calculations Assumption: Assume the catch basin has a 0.45 m radius. Formula Used Area (circle) = III" (pi x radius squared) where 11=3.14159 Area of Standard Catch Basin Area of standard catch basin is 3.14159 x 0.45 m x 0.45 m = 0.636 m' Application Rates based on methoprene pellets: Label rate states - 5.6 -11.2 kglha or 0.56 -1.12 glm' of water surface, then Low application rate = 0.636 m' x 0.56 glm' = 0.356 g Hiah application rate = 0.636 m' x 1.12 glm' = 0.712 a The water in a catch basin can be considered to be poliuted andlor hi9hly or9anic therefore the hi9h application rate is recommended on the label. Amount to Use per catch Basin How much methoprene peliets is 0.712 g? From the Material Safety Data Sheet (MSDS), we find Specific Gravity = 1.04 9/CC Thus, 1.04 g/1 cc = 0.712 g/'x' cc; therefore, 'x' = 0.69 cc Because 1 teaspoon = 5 cc 0.69 cc = - 0.14 teaspoons Therefore, use slightiy under a quarter teaspoonl standard catch basin Measuring Spoons Long-handled measuring spoons are available as part of a set from most food and department stores. Due to the irregular shape of the peliets, a level 0.25 teaspoon of methoprene peliets would be a practical treatment per one standard catch basin. -31- -, McLachlin, Laura From: Sent: Cc: Subject: Le ber, Chuck Dr. [Chuck.Leber@moh.gov.on.ca] Thursday, April 1 0, 2003 1 :43 PM Le ber, Chuck Dr. FW: Ontario Ministry of the Environment Permit Applicant Guide fo r Larviciding ~ ~ WNV Permit Guide Final -April ... FYI - I am attaching the April 2003 final version of the MOE permit applicant guide for larviciding for control/prevention of West Nile Virus. A copy will be posted on the MOE website www.ene.gov.on.cain addition to several fact sheets regarding pesticide use regulations, larviciding, adulticiding and home use of pesticides later next week. Geoff Cutten Senior Pesticides Regulatory Scientist Pesticides Section Standards Development Branch Ministry of the Environment 40 St. Clair Ave. West 7th floor Toronto, Ontario M4V 1M2 email geoff.cutten@ene.gov.on.ca 416-327-5174 fax 416-327-2936 1 " ONTARIO REGULATION 199/03 made under the HEALTH PROTECTION AND PROMOTION ACT Made: May 14,2003 Filed: May 15,2003 Printed in The Ontario Gazette: May 31, 2003 CONTROL OF WEST NILE VIRUS Determination if action required L A medical officer of health shall make a determination, based upon a local risk assessment in accordance with the document published by the Ministry of Health and Long-Term Care entitled West Nile Virus Preparedness and Prevention Plan for Ontario, whether action is required bya municipality to decrease the risk of West Nile Virus to persons either inside or outside the health unit served by the medical officer of health Notice to municipality 2~ (1) Where the medical officer of health has determined that action is required, he or she may give notice to the municipality of the required action (2) In determining required actions under subsection (1), the medica1 officer of health shall have regard to, (a) the document mentioned in section 1; and (b) the generally accepted practices in the field of public health with regard to decreasing the risk of West NiJe virus to persons" Must comply 3. A municipality shall comply with any requirements set out in the notice. What may be required 4. Action required under this Regulation may include, without being limited to, (a) requirements respecting source reduction measures; (b) requirements respecting surveil1ance; (c) requirements respecting public awareness campaigns about personal protection; (d) requirements respecting the control measures for larviciding and adulticiding set out in Table 1; and (e) requirements respecting the time within which the action shall be taken. TABLE 1 LARVlCIDING AND ADULTICIDING IN ONTARIO WEST NILE VIRUS RESPONSE 'Triggers" based on surveîllance ofWNv positive humans, birds, mosquito pools or mammals (horses) Current-YearWNv Last Year's WNv Preparatory Status Larviciding ACTION Adulticiding ACTION findings in Health Unit findings in Health Unit (Larval surveys, or municipality or municipality mosquito trapping, mapping" trainin;: etc.\ No West Nile virus No West Ni]e virus Not yet done Do the preparatory work, Not indicated found yet foUnd; virus found in then larvicide where adjacent Health Unites) indicated No virus found yet Virus found Not yet done Do the preparatory work, Not indicated " then larvicide where indicated No virus found yet Virus found Done last year and under Larvicide where Not indicated way this year indicated Virus found in non- Virus found or not found Done or under way this If a "hot spot" and larvae Adulticide a 3-km human {dead bird, y= are present, larvicide "Zone" ONLY IF there mosquito pool or around this "hotspot" (if are high-risk indicators mammal) - isolated or as nott~~ìlateinthe of transmission to a "hot spot" ",,",on humans* Human case(s) - one or a Virus found or not found Done or under way this Larvicide around the Adulticide a 3-km radius few in a space-time y= case or cluster ifJarvae Zone around the case or "cluster" are present {an~~~ not cluster too late in season Human cases continue to Virus found or not found Done or under way this Larvicide widely where Adulticide 3-km Zones occur; continued high- y= larvae are foun~n~fnot maY.l~:~j~~tiguous or risk indicators* too late in season overla III Note: Public education efforts and non-pesticide means of mosquito source reduction should be in place, and increased as increasing evidence of virus is found (especially human cases) in the current year. * HiI!h-risk indicators of transmission to humans: increasing dead bird sightings; high mosquito infection rates; abundant bridge vector populations; increasing mammal (horse) cases; proximity of mosquito breeding sites to human populations (especially large population centres) and weather conditions that favour mosquito breeding. 1. These are minimum activity standards. Medical Officers of Hea1th may increase the Zone size to be treated or take additional mosquito control actions, if justified by scientific data or recommendations. 2. Medica1 Officer of Health will maintain a means to record, investigate, and report any confirmed or likely adverse or unintended human health effects attributed to mosquito control actions, and will report any non-human environmental adverse effects that he or she knows about to the Ministry of the Environment and/or other relevant local or provincial authorities. West Nile Virus Questions and Answers Resource Document For Health Care Providers Prepared by Health Protection Department May, 2003 elgin st. thomas health unit Elgin-St. Thomas Health Unit 99 Edward Street St. Thomas, ON N5P 1Y8 (519) 631-9900 1-800-922-0096 Fax: (519) 633-0468 http://www.elginhealth.on.ca //" \ Index of Questions and Answers Section A: Generallnformation....................................................Page 1 A-1 What is West Nile virus? A-2 How is West Nile virus spread? A-3 Where did West Nile virus come from? A-4 How did West Nile virus get to North America? A-5 What areas of Canada have been affected? A-6 Is West Nile virus now established in the Western Hemisphere? A-7 Is the disease seasonal in its occurrence? A-8 How long does it take to get sick if bitten by an infected mosquito? A-9 What are West Nile virus, West Nile fever, and West Nile encephalitis? A-10 How many cases of West Nile disease in humans have occurred in the U.S.? A-11 What is the history of WN virus in Canada? A-12 How many cases ofWNv disease in humans have occurred in Canada? A-13 What proportion of people with severe illness due to West Nile virus die? A-14 Who is more likely to get sick after being infected with WN virus? A-15 When is the risk greatest? A-16 How do people get infected with West Nile virus (WNV)? A-17 What is the basic transmission cycle of West Nile virus? ( \..._- A-18 How does West Nile virus actually cause severe illness and death in humans? A-19 How long does the West Nile virus remain in a person's body after he or she is infected? A-20 If a person contracts West Nile virus, does that person develop a natural immunity to future infection by the virus? A-21 How do I find out if I have immunity? A-22 Who is at risk of getting infected with West Nile virus? A-23 Who is at risk for serious health effects from WN virus? A-24 What are the symptoms of West Nile virus infection? A-25 What is the incubation period in humans (I.e., time from infection to onset of disease symptoms) for West Nile encephalitis? A-26 How long do symptoms last? A-27 What are the long-term effects of WN virus? A-28 I think I have symptoms of West Nile virus. What should I do? A-29 Is there a vaccine for WN virus? A-30 How do doctors diagnose West Nile virus infection? A-31 How are blood samples tested for WN virus? A-32 How is West Nile encephalitis treated? A-33 If I live in an area where birds or mosquitoes with West Nile virus have been reported and a mosquito bites me, am I likely to get sick? A-34 Can you get West Nile encephalitis from another person? A-35 What can people do to reduce their risk of WN virus infection? ii · · · iii ( í , B-1 B-2 B-3 B-4 B-5 B-6 B-7 Section B : Pregnancy and Breastfeeding ...................................... Page 9 Does pregnancy increase the risk of becoming infected with WN virus? Is a woman's pregnancy at risk if she gets infected with West Nile virus? Can a pregnant woman pass WN virus to her unborn baby? Can WN virus be passed to a child through breast milk? Should women with symptoms of WN virus continue to breastfeed their children? What steps should pregnant and breastfeeding women take to reduce their risk of getting WN virus? Is it safe for pregnant and breastfeeding women to use insect repellents that contain DEET? Section C: Occupational Risks ................................................... Page 11 C-1 Are laboratory workers in contact with WNV-positive specimens at risk for WNV infection? C-2 How should health care workers protect themselves if they are caring for patients with WNv illness? C-3 Do people who work outdoors need to change their safety practices? C-4 If I have to wear protective clothing, how can I avoid heat stress on hot, humid days? Section D: Blood Transfusions and Transplants .......................... Page 12 D-1 Can West Nile virus be transmitted through blood? D-2 Does the risk of getting WN virus mean that people should be concerned about receiving transfusions or transplants? D-3 What has Health Canada done to ensure blood safety since it became known that WN virus could be transmitted through blood? D-4 What does Health Canada do to ensure the safety of the blood supply in Canada? ( ~- D-5 Can someone get WN virus by giving blood? iv D-6 What happens if someone with a probable case of WN virus has donated blood? 0-7 What happens if someone with a confirmed case of WN virus has donated blood? 0-8 Why are people with confirmed cases of WN virus infection allowed to donate blood again after eight weeks? D-9 What happens when people with symptoms of WN virus infection offer to donate blood? D-10 Will the screening test be available in time? D-11 What is being done in the interim (before the commercial test is available)? D-12 What is being done to reduce the risk of transmitting WN virus through organs and tissues? Section E: Animals and WNv (Including Horses) ........................... Page 15 E-1 Can animals other than birds be infected with West Nile virus? E-2 How do animals become infected with WN virus? E-3 What signs do infected animals have? E-4 Can people become infected by touching or being around animals infected with WN virus? E-5 Is there a treatment for animals infected with WN virus? E-6 Are there vaccines to protect animals from WN virus? E-7 Besides mosquitoes, can you get West Nile virus directly from other insects or ticks? E-8 Can you get West Nile virus directly from birds? E-9 Has West Nile virus caused severe illness or death in horses? E-10 How do the horses become infected with West Nile virus? E-11 How does the virus cause severe illness or death in horses? E-12 Can I get infected with West Nile virus by caring for an infected horse? e e e v E-13 Can a horse infected with West Nile virus infect horses in neighboring stalls? E-14 My horse is vaccinated against eastern equine encephalitis (EEE), western equine encephalitis (WEE), and Venezuelan equine encephalitis (VEE). Will these vaccines protect my horse against West Nile virus infection? E-15 Can I vaccinate my horse against West Nile virus infection? E-16 How long will a horse infected with West Nile virus be infectious? E-17 What is the treatment for a horse infected with West Nile virus? Should it be destroyed? E-18 What are the plans for horse surveillance? E-19 Can squirrels infected with West Nile virus transmit the virus to humans? E-20 Can you get WNV from eating game birds or animals that have been infected? E·21 Are duck and other wild game hunters at risk for West Nile virus infection? E-22 What should wild game hunters do to protect against West Nile virus infection? Section F: Personal Protection and Source Reduction .................. Page 19 F·1 What can I do to protect myself and my family? F-2 How about using pesticides around my home? F-3 What can I do around my property to discourage mosquitoes? Section G: Mosquito Repellents .................................................. Page 21 G-1 Why should I use insect repellent? G-2 When should I use mosquito repellent? G-3 What time of day should I wear mosquito repellent? vi G-4 How often should repellent be reapplied? G-5 Should I wear repellent while I am indoors? G-6 How does mosquito repellent work? G-7 Which mosquito repellent works the best? G-8 How does the percentage of DEET in a product relate to the amount of protection it gives? G-9 Why is DEET recommended? G-10 Are non-DEET repellents effective (e.g. Skin-50-Soft, plant-based repellents)? G-11 Do products in the store say "DEET" on the package? G-12 Is DEET safe? G-13 What are some general considerations to remember in order to use products containing DEET safely? G-14 How should products containing DEET be used on children? G-15 Is DEET safe for pregnant or nursing women? G-16 Are there any risks due to using repellents containing DEET? G-17 Should parents spray insect repellent on their children before they go to school? G-18 Should children be given repellent to use during the day? Section H: Surveillance - Birds ................................................... Page 25 H-1 What surveillance activities will the Elgin 51. Thomas Health Unit doing in 2003? H-2 What is Bird Surveillance? H-3 What types of birds carry West Nile virus? e e e H-4 f ,/'- ¡ H-5 H-6 H-7 H-8 vii Do birds infected with West Nile virus die or become ill? Why are dead crows monitored? How can I report a sighting of dead bird(s) in my area? Why do some areas stop collecting dead birds? How do I dispose of a dead bird that isn't going to be sent away for testing? Section I: Mosquitoes and Mosquito Habitats ............................... Page 27 1-1 What types of mosquitoes spread West Nile virus? 1-2 What is "amplification" and "bridging vectors"? 1-3 I understand West Nile virus was found in "overwintering" mosquitoes in early 2000. What does this mean? 1-4 What are stormwater ponds? {' 1-5 \ What stormwater facilities are potential breeding grounds for mosquitoes that carry West Nile virus? Section J: Surveillance - Mosquitoes and Mosquito Larvae .......... Page 30 J-1 What is Mosquito Surveillance? Section K: Surveillance - Human ................................................ Page 31 K-1 What is Human Surveillance? K-2 What are the plans for human surveillance? Section L: Pesticides ................................................................. Page 32 L-1 L-2 L-3 L-4 ¡ L-5 '-..- Who decides whether to use pesticides to control the spread of WN virus? What about using pesticides to control mosquitoes in our community? What are larvicides? What are adulticides? If provincial and local authorities decide to spray, what products would they use? viii L-6 Which type of pesticide product do authorities prefer to use? L-7 What is methoprene? L-8 What is Bti? L-9 What steps do provincial/local health authorities take to ensure public safety when pesticides are used? L-10 Are mosquito control products safe? Section M: Provincial WNv Plans ................................................ Page 36 M-1 What is the Ontario Government's 7 Point Action Plan for West Nile virus? Section N: Additional Resources ............................................... Page 37 N-1 How do I find out more about WNv? Source documents for Questions and Answers include: www.health.gov.on.ca www.HealthyOntario.com http://www.hc-sc.gc.caJenglish/index.html http://www.cdc.gov/ncidod/dvbid/westnile/index.htm e e e 1 Section A: General Information A-1 Q. What is West Nile virus? A. West Nile virus belongs to a family of viruses called Flaviviridae. It is spread by mosquitoes that have fed on the blood of infected birds. West Nile virus is closely related to the viruses that cause Dengue fever, Yellow fever and St. Louis encephalitis. A-2 Q. How is West Nile virus spread? A. West Nile virus is spread to humans by the bite of an infected mosquito. A mosquito becomes infected by biting a bird that carries the virus. You or your child cannot get West Nile virus from a person who has the disease. West Nile virus is not spread through person-to-person contact such as touching, kissing or caring for someone who is infected. A-3 Q. Where did West Nile virus come from? A. The virus was first isolated in 1937 in the West Nile district of Uganda. Since then, there have been outbreaks in Egypt, Israel, South Africa, and in parts of Europe, Asia and North America. The first recorded outbreak in North America happened in New York City in 1999. A-4 Q. How did West Nile virus get to North America? A. No one knows for sure how the virus made its way to North America. There are many theories, including one that suggests the virus arrived on this continent through an infected migratory or imported bird, or through an infected mosquito that was transported to North America by accident. During 2002, more than 4,000 people in North America became ill after being infected with WN virus. This is the largest outbreak of West Nile virus infection ever recorded. A-5 Q. What areas of Canada have been affected? A. In 2002 the WNv spread into five Canadian provinces: Nova Scotia, Quebec, Manitoba, Saskatchewan, and Ontario. A-6 Q. Is West Nile virus now established in the Western Hemisphere? A. The continued expansion of West Nile virus in the United States and Canada indicates that it is permanently established in the Western Hemisphere. 2 A-7 Q. Is the disease seasonal in its occurrence? e A. In the temperate zone of the world (i.e., between latitudes 23.50 and 66S north and south), West Nile encephalitis cases occur primarily in the late summer or early fall. In the southern climates where temperatures are milder, West Nile virus can be transmitted year round. A-8 Q. How long does it take to get sick if bitten by an infected mosquito? A. Being bitten by an infected mosquito will not necessarily make you sick. Most people who are infected with West Nile virus have no symptoms or experience only mild illness. If illness occurred, it would occur within 3 to 15 days of being bitten by an infected mosquito. A-9 Q: What are West Nile virus, West Nile fever, and West Nile encephalitis? A.West Nile virus is a flavivirus commonly found in Africa, West Asia, and the Middle East. It is closely related to St. Louis encephalitis virus found in the United States. The virus can infect humans, birds, mosquitoes, horses and some other mammals. West Nile fever is a mild disease in people, characterized by flu-like symptoms. West Nile fever usually lasts only a few days and does not appear to cause any long-term health effects. West Nile encephalitis, West Nile meningitis or West Nile meningoencephalitis are more serious diseases that may result from West Nile virus. Encephalitis refers to an inflammation of the brain, meningitis is an inflammation of the membrane around the brain and the spinal cord, and meningoencephalitis refers to inflammation of the brain and the membrane surrounding it. e A-10 Q. How many cases of West Nile disease in humans have occurred in the U.S.? A. In 2001, there were 66 human cases of severe disease and 9 deaths. In 2000, 21 cases were reported, including 2 deaths in the New York City area. In 1999, 62 cases of severe disease, including 7 deaths, occurred in the New York area. In 2002 there were 4156 cases of human illness and 284 deaths linked to the WNv. No reliable estimates are available for the number of cases of West Nile encephalitis that occur worldwide. A-11 Q. What is the history of WN virus in Canada? A. The first reports of West Nile virus activity in Canada came in August 2001, when the virus was found in dead birds and mosquito pools in southern Ontario (Windsor). Canada had its first confirmed human cases in 2002, after people tested positive for West Nile virus in parts of Quebec and Ontario. The virus was aiso found in birds, horses or mosquitoes in Nova Scotia, Quebec, Ontario, Manitoba and Saskatchewan. In addition, two people from Alberta became infected, but these cases are thought to be travel- . related. 3 A-12 Q. How many cases ofWNv disease in humans have occurred in Canada? A. The Ontario Ministry of Health and Long-Term Care reported 392 human cases of West Nile virus infection in 2002. This included probable cases (84) as well as laboratory confirmed (325) diagnosis. West Nile virus involvement was suspected in 17 deaths in Ontario. A-13 Q. What proportion of people with severe illness due to West Nile virus die? A. Among those with severe illness due to West Nile virus, case-fatality rates range from 3% to 15% and are highest among the elderly. Less than 1% of persons infected with West Nile virus will develop severe illness. A-14 Q. Who is more likely to get sick after being infected with WN virus? A. Evidence shows that many people infected with WN virus have mild symptoms, or no symptoms at all. People with weaker immune systems and people with chronic diseases, are at greater risk for serious health effects. While persons of any age or health status can be at risk of serious health effects associated withWest Nile virus infection, the overall risk of serious health effects increases with age. This is why it is so important to protect yourself. A-15 Q. When is the risk greatest? i , , A. The risk of becoming infected is greatest during mosquito season. In Canada, this can start as early as mid-April and last until the first hard frost in late September or October. A-16 Q. How do people get infected with West Nile virus (WNV)? A. The principle route of human infection with West Nile virus is through the bite of an infected mosquito. Mosquitoes become infected when they feed on infected birds, which may circulate the virus in their blood for a few days. The virus eventually finds its way into the mosquito's salivary glands. During subsequent blood meals, the virus may be injected into humans and animals, where it can multiply and possibly cause illness. Additional routes of infection have become apparent during the 2002 West Nile epidemic. It is important to note that these other methods of transmission represent a very small proportion of cases. A recent investigation has confirmed WNV transmission through transplanted organs. Investigations of other patients who developed WNV infection within several weeks of receiving blood products or organs are ongoing to determine whether WNV was transmitted by transfusion or transplantation in any of these cases. There is one reported case of transplacental (mother-to-child) WNV transmission. Aithough transmission of WNV and similar viruses to laboratory workers is not a new phenomenon, two recent cases of WNV infection of laboratory workers have been reported. i \ '- 4 A-17 Q. What is the basic transmission cycle of West Nile virus? e A. Mosquitoes become infected when they feed on infected birds, which may circulate the virus in their blood for a few days. Infected mosquitoes can then transmit West Nile virus to humans and animais while biting to take blood. The virus is located in the mosquito's salivary glands. During blood feeding, the virus may be injected into the animal or human, where it may multiply, possibly causing illness. A-18 Q. How does West Nile virus actually cause severe illness and death in humans? A. Following transmission by an infected mosquito, West Nile virus multiplies in the person's blood system and crosses the blood-brain barrier to reach the brain. The virus then interferes with normal central nervous system functioning and causes inflammation of brain tissue. A-19 Q. How long does the West Nile virus remain in a person's body after he or she is infected? A. There is no scientific evidence indicating that people can become chronically infected with West Nile virus. Antibodies and "memory" white blood cells (T-Iymphocytes) that the body produces to the virus may remain in a person's body for a long period of time. These antibodies and T -lymphocytes can last for years, and may last for the rest of a person's life. When laboratory testing is performed, diagnostic tests look for antibodies. Both antibodies and "memory" T-Iymphocytes provide future protection from the virus. e A-20 Q. If a person contracts West Nile virus, does that person develop a natural immunity to future infection by the virus? A. It is assumed that immunity will be lifelong; however, it may lessen in later years. A-21 Q. How do I find out if I have immunity? A. Your doctor can arrange for a blood test to determine if you have immunity. A-22 Q. Who is at risk of getting infected with West Nile virus? A. Everyone who is active and outside during the summer months doing such activities as gardening, golfing, walking or camping, should take precautions to avoid mosquito bites. Everyone is at risk from WNv and should make sure they use all the protection measures to avoid contact with mosquitoes. People who like to work outside should avoid early morning and late evening when mosquitoes are most active. . 5 A-23 Q. Who is at risk for serious health effects from WN virus? A. While persons of any age and health status can be at risk for serious health effects associated with West Nile virus infection, the overall risk of serious health effects increases with age. People with weaker immune systems are considered to be at greater risk for serious health effects. This higher risk group includes: . people with chronic diseases, such as cancer, diabetes, alcoholism, or heart disease . people that require medical treatment that may weaken the immune system, i.e. chemotherapy. Although individuals with weaker immune systems are at greater risk, WN virus can cause severe health effects for people of any age and any health status. This is why it is so important to reduce the risk of getting bitten by mosquitoes. Anyone exposed to mosquitoes in an area where WN virus has been detected is at some degree of risk for infection. A-24 Q. What are the symptoms of West Nile virus infection? A. Many infected people have no symptoms and do not get sick or have only mild symptoms. When infection does cause illness, symptoms will usually appear within two to 15 days. The extent and severity of symptoms vary widely from person to person. In mild cases, there may be flu-like symptoms, including fever, headache and body aches. Some people may also develop a mild rash, or swollen lymph glands. Some individuals have weaker immune systems, and they are at greater risk of developing symptoms and health effects that are more serious, including meningitis and encephalitis. Meningitis is inflammation of the lining of the brain or spinal cord. Encephalitis is inflammation of the brain itself. These conditions can be fatal. In such cases, symptoms could include the rapid onset of severe headache, high fever, stiff neck, nausea, difficulty swallowing, vomiting, drowsiness, confusion, loss of consciousness, lack of coordination, muscle weakness and paralysis. During 2002, several other symptoms of WN virus were identified including movement disorders, parkinsonism, poliomyelitis-like syndrome and muscle degeneration. Anyone who has a sudden onset of these symptoms should seek immediate medical attention. A-25 Q. What is the incubation period in humans (i.e., time from infection to onset of disease symptoms) for West Nile encephalitis? A. Usually 3 to 14 days. A-26 Q. How long do symptoms last? A. Symptoms of mild disease will generally last a few days. Symptoms of severe disease may last several weeks. Neurological effects may be permanent. 6 A-27 Q. What are the long-term effects of WN virus? A. Because WN virus is an emerging disease, the long-term effects are not fully understood. Studies to date show that some people with serious symptoms and health effects recover completely, while others experience prolonged health problems. These problems can include: e · physical effects, such as long-term muscle weakness and paralysis, fatigue and headache · cognitive effects, such as confusion, depression, problems with concentration and memory loss · functional effects, such as difficulty with preparing meals, going out, shopping, etc. Scientists do not know why some people recover while others continue to have varying degrees of health problems. A-28 Q. I think I have symptoms of West Nile virus. What should I do? A. If you or your family members develop symptoms such as high fever, confusion, muscle weakness, and severe headaches, you should see your doctor immediately. A-29 Q. Is there a vaccine for WN virus? A. At this time, there is no licensed vaccine to protect people against WN virus. For several years, the National Institute of Allergy and Infectious Diseases (NIAID) in the a United States has supported research to develop a vaccine against West Nile virus. In _ 1999, NIAID funded a fast-track project to develop a West Nile virus vaccine with private industry. Since then, scientists have developed a prototype vaccine that has shown promise in animal tests. The company is moving forward with Phase I trials. Vaccine is now being produced and an investigational new drug application will be filed with the Food and Drug Administration. Human trials are anticipated to begin in early 2003. Heaith Canada is monitoring these developments closely. A vaccine licensed in the U.S. does not receive an automatic license in Canada. Manufacturers or importers who wish to sell a vaccine in Canada must apply to Health Canada for a license. They must also provide Health Canada with scientific evidence that the vaccine is safe and effective when used as directed. A-30 Q. How do doctors diagnose West Nile virus infection? A. The first thing doctors look for are symptoms of WN virus infection. The type of symptoms and their severity can vary widely from case to case. In mild cases, there may be flu-like symptoms, including fever, headache and body aches. Some people may also develop a mild rash or swollen lymph glands. Individuals of all age ranges may develop more severe symptoms and health effects including meningitis and encephalitis but this is particularly true for people with weakened immune systems and the elderly. Meningitis is infiammation of the lining of the brain or spinal cord. Encephalitis is inflammation of the brain itself. In these cases, symptoms include the rapid onset of severe headaches, high fever, stiff neck, nausea, difficulty swallowing, vomiting, drowsiness, confusion, loss of consciousness, lack of coordination, muscle weakness and paralysis. e 7 A-31 Q. How are blood samples tested for WN virus? A. The test of choice for patients is for the presence of antibodies to West Nile virus. There are two categories of antibody blood tests for WN virus that may be done: a) front- line testing; and b) confirmatory testing. Front-Line Testing: Doctors use the results of frontline tests to decide on treatments and therapies for patients. These tests look for antibodies to WN virus and are generally done on two separate blood samples taken about three weeks apart. If the first test is positive, it could mean that the person was exposed to WN virus or possibly other viruses in the Flavivirus family recently or sometime in the past. (Other Flaviviruses include St.Louis encephalitis and Dengue fever). If antibodies in the second sample increase by four times or more, it means that the infection is recent. This means a "probable" case of WN virus infection. If West Nile cases are confirmed in a given locality and antibodies of a certain minimal titre are demonstrated in the first blood sample (the acute serum), it is acceptable to consider this to be a case of West Nile as a guide to doctors for patient treatment. In 2002, the frontline tests were handled by Health Canada's National Microbiology Laboratory (NML) in Winnipeg and by some laboratories in Ontario and Quebec. Because we anticipate a higher demand for front-line tests in 2003, the NML is providing provincial laboratories with testing technology and training so that they can diagnose WN infection in people more quickly. So far, labs in Newfoundland and Labrador, Quebec, Ontario, Alberta and British Columbia have been equipped and trained. There are two main tests used for frontline testing in North America: the HI test and the ELISA test. Both tests work equally well and produce results within 48 hours. Last year, most labs in Canada used the HI test. This year, the NML has negotiated with the US Centres for Disease Control and Prevention to obtain raw materials for the ELISA test. The NML plans to make kits for ELISA testing available to labs across the country, so labs will have both tests available to them. Confirmatory Testing: Once a front-line test shows that a case is "probable", the samples can be sent to Health Canada's NML to confirm the diagnosis. It is important to note that doctors to not need the results of confirmatory tests to begin treating patients. Confirmatory tests are done to provide researchers and public health officials with important information about WN virus such as: · whether the virus is turning up again in an area where cases were previously recorded · whether the virus has spread to new areas · the geographical distribution of the virus as it spread · new ways the virus can be spread (i.e. through blood transfusions) · who may be at greater risk for serious health effects. A-32 Q. How is West Nile encephalitis treated? A. There is no specific treatment for West Nile virus infection. In more severe cases, intensive supportive therapy is indicated, often involving hospitalization, intravenous fiuids, airway management, respiratory support (ventilator), prevention of secondary infections (pneumonia, urinary tract, etc.), and good nursing care. 8 A-33 Q. If I live in an area where birds or mosquitoes with West Nile virus have been reported and a mosquito bites me, am I likely to get sick? A. No. Even in areas where the virus is circulating, very few mosquitoes are infected with the virus. Even if the mosquito is infected, less than 1 % of people who get bitten and become infected will get severely ill. The chances you will become severely ill from any one mosquito bite are extremely smail. A-34 Q. Can you get West Nile encephalitis from another person? A. No. West Nile encephalitis is NOT transmitted from person-to-person. For example, you cannot get West Nile virus from touching or kissing a person who has the disease, or from a health care worker who has treated someone with the disease. A-35 Q. What can people do to reduce their risk of WN virus infection? A. If WN virus is found in birds, mosquitoes, horses or people in your area, you can take steps to reduce the risk of getting mosquito bites. For example, wear protective clothing when outdoors, and use insect repellents that contain DEET or other approved ingredients. Insect screens on doors and windows will reduce the chance of mosquitoes entering your home; make sure screens have no holes and fit tightly. Also, take steps to reduce mosquito populations around your home and property. For example, reduce standing water around your home e.g., dispose of old car tires, empty bird baths twice a week, and empty pool covers regularly. For most Canadians, the risk of WN virus infection is low, and the risk of serious health effects from the virus is even lower. However, anyone exposed to mosquitoes in an area where WN virus has been detected is at risk for infection. Anyone who becomes infected is at risk for serious health effects. e e e 9 Section B : Pregnancy and Breastfeeding B-1 Q. Does pregnancy increase the risk of becoming infected with WN virus? A. Being pregnant does not increase a woman's risk of getting WN virus. Pregnant women who have concerns about WN virus or their general health, should speak with their doctor or health care provider. B-2 Q. Is a woman's pregnancy at risk if she gets infected with West Nile virus? A. There is one documented case of transplacental (mother-to-child) transmission of WNV in humans. Although the newborn in this case was infected with WNV at birth and had severe medical problems, it is unknown whether the WNV infection itself caused these problems or whether they were coincidental. More research will be needed to improve our understanding of the relationship - if any - between WNV infection and adverse birth outcomes. Nevertheless, pregnant women should take precautions to reduce their risk for WNV and other arboviral infections by avoiding mosquitoes, using protective clothing and repellents containing DEET. When WNV transmission is occurring in an area, pregnant women who become ill should see their health care provider. If their symptoms are consistent with acute WNV infection they should undergo appropriate diagnostic testing. i B-3 Q. Can a pregnant woman pass WN virus to her unborn baby? A. There is one known case in the United States of a mother passing West Nile virus to her unborn baby. In this case, the child was born with serious medical problems. However, it is not known whether the problems were caused by WN virus or by other factors. Since the evidence shows it is possible to pass WN virus to an unborn child, pregnant women should take immediate steps to reduce their risk of mosquito bites if they are in an area where WN virus is active. If they develop symptoms of WN virus infection, they should call their doctor or health care provider right away. B-4 Q. Can WN virus be passed to a child through breast milk? A. There is evidence that this is possible. In one case in the United States, a woman was infected with WN virus after the birth of her child. She breast-fed her baby, and the baby later tested positive for WN virus infection. Laboratory tests determined that WN virus was present in the breast milk. Investigators looking into the case believe it is unlikely that the baby was infected by a mosquito bite.They concluded that breast milk was the most likely source of infection. Despite being infected with WN virus, the child had no symptoms and remained healthy. 10 8-5 Q. Should women with symptoms of WN virus continue to breastfeed their children? e A. Women who are breast-feeding their children should contact their doctors for advice if they have symptoms of any illness, including WN virus. It appears that WN virus can be passed through breast milk, but the level of risk is still unknown. On the other hand, the health benefits of breast-feeding are well known. Women who have concerns about the potential to transmit WN virus through breast-feeding should consult their doctor for advice in their specific situation. B-6 Q. What steps should pregnant and breast-feeding women take to reduce their risk of getting WN virus? A. Since there is evidence that WN virus could be passed through breast milk and from a mother to her unborn child, it is important for pregnant and breast-feeding women to take steps to reduce their risk of WN virus infection. The best way to reduce the risk of infection is to reduce the risk of mosquito bites. If WN virus activity is detected in your neighbourhood, town or region: · Limit time spent outdoors at dawn and dusk, when many mosquitoes are most active. · Wear light-coloured long-sleeved shirts, long pants, and a hat when outdoors in areas where mosquitoes are present. · Make sure that door and window screens in the home fit tightly and have no holes. · Use insect repellents that contain DEET or other approved ingredients. Read and a follow the directions on the label. ,., Another way to reduce the risk of mosquito bites is to reduce mosquito populations around your home and surrounding property. Mosquitoes need standing pools of water to breed, so it is a good idea to get rid of standing water from such items as pool covers, saucers under flower pots, pet bowls, wading pools, and oid tires. Empty bird baths twice a week. Cover rain barrels with screens, and clean eaves troughs regularly to prevent clogs that can trap water. B-7 Q. Is it safe for pregnant and breastfeeding women to use insect repellents that contain DEET? A. There is no evidence that the use of DEET by pregnant or breastfeeding women poses a health hazard to unborn babies or children who are nursing. However, as a, safety precaution, women in these situations may wish to consider the use of non- chemical methods to prevent mosquito bites as a first line of defense against WN virus. e 11 i \ ", Section C: Occupational Risks C-1 Q. Are laboratory workers in contact with WNV-positive specimens at risk for WNV infection? A. Yes, and approximately 20 laboratory-acquired WNV infections have been reported in the medical literature over many decades. In the two most recently reported cases, WNV infection of two microbiologists working with WNV-positive samples resulted frQm percutaneous inoculation (pierced through the skin). Both persons had mild, self-limited illnesses. More laboratories have recently become involved in WNV diagnostic and reference activities. This has probably increased the risk for laboratory acquired WNV infections. Laboratory workers handling materials that are potentially infected with WNV should use every precaution to minimize their risk for exposure C-2 Q. How should health care workers protect themselves if they are caring for patients with WNv illness? A. WNv is not spread from person to person unless there is exposure to blood. Usual universal precautions will protect the health care worker from WNv illness. C-3 Q. Do people who work outdoors need to change their safety practices? A. It is not necessary to limit usual outdoor work or change standard outdoor health and safety practices, unless there is evidence of mosquito-borne disease in the area you are working. Workers should wear protective clothing such as long pants, long-sleeved shirts, and socks. C-4 Q. If I have to wear protective clothing, how can I avoid heat stress on hot, humid days? A. If you wear a long-sleeved shirt, long pants, shoes and socks to reduce the risk of mosquito bites, you may be at greater risk for heat stress on hot, humid days. To avoid symptoms of heat stress, you should: · Wear light-coloured, breathable clothing that allows moisture to evaporate quickly · Use extra caution if you are required to wear clothing on the job that limits evaporation - you could develop heat stress more quickly · Drink plenty of non-alcoholic and non-caffinated liquids to maintain body hydration \"".-- 12 Section D: Blood Transfusions and Transplants e D-1 Q. Can West Nile (WN) virus be transmitted through blood? A. Yes. There have been confirmed cases in Canada and the United States of West Nile virus being spread through blood transfusions and organ transplants. D-2 Q. Does the risk of getting WN virus mean that people should be concerned about receiving transfusions or transplants? A. The risk of getting WN virus through these procedures is considered to be very low, and there are only a few confirmed cases. The benefits of blood transfusions and organ transplants outweigh the risk of becoming infected with WN virus. People scheduled to receive transfusions or transplants should discuss any concerns they have with their doctor or surgeon. Viruses of the family to which West Nile virus belongs cannot be transmitted through fractionated blood products, such as immune globulins, because these viruses are inactivated or removed during the manufacturing process. D-3 Q. What has Health Canada done to ensure blood safety since it became known that WN virus could be transmitted through blood? A. In September 2002, Health Canada gave blood operators instructions to minimize the risk of spreading West Niie virus through the blood supply. This involved deferral or withdrawal of blood from donors suspected or shown to be infected with the West Niie virus. e In January, 2003, HC opened up a dialogue with industry during a HC sponsored Workshop to foster development of a blood donor screening test for WN virus. HC met with industry on several occasions during the period between Jan-April to review the progress of the commercial WN virus test and to provide options for priority review and approval of the test. A complete submission for the WNV blood donor screening test was received from industry on April 30th. It is currently under priority review with a target date for implementation for investigational purposes on July 1st. As well, since September 2002, HC has met with blood operators on a regular basis to review contingency plans for the interim period before the test is avaiiable. HC has been working with CBS and HQ to transfer WN virus testing technology "know- how" to the blood operators to assist them in developing in-house West Nile virus testing capability in case the commercial WN virus test is delayed. HC will continue to provide up-to-date surveillance information to CBS and HQ to assist with contingency plans. The surveillance data helps to identify low-risk areas that the blood operators could focus on for donations in the case of a shortage, or high-risk areas of Canada that they would avoid. . 13 D-4 Q. What does Health Canada do to ensure the safety of the blood supply in Canada? A. Health Canada regulates blood under the Food and Drugs Act and Regulations, which are aimed at maximizing the safety of blood in Canada. Health Canada's role includes: · assuring that blood operators follow current laws and reguiations · conducting regular inspections of blood establishments · licensing the blood establishments · monitoring the blood system for emerging pathogens · identifying potential safety threats · assessing and managing risks related to blood safety · assuring that laws and regulations address current safety needs D-5 Q. Can someone get WN virus by giving blood? A. No. Donating blood is a safe procedure and the West Nile virus cannot be transmitted in that way. D-6 Q. What happens if someone with a probable case of WN virus has donated blood? A. In this situation, Health Canada has instructed blood operators to: , I · Quarantine transfusion products that contain the donor's blood. · Quarantine products that are awaiting pooling for further manufacture. · Defer the donor from giving blood. If further tests indicate the person is not infected with WN virus, the quarantined products can be released and the person can become an active donor, unless deferred for some other reason. D-7 Q. What happens if someone with a confirmed case of WN virus has donated blood? A. In this situation, Health Canada has instructed blood operators to: · Withdraw any transfusion products that contain the donor's blood. · Withdraw any products that were awaiting pooling for further manufacture. · Defer the donor from giving blood for a period of eight weeks from the date of probable infection. D-8 Q. Why are people with confirmed cases of WN virus infection allowed to donate blood again after eight weeks? A. West Nile virus only stays in the blood of an infected person for four to seven days. After that, the person's blood contains antibodies to the virus, but does not contain the virus itself. WN virus infection is only spread through blood if the blood contains live virus. Donors can donate blood again after a period of eight weeks, which is the normal donation cycle. This period also permits an extra margin of safety to ensure that the virus is no longer present. i \ ''---.._-- 14 D-9 Q. What happens when people with symptoms of WN virus infection offer to donate blood? e A. When people have symptoms of WN virus infection, their blood may contain an infectious WN virus. Therefore, Health Canada has instructed blood operators to defer potential donors who have symptoms that suggest possible WN virus infection. It is important to remember, however, that many people infected with WN virus have no symptoms, so it is difficult to identify them and defer them from donating blood. D-10 Q. Will the screening test be available in time? A. The test was submitted on April 30'h, and is currently under priority review. Because the test is new, it will take some time for the blood system operators to familiarize their staff with the use of the new equipment. The target date for implementing the test on an investigational basis remains July 1, 2003. Everyone is on schedule for meeting this date. D-11 Q. What is being done in the interim (before the commercial test is available)? A. The blood operators will be using blood components that were collected and stockpiled during the winter season which is considered mosquito-free and therefore also "WN virus free". There should be sufficient frozen plasma collected to cover the interim period. There will also be limited testing on fresh blood components that cannot be stored for long periods of time, and must be collected and used before the test is available. D-12 Q What is being done to reduce the risk of transmitting WN virus through organs and tissues? A. When the risk of transmission through blood and tissues was established last summer, e the first priority for the Department was to address the risk of transmission through blood, since this is where the greatest risk lies, and the greatest number of people potentially affected, including organ and tissue recipients. We are now focusing intensely on the specific risks of WNV transmission through organ and tissue transplantation. Health Canada has been meeting with the transplantation community; a number of enhanced safety measures have been identified, and are being discussed with the transplant centres, industry and blood operators. These safety measures include the testing of blood from live and cadaveric donors. There are existing safeguards. Tissue and organ donors are currently subject to an intense screening protocol to ensure that the donor is free of any infectious disease. As part of this screening, live organ and tissue donors have their blood tested, much as a blood donor's blood would be tested. By implementing the WNV blood test in the screening of the blood system, live organ and tissue donors would also be screened for WNV. As well, organ recipients often receive blood transfusions following their surgery. Therefore, much of the risk for transplant recipients is addressed by having the WNV testing implemented in the blood system. Where circumstances are a matter of life-or-death, the benefits of a transplant outweigh the risk of WNV transmission. We will continue to communicate to the public about developments in the strategy for addressing the risks of WNV transmission through tissues and organs as they become available. Health Canada is currently in active discussion with the transplant community, industry and operators. For information about the blood operators, visit their Web sites or call their toll-free numbers. Canadian Blood Services: 1-888-236-6283 www.bloodservices.ca e 15 Section E: Animals and WNv (Including Horses) (r~ , E-1 Q. Can animals other than birds be infected with West Nile virus? A. Yes. Horses are very susceptible to WN virus. There have been thousands of confirmed cases of infected horses across the United States. There have also been confirmed and/or probable cases of infected horses in Quebec, Ontario, Manitoba and Saskatchewan. In the U.S., there have also been small numbers of confirmed cases in cats, dogs, domestic rabbits and in certain types of squirrels, chipmunks, skunks and bats. E-2 Q. How do animals become infected with WN virus? A. The source of infection for animals is the same as the source for most people who become infected - the bite of an infected mosquito. When there are reports of infected dead birds, or other animals in the area, it means there are likely infected mdsquitoes too, and people should take action to reduce the risk of exposure to mosquitoes. E-3 Q. What signs do infected animals have? A. Some may have no signs at all. Others may have a range of signs inciuding fever, muscle spasms, weakness, lack of coordination, seizures and changes in temperament or personality. \ For horses, signs of WN virus infection may include stumbling, weakness in hind limbs, inability to stand, paralysis of the limbs, listlessness and head shaking. In severe cases, horses may die or need to be euthanized. E-4 Q. Can people become infected by touching or being around animals infected with WN virus? A. There have been no recorded cases of animals passing West Nile virus infection to other animals or to people. However, people who handle dead birds or animals should still follow standard health and safety practices. For example, cover any open wounds, and wear protective gloves and a mask. These health and safety practices are also important for peopie who work with animals at risk for WN virus infection, such as horses and flocks of domestic birds. Health Canada has issued an Occupational Health Advisory for people whose jobs may put them at risk for WN virus infection. E-5 Q. Is there a treatment for animals infected with WN virus? A. There is no specific treatment, but supportive therapies may reduce the severity and duration of clinical signs. Peopie who suspect that horses, other animals or pets have become infected with WN virus should contact a veterinarian for information and advice. 16 E-6 Q. Are there vaccines to protect animals from WN virus? e A. In 2002, a vaccine for horses was given a provisional license in Canada and was available from veterinarians. There is no Vaccine at this time for other animals or pets. E-7 Q. Besides mosquitoes, can you get West Nile virus directly from other insects or ticks? A. Infected mosquitoes are the primary source for West Nile virus. Ticks infected with West Nile virus have been found in Asia and Africa. Their role in the transmission and maintenance of the virus is uncertain. There is no information to suggest that ticks played any role in the cases identified in the United States or Canada. E-8 Q. Can you get West Nile virus directly from birds? A. There is no evidence that a person can get the virus from handling live or dead infected birds. However, persons should avoid bare-handed contact when handling any dead animals and use gloves or double plastic bags to place the carcass in a garbage can. E-9 Q. Has West Nile virus caused severe illness or death in horses? A. Yes. While data suggest that most horses infected with West Nile virus recover, results of investigations indicate that West Nile virus has caused deaths in horses in the United States and Canada. e E-10 Q. How do the horses become infected with West Nile virus? A. The same way humans become infected-by the bite of infectious mosquitoes. The virus is located in the mosquito's salivary glands. When mosquitoes bite or "feed" on the horse, the virus is injected into its blood system. The virus then multiplies and may cause illness. The mosquitoes become infected when they feed on infected birds or other animals. E-11 Q. How does the virus cause severe illness or death in horses? A. Following transmission by an infected mosquito, West Nile virus multiplies in the horse's blood system, crosses the blood brain barrier, and infects the brain. The virus interferes with normal central nervous system functioning and causes inflammation of the brain. E-12 Q. Can I get infected with West Nile virus by caring for an infected horse? A. West Nile virus is transmitted by infectious mosquitoes. There is no documented evidence of person-to-person or animal-to-person transmission of West Nile virus. Normal veterinary infection control precautions should be followed when caring for a horse suspected to have this or any viral infection. e 17 E-13 Q. Can a horse infected with West Nile virus infect horses in neighboring stalls? A. No. There is no documented evidence that West Nile virus is transmitted between horses. E-14 Q. My horse is vaccinated against eastern equine encephalitis (EEE), western equine encephalitis (WEE), and Venezuelan equine encephalitis (VEE). Will these vaccines protect my horse against West Nile virus infection? A. No. EEE, WEE, and VEE belong to another family of viruses for which there is no cross-protection. E-15 Q. Can I vaccinate my horse against West Nile virus infection? A. A West Nile virus vaccine for horses was recently approved, but its effectiveness is unknown. E-16 Q. How long will a horse infected with West Nile virus be infectious? A. We do not know if an infected horse can be infectious (i.e., cause mosquitoes feeding on it to become infected). However, previously published data suggest that the virus is detectable in the blood for only a few days. / ( '\ E-17 Q. What is the treatment for a horse infected with West Nile virus? Should it be destroyed? A. There is no reason to destroy a horse just because it has been infected with West Nile virus. Data suggest that most horses recover from the infection. Treatment would be supportive and consistent with standard veterinary practices for animals infected with a viral agent. E-18 Q. What are the plans for horse surveillance? A. The Canadian Food Inspection Agency, along with Provincial Veterinary Laboratories, veterinarians and other members of the animal health community, will take the lead in monitoring for West Nile virus in horses. E-19 Q. Can squirrels infected with West Nile virus transmit the virus to humans? A. A small number of squirrels have tested positive for the West Nile virus. There is no evidence that people could become infected with the West Nile virus by being near an infected squirrel or in the yard with a dead one. However, the presence of an infected squirrel does mean that there could be infected mosquitoes nearby, and people should use protective clothing and repellent, and avoid maintaining mosquito-breeding sites on their property. i \ "..---- 18 E-20 Q. Can you get WNV from eating game birds or animals that have been infected? A. There is no evidence that WNV virus can be transmitted to humans through consuming infected birds or animals. In keeping with overall public health practice, and due to the risk of known food-borne pathogens, people should always follow procedures for fuliy cooking meat from either birds or mammals. E-21 Q. Are duck and other wild game hunters at risk for West Nile virus infection? A. Because of their outdoor exposure, game hunters may be at risk if they become bitten by mosquitoes in areas with West Nile virus activity. The extent to which West Nile virus may be present in wild game is unknown. E-22 Q. What should wild game hunters do to protect against West Nile virus infection? A. Hunters should follow the usual precautions when handling wild animals. If they anticipate being exposed to mosquitoes, they should apply insect repellents to clothing and skin, according to label instructions, to prevent mosquito bites. Hunters should wear gloves when handling and cleaning animals to prevent blood exposure to bare hands and meat should be cooked thoroughly. e e e 19 Section F: Personal Protection and Source Reduction F-1 Q. What can I do to protect myself and my family? A. To avoid being bitten by mosquitoes, you can take action on two fronts: 1. Minimize your exposure to mosquitoes: · When going outdoors, use insect repellents that contain DEET or other approved ingredients. · Try to avoid spending time outdoors at dawn and at dusk when mosquitoes are most active. · Wear protective clothing such long-sleeved shirts, long pants and a hat. Light coloured clothing is best because mosquitoes tend to be more attracted to dark colours. · Make sure that door and window screens fit tightly and have no holes that may allow mosquitoes indoors. 2. Eliminate Mosquito Breeding Sites Around your Home and Cottage: Mosquitoes lay eggs in standing water and it takes about four days for the eggs to grow into adults that are ready to fly. Even a small amount of water, for example, in a saucer under a flower pot, is enough to act as a breeding ground. As a result, it is important to eliminate as much standing water around your property as possible by: · Regularly draining standing water from items like pool covers, saucers under flower pots, recycle bins, garbage cans etc. · Remove old unused items from around your property including old tires, that have a tendency to collect water. · Change the water in wading pools, bird baths, pet bowls and livestock watering tanks twice a week. · Cover rain barrels with screens. · Clean out eaves troughs regularly to prevent clogs that can trap water. · If you have an ornamental pond, consider getting fish that will eat mosquito larvae. F-2 Q. How about using pesticides around my home? A. Over the counter products that are designed to get rid of garden pests arent' effective for overall mosquito control. Regarding the use of other pesticides, only workers who are licensed by provincial authorities and are trained in the safe use of pesticies can carry out mosquito control programs. Decisions on whether or not to use pesticides to control the spread of West Nile virus in your community will be made by local and provincial health authorities. F·3 Q. What can I do around my property to discourage mosquitoes? A. The best way to keep mosquitoes away is to clean up areas where they like to breed. Unlike birds or other insects, mosquitoes do not fly very far and tend to stay close to their breeding sites and normal habitat. Take a look around your house and property and get rid of places that are mosquito friendly that would make good breeding sites or resting places for mosquitoes. 20 Anv tyoe of standinq water: · Clean up and empty containers of standing water such as old tires, flower pots, wheelbarrows, barrels or tins cans that are outdoors · Drill holes in the bottoms of used containers so water can't collect · Change water in bird baths every other day . Swimminq or wadinq oools: · Immediately remove water that collects on pool covers · Make sure the pool's pump is circulating · Turn over wading pools when not in use Check eaves and drains: · Don't let things pile up. Clear leaves and twigs from eavestroughs, storm and roof gutters throughout the summer · Make sure drainage ditches are not clogged · Check flat roofs frequently for standing water Yard and lawn maintenance: Think mosquito prevention when working in the yard. Lawn cuttings, raked leaves or other decaying debris such as apples or berries that fall from trees should be collected and recycled or mulched so that organic matter does not end up in storm sewers as a food source for mosquito larvae. . · Turn over compost frequently · Fill in low depressions in lawn areas · Clear out dense shrubbery where mosquitoes like to rest · Spread the word. Point out potential mosquito breeding areas to your neighbours The best way to keep mosquitoes away is to clean up areas where they are likely to breed. Check windows: · Check window screens for holes and make sure they fIt snugly into the window frame so mosquitoes will not get indoors If you don't have screens, consider keeping windows closed between the hours of dusk and dawn . 21 Section G: Mosquito Repellents G-1 Q. Why should I use insect repellent? A. Insect repellents help people reduce their exposure to mosquitos that may carry potentially serious viruses such as the West Nile virus, allowing them to continue to play and work outdoors. G-2 Q. When should I use mosquito repellent? A. Apply repellent when you are going to be outdoors and will be at risk for being bitten by mosquitoes. G-3 Q. What time of day should I wear mosquito repellent? A. Many of the mosquitoes that carry the West Nile virus are especially likely to bite around dusk and dawn. If you are outdoors around these times of the day, it is important to apply repellent. In many parts of the country, there are mosquitoes that also bite during the day, and these mosquitoes have also been found to carry the West Nile virus. The safest decision is to apply repellent whenever you are outdoors. \ G-4 Q. How often should repellent be reapplied? A. Follow the directions on the product you are using in order to determine how frequently you need to reapply repellent. Sweating, perspiration or getting wet may mean that you need to re-apply repellent more frequently. If you are not being bitten, it is not necessary to re-apply repellent. Repellents containing a higher concentration of active ingredient (such as OEET) provide longer-lasting protection. G-5 Q. Should I wear repellent while I am indoors? A. Probably not. If mosquitoes are biting you while you are indoors, there are probably better ways to prevent these bites instead of wearing repellent all the time. Check window and door screens for holes that may be allowing mosquitoes inside. If your house or apartment does not have screens, a quick solution may be to staple or tack screening (available from a hardware store) across the windows. G-6 Q. How does mosquito repellent work? A. Female mosquitoes bite people and animals because they need the protein found in blood to help develop their eggs. Mosquitoes are attracted to people by skin odors and carbon dioxide from breath. Many repellents contain a chemical, N,N-diethyl-m-toluamide (DEET), which repels the mosquito, making the person unattractive for feeding. DEET does not kill mosquitoes; it just makes them unable to locate us. Repellents are effective only at short distances from the treated surface, so you may still see mosquitoes flying nearby. As long as you are not getting bitten, there is no reason to apply more OEET. 22 G-7 Q. Which mosquito repellent works the best? · A. The most effective repellents contain OEET (N,N-diethyl-m-toluamide), which is an ingredient used to repel pests like mosquitoes and ticks. OEET has been tested against a variety of biting insects and has been shown to be very effective. The more DEET a repellent contains the longer time it can protect you from mosquito bites. A higher percentage of DEET in a repellent does not mean that your protection is better-just that it will last longer. DEET concentrations higher than 50% do not increase the length of protection. G.8 Q. How does the percentage of DEET in a product relate to the amount of protection it gives? A. Based on a recent study: · A product containing 23.8% DEET provided an average of 5 hours of protection from mosquito bites. · A product containing 20% DEET provided almost 4 hours of protection · A product with 6.65% DEET provided almost 2 hours of protection · Products with 4.75% OEET and 2% soybean oil were both able to provide roughly 1 and a half hours of protection Choose a repellent that provides protection for the amount of time that you will be outdoors. A higher percentage of DEET should be used if you will be outdoors for several hours while a lower percentage of DEET can be used if time outdoors will be limited. You can also re-apply a product if you are outdoors for a longer time than expected and start to be bitten by mosquitoes. · . G-9 Q. Why is DEET recommended? A. OEET is the most effective and best-studied insect repellent available. Studies involving humans and mosquitoes report that only products containing OEET offer long- lasting protection after a single application. G-10 Q. Are non-DEET repellents effective (e.g. Skin-So-Soft, plant-based repellents)? A. Some non-DEET repellent products that are intended to be applied directly to skin also provide some protection from mosquito bites. Studies have suggested that other products do not offer the same level of protection, or that protection does not last as long as products containing DEET. A soybean-oil-based product has been shown to provide protection for a period of time similar to a product with a low concentration of OEET (4.75%) People should choose a repellent that they will be likely to use consistently and that will provide sufficient protection for the amount of time that they will be spending outdoors. Product labels often indicate the length of time that one can expect the product to protect them. Persons who are concerned about using DEET may wish to consult their health care provider for advice. · 23 G-11 Q. Do products in the store say "DEET" on the package? A. Most insect repellents that are available in stores are labeled with the chemical name for DEET. Look for N,N-diethyl-m-toluamide or, sometimes, N,N-diethly-3- methylbenamide. Choose a repellent that offers appropriate protection for the amount of time you will be outdoors. A higher percentage of DEET should be used if you will be outdoors for several hours while a lower percentage of DEET can be used if time outdoors will be limited. G-12 Q.ls DEET safe? A. Yes, products containing DEEr are very safe when used according to the directions. Because DEET is so widely used, a great deal of testing has been done. When manufacturers seek registration for products such as DEET, laboratory testing regarding both short-term and long-term health effects must be carried out. Over the long history of DEET use, very few confirmed incidents of toxic reactions to DEET have occurred when the product is used properly. G-13 Q. What are some general considerations to remember in order to use products containing DEET safely? A. Read the manufacturer's instructions on the label carefully. · Do not use repellent on open wounds, or if skin is irritated or sunburned. · Do not get in eyes - if this happens, rinse with water right away. · Wash skin with soap and water when you return indoors or when protection is no longer needed. · Avoid breathing mist from spray-type repellent. Always apply in a well-ventilated area: never apply spray repellent inside a tent. Do not use near food. · Check for sensitivity - apply repellent to a small area of skin on the arm and wait for 24 hours before use. G-14 Q. How should products containing DEET be used on children? A. Health Canada advises that DEET containing repellents not be used on children under 6 months of age. · It recommends that, where there is a high risk of complications to the child from insect bites, DEET may be considered for children aged 6 months to 2 years. (Apply only once a day) · Use sparingly, avoid the face and hands, apply only once a day, and use the least concentrated product (10% or less). · Health Canada also advises not applying DEET more than three times a day to children between 2 and 12 years of age. Always follow the recommendations appearing on the product label when using repellent. c . When using repellent on a child, apply it to your own hands and then rub them on your child. Avoid children's eyes and mouth and use it sparingly around their ears. . Do not apply repellent to children's hands. (Children tend to put their hands in their mouths.) 24 . Do not allow young children to apply insect repellent to themselves; have an adult do it for them. Keep repellents out of reach of children . . Do not apply repellent to skin under clothing. If repellent is applied to clothin9, wash treated clothing before wearing again Using repellents on the skin is not the only way to avoid mosquito bites. Children and adults can wear clothing with long pants and long sleeves while outdoors. DEET or other repellents such as permethrin can also be applied to clothing (don't use permethrin on skin), as mosquitoes may bite through thin fabric. Mosquito netting can be used over infant carriers. Finally, it may be possible to reduce the number of mosquitoes in the area by getting rid of containers with standing water that provide breeding places for the mosquitoes. G-15 Q. Is DEET safe for pregnant or nursing women? A. There are no reported adverse events following use of repellents containing OEET in pregnant or breastfeeding women. G-16 Q. Are there any risks due to using repellents containing DEET? A. Use of these products may cause skin reactions in rare cases. If you suspect a reaction to this product, discontinue use, wash the treated skin, and seek medical attention. If you go to a doctor, take the product with you. Cases of serious reactions to products containing DEET have been related to misuse of the product, such as swallowing, using over broken skin, and using for multiple days without washing skin in between use, for example. Always follow the instructions on the product label. . G-17 Q. Should parents spray insect repellent on their children before they go to school? A. Whether children spend time outside during the school day should determine the need for applying repellent. If children will be spending time outdoors (for example, in recreational activities, waiking to and from school), parents may wish to apply repellent. Mosquito repellent containing DEET is the most effective in providing long-lasting protection from mosquito bites. G-18 Q. Should children be given repellent to use during the day? A. The age and maturity of the child should be taken into account before giving repellent to children for their own use. As with many other chemicals, care should be taken ìhat DEET is not misused or swallowed. Parents should find out if a child will be outside during the school day, and should discuss proper use of the product with their children. Parents should also consult local school officials to obtain policies and procedures specific to bringing repellent to school. . 25 Section H: Surveillance - Birds / \ , H-1 Q. What surveillance activities will the Elgin St. Thomas Health Unit doing in 2003? A. West Nile virus was confirmed in 6 crows in Elgin County in 2002. The Elgin St. Thomas Health Unit will continue with dead bird, mosquito and human surveillance in 2003 as a way of tracking the virus. Larval testing and potentially, larviciding will be added to the local activities in 2003. Just as importantly, you need to take precautions to protect yourself and your family from mosquitoes by reducing breeding grounds and by using protection against mosquito bites. H-2 Q. What is Bird Surveillance? A. Staff at the health unit began a dead bird surveillance program in April as a way of tracking the virus. Crows are especially sensitive to the strain of West Nile virus now circulating, which is why they are being monitored for the virus by the health unit. Last year, neighbouring regions reported a dramatic increase in dead bird sightings in a particular geographic areas about two weeks prior to a human case. Residents across the county are asked to report sightings of dead or ill crows to the health unit at (519) 631-9900. The Canadian Cooperative Wildlife Health Centre, along with provincial laboratories and Health Canada's National Microbiology Laboratory in Winnipeg, will test dead birds for West Nile virus from late April until the first hard frost. The tests will be done mainly on crows, jays, magpies and ravens. Experience from past outbreaks has shown that these species are very susceptible to West Nile virus. This makes them the best indicator for determining whether people in particular areas are at risk. H-3 Q. What types of birds carry West Nile virus? A. The virus has been found in more than 150 bird species in North America. Some species may have no obvious signs of illness when infected. Others, such as crows, blue jays, magpies and ravens, get sick more often and can die. H-4 Q. Do birds infected with West Nile virus die or become ill? A. In the 1999 New York area epidemic, there was a large die-off of American crows. Since then, West Nile virus has been identified in more than 100 species of birds found dead in North America. Most of these birds were identified through reporting of dead birds by the public. H-5 Q. Why are dead crows monitored? A. Nearly 100% of crows that are infected with WNv die from their infection. Monitoring dead crows therefore provides a very good indicator or WNv activity in the community. Experience has shown that dead bird sightings peak just before human cases begin to appear. ( 26 H-6 Q. How can I report a sighting of dead bird(s) in my area? A. You can call the Elgin-StThomas Health Unit at (519) 631-9900 to report dead birds. Not all birds will be collected for testing. Only crows that are freshly dead, have no evidence of decay and no evidence of trauma are suitable for testing. H-7 Q. Why do some areas stop collecting dead birds? A. Some areas are no longer collecting dead birds because they have sufficiently established that the virus is in an area, and additional testing will not reveal any more information. Shifting resources away from testing of dead birds allows those resources to be devoted elsewhere in surveillance and control. H·8 Q. How do I dispose of a dead bird that isn't going to be sent away for testing? A. To dispose of a dead bird, use plastic or iatex gloves to carefully place it in a double plastic bag. You may also use a double plastic bag as a glove to pick up the bird. Then wrap the bird in the bag, tie it off and place it in the outdoor trash. Wash your hands with soap and water when finished. . . . 27 Section I: Mosquitoes and Mosquito Habitats 1-1 Q. What types of mosquitoes spread West Nile virus? A. There are 74 known species of mosquitoes in Canada. West Nile virus infection has been found in 10 of these, but it is more common in species that feed on birds. Examples include Culex pipiens, Culex restuans and Culex tarsaHs. Not all of the 74 different species in Canada are found in all parts of the country. The actual numbers of mosquitoes in different areas will vary according to the time of year. Temperature and rainfall can also have a dramatic effect on mosquito populations. It is estimated that fewer than 1 % of mosquitoes in any given area are infected with WN virus. This means the risk of being bitten by an infected mosquito is low. However, it could happen to anyone in areas where WN virus is active. The best way to reduce your risk is to avoid getting mosquito bites. 1-2 Q. What is "amplification" and "bridging vectors"? A. Mosquitoes become infected with West Nile virus by biting infected birds. Infected mosquitoes then bite other birds and transmit the infection to these birds. These birds then become a source of infection for other mosquitoes. This repetitive process is called "amplification". It begins in the early spring and by mid-summer a large number of infected mosquitoes and birds can result. The main mosquitoes involved in the amplification process in Ontario are Culex pipiens and Culex restuans. These mosquitoes prefer to feed on birds but may also bite humans or animals under certain circumstances. Culex pipiens and Culex restuans tend to lay eggs in man made structures that contain water such as street side catch basins, road side ditches, and man made containers (tires, bottles, buckets, bird baths, roof gutters, swimming pool covers, etc.) In these structures, the eggs develop into larvae, then pupae and then flying adult mosquitoes. Adult Culex pipiens and Culex restuans tend to fly between Y. mile to one mile and bite between dusk and dawn. Later in the spring and summer other mosquitoes called "bridging vectors" emerge. These mosquitoes will feed on birds, humans and animals. They can therefore bite a bird that has been infected with West Nile virus and then transmit this infection to humans with their next bite. A common "bridging vector" in Ontario is Aedes vexans . Aedes vexans prefers to breed in temporary pools created by rainfall and in marshes and swamps. The adult mosquito can fly five miles or more, and bites anytime of the day or night. 1-3 Q. I understand West Nile virus was found in "overwintering" mosquitoes a in early 2000. What does this mean? ¡ , "' A. One of the species of mosquitos found to carry West Nile virus is the Culex species. This species survived through the winter, or "overwintered," in the adult stage. The fact that the virus survived along with the mosquitoes was documented by the widespread transmission during the summer of 2000. 28 1-4 Q. What are stormwater ponds? A. When land is developed to create homes, roads, businesses and other improvements, the natural system of trees and dense vegetation is replaced with pavement, hard surfaces and compacted lawns. As a result, less rainwater soaks into the ground and more of it runs off the hard surfaces at a faster rate, contributing to combined sewer overflows, flooding and water pollution. Stormwater picks up oil, fertilizers, pesticides, bacteria and other pollutants as it runs off parking lots, streets, rooftops, lawns and other hard surfaces. e Stormwater ponds detain and slow the rate of runoff from developed areas and remove pollutants that are collected in the runoff. These stormwater ponds are commoniy used to reduce flooding, erosion, landslides, and pollution. These facilities help protect public health and safety, public and private property, and water quality in local rivers and streams. 1-5 Q. What stormwater facilities are potential breeding grounds for mosquitoes that carry West Nile virus? A. . Catch Basins Mosquitoes that carry the West Nile virus can breed in standing water. Many catch basins are designed to trap pollution and hold a small amount of stormwater after a rainfall event. These catch basins can be breeding grounds for mosquitoes that carry West Nile virus. The Elgin-St. Thomas Health Unit will be sampling water from these types of catch basins in the urban area to monitor them for the presence of mosquitoes carrying West Nile virus. e . Stormwater Ponds and Water Quality Facilities Stormwater ponds and water quality facilities are designed to flIter pollution from stormwater runoff and reduce flooding. Most of the facilities built into residential and commercial developments are designed to drain in a few days, which prevents mosquito larvae from completing their development. Some stormwater ponds and water quality facilities are designed to hold water most of the year or may retain small pools of water. These facilities are generally designed to provide habitat for many species of frogs, birds, flsh and aquatic insects that feed on mosquitoes and their larvae. If mosquitoes carrying the West Nile virus are detected, the Health Unit and authorities in the affected municipality will provide guidance to residents on more aggressive control measures. . Wetlands Although healthy wetlands can provide habitat for mosquitoes, typical water conditions, water quality, and natural predators deter mosquito use and minimize larval success if egg laying occurs. Predators - including other aquatic insects, amphibians, and birds - feed on any mosquitoes present. Wetlands are a critical element in a healthy ecosystem that benefits people, water quality and wildlife. e Wetlands clean and slowly release rainwater, provide flood protection, and wildlife habitat. Many wetlands recharge groundwater and prevent streams from drying up during the summer. We will not eliminate mosquitoes by draining wetlands. We could 29 actually increase the mosquito population if their natural predators are destroyed by draining a wetland. Many mosquito species need only a small puddle or depression in which to breed. Rivers and Streams Under normal circumstances, mosquitoes cannot breed successfully in flowing water, and therefore streams and rivers can only produce mosquitoes when they dry up and leave shallow, stagnant puddles in the stream bed or in backwater areas. Streams and rivers provide good habitat for predators that feed on mosquitoes and mosquito larvae. \. 30 Section J: Surveillance - Mosquitoes and Mosquito Larvae J-1 Q. What is Mosquito Surveillance? A. Mosquito surveillance is being used to help determine the presence and abundance of the types of mosquito responsible for transmitting WNv. This information can be used to point to areas of high risk and wili help in the planning of prevention and control strategies. Because mosquitoes feed on birds, it is possible to find the virus in mosquitoes. Mosquitoes caught in traps can be tested to identify the species, count the number of mosquitoes trapped and identify if any of the mosquitoes carry the virus. Traps, set out weekly in selected, secure locations, use light and carbon dioxide to attract mosquitoes in the early evening. When attracted to the trap, a fan draws the mosquito into a netted container. The live mosquitoes are collected the next morning and sent to a laboratory for testing. e e . 31 Section K: Surveillance - Human K-1 Q. What is Human Surveillance? A. Health Units are working closely with hospitals and health care providers to determine if cases of serious illness might be related to WNv infections. K-2 12 What are the plans for human surveillance? A. As in previous years, health care providers will watch for symptoms of WN virus infection in their patients. They wili request laboratory tests where appropriate. They wili also report all probable and confirmed cases of West Nile virus infection to local I provincial health authorities. Health Canada is working in collaboration with the provinces so that they can do the initial tests themselves. This will improve the time-frame for test results. So far, Health Canada has provided training and technology transfer to labs in Newfoundland and Labrador, Quebec, Ontario, Alberta and British Columbia. Discussions are ongoing with other provinces. Human surveillance information is used in a number of important ways. Knowing that WN virus is in an area puts doctors and the general public on alert. It also provides more clues about who may be at risk for serious health effects from WN virus. In addition, human surveillance provides information to help ensure the safety of the blood supply in Canada \ 32 Section L: Pesticides . L-1 Q. Who decides whether to use pesticides to control the spread of WN virus? A. Provincial and local health authorities are responsible for deciding whether to use pesticides to control the spread of WN virus. Some of the factors they may consider include the following: · the number of mosquitoes in the area · the extent of WN virus activity in local mosquito populations · the degree of risk the mosquitoes pose to people in the area · the size of the area to be treated · the number of people who live nearby · whether it is early or late in the mosquito season · whether other options for mosquito control would be effective in reducing risks to people · how the community feels about pesticide programs · the extent of local WN virus activity in birds, horses, other animals and people L-2 Q. What about using pesticides to control mosquitoes in our community? A. Registered pesticides can be used at two different points in the life cycle of a mosquito: larvicides at the larva stage and adulticides at the adult stage. . A decision to use mosquito larviciding or adulticiding in a community requires a local risk assessment along with consultation from the Medical Officer of Health and provincial authorities. In Canada, all pesticides are registered by Health Canada's Pest Management Regulatory Agency (PMRA). Once this agency has made a decision to register a pesticide product in Canada, the Ontario Ministry of the Environment is responsible for regulating its sale and use mainly through training, licensing and permit requirements. L·3 Q. What are larvicides? A. In the larva stage, pesticide products called larvicides are placed in stagnant water which is where mosquitoes prefer to lay their eggs (e.g. storm sewers). Larvicides can only be sold at licensed vendor outlets and applied by trained and licensed applicators or trained technicians. The licensed applicator must obtain a permit issued by the Ontario Ministry of the Environment. There are a number of larvicides registered by Health Canada. Larvicides that cause minimal impact to the environment and do not present unacceptable risks to human health will be permitted by the Ontario Ministry of the Environment. The pµblic must receive advance notice before the application of a larvicide in their community. . 33 L-4 Q. What are adulticides? A. Control of adult mosquitoes involves the application of pesticides called adulticides in late evening when adult mosquitoes are most active and mosquito control is most effective. There are a number of pesticides to control adult mosquitoes registered by Health Canada. For disease control programs Health Canada supports the use of malathion applied by ground equipment in urban areas. Adulticides are applied by trained and licensed applicators. Advance notice must be given to the public before an adulticides is applied in a community. The use of adulticides might be necessary only where there is a significant risk to human health from WNv and when other disease prevention or mosquito control measures either have failed or would clearly be inadequate to stop the spread of the virus. L-5 Q. If provincial and local authorities decide to spray, what products would they use? A. That depends on the time of year and the current stage of development for local mosquito populations. There are four stages in a mosquito's life cycle: egg, larva, pupa and adult. Egg: Mosquitoes lay eggs in clusters, in standing water. The eggs fioat on the water's surface, sometimes in rafts of a hundred or more. Most eggs hatch into larvae within 48 hours. Larva: Larvae live in the water and come to the surface to breathe. They shed their skin four times and become larger each time. After the fourth molt, a larva becomes a pupa. Pupa: This is a resting, nonfeeding stage that lasts for about two days. When the mosquito is fully developed, the pupal skin splits and an adult mosquito emerges. Adult: The adult mosquito rests on the water's surface while all of its parts harden and its wings dry. After this, it is ready to fly. Mosquitoes can only be controlled when they are larvae or adults. Products that control larvae are called larvicides. Products that control adult mosquitoes are called adulticides. L-6 Q. Which type of pesticide product do authorities prefer to use? A. In general, the use of larvicides is preferred to the use of adulticides, for the following reasons: · Larvicides are more targetted because they are applied directly to mosquito breeding areas. · Larvicides control mosquito populations before they become blood-feeding adults. · Larvicides may reduce the need to use adulticides. This may result in an overall reduction in pesticide use. Larvicides and adulticides are part of an integrated approach to mosquito control that also includes surveillance and reducing sources of standing water where the larvae live. It may be necessary to use adulticides where there are large numbers of adult mosquitoes, or where there is an imminent risk of human infection. ( 'n~~ 34 L-7 Q. What is methoprene? A. Methoprene (Altosid) is very effective against Culex species and is recommended for use in catch basins, since catch basins contain a high density of Culex larvae. Methoprene comes in briquettes that look like hockey pucks. These briquettes are heavy and so are not washed away by rain water coming into catch basins. The briquettes release the Methoprene for up to 30 days although even longer acting briquettes are available in the United States. e Methoprene is called an "insect growth regulator" or "biorationallarvacide". This means it mimics a natural hormone in the insect and so prevents the larvae from maturing into adult mosquitoes. Methoprene has been registered by the United States Environmental Protection Agency (US EPA) since 1975. The US EPA has placed Methoprene in the "lease toxic" category with regards to humans stating that it "does not pose unreasonable risk to human health". Methoprene has no known serious health risks. As well, the public should have no exposure to Methoprene since the briquettes will be placed mainly in catch basins, and Methoprene dissipates rapidly in the environment once it is released from the briquette. Methoprene is rapidly broken down by sunlight. It breaks down quickly in water and soil, and will not leach into groundwater. It is classified by the US EPA as not posing an unreasonable risk to wildlife or the environment. The effect of Methoprene has been studied on a great number of species. It has been found to have no effect on bees or dragonflies. Methoprene has been found to be acutely toxic to some species of freshwater, estuarine and marine invertebrates such a crayfish. However, there appears to be few long lasting effects after treatment. Reports offrog abnormalities have been widely circulated but have not stood up to scientific scrutiny. Most of the studies done on Methoprene toxicity involve much higher concentrations than would be found using Methoprene for mosquito control. The US EPA in 2001 concluded that exposure to Methoprene will not reach levels toxic to aquatic non-target organisms. e L-8 Q. What is Bti? A. Bti (Vectobac, Aquabac, Teknar) is the product that would be used in woodland lots, natural ponds and boggy areas. It is used in a granular form that is applied by hand or using a hand held applicator device. Aerial application may be necessary in remote, otherwise inaccessible bodies of water which are found to be a source of "bridging vector" larvae. Bti is a "microbial larvicide" . This means it is a naturally occurring bacteria that produces a crystallized toxin. When the larvae eat the bacteria, the specific conditions in the mosquitoes stomach causes the crystallized toxin to be released resulting in the death of the larvae. Bti has been registered by the US EPA since 1983. Bti is effective against mosquitoes and black flies, and may affect some midges. Extensive studies by the EPA have found that Bti is essentially nontoxic to humans and so there are no concerns for human health effects. As well, e~tensive studies have shown that Bti does not pose a risk to wildlife, non-targeted species, or the environment, when used according to label directions. e 35 ( L-9 Q. What steps do provincial/local health authorities take to ensure public safety when pesticides are used? A. All workers who carry out mosquito control programs are licensed by provincial authorities and are trained in the safe use of pesticides. If local authorities decide that the risk of WN virus infection warrants the use of pesticides in a certain area, they will notify the public in advance. This will enable people to take precautions and minimize their exposure to pesticide products. L-10 Q. Are mosquito control products safe? A. Pesticides are carefully regulated and must be registered with the Pest Management Regulatory Agency before they can be used in Canada. As part of the registration process, the products undergo a rigorous scientific assessment to determine whether they are safe. The assessment looks into many areas, including risks to human health and the environment and whether the product is effective. The Pest Management Regulatory Agency refuses to register pesticide products that are ineffective or pose unacceptable risks. c___ 36 Section M: Provincial WNv Plans M-1 Q. What is the Ontario Government's 7 Point Action Plan for West Nile virus? A. Ontario's Ministry of Health and Long Term Care (MOHL TC) launched a seven point action plan to combat WNv over the next five years. 1. New lab capabilities - Addition of new staff and equipment to provide new provincial testing capabilities, reducing the time it takes to get WNv test results. 2. Tracking the virus - tracking the migration of the virus through reporting of infected birds, livestock and mosquitoes. 3. Education - keeping the public informed of developments with WNv and advising about protection of yourself and your family. 4. Mosquito control- funding is being made available to every public health unit to retain mosquito control personnel for larviciding and, as a last resort, adulticiding. 5. Early warning - a pilot project is being implemented for an early warning system to better track the outbreak of the virus and to be able to make more timely decisions on its management 6. Community exposure study - in Halton Region a voluntary blood testing study is being conducted to determine how widespread the disease is and the potential it has for spreading. 7. Research - the MOHL TC continues to consult with communities and with national and international health care professionals to advance and maintain an ongoing flow of information on WNv. '. e e e 37 /~. I \ Section N: Additional Resources N-1 Q. How do I find out more about WNv? A. Health services and other resources Include: WWW.health.qov.on.ca www.HealthvOntario.com Open during business hours, these services provide general information on health care: INFOline: 1-877-234-4343 TTY: 1-800-387-5559 Telehealth Ontario: 1-866-797-0000; TTY 1-866-797-0007 Open 24/7, this service uses nurses to answer immediate health concerns. Health Canada: 1-866-999-7612; TTY 1-800-267-1245 www.hc-sc.qc/enqlish/diseases/westnile.html Centers for Disease Control and Prevention, Atlanta, Georgia Tel: 1-404-639-3311 www.cdc.aov/ncidod/dvbid/westnile/indexlhtm Ministry of the Environment Tel: 1-800-565-4923 www.ene.gov.on.ca REPORTS OF COUNCIL AND STAFF June 24th, 2003 Staff Reports ~ (ATTACHED) J)£F,é«þp T D ::>- ..J<J<...'1 '~-¡c3 3 7 General Manager, Long-Term Care - VON Middlesex-Elgin Community Walk General Manager, Long-Term Care - Compliance Follow-up at Elgin Manor Technical Services Officer - Hot Mix Asphalt Paving - Contract No. 6220-03 Technical Services Officer - Urban Road Policy Review Technical Services Officer - Community Safety Zone Request and Policy Manager of Engineering Services - Terrace Lodge - Update 2 Manager of Engineering Services - County Road #51 (Fruit Ridge Line) Reconstruction Director of Human Resources - Market Survey 2003 Accounting Clerk - 2003/2004 Community Support Services Proposed Budget Accounting Clerk - Budget Comparison to March 31, 2003 Purchasing Co-Ordinator, Financial Services Accounting Clerk, Deputy Clerk and County Archivist- Digital CopierslDocument Management Software County Archivist and Manager of Library Services - County Representative On the Elgin-St. Thomas Archives Association General Manager, Long-Term Care - Ministry Complaint Investigation.. Bobier Villa 4f!' «>-""-. REPORT TO COUNTY COUNCIL FROM: Helen L. Notte, General Manager, Long-Term Care DATE: June 3, 2003 SUBJECT: VaN Middlesex-Elgin Community Walk INTRODUCTION: VON Middlesex-Elgin have requested that the County Homes consider our participation as a Corporate Sponsor for their Great Community Walk, August 24, 2003. With approval from the Warden, arrangements are being made to support this fund-raising event at a cost of approximately $70.00, in exchange for which, County Council will be publically recognized as a Corporate Sponsor. This report is for Council's information. DISCUSSION: VON Middlesex-Elgin has planned a Community Walk August 24, 2003 rather than hosting their Annual Dinner Auction. The County Homes have been asked to provide coleslaw for two hundred and fifty (250) people, in exchange for which the Homes would be acknowledged as a 'Corporate Sponsor'. An income tax receipt will be issued for the value of the gift. In 2002, Council donated a Tremaine Atlas, valued at $75.00, to the VaN's Silent Auction. In order to meet the VaN's time-sensitive deadline for a response, the Warden was consulted. With Warden Wilson's approval, arrangements have been made to provide coleslaw for this fund-raising event. The cost will be $70.00 approximately. CONCI.;USION: A gift of coleslaw, valued at $70.00, will be donated by County Council to the VaN Middlesex-Elgin Community Walk on August 24, 2003, with the Warden's approval. Cou(lty Council will be publìcally recognized as a 'Corporate Sponsor' for this fund-raising event. For comparison, Council donated a $75.00 Tremaine Atlas to tile VON's 2002 fund-raising event. This report is for Council's informatiqn. 3 1 RECOMMENDATIONS: THAT the June 3,2003 report, 'VON Middlesex-Elgin Community Walk', be received and filed. Respectfully Submitted Approved for Submission !~x~ Helen L. Notte General Manager Long-Term Care and Seniors Services Ma onald Chief Administrative Officer , 4 2 /~s: .v ,c\."'-:' SOU A Branch ofVON Canada 200-1151 Florence Street, London, Ontario N5W2M7 TEL: (519) 659-2273 . FAX: (519) 659-6191' www.von.ca .<~Q,m ". . , . . < " tI(> ~" "'-I>",.",c;p" VON MIDDLESEX-ELGIN April 2003 ¡IfsL§;CC'J221Y\.SJ.L : I ¡\1A' ',/ 2 .,~../'" 1.1 1 L'Y;.~.? --(;1 , ',,: v",-, \~Jv~ ¡ TK:~ffY·<."'·-"·'''~." - ~~v~.<:i:~J~<~£~_ Helen Notte Director, Elgin County Homes for Seniors R.R.#1 St. Thomas, Ontario N5P 4C1 Dear Helen: Healthy communities are strong communities. To be successful, we must work together building on our strengths and accomplishments. You have been a generous supporter of the YON Annual Dinner Auction held during the fall of each year. We have decided to focus our fundraising efforts this year on a Community Walk instead of the Dinner Auction event We hope that you will continue to support YON charitable programming and invite you to participate as a Corporate Sponsor for the event. We would like to request of the County Homes that you consider preparing and providing coleslaw for 250 people as your support and contribution for the event. As a Corporate Sponsor, your business will be identified as a "Community Champion" on promotional material and you will receive an income tax receipt for your generosity. Promotional material for the event includes posters, pamphlets and event T- shirts. For your infomnation, a fact sheet is included in this package. We hope to distribute brochures by mid-June therefore we need confirmation of corporate sponsorship by May 26, 2003. I would be pleased to personally address any questions that you may have. Please call me at 637-64D8. Thank you for caring enough to consider assisting YON to continue "touching the lives" of many throughout Elgin County. VON Cares - Partners for a Healthier Community ~ ~~Ju D. J. Smale Manager, YON Volunteer Programs Middlesex-Elgin Branch Cc: P. Muma, S. shetíf{ ELGIN OFFICE 175 $. Edgeware Road St Thomas. Ohtario N5P 4C4 (519) 631-3270 VOLl~EERPROGRAMS (519) 637-6408 FAX: (519)631-4798 MIDDLESEX OFFICE 100 Albert Street StrathroY10ntario N7G I V5 (519) 245-3170 FAX: (519) 245-3164 FAMILY SUPPORTS 101-1151 Florence Street London, Ontario N5W 2M7 (519) 657-4570 TOLL FREE: 1-866-662-6605 FAX: (519) 657-8031 5 :7~ o l)fJ ~ 7 \liON ¿i: -:¡., / ~ co/>. /{9"v o ,0 ~l,lFE. so'JC V ON MIDDlESEX-ELGIN A Branch of VON Canada 200-1151 Florence Street, London, Ontario N5W 2M? TEL: (519) 659-2273 . FAX: (519) 659-6191 . www.Yon.ca ¢,,,,~. '''.'' ij ~ < . .~. '%;"-1.. r;p.r-'# Elgin County's VON Great Community Walk FACT SHEET WHEN: Walk will take place on Sunday, August 24, 2003 WHAT: This is a pledge event which participants can walk two, five or ten kilometers. For safety reasons we ask that no roller blades, skateboards or bicycles participate. WHERE: The walk location will be at Springwater Conservation Area. The walk area will be in a natural setting. Following the walk, all participants are invited to join together for a celebration including entertainment, a complimentary BBQ and something for everyone. WHO: This is a family event open to the general public and both individuals and teams are invited to enter. WHY: 100% of funds raised will stay in Elgin County and will support VON charitable programming. COST: There is no entry fee or pledge level you must achieve. GOAL: The goal of the walk is that we attract 250 participants who will work together as a team to make our community a better place for all. ELGIN OFFICE 175 S. Edgeware Road St. Thomas, Ontario N5P 4C4 (519) 631,3270 VOL~ERPROGRAMS (519) 637-6408 FAX: (519)631-4798 MIDDLESEX OFFICE 100 Albert Street Stratbroy, Ontario N7G IV5 (519)245-3170 FAX: (519) 245-3164 FAMILY SUPPORTS 101-1151 Florence Street London, Ontario N5W 2M? (519) 657-4570 TOLL FREE: 1-866-662-6605 FAX: (519) 657-8031 6 REPORT TO COUNTY COUNCIL FROM: Helen L. Notte, General Manager, Long-Term Care DATE: May 26,2003 SUBJECT: Compliance Follow-up at Elgin Manor INTRODUCTION: The follow-up to the Annual Compliance Review was conducted by the Ministry of Health and Long-Term Care at Elgin Manor on May 21,2003. This report is provided for Council's information. DISCUSSION: All long-term care facilities are reviewed annually by the Ministry of Health and Long-Term Care to ensure that programs, services and care meet required standards. The Ministry's Compliance Officer will do follow-up inspections as necessary. The Manor's anflual review was completed in February 2003, at which time, an unmet standard regarding resident's weights was recorded. That review report was brought forward to Council at that time. At the follow-up inspection, the Ministry representative noted that the issue of weights had been dealt with and the Home meets the standard. No unmet standards were cited on this follow-up inspection. The Officer did make three (3) observations related to the weights, policy and procedures being reviewed, and pain and symptom management. Resident weights are taken and recorded; the Registered Dietitian monitors the weight changes regularly. The Homes' Policies and Procedures are in the process of being reviewed and revised, led by the Task Force members. A pain and symptom management policy has been developed. This report is for Councif1s information. CONCLUSION: The Ministry of Health and Long-Term Care has completed its' follow-up to the ann.ual compliance inspection at Elgin Manor. No unmet standards were cited; threå (3) observations were made related to weight programs, policy and 7 1 procedure review and pain and symptom management. This report is provided for Council's information. RECOMMENDATIONS: THAT the report dated May 26,2003, 'Compliance Follow-up at Elgin Manor', be received and filed. Respectfully Submitted Approved for Submission ~¿~ Helen L. Notte General Manager Long-Term Care Mark c onald Chief Administrative Officer 8 2 -".;,..>-;+.>.;- <_·_"_-,....~..""'"',T··'~,·,·~"-<.:1:~ø.: (i) Ontario Ministry of Health Long-Term Care Division Residential Services Branch 5700 Yonge Street, 7th Floor North York ON M2M 41<2 Report of Unmet Standards or Criteria Rapport sur les normes ou critères non respectés Ministère de la Santé Division des soins de longue durée Direction des services en étab!issement 5700, rue Yonge, 7e é!age North York ON ,J~2M 41<2 Regional Offic;eslBureaux régionaux Toronto (416) 327-8994, London (519) 434-1105, Ottawa (613) 787'-4040 Date of review/Datede I'inspection ;2./ /ð3 Long-Term Care Faci!itylEtablissement de soins de longue durée ¿:'Jtj:UV ~ f? . f< .:t:I I ../-1. 77z.c.rna.o Name and title of LTC Division representativeINom at foncûon du (de la) representant(a} de la Division ~~, C~II'~ AddresslAdresse ¿¡ ~,.rU '-<+ Type of review/Genre d'inspection D Annual Annuelle r-Yl'ollow-up ~-~,~a..l... ~ SUlVI ~....-"-- D Referral Visite d'un(e) ,conseiller(ère) D D D Complaint Investigation Enquête à la suite d'une plainte Complaint investigation follow~up Suivi d'une enquête à la suite d'une plainte Pre-sale Préalable à la vente D D D Post-sale Postérieure à la vente Preølicense Préalable à la délivrance du permis Other (specify) Autre (précisez) The foflowing statements reflect the results of the facility operaüonal review as based on Ministry of Health standards and criteria for resident care, programs and services in Long· Term Care facilities. Les observations suivantes i!lustrent les résultats de /'inspection des opéraüons de I'établissement effectuée sur la base des normes et critères du ministère de la Santé en matière de soins aux pensionnaíres et de programmes et de services offerts dans les établissements de soins de longue durée. Standards or criteria Normes ou critères Reviewresulls Résuitatsde l'lnspection Date for corrective action Date de la mesure corrective . ;;;. '-I .-A5I' ~ , Signature of long-Term Care Division representative/Signature du (de la) représentant(e} de la Division des soins de longue durée Original: Division des soms longue durée Copy: Long-Term Care Facility - . Copie: EtabIissement de soins de longue durée ~~ 9 Page I of/de I 2088--?2 (94103) 753G-4426 , . .~ ~ Ontario Ministry of Health " and Long-Term Care Ministère de la Santé et des Soins de ongue durée Observåtion/Discuss~n Summary ~egional Offices/Bureauxrégionaux 1amilton (905) 546"8294, ,Kingston (613) 536-7230, London (519) 675-7680 ;udbury (705) 564-3130, Toronto (416) 327-8952 . . ...... . -, Somrnair~des observationset discÜssions ong- Term Care Facility/Etablissement desOÎns de longue duree 8t~'/T}~ ¡;? ;.q ¡s,J I (. l/r...er-r-n =' ,ddress/Adresse ....-/"~~Æ , él~~-,,-- 1- ~ a..L;;X" ~ O~",--, Jame and title of LTC Division rE:presentative/Nom at fonction du (de Ja), représentant(e) de la Division Type of review/Genre d'inspection -J Annual Annuelle o o o Complaint Investigation Enquête ~ fa suite d'une plainte Complaint investigation foUow-up Suivi d'une enquête à la suite d'une pl~inte Pre:..sa!e Préa!ab!e à fa vente Post-sale Postérieure à la vente -yFoIIQw-up _ _.. _ 0 ~ SU¡VI ~~ o o Pre~lìcense- Préalableà!a dé1ivrance du permis. ] Referra! Visite d'un(e) conseiller(ère) O Other (speqify) . Autre (précisez) The following reflec.t explanatory detail related to )bservations/discussions over the course of the review. This nformation is provided as guidance to the facility and written 'esponse is not'required. On trouveraci-dessdus une explication détail/éedes observations et discussions formu/ées au cour~ de !'inspection. :Ges renseignements: sont foumis à I'établissyment à titred?nfonnation; iI n'est pas nécessaired'yrépondre par écfit. . I. "h'~;/Slt.J ~ --. ,'19 ~~'J ¡Ý~t/~~. ~J :; ~:::~ ~ : l,~¡":Ú; Z;L :; .:;;;;~:!:::: . ...Þ# í(,~ ; --- r/ C tC- ~J (¡LJ "-'81'"'1 ) r-.'./'t .)./J A PJ~ '--0 .Apß ~~,. '-')//?f'~~ ,--<--v -c:~ 9 . 3'. _ 4-( <- ~ /? .-7 t1 f/,.. ~/7t ~ -"J.d_ r/~~ð ~/..-?"> J J /.J Ì,/)h' -;U r7744?4'u...-~ ~~ ~-<-. . :..J ' . U ~U~~ .6fj ~ p~ 7 ~ f3-.~,d4"~ . 5l^lŒ-r~",:hd?U ~.-~ ~cV ~~~ g d~-I./'oC£..Q-ýra-/'. ./U ~~J ~, J ..'<.Þ'.Jt..- tJ A\ Roo,;"ed fŒ Ih. F,.'ity b,/R"", po"' 'JJt'1':~"1 pa< /ÓÚ h ,~ ì i ret.13mregÃÑéÕRdel 'programmes ~ Original: Health Care Pr Original: Programmes de soins de samé CoPy: long-Term Care Facility Caple: Bablissement de soins de longue durée o ~age I of/de I 7530-5557 CORRESPONDENCE - June 24. 2003 Items for Consideration 1. Donna Lunn, Elgin Community Futures Development Corporation, requèsting support for broadband Internet access initiative. (ATTACHED) 2. Thomas K. Findlay, Chairman and Linda Todd, Secretary, Kirkin' of the Tartan Committee, with a request to borrow the Elgin County flag and pole for the Kirkin' 0' the Tartan parade and service on September 21, 2003 at Knox Presbyterian Church. 3. St. Thomas Gun Club, with a request to borrow the County flag to fly during the Canadian Trapshooting Championship June 25-30, 2003. (phone call received from Pam Muma requesting use of the flag) Jun.16. 2003 1:05PM No.99 ¡ I P, 2/3 Broadband Internet service may soon be available throughout Elgin County!!! The construction of this service requires that a significant portion of the costs be covered by the Provincial and Federal Governments. Elgin Community Futures Development Corporation (ECFDC) is the community champion to get this service to our County. As of May 22 2003, ECFDC has already been approved for $900,000 of funding toward the project by the Ontario Government, through the Connect Ontario: Broadband Regional Access (COBRA) program, On June 6th, a proposal was submitted to the Broadband for Rural and Northern Development (BRAND) program (COBRA's Federal counterpart) to subsidize another portion of the cost of the new network. As a requirement for BRAND we need to show community and public support for the project through letters of commitment from possible users of this network (Le,.: residents, businesses, farmers, municipalities, organizations, etc who do not currently have internet service, or who are unsatisfied with what they currently receive), The consortium of Amtelecom, Hydro One and Eastern Independent Telecommunications Inc won the tender over many other vendors. A fibre backbone will be provided and the "last mile" to residents and businesses can be accomplished by a secure licensed wireless broadband Presently, Amtelecom is the primary internet service provider (ISP) for this network. They will be providing internet access to users using wireless technology once the network is complete. The estimated costs will be a one time $100 connection/installation of wireless antenna and modem for a high speed broadband service. The wireless service is over a licensed spectrum to provide for better security and reliability. Monthly charges would be a maximum of: · $52.95 for a 1 Mbps (ample service for residential, home offices & small business use) · $119.95 for a 1.5 Mbps. Also available are 5Mbps and 10Mbps, which are $399.95/month and $899.95/month respectively with a $150 installation fee, and are negotiable depending on site specifics. If the above sounds desirable to you, and you would like to see this network developed, please complete the attached letter and Fax to: (519) 633-5070 or Email to; donna@elgincfdc.ca Mail to: Elgin Community Futures Development Corporation 300 South Edgeware Road St. Thomas, Ontario N5P 4L 1 Fax or email is preferred as the deadline for receipt of your letter is June 23, 2003. If responding as a business, please copy the letter onto your letterhead All of us appreciate your time and thank you for your consideration and support. Questions?? Call 519-633-7597 ext 27 for Donna or ext 36 for Jesse. 12 CORRESPONDENCE - June 24. 2003 Items for Information - (Consent Aaenda) 1. St. Thomas REACT Inc., NEWSLETTER - May 2003 (ATTACHED) 2. Steve Peters, M.P.P., Elgin-Middlesex-London, supporting Council's resolutions to: 1) Honourable Jerry Ouellette, Minister of Natural Resources and Honourable Chris Stockwell, Minister of the Environment, concerning the City of Brampton's resolution regarding the Emèrald Ash Borer; 2) Honourable Harbrance Singh Dhaliwal, Minister of Natural Resources and Honourable David Anderson, Minister of the Environment, concerning the Emerald Ash Borer. (ATTACHED) 3. Gerald Crowell, Media Contact, Ministry of Consumer and Business Services, NEWS RELEASE, "Retail Closing on Canada Day" (ATTACHED) 4. Honourable Gar Knutson, Elgin-Middlesex-London, acknowledging Council's resolution concerning changes to the Correction Policy with respect to first degree murder and incarceration in minimum-security facilities. 5. Brad Searchfield, Executive Vice President, Real Estate & Sales, Ontario Realty Corporation, regarding the Provincial Secondary Land Use Program on Hydro Corridor lands and the two-year municipal planning period start date. (ATTACHED) 6. Diana Summers, OGRA Manager of Policy, Ontario Good Roads Association, HeadsUP Alert, regarding the P.C. Party proposal to require municipalities to pass a referendum in order to raise existing taxes or introduce new ones. (ATTACHED) 7. Claude Fortin, Chief Municipal Wastewater Effluents Division, Environmental Protection Service, Environment Canada, concerning the proposed use of a long- term strategy for pollution preventative planning for managing wastewater effluents. (ATTACHED) 8. Herb Kreling, President, Canadian Association of Police Boards, acknowledging Councils support of the CAPB's resolution concerning the incarceration of criminals convicted of first degree murder in minimum security facilities. (ATTACHED) 9. David J. Johnson, Chair, Assessment Review Board, with information concerning a complaint streaming strategy adopted by the Assessment Review Board. (ATTACHED) 10. Honourable Ernie Eves, Premier of Ontario, acknowledging Council's resolution concerning the jurisdiction over farmed and ranched deer and elk. 11. Honourable Jerry J. Ouellette, Minister of Natural Resources, acknowledging Council's resolution concerning the proposed shot gun use for deer hunting and points of clarification. (ATTACHED) 2 12. John Wellard, President of Union Gas, with a follow-up to the announcement of his appointment as President of Union Gas. (ATTACHED) 13. K.C. Emerson, Honorary Chairman, Carol Judd, Chairman, Lynda Millard, Secretary, Vienna's Sesquicentennial Celebration, thanking the County for its part in the Celebration. (ATTACHED) 14. Nick Wells, Chair, and Diana Player, Secretary, The Talbot Settlement Bi-Centennial Committee, thanking the Warden and County Staff for their assistance with the Talbot Settlement Bi-Centennial Celebrations. (ATTACHED) 15. Cynthia St. John, Chief Administrative Officer, Elgin-St. Thomas Health Unit, with a copy of the Audited Statements for the period ending December 31, 2002. (available for viewing in Administrative Services) 16. AMO Member Communication ALERT: 1) Fair Deal Is No Deal for Municipalities- AMO to Conduct Independent Municipal Financial Review (ATTACHED) 17. Honourable Frank Klees, Minister of Transport, with copy of correspondence regarding the County of Wellington's resolution concerning Advanced Road Weather Information System. (ATTACHED) 18. Steve Peters, M.P.P., Elgin-Middlesex-London, with copy of correspondence re: financial burden to municipalities to fight West Nile Virus. 19. Geoff Kettel, Senior Manager Corporate Liaison and Resource Service, Public Health Branch, Ministry of Health and Long-Term Care, acknowledging Council's resolution concerning West Nile Virus funding. May 2003 NEWSLETTER JUN 4 ?~a3 St. Thomas REACT Inc. ~ ...",. P.O. Box 20047,456 Talbot St., St. Thomas, ON N5P"4H4 t'r~~ !,_, - REACT MONTH/SAFETY AWAKE BREAK The month of May was recognized in the City of St. Thomas as REACT month. We are proud, again to fly our flag at City Hall. In observance of REACT month, St. Thomas REACT with the continued support of our community once again hosted a "Safety Awake Break at the Eagle Rest Station on Highway #3 between Eagle and Wallacetown. This was the 12th year that St. Thomas REACT volunteers have manned this Rest Station, offering free refreshments as an incentive to travelers to stop, stretch and take a break from driving. Even a short break from behind the wheel helps to alleviate driver fatigue, which is the #1 cause of many holiday accidents. b# A special Thanks to DnttonlDunwieh Township for allowing us the use of the Eagle Rest Station for The Safety Awake Break site, to Me Donald's Restaurant for supplying their orange drink, The Corner Store for ice, Charlton's Quality Meat for supplying the hotdogs, Port Stanley Food Market for Hot dog buns, Tim Horton's for coffee, Petro Canada for the Gas needed to run our generator, Pioneer for propane and Regional Mental Health Care - St. Thomas for the use oftheir popcorn machine and donation of thejr popcorn supplies. This year the weather was on our side. Although a bit windy it was dry and reasonably warm. We had between 80 and 100 weary travelers stop at the rest station to enjoy something to drink or eat. We even had some faithful ftiends, who stop every year to visit us and enjoy our ftee reftesbments. One boy loved our popcorn so much he even brought a ftiend with him this year. They stopped once on their way to their destination on Saturday morning and again Monday afternoon on their way home. Again, it is through community minded businesses like you that we were able to provide these reftesbments and awareness to travelers to take a break ftom driving so that they can get to their destination safely" This was possible through your generous donations. THANK YOU! In January, we sent out our direct mail letters for donations to update our team equipment. This year our goal is to raise $5000.00 to purchase the fol1owing items: · 2 - Kenwood Radios and Mikes $1400.00 · 4 - Laser Dash Mount Lights $1200.00 · 4 - Kenwood Batteries $400.00 · First Aid Supplies $1400.00 · Small 1500 Generator $600.00 We wOl¡]d like to thank the Kinsman Gnh for their donation of$loo.00, Format Indnstries for their donation of $400.00 Presstran for their donation of$400.00, St. Thomas Fire Department Fire Muster Committee for their donation of $250,,00 and to the City or St. Thomas for their donation of$500,OO. Their quick response to our direct mail campaign has been greatly appreciated. Thank you for your support to our team. All donations are stil1 welcome. They're Back! Every where you look there are children on bikes, rollerblades, scooters and skateboards. Regular maintenance of equipment is important to ensure our children's safety: . Check skateboards for cracks. Tighten bolts on the trucks and replace worn wheels ..- . Make sure roHerblades are the proper size. Replace worn wheels, lubricate bearings, rotate wheels every occasionally to minimize wear. . Wipe down the entire bike with a damp rag and look for cracks in the ftame, rims and crank. Check bike for broken, bent or loose spokes. Check that bolts on the seat, seat post, handlebar stem and axle are tight. Check brakes and make any needed adjustments. Oil the chain and sprockets. Check tire pressure. . Check scooter for cracks in the ftamework. Tighten all bolts. Check wheels for wear and check the brake system (If it applies) . Remember to make sure your child's helmet is properly sized, ftee of defects, such as cracks worn straps and that the fastener locks securely under their chin. A rew minutes to check definitely beats a rew hours at Emerg. 17 CONTACT INFORMATION Address: St. Thomas REACT Inc. P.O. Box 20047 St. Thomas, Ontario N5P 4H4 d Our uew E-mail address is ¥c, sttreactía2hotmail.com Phone Contacts: President Mary-Ellen Hicknell Or Coordinator Fred Satterley 782-3040 633-6309 St. Thomas REACT welcomes all comments and inquiries! POINTS TO PONDER Why do people order double cheeseburgers, large fÌ'ies and a DIET soda! Only in Canada.." do people use answering machines to screen calls and then have call waiting so we won't miss a call fÌ'om someone we didn't want to talk to in the first place! Ever wonder about those people who spend $2.00 on those bottles ofEvian water? Try speUing Evian backwards: Naïve. When someone asks you "A penny for your thoughts" and you put in your two cents, what happens to the other penny? Why are wise man and wise guy opposites? Why do overlook and oversee mean opposite things? Does that screwdriver belong to Philip? Do people in Australia call the rest of the world 'up over'? Can a stupid person be a smart-elick? Why is it called lipstick if you can still move your lips? Why is the third hand on the watch called the second hand? Why is it that night falls but day breaks? Why is it that when you are driving and looking for an address, you turn down the volume on the radio? Why is lemon juice made with artificial flavour and dishwashing liquid made with real lemons? Are part-time bandleaders semi-conductors? Can you buy an entire chess set in a pawnshop? Day light savings time - why are they saving it and where do they keep it? Did Noah keep bees in archives? Does killing time damage eternity? A mend is the one who knows you and loves you just the same. He who is ashamed of asking is afÌ'aid of learning. Never invest your money in anything that eats or needs repair 20 · Remove old unused items rrom around your property including old tires that have a tendency to coHect water. · Change the water in wading pools, birdbaths, pet bowls and livestock watering tanks twice a week. · Cover rain barrels with screens" · Clean out eaves troughs regularly to prevent clogs, that can trap water. · If you have an ornamental pond, consider getting fish that wiH eat mosquito larvae, (Infonnation taken rrom Health Canada) St. Thomas REACT volunteers were asked to provide safety snpport for the following events: · Every Friday and Saturday night security for Eastway Ford · February I - Figure Skating · February 2 - Figure Skating · February 12 - Proper Radio Procedures and Emergency Procedures at events · February 20 - Search for Alzheimer Patient · February 21 - All Stars Hockey · February 25 - All Stars Hockey · April 16 - Assisted with Traffic for Fire at 80 Confederation Dr. · April 23 - Search for Alzheimer Patient · Every Monday to Thursday for the Month of May Traffic for St. Thomas Soccer Club · May 16 - May 19 Safety Awake Break · May 21 - Track & Field Meet at St. Joe's · May 24 - Talbot St. Reenactment · May 25 - Reenactment in Port Stanley ~ .~' :.2"1',;: ., 'JØ0;,a; ¥!Î c4."~iI'Þ;f.:,.,¡if"·>' ., r' f· J'",~-,~~:~::::;:j . ~'-^,P~ -- Under the authority of Her ExceHency the Right Honourable Adrienne Clarkson, c.c., C.M.M., C.D. Governor General, the Canadian Peacekeeping Service Medal will be presented by Mr. Gar Knutson M.P. to Petty Officer Second Class (Retired) Charles Stuart K. G, C.P.S.M.S.S.M., C.D. This award honours Charles' service on a UN sanctioned International Peacekeeping Mission (Haiti-UN sanction 875) on the H.M.C.S. Fraser (Oct-Dec 1993) and recognizes his valuable contribution to W orId Peace. Charles joined the Canadian Navy in March of 1977 and retired 24 Y2 years later on August 17, 200 I" This Honour can be added to his Gulf and Kuwait MedaL Special Service Medal and Canadian Forces Decoration. His official signature is now Charles Stewart K.G., C.P.S.M., S.S.M., c.D. It's one heck of a way to learn the alphabet. He can also add a V for Volunteer. St. Thomas REACT Salutes You! UPCOMING EVENTS · Eastway Ford Security every Friday and Saturday night. · May 3 1 - Triathlon · June I - Triathlon · June 7 - Sunshine Walk · June II - Emergency Response Day · June 14 - Van Fest ac.· :_,'é{-.' ':-';',::> ,'w,- jfi;;: ~r~ · REACTer of the Month for February was Vicki Stewart. Vicki is one of our Junior REACTer who has just joined our team. She is a student at St. Joseph's High School. Congratulations Vicki! · REACTer of the month for March was Robert SatterIey. Robert is the father of a beautiful daughter. He has been with St. Thomas REACT for 6 years and was our REACTer of the year for 2002. Congratulations Robert! · REACTer of the month for April was Emily Thomas, Emily is single and works part time for Gamma Dyna Care Labs. She has been with St. Thomas REACT for 4 years and is currently our treasnrer. Congratulations Emilyl 1 9 HOW TO SIZE A BIKE HELMET · The bike helmet should be CSA approved. · It should fit snuggly and not move around on the child's head · It should fit 2 fingers or less above the child's eye brows · Straps should meet in a V shape just below the ears and no more than two fingers between the chin and the strap THE FIVE-STEP HELMET FIT TEST 1. With one hand, gently lift the ITont ofthe helmet up and back If the helmet moves back to uncover the forehead, you win need to'tighten the ITont strap to junction Also, adjust the padding thickness and/or position, especiany in the back. Make sure the chinstrap is snug. If this doesn't work, then the helmet may be too big. 2, With one hand, gently lift the back of the helmet up and forward. If the helmet moves forward to cover the eyes, you will need to tighten the back strap. Make sure the chinstrap is snug and adjust the padding thickness and/or position, especiany in the ITont. 3. Put a hand on each side of the helmet and rock ITom side to side" Shake your head "no" as hard as possible. If the helmet slips ITom side to side then you need to check the padding on the sides and make sure the straps are evenly adjusted. 4. Open your mouth (lower jaw) as wide as possible, without moving your head. The top of your helmet should pun down. If the heimet does not pull down when opening your mouth then you need to tighten the chinstrap. Make sure the ITont and back strap junction is under each ear. 5, Check to see if the ITont edge of the helmet covers your forehead, The ITont edge of the helmet should not be more than 1 to 2 finger-widths ITom your eyebrows. If the helmet does not cover your forehead then you need to position the helmet no more than 1 to 2 finger-widths above the eyebrows Tighten any loose straps. Make adjustments so the helmet stays over the forehead. Remember a bicycle helmet reduces the risk of serious head aud braiu iujury by 85-88%. However, it is uot euough to simply buy aud wear oue, YOU NEED TO MAKE SURE IT FITS PROPERLY! (Informatiou gathered ITom the Children's Hospital of Eastern Ontario and the National Highway Traffic Safety Administration) WEST NILE VIRUS People can get the virus if a mosquito bites them. The risks of being bitten by an infected mosquito are low and the chances of being seriously ill are even lower. Anyone who is exposed to mosquitoes in an area that has the West Nile Virus has the potential to become infected. , There are two things you can do to avoid being bitten by mosquitoes. I. Minimize your exposure to mosquitoes: · When going outdoors, use insect repenents that contain DEET or other approved ingredients. · Try to avoid spending time outdoors at dawn and at dusk when mosquitoes are most active, · Wear protective clothing such as long- sleeved shirts, long pants and a hat Light coloured clothing is best because mosquitoes tend to be more attracted to dark colours. · Make sure that door and window screens fit tightly and have no holes that may allow mosquitoes indoors, 2, Eliminate Mosquito Breeding Sites Around your Home: · Regularly drain stancting water ITom items like pool covers, saucers under flowerpots, recycle bins, garbage cans etc. Room 331 Main Legislative Building Queen's Park Toronto, Ontario M7A 1A4 ~ Ontario Constituency Office: 542 Talbot Street 81. Thomas, Ontario N5P 1C4 Tel: (416)325'7250 Fax: (41ô) 325-7262 Email: steve_peters-mpp @ontla.ola.org S.TE.VEP, E. ..TE, RS,. M...P.P. . .-. ..- -.. .. ........ .. ......... ..' -, ELGIN - MIDDLESEX - LONDÒN·· ":j':;<i:' Tel: (519) 631-0666 Fax: (519) 631-9478 >TolI Free: 1-800-265-7638 \.'''' ;..Jfmail: steve_peters-mpp-co ","" ""V @ontla.ola.org JUN 9 2003 June 2, 2003 Honourable Jerry Ouellette Minister of Natural Resources Whitney Block, 6th Floor, Room 6630 99 Wellesley Street West Toronto, ON M7A IW3 Honourable Chris Stockwell Minister of the Environment 12th Floor 135 St. Clair Avenue West Toronto, ON M4V IP5 Dear Ministers: Please find enclosed a resolution ITom the County of Elgin that endorses a City of Brampton resolution (also enclosed) that calls your government to take the lead role in the development of a comprehensive strategy to control and remediate the effects of the infestation of the Emerald Ash Borer (EAB) and to provide the necessary funding for this purpose. As you are well aware, the EAB poses a huge threat to Ontario's ash trees, a group of tree species that is commonly seen lining the streets of many ofthis province's municipalities. Ministers, I would appreciate your reviewing the correspondence, responding to the County of Elgin and the City of Brampton and forwarding copies of your letters to my office. Thank you in advance for Y0)ll' time and consideration. Sincerely, ~~ Steve Peters, M.P.P. Elgin-Middlesex -London Cc: County of Elgin City ofBrampton 21 Retail Closings on Canada Day Page 1 of2 @ Ontario Mi"istry "f Consumer and Business Services centra! site! feedback! search [ site map I français I News ßgj"'a!3"'_" I ªIQºb!Jre~_?ndEª-rnRhJ",j§ I ºQD§Wm"'Lªgjõl! I M[oJ~!¡yPlans anclJ~",port§ I Consw.ltation Docu.rnents I AccessP[w.§ News Releases Retail Closings on Canada Day TORONTO -. June 11, 2003 -- Shoppers and merchants are reminded that under the Retail Business Holidays Act (the "Act') Canada Day, Tuesday, July 1, 2003 is among the ei9ht days annually when most stores must be closed. The Act, administered by the Ministry of Consumer and Business Services, exempts some retail operations from the requirement that businesses remain closed and offer no goods for sale. Flower shops, gas stations and book or magazine stores under 2,400 square feet, with a maximum of three employees, are among exempted businesses. Stores may be open in locations established as tourist areas by specific municipal bylaws. Also, stores may, but are not required to be, open Sundays other than Easter Sunday, unless prohibited by the municipality. Any questions about tourist designations or local hours of retail operation should be directed to the Municipal Clerk's offiée in the specific jurisdiction. Minimum fines for opening on prohibited days of retail operation are $500 for a first offence, $2,000 for a second offence and $5,000 for a third or subsequent offence. Retail outlets found 9uilty may be fined up to $50,000 or the total amount of gross sales for the day, whichever is greater. Enforcement of the Retail Business Holidays Act is the responsibility of local police services. -30- Contacts: Ref: Store Openings: Public Inquiries: 416-326-8800 or 1-800-889-9768 Media Contact: Gerald Crowell Ministry of Consumer and Business Services Tel.: (416) 326-8529 Fax: (416) 326-8543 ® Ontario This sitE' maintained by the Government of Ontario home I ceDtraLsite I feedback I search I site maR I francais I lmlR E'mtectina Consumer.s I Mhs. Death§ & Marriaaesl S"¡Y[Og Business I t-J,ewsroom..&Publications I Onling_Services I AbOW.U.he Ministry IE",lated Sites Telephone Service: For general ministry information, ca.]] (416) 326-8555 or Toll free 1-800-268-1142 (in Ontario). For consumer information and advice: (416) 326-8800 or Toll free 1-800-889-9768. TTYffeletypewriter users only: (416) 325-3408 or ToU free 1-800-268-7095. http://www.cbs.gov.on.ca/mcbs/english/5NDNKYhtm 23 6/11/03 (jar ~nutson, '7vf.p. Elgin - Middlesex - London OTTAWA OFFICE Room 832 Confederation BuJIding House of Commons K1AOA6 Tel. (6f3) 990-7769 Fax (613) 996-0194 E-Mail: knutsg@pan.gc.ca .. HOUSE OF COMMONS CANADA JUN ¡ G 20m St. Thomas June 4, 2003 County of Elgin 450 Sunset Drive St. Thomas, Ontario N5R 5Vl Dear Ms. Heffren, Thartk you for forwarding my office a copy of your letter to the Honourable Wayne Easter regarding changes to the Corrections Policy with respect to first degree murders incarceration to minimum-security facilities. I appreciate being kept informed and up to date on the issues that concern the local governments in this riding. If this office can be of any assistance, please do not hesitate to contact me. Sincerely, ~~ The Hon. Gar Knutson, P.c., lVI.P. Elgin-Middlesex- London GK:alc .+. CONSTITUENCY OFFICE 499 Talbot St. 81. Thomas, Ontario N5P 1C3 TeL (519) 631-3921 1-800-265-7810 Fax (519) 631-8555 d Ontario Realty Corporation Société immobilière de l'Ontario June 5, 2003 JUN ! 0 2003 To: Chief Administrative Officers & Municipal Clerks The Ontario Realty Corporation (ORC), as agent for Management Board Secretariat (MBS), is now responsible for the management of the Provincial Secondary Land Use Program on Hydro Corridor lands. Over the past number of months, we have met with municipalities across the province to outline the new process and clarify the role of municipalities during the two-year municipal planning period. During these meetings, some municipalities have expressed concerns about the timing of the planning period. In response to this concern, MBS and the ORC have discussed this matter further with the Association of Municipalities of Ontario (AMO). It is important for all affected municipalities to have a full two years to review and identify potential public linear uses of Hydro Corridor lands in their areas. The Ontario government has agreed that the start date for the two-year municipal planning period will commence June 1, 2003 with the completion date of May 31, 2005. The ORC is committed to working with Ontario municipalities and this is another positive step towards working together for our mutual benefit. For further information about Hydro Corridor lands and the municipal planning period, I would encourage you to visit our website at: www.orc.on.ca. Brad Searchfield Executive Vice President, Real Estate & Sales 24 Please circulate to: Mark G. McDonald JUlie 9, 2003 OGRA Calls for Withdrawal of Referendum proposal in RoC. Platform OGRA President Merwyn Sheppard recently wrote to Premier Eves expressing concern and dismay over certain proposals contained in the recently-released P. C. Party election platform. OGRA's President wrote that the proposal to require municipalities to pass a referendum in order to raise existing taxes or introduce new ones is both expensive and redundant. Municipal councils face the ultimate referendum every three years and must balance the budget each and every year. The President asked why there was no proposal to share the existing fuel tax which is all municipalities have asked for to assist them in providing their mandated services. As well, the President asked why the province would buy municipal bridges when a bridge program would achieve the goal of upgrading and repairing structures withoutconfusing the issue with ownership changes. Sorting out Who Does What has taken considerable time and money and this proposal runs counter to that effort. OGRA agrees with AMO that the referendum com ponent of the P. C. platform should be withdrawn. Municipalities are encouraged to let the Premier and their MPPs know of their opposition to the referendum proposal. For more information contact Diana Summers, OGRA Manager of Policy, at 905-795-2555. jI 25 ~¡,..~ ONTARIO GOOD ROADS ASSOCIATION 530 Otto Road, Unit #2 Misslssauga, ON Tel: (905) 795-2555 Fax: (905) 795-2660 Email: info@ogra.org 1+1 Environnement Environment Canada Canada June 12, 2003 Please distribute to Head of Council and Senior Staff On June 7, 2003, Environment Canada published in the Canada Gazette, Part I a Proposed Notice under Part 4 ot the Canadian Environmental Protection Act, 1999 (CEPA 1999) outlining a proposed instrument to manage the risk posed by ammonia dissolved in water, inorganic chloramines and chlorinated wastewater effluents. These substances are released to the aquatic environment from a number of sources, a primary source being effluents trom wastewater collection and treatment systems. The Minister of Health and the Minister of the Environment have the obligation to assess, under the Canadian Environmental Protection Act, 1999 (CEPA 1999), substances for their effects on human health and the environment. For those substances that are "toxic" under CEPA 1999, the federal government is obligated to propose a risk management instrument. Environment Canada is proposing to use pollution prevention planning under CEPA 1999 for ammonia dissolved in water, inorganic chloramines and chlorinated wastewater effluents as a first step of a long-term strategy for managing wastewater effluents. The Proposed Notice outlines requirements for owners, including municipalities, of selected wastewater collection and treatment systems to prepare and implement pollution prevention plans. This is a flexible instrument which encourages system-wide reviews and life cycle considerations, leads to early reductions of toxic releases, and can result in fundamental reconsideration of system design and operation. For further information please refer to the following web addresses: Canada Gazette: http://canadagazette.gc.calpartI/2003/20030607/pdf/g 1-13723 .pdt Environment Canada CEPARegistry (to be updated by June 16, 2003): www.ec.gc.ca/CEPARegistry/documents/partlmwwe/summary.cfm Claude Fortin Chief Municipal Wastewater Effluents Division Environmental Protection Service, Environment Canada (819) 997-5416 26 * ., JUN I 3 2005 Canadian Association of Police Boards Association canadienne des commissions de police COt~~T';;' 05 June 2003 Mrs. Sandra J. HefITen, Deputy Clerk The Corporation of the County of Elgin 450 Sunset Drive St. Thomas, ON N5R 5Vl Dear Mrs. HefITen: Re: Incarceration in Minimum Security Facilities I am writing on behalf of the Board of Directors of the Canadian Association of Police Boards (CAPB) to thank you for supporting the CAPB's resolution 01-01, which calls on the Federal Government to take corrective action to prohibit the incarceration of criminals convicted of first degree murder in minimum security facilities. The CAPB continues to lobby the Solicitor General of Canada on this issue and spoke to the Honourable Wayne Easter personally about it as recently as March 24, 2003. To date, the Government's response remains unsatisfactory and we will continue to press this matter. By way of background, the CAPB is a national organization formed in 1989 in response to a recognized need for infonnation exchange and education for members of Canadian municipal police governing bodies. In addition to providing a means for the collection and sharing of information, the Association also provides a forum for discussing matters relevant to policing in Canada today. Our Annual Meeting and Conference is an important vehicle in achieving this mandate. Resolution 01-01 is but one of many issues of concern to police governors and municipal leaders across the country on which we can work together. Members of your Council or Police Services Board may be interested in attending this year's Annual Conference as it is an excellent opportunity to discuss issues of mutual concern with colleagues ftom other parts of Canada. I am pleased to provide the enclosed infonnation about the Conference being held in Halifax, Nova Scotia ftom August 20 to 23, 2003 at the Casino Nova Scotia Hotel (fonnerly the Sheraton). This year's conference theme of Charting a Course for the Future was chosen in response to feedback received ftom delegates at last year's conference and to help us prepare to meet the challenges facing policing today and in the near future. The program begins with a keynote address by Dr. Christopher Murphy, Associate Professor and Chair of the Department of Sociology and Social Anthropology at Dalhousie University. Dr. Murphy has an extensive background in police research and will speak about some of the trends he sees impacting on municipal police services. Other trends will be explored throughout the first morning of the Ottawa City Hal!, 110 Laurier Avenue West, Ottawa, Ontario KIP 1)1 Telephone, (613) 560;1312 e~mail: wendyJedec@ottawa.cawebsite:VlWW.capb.ca. Facsimile, (613) 580-2728 27 conference, as well as what police boards can do to help their police services prepare to meet these new challenges. The program also offers plenty of opportunities for small discussion groups and interactive sessions. Workshop topics include: Principles and Practices of Board Governance; Planning for Future Needs: Ottawa's Strategic Staffing Initiative; Conflict Resolution / Fostering Effective Co=unication; and the Board's Role in Budgeting and Financial Control. Should you require additional information, please do not hesitate to contact our office, or visit our web site at www.capb.ca. Sincerely, IJ J~ Herb Kreling, President f Canadian Association of Police Boards 28 Assessment Review Board 250 Yonge Street 29th Floor TorontO ON M58 2L7 Commission de révision de 'évaluðtion foncière 250 rue Yohge 29 I'e étage Toronto ON M582L7 JUN 1 3 2003 ~ Ontario Telephone: Fax: Toll Free: (416) 314-6900 (416) 314-3717 1-800-263-3237 Téléphone: Télécopieur: Sans Frais: (416) 314-6900 (416) 314-3717 1-800-263-3237 MEMORANDUM TO: Counsel of the Assessment Bar, Property Tax Agents, Municipal Property Assessment Corporation and Municipalities FROM: David J. Johnson, Chair SUBJECT: Complaint Streaming Strategy DATE: June 5, 2003 March 31, 2003 was the deadline for filing complaints with the Assessment Review Board for the 2003 taxation year. The Board has received approximately 55,000 complaints for the 2003 taxation year. I am writing to advise you of the complaint streaming strategy that the Board has adopted with respect to these complaints as well as the outstanding case load from previous years. It builds upon the successful elements of previous years' strategies while incorporating recommendations we received during the Assessment Review Board's Stakeholder Consultation process this past year. > The Board will consolidate 2003 complaints with previous years' complaints wherever possible. This will include consolidation with previous years' complaints currently proceeding through the pre-hearing process. The status of the previous years' complaints will dictate the process and timing of consolidation. > All residential complaints will continue to be grouped and scheduled by neighbourhood. Residential complaints will not be automatically streamed for a pre-hearing but complainants may request conversions to pre-hearings if they feel their issues are too complex to proceed directly to a hearing. The Board will normally provide 30 to 60 days notice of these hearings. The first hearings for 2003 residential complaints were heard in April 2003. > Properties having both the specific property codes, as identified in the table on page 2 of this memorandum, and certain threshold assessed values will be streamed for pre-hearings. In the Cities of Toronto, Hamilton, Ottawa and the Regions of York, Durham, Halton, Peel and Niagara the assessed value of $1,000,000 will be used to identify candidates for pre-hearing. In all other areas of the Province, an assessed value of $500,000 will be used. 29 ,. -2- PRE-HEARING PROPERTY CODES PROPERTY TYPE PROPERTY CODE DESCRIPTION . VACANT LANDS 105,106 Vacant commercial/industrial . 112* Vacant multi-residential. MULTI-RESIDENTIAL 340 Multi-residential (more than six units)' 352 Row housina 360*,361* Boardina House, Bachelorettes 373*,374* Co-oo housina . COMMERCIAL 400,401* , Office buildina 410,411,412,415 . Retail 420,421 . Automotive, Service Station 428,429,430,431 Shoooina Centres, Discount Stores 440 Hotels 470,471,472,475 Multi tvoe comolex INDUSTRIAL 500 Expanded from previous years to . include all codes. . SPECIAL 600*,700* . * new codes for the 2003 taxation year. » Parties will not normally be consulted on the dates for pre-hearings but the Board will provide 45 to 60 days notice. The Board intends to start scheduling pre-hearings for properties that meet the above noted criteria late in summer of 2003. » The Board will review all non-residential complaints beyond those with codes as noted in the table above and with va!ues in excess of $1 ,000,000 in the Cities of Toronto, Hamilton, Ottawa and the Regions of York, Durham, Halton, Peel and Niagara. In all other areas of the Province an assessed value of $500,000 will be used to determine if a pre-hearing would be appropriate. Board staff will contact the parties to discuss this point. If the parties do not request a pre-hearing, a hearing will be scheduled. Once scheduled, requests for conversions to a pre-hearing will only be considered in exceptional circumstances and any such requests must be received by the Board well in advance of the hearing date. 30 -3- ~ Parties may continue to write to the Board and request a pre-hearing for any property. Such requests must outline the basis for the request and must be copied to all other parties. Please refer to the Board's Rule of Procedure in this regard. Thank you for your continued co-operation as we move forward in 2003. DJJ/ar/ih 3 1 The Premier of Ontario Le Premier ministre de ¡'Ontario lij "<ImmEl" Ontario Legislative Building Queen's Park Toronto, Ontario M7A1A1 Hôtel du gouvernement Queen's Park Toronto (Ontario) M7A1A1 June 10, 2003 ~ w JUN 1 2 2003 """"'II'I! "_"~ .1"" " e:.Jf-d).~", ,¡J Mrs. Sandra J. Heffren Deputy Clerk County of Elgin 450 Sunset Drive St. Thomas, Ontario N5R 5VI Dear Mrs. Heffren: Thank you for your letter informing me of council's resolution about the jurisdiction over fanned and ranched deer and elk. I appreciate your keeping me informed of council's activities. I note that you have sent a copy of your letter to my colleagues, the Honourable Jerry J. Ouellette, Minister of Natural Resources, and the Honourable Helen Johns, Minister of Agriculture and Food. I trust that the ministers will also fmd council's views informative. Once again, I appreciate having this matter brought to my personal attention. Yours sincerely, ~~~ - ,...- c:_~ Ernie Eves, MPP Premier c: The Honourable Jerry J. Ouellette The Honourable Helen Johns @ ~ Ministry of Natural Resources Minister Ministère des Ministre Richesses naturelles Queen's Park Toronto ON M7A 1W3 416314-2301 Ontario JUN 1 0 Z003 MNR10MC-2003-1634 Mrs. Sandra J. Heffren Deputy Clerk County of Elgin 450 Sunset Drive St. Thomas ON N5R 5V1 JUN 12 2003 Dear Mrs. Heffren: ÐJ3~N ~~l~~~~ ~.j"..'i{"JR",,,,,,i'J Thank you for your resolution of April 10, 2003, with regard to the Proposed Shot Gun Use for Deer Hunting. I would like to bring to your attention some points of clarification related to your resolution: 1) Hunter participation in the muzzle-loader hunt in WMU 91 has not increased since its introduction in 1999, but has slightly decreased. 2) The Ministry of Natural Resources' (MNR) primary purpose in proposing the removal of the restriction of firearm type in WMUs 91 and 92 (middle hunt only) is to provide increased hunting opportunities. Deer population control is achieved primarily through numbers of tags issued. 3) MNR, through its tracking of hunting incidents over many years, has not observed any difference in hunting accidents related to firearm type. 4) There is no evidence to support the allegation that shotgun use increases the likelihood of wounding over other firearm types. I welcome your comments and will take into consideration all views, including yours, when making a decision about regulation changes with respect to firearm restrictions in WMU 92 and 91. Again, thank you for writing. c: Steve Peters, MPP, Elgin-Middlesex-London Bert Johnson, MPP, Perth-Middlesex Alec Denys, District Manager, Aylmer District 32 (1) u1Iongas John Wellard President A Duke Energy Company June 9, 2003 JUN 12 2i!OJ Warden John Wilson The County of Elgin 450 Sunset Drive St. Thomas, Ontario N5R 5V1 Dear Warden Wilson, I wanted to take this opportunity to follow up on the announcement of my assuming the role of President of Union Gas on Friday, May 30th. As you know, Union Gas is a large storage, transmission and distribution company based in Chatham, serving over 1.1 million customers in northern, eastern and southwestern Ontario. I assure you that Union Gas will continue to provide the same safe, reliable and environmentally responsible service that has been offered in the past, and will maintain the highest standards of service to the more than 400 communities we serve in Ontario. Please do not hesitate to contact me or our offices should you have questions or require any information about Union Gas, our services, or the broader energy sector in general. You can be certain of our full cooperation and enthusiasm. Sincerely, ~~ John Wellard P.O. Box 2001, 50 Ken Drive North, Chatham, ON N7M 5Ml tel. 519 436 4559 fax 519 436 4667 Union Gas Limited 33 ~777777777777777777~77~ å . . å * Bless you for gIvIng * * * * of your * * * * å Time, T * * * * * your * * * * E * * ' nergy, * * * * and your * * * * Sclfl * * * * * * We would like to thank you for being a part of * * the "Celebrate Vienna Committee". Thanks to * * volunteers like your self, Vienna's Sesquicentennial * * å f Celebrations were a huge success! T * * * * * Thank you, * * * ~ ~ L/ "'" ~ T '~}'7'~vMì~ , * * å K. C. Emerson Carol Judd Lynda Millard å v v * Honourary Chairman Chairman Secretary * å å v v * * å å v v ~~~~~~~~~~~~~~~~~~~~~~~ 34 1803 Loyal WeRemau¡ 2003 To: From: Re: Warden John R. Wilson, County of Elgin The Talbot Settlement Bi-Centennial Committee Our Sincere Thanks Dear Mr. Warden, The Talbot Settlement Bi-Centennial Committee would like to take this opportunity to extend our most sincere thanks for the incredible amount of personal time that you have offered in assisting or supporting our events during the "Raids on the Talbot Settlement". To see your presence at so many events was an encouragement in itself. For your beaming smile and always Supportive advice, we are grateful. For those of us involved at the historical point of view, this event was a chance to recreate something that might have been. For those of us involved in this event ftom the early planning stages, the event was a complete success. For those involved in local tourism, we hope we have raised the public's awareness of the beauty of this County. We would like to extend our sincere thanks to all staff and administration at the County level, who have been involved in the planning process for the Raids on the Talbot Settlement. Without the wisdom, input and assistance ftom staff like Brian Masschaele and Cathy Bishop, as well as Mark McDonald and Linda Veger, our volunteers would have been lost in the process. For all the sage advice we have been given during the past several years we are forever grateful. Again, even though we will be acknowledging them individually, please extend our thanks and sincere appreciation for a job well done, to everyone involved. On behalf of the Bi-Centennial Committee, Sincerely, Nick Wells, Chair Diana Player, SecretaIy ~ 35 The Talbot Settlement Society PO..Box 20134 St. Thomas, Ontario N5P 4H4 elgin st.thomas health unit 99 Edward Street SI. Thomas, Ontario N5P 1 Y8 Telephone: (519) 631-9900 Toll Free Telephone: 1-800-922-0096 Fax: (519) 633-0468 www.elginhealth.on.ca May 8, 2003 MAY 12 200J Mr. Mark McDonald Chief Administrative Officer County of Elgin 450 Sunset Drive St. Thomas, ON /I /1/" ,. j N5R 5V1 / jI~- Dear~ald: On behalf of the Board of Health of the Elgin St. Thomas Health Unit, I am enclosing a copy of the Audited Statements for the period ending December 31, 2002 approved at the April 23, 2003 Board of Health meeting. If you require any further information, please don't hesitate to contact me. Yours truly, Cynthia St. John Chief Administrative Officer enclosure ---- -.-----,-"-.....----...-,'--- ---,- ..----- ----,. ..------ ~-¡ ~~ ELGIN-ST. THOMAS HEALTH UNIT Financial Statements Year Ended December 31, 2002 and Auditors' Report to the Board of Health, Members of Council, Inhabitants and Ratepayers of the participating municipalities of the County of Elgin and the City of St. Thomas RAVEN&SHAWLLP Chartered Accountants 204-460 Wellington Street St. Thomas, ON N5R 6H9 Telephone: (519) 631-8250 Telephone: (519) 637-3500 Facsimile: (519) 631-8919 AUDITORS' REPORT To the Board of Health, Members of Council, Inhabitants and Ratepayers of the participating municipalities of the County of Elgin and the City of St. Thomas: We have audited the statement of financial position of the Elgin-St. Thomas Health Unit as at December 31, 2002 and the statements of financial activities and cash flows for the year then ended. These financial statements are the responsibility of the Health Unit's management. Our responsibility is to express an opinion on these financial statements based on our audit. We conducted our audit in accordance with Canadian generally accepted auditing standards. Those standards require that we plan and perform an audit to obtain reasonable assurance whether the financial statements are fÌ'ee of material misstatement. An audit includes examining, on a test basis, evidence supporting the amounts and disclosures in the financial statements. An audit also includes assessing the accounting principles used and significant estimates made by management, as well as evaluating the overall financial statement presentation. In our opinion, these financial statements present fairly, in all material respects, the financial position of the Elgin-St. Thomas Health Unit as at December 31, 2002 and the results of its operations and' cash flows for the year then ended in accordance with the accounting principles disclosed in note 1 to the financial statements. A,-/~ Chartered Accountants Aprilll,2003 - 1 - ELGIN-ST. THOMAS HEALTH UNIT STATEMENT OF FINANCIAL ACTIVITIES YEAR ENDED DECEMBER 31. 2002 2002 2001 REVENUES Operating grants Municipal County ofElgin $I,II 1,408 $1,072,261 City of St. Thomas 772.334 745.131 1,883,742 1,817,392 Ministry of Health and Long- Tertn Care (Note 2) 2.586.594 2.173.164 Total operating grants 4.470.336 3.990.556 Other Environmental program - user fees 55,075 52,014 - property enquiries 9,500 12,000 Rentals 60,290 64,347 Other fees and recoveries 40,558 36,621 Clinics 10,667 II,170 Interest 10,624 24,102 West Nile Virus - municipal contributions 9.406 Total other revenues 196.120 200.254 TOTAL REVENUES 4,666,456 4,190,810 EXPENDITURES - SCHEDULE 4.569.023 4.II2.419 EXCESS OF REVENUES OVER EXPENDITURES 97,433 78,391 TRANSFER TO RESERVE (Note 6) 229 1.670 NET REVENUES FOR THE YEAR 97,204 76,721 SURPLUS, BEGINNING OF YEAR 94,412 211,064 SURPLUS RETURNED TO MUNICIPALITIES (Note 7) (94.412) (J 93.373) SURPLUS, END OF YEAR $ 97.204 $ 94.412 -2- ELGIN-ST. THOMAS HEALTH UNIT STATEMENT OF FINANCIAL POSITION DECEMBER 31. 2002 2002 2001 FINANCIAL ASSETS Cash $655,032 $610,043 Accounts receivable 43,255 55,052 Other assets 9.404 6.543 $707.691 $671.638 LIABILITIES Accounts payable and accrued liabilities Deferred revenue (Note 4) Due to the Ministry of Health and Long-Term Care $384,616 $346,593 8,757 77,306 160.093 96.535 553.466 520.434 FUND BALANCES Reserve - Environmental Program (Note 5) Surplus 57,021 56,792 97.204 94.412 154.225 151.204 $707.691 $671.638 ... ...... Member -3- - ___ m_ .. _ __ - -....-----.--- ----.-.._-.._--- - ELGIN -ST. THOMAS HEALTH UNIT STATEMENT OF CASH FLOWS YEAR ENDED DECEMBER 31. 2002 2002 2001 CASH PROVIDED BY (USED IN): OPERATING ACTIVITIES Excess of revenues over expenditures $ 97,433 $ 78,391 Change in non-cash items: Accounts receivable 11,797 (23,371 ) Other assets (2,861 ) (553) Accounts payable and accrued liabilities 38,023 15,147 Deferred revenue (68,549) 3,085 Due to Ministry of Health and Long- Tenn Care 63.558 65.951 Cash provided by operating activities 139.401 138.650 FINANCING AND INVESTING ACTMTIES Surplus returned to municipalities (94,412) (193,373) Purchase of equipment - environmental program (5.537) Cash (used in) financing and investing activities (94.412) 098.910) INCREASE (DECREASE) IN CASH POSITION 44,989 (60,260) CASH POSITION, BEGINNING OF YEAR 610.043 670.303 CASH POSITION, END OF YEAR $655.032 $ 610.043 - 4- ELGIN-ST. THOMAS HEALTH UNIT NOTES TO THE FINANCIAL STATEMENTS DECEMBER 31.2002 1. ACCOUNTING POLICIES The financial statements of the Elgin-St. Thomas Health Unit are the representations of management prepared in accordance with local government accounting standards established by the Public Sector Accounting Board of the Canadian Institute of Chartered Accountants. The following are the Health Unit's significant accounting policies: CaDital Assets The historical cost and accumulated depreciation of capital assets are not reported in these financial statements in accordance with the Ontario MinislIy of Health and Long- Tenn Care (MinislIy) funding guidelines. Amounts expended to purchase such assets are included in expenditures on the statement of financial activities. Deferred Revenue The Elgin-St. Thomas Health Unit administers other non-mandatory public health programs sponsored by the MinislIy which are reported on a MinislIy fiscal year end of March 3 I st. Any unexpended revenues for these programs at December 3 I st is reported as deferred revenue on the statement of financial position. 2. MINISTRY OF HEALTH AND LONG-TERM CARE GRANTS 2002 2001 Mandatory program allocation Other MinislIy program funding (costs): Healthy Babies Healthy Children Early Childhood Development West Nile Virus Water quality Influenza immunization program Aids $1,791,735 $1,720,857 534,445 207,692 34,406 465,095 17,816 500 (30,490) 17,702 $2.586.594 $2.173.164 -5- ELGIN-ST. THOMAS HEALTH UNIT NOTES TO THE FINANCIAL STATEMENTS DECEMBER 31. 2002 3. POST EMPLOYMENT BENEFITS The Health Unit makes contributions to the Ontario Municipal Employees Retirement Fund (OMERS), which is a multi-employer plan, on behalf of its employees. The plan is a contributory defined benefit plan which specifies the amount of the retirement benefit to be received by the employees based on the length of service and rates of pay. Effective August 1, 1998, OMERS declared a contribution holiday, which temporarily suspended payments to the plan to December 31, 2002. 4. DEFERRED REVENUE Balance, beginning of year Healthy at Early Total Heart Years 2002 2001 $14.274 $ 63.032 $ 77.306 $ 74.221 Receipts Grants Other 57,437 2,536 59,973 140,059 - 1.373 - 57,437 2,536 59,973 141,432 62.954 65.568 128.522 138.347 (5.517) (63.032) (68.549) 3.085 $ 8.757 $ $ 8.757 $ 77.306 Expenses Program costs Excess (deficiency) for year Balance, end of year -6- ELGIN-ST. THOMAS HEALTH UNIT NOTES TO THE FINANCIAL STATEMENTS DECEMBER 31. 2002 5. RESERVE - ENVIRONMENTAL PROGRAM 2002 2001 Balance, beginning of year $56,792 $60,659 Revenue Transfer rrom operations 229 1,670 Expenditures Furniture and equipment 5.537 , Balance, end of year $57.021 $56.792 6. ENVIRONMENTAL PROGRAM 2002 2001 Income User fees $64.575 $64.013 Expenditures Salaries and benefits 57,916 57,083 Other program costs 6.430 5 .260 64.346 62.343 Transfer to reserve for environmental program $ 229 $ 1.670 7. SURPLUS RETURNED TO MUNICIPALITIES 2002 2001 County ofE1gin $62,626 $107,167 City of St. Thomas 31.786 86.206 $94.412 $193.373 8. LEASE COMMITMENT The Health Unit leases office space under a lease agreement with the County of Elgin. The minimum annual rental under this agreement for the year 2003 is $402,395. - 7- ELGIN-ST. THOMAS HEALTH UNIT NOTES TO THE FINANCIAL STATEMENTS DECEMBER 31. 2002 9. PUBLIC SECTOR SALARY DISCLOSURE In 2002, no employees were paid a salmy, as defined in the Public Sector Salary Disclosure Act, 1996, of$IOO,OOO or more by the EIgin-St. Thomas Health Unit. 10. COMPARATNEFIGURES Certain comparative figures have been reclassified to conform to the 2002 financial statement presentation. - 8- ELGIN-ST. THOMAS HEALTH UNIT SCHEDULE OF EXPENDITURES YEAR ENDED DECEMBER 31.2002 2002 2001 Salaries and wages Nursing $ 898,645 $ 914,391 Management 499,992 490,517 Inspection and environment 304,707 275,079 Nutrition and health promotion 330,970 303,231 Clerical and support 244,385 241,108 Maintenance and security 31,099 25,052 Sick leave payouts 4.079 2.309.798 2.253.457 Fringe benefits Medical insurance 94,824 III ,486 Canada pension plan 92,237 79,146 Employment insurance 62,915 59,767 Employer health tax 48,984 48,344 Long term disability 44,997 52,124 Dental plan 39,294 43,216 Workplace safety insurance 18,882 17,194 Supplementary unemployment benefits 15,197 5,712 Group life insurance 14,399 10,515 Vision and other 11,285 11,876 Benefits to other programs (54.218) (46.089) 388.796 393.291 Fees and honoraria Dental fees - CINOT program 120,566 92,755 Dental consultant 25,004 25,004 Labour relations 23,980 21,630 Audit and legal 13,864 10,324 Medical II,915 9,479 Board 7.423 5.079 202.752 164.271 -9- Rc J ELGIN-ST. THOMAS HEALTH UNIT SCHEDULE OF EXPENDITURES YEAR ENDED DECEMBER 31. 2002 2002 2001 Travel $ 62.097 $ 63.543 Equipment 58.533 30.030 Program materials and supplies 82.946 75.905 Rent and utility services Building rent 402,395 353,907 Utilities 41,206 36,044 Maintenance and supplies 35,306 40,415 Property taxes 20.548 43.314 499.455 473.680 Admiuistrative Professional development 25,963 30,385 Telephone 22,660 24,794 Printing and supplies 21,499 27,332 Equipment maintenance and rental 21,554 18,406 Public awareness and promotion 21,030 28,557 Special projects 20,791 24,460 Insurance 15,993 12,576 Fees and subscriptions 10,525 8,054 Postage 9,242 7,231 Bank charges 5,516 5,380 Courier 1,708 1,987 Staff recruitment 1.486 3.082 177.967 192.244 Total mandatory program expenditures 3.782.344 3.646.421 Other programs Healthy Babies Healthy Children 534,675 465,998 Early Childhood Development 207,692 West Nile Virus 43,812 Aids 500 786.679 465.998 TOTAL EXPENDITURES $4.569.023 $4.112.419 - 10- 86/13/83 22:8B:43 EST; ASSOCIATION OF?-} 1 519 633 7661 CLERK-Elgin Co Page B82 JUN-13-03 FRI 05:40 PM 260 FAX NO, 416 971 6191 p, 01 , '. Ie ,~,} .,' ,\., ~ . M:',~ber Communication / r:: r' Association of Muni cipalities of Ontario ---'''""1 e rt . -, -- 393 Universdy AV€f1ue, Suitc 1701 . Tetonlo. ON M5G 1E6 Td: (416) 971-9800-fax: (416) 971-6191 emé'lB: cmo@arno.municom.oom To tIe immediate ilttention of the (;Ierk and Council June 13, 2003 - Alert 03/034 FAIR DEAL IS NO DEAL FOR MUNICIPALITIES _ AMO TO CONDUCT INDEPENDENT MUNICIPAL FINANCIAL REVIEW IS51.\": AMO holds a press conference today. Th~ following is today's Press Release. A copy of the Speakers' Remarks and other inforrnalion can b(l found on the AMO website at www.municom.com. -................,....... "~'-'--_.,----... Tonm{(., Ont., June 13, 2003 - Disappointed by Premier Ernie Eves' refusal to join the Association of Municipalities of Ontario (AMO) to conduct an independent review of the state of rnunit;ip;:¡1 finMces, AMO President Ken Boshcoff annolJ/1ced today that AMO would proceed with its own rcvi~)w, with or without the Province's support. "Howc:;;n we properly determine what tax measures may be required without clearly understanding the current financial condition of tile municipal sector?" said Mississauga Mayor Hazel McCallion, chair of thG Large Urban Mayors' Caucus of Ontario (LUMCO). "If a review of eduCf.\tion fjnanct~ made sense for the Province last year, why doesn't a review of municipal financQ make sense now? Before any referendum legislation is put into place, the Province ncø<ls to do its homÐwork," she added. In response to LUMCO's recent resolution requesting the Province and AMO conduc.i an indep..:mdønt review, Premier Eves stated that he could not support an approach that 'would underminc and compromise the role of the eJected members of the Ontario Legislature." "Per/laps, Pmmier Eves fears the outcome of such a process," said Mayor McCallion. 'Wouldn't the legislative process benefit from such a review?" Bosh<.:off called upon tile Premier to re-consider and join AMO in this independent financial revÎFNJ. Thi$ i/lfmmJlion is DV;Jilable t¡¡rough AMO's webs;tc at WWIIKßJRlJicom.com. frjf more ilJffmu:¡!ioll, ploas" contact! Pat Vanini, Executive Director, AMO et 416-971-9856 ext. 316 36 Ministry of Transportation Office of the Minister Ferguson Block, 3rd Floor 77 WeiJesJey St. West Toronto Ontario M7A 1Z8 416 327 ·9200 wwwmtogov,on,ca Ministère des Transports Bureau du ministre Éd¡fice Ferguson, 3B étage 77, rue Wel!esley ouest Toronto (Ontario) M7A 1Z8 41 6 327-9200 www.mto.gov..on..ca ~~ ~~ Ontario jUN 2 2003 JUN Hi 2003 Ms. Donna Waugh, A.M.CT Clerk County of Wellington 74 Woolwich Street Guelph, Ontario N1 H 3T9 ~, ~--~ ..;¡ """ ~ú_""mít Dear Ms. Waugh: Thank you for the County of Wellington's Council's resolution, forwarded to me by Mr. Ted Arnott, MPP, Waterioo-Wellington, requesting access to my ministry's Advanced Road Weather Information System (ARWIS). I appreciate your request and would like to inform you that the Ontario Ministry of Transportation (MTO) is continuing to develop this system across its road network to assist in winter highway maintenance. At this time, the system is still being refined. However, please be assured that my ministry recognizes that the information is useful to municipalities and is prepared to provide free access to information that would benefit operations. We are currently developing a template agreement to enabie data sharing. We expect to have this completed by mid-summer. In the meantime, should you have any additional questions please contact Mr. Shael Gwartz, Manager, Maintenance Office, at (905) 704-2622 .../2 37 -2- Thank you again for taking the time and effort to inform us of the county's resolution relating to ARWIS. Yours sincerely, ~~ / )-;ank Klee Minister c: Premier Ernie Eves Mr. Ted Arnott, MPP, Waterloo-Wellington Honourable Brenda Elliott, MPP, Guelph-Wellington The Association of Municipalities of Ontario Mr. Oavid Carey, Treasurer and Deputy Clerk, County of Huron Mrs. Sandra J. Heffren, Deputy Clerk, County of Elgin FK:dm 38 RECEIVED t~ """",,;;,;= Ontario A':'2 - 1 2003 ¡;.,V y\v LEGiSLATiVE ASSEMBLY Of ONTARIO MINISTERS OFFICE Quet:n's Patk. \larcÌ1 2-+. 21)1)' PLEASE REPLY TO: TED ARNOTT, MPP WATERLOO·WELlINGTON QUEEN'S PARK OFFICE 4th Roar, Mowat Block 900 Bay Street Toronto. OntariO MìA IL2 íEL. A16ì 325-3880 FAX ,416\ 325-66<19 èmail: leG_J.mott@ontlacla C~ 'NINWtedJmmtmpp cern The Hon, Fr~~r~k ~(lèC3 \!in¡Sler ùfTransponalion ,,,I Fl r BI' .) "" !:"'crguson OC~'- -7 Wdlesk> SL W fiJronto. Ontario \1-,\ lZS m 2-003 -30&-g Dear \[iniskc Please tind enclosed a resolution passed b\ the Council of the County of'vVellington regarding municipal :lccess to the Road We:lther [nform:ltion System. ¡ would greatly appreciate your re\¡ew of their advice [support the ick::t ofassisting lTiunicipaìlties by pro\ iding access to ¡nfoITmtion abollt roads. Thank vou in advance for ::our consideration ofth¡s ad\ ice. please respond to C ouncii and send me a cop' oCyùur replv Best wishes Sincereiv. /-rJ !, - \I i~, -À_ , . Ted Amott, \[ PP Waterloo- Wellington 1-.\, aj C.t:: Donna Waugh, Clerk ..-. -- , 39 : \ .-..... "\ ... ~.............. :.;.r"·~ ~ ~LUj ,- "~ ~. ,_/ '- - - - - - .- - - - , -~..,.---'----""~~""""~~'~"'",""'-"'---- ''''Mt<>.~I""-\,,x.lljncr:''nJMinl:!CffiŒ:181 Sl Andrew:::t. East· 2M Roor· ;:rgus· Ontana NH.1 ¡P9· Tel 5-19ì 787-5247 . Fax (519) 787-3249· Toll Fr~: :-BCO-265-23é:: "" 4 >"'ti- -t.r:=:...~~, - I.~¡ I " :q~~~)S .~~c6- ....~:o:~." íNTY OF WELU","GTOi" ::"'jNA "I'IAUGh, .... \:1': T :-~ 'NCCL.'IiC:- ::;7REE-:- GUEL?~, :NTARiC 'j1H 3:9 ::..~::;i<: -=~, ,:5~9) 337-2SCO :::<1252 :::~l :5191 337-~9C9 ",__-:1211: ·:cnr.aw@c-:::t.;r.t'/wt'!!unyton on c.a ~1"rch:4 2003 Fe r-lOnourable Ernie Eves Fremier of Ontario L"gislative Building cueen's Park ,:ronto ON M7,2, 1A>ì Cear Mr Premier p.: [he Session of wellingwn Ccuntv Council he!C on ïhursdav, Feoruarv 27. 2'J03 the aetached resolution from the count'! of Huron, requesting ~'1e Frovince allow municipalities to access [he information supplied Cv ::le R:ad weather Information s;stem, lNas Slip ported. '3 r"'¡cerelv, /\ ; \ h ~,--,DnrC.\" llA'lU?j I CJnna \^Jaugh, p..M C"T. e erk Mr, ïed Arnott, M.P P, waterloo-wellington ¡ , , -I i\¡ìr- ~r~nda r"';~-t "1" ~ rllplr,'" "\'~II'lna-on I 1).b,e,1 CiIJUL...¡!v...-:-,.,\.;) ,-,'f.--i:-'JJe ,__L ! The ,2,ssociation of Muricipaiities cf ontario Ccuntv Of Huron 4n .U ·~ ~~=I~ t\!~ W~~~2 Corpor..ltion of the COUNTY of HURON CLERK- ADMú'iISTRATOR Court House, Goderich, Ontario, NïA 1 '.~2 (519) 524-3394 Fax (519) 52~-2044 January Î 0, 2003 The Ho,""ourabla Ernie Premier of Ontario Legislative Building Queen's Par!, Toronto, Ontario r eves w17A 1Aí CC~"^.}--'\/ Dear Mr Premier: ...../.'1 .~! " f, ¡ -;-'1f';.... , "'" -""""..i ;";-2;: Road VVeather information Svstem EVG 0~~~~;'~'-~Aii~I~' C;:, On January 9, 2003, Council of the County of Huron adopted the follow¡ng reccr:tmendation from the Agriculture! Public \J\fcrks and Seniors Commit:es ,of December 6, 2002: "That the County of Huron petition the Pro'/!fiCe of Ont2rio to 2¡[C\rV a!1 Counties and Regions to access the inroríìlêt:on supplied by the Road \Veather Information Svstem "vhich \¡vou!d ~:e of great ass¡star.ce to all reads departments throughout the pro\Jince ,'¡hen perforrn¡ng ,-".inter operations. In addition, this motier is to be sent to a!1 Counti~s and RegIons in the provirlce Tor support." Yours :íu\V, - -- -- !!----- -, . David 8'{ Treasurer and Deputy Cie", - - J.:~N . ~ "f'." .II 4 ZUU0 ~~ r~.:-: ~/"/ELUNGjCN - _= ;':;;: Tì-\E C:)L;;-¡:Y c~E:=1K DC/bl cc )"il Counties and Regions Association of ivlunicipalities of Ontario 41 West Nile Virus Questions and Answers Resource Document For Health Care Providers Prepared by Health Protection Department May, 2003 elgin st. thomas health unit EIgin-St. Thomas Health Unit 99 Edward Street St. Thomas, ON N5P 1Y8 (519) 631-9900 1-800-922-0096 Fax: (519) 633-0468 http://www.elginhealth.on.ca r···· Index of Questions and Answers Section A: Generallnformation....................................................Page 1 A-1 What is West Nile virus? A-2 How is West Nile virus spread? A-3 Where did West Nile virus come from? A-4 How did West Nile virus get to North America? A·5 What areas of Canada have been affected? A-6 Is West Nile virus now established in the Western Hemisphere? A-7 Is the disease seasonal in its occurrence? A-8 How long does it take to get sick if bitten by an infected mosquito? A-9 What are West Nile virus, West Nile fever, and West Nile encephalitis? A-10 How many cases of West Nile disease in humans have occurred in the U.S.? A-11 What is the history of WN virus in Canada? A-12 How many cases of WNv disease in humans have occurred in Canada? A-13 What proportion of people with severe illness due to West Nile virus die? A-14 Who is more likely to get sick after being infected with WN virus? A-15 When is the risk greatest? A-16 How do people get infected with West Nile virus (WNV)? A-17 What is the basic transmission cycle of West Nile virus? A-18 How does West Nile virus actually cause severe illness and death in humans? \ '----- A-19 How long does the West Nile virus remain in a person's body after he or she is infected? A-20 If a person contracts West Nile virus, does that person develop a natural immunity to future infection by the virus? A-21 How do I find out if I have immunity? A-22 Who is at risk of getting infected with West Nile virus? A-23 Who is at risk for serious health effects from WN virus? A-24 What are the symptoms of West Nile virus infection? A-25 What is the incubation period in humans (i.e., time from infection to onset of disease symptoms) for West Nile encephalitis? A-26 How long do symptoms last? A-27 What are the long-term effects of WN virus? A-28 I think I have symptoms of West Nile virus. What should I do? A-29 Is there a vaccine for WN virus? A-30 How do doctors diagnose West Nile virus infection? A-31 How are blood samples tested for WN virus? A-32 How is West Nile encephalitis treated? A-33 If I live in an area where birds or mosquitoes with West Nile virus have been reported and a mosquito bites me, am I likely to get sick? A-34 Can you get West Nile encephalitis from another person? A-35 What can people do to reduce their risk of WN virus infection? ii . . . iii Section B : Pregnancy and Breastfeeding ...................................... Page 9 B-1 Does pregnancy increase the risk of becoming infected with WN virus? B-2 Is a woman's pregnancy at risk if she gets infected with West Nile virus? B-3 Can a pregnant woman pass WN virus to her unborn baby? B-4 Can WN virus be passed to a child through breast milk? B-5 Should women with symptoms ofWN virus continue to breastfeed their children? B-6 What steps should pregnant and breastfeeding women take to reduce their risk of getting WN virus? B-7 Is it safe for pregnant and breastfeeding women to use insect repellents that contain DEET? Section C: Occupational Risks ................................................... Page 11 C-1 Are laboratory workers in contact with WNV-positive specimens at risk for WNV infection? C-2 How should health care workers protect themselves if they are caring for patients with WNv illness? C-3 Do people who work outdoors need to change their safety practices? C-4 If I have to wear protective clothing, how can I avoid heat stress on hot, humid days? Section D: Blood Transfusions and Transplants .......................... Page 12 D-1 Can West Nile virus be transmitted through blood? D-2 Does the risk of getting WN virus mean that people should be concerned about receiving transfusions or transplants? D·3 What has Health Canada done to ensure blood safety since it became known that WN virus could be transmitted through blood? D-4 What does Health Canada do to ensure the safety of the blood supply in Canada? D-5 Can someone get WN virus by giving blood? iv D-6 What happens if someone with a probable case of WN virus has donated blood? 0-7 What happens if someone with a confirmed case of WN virus has donated blood? 0-8 Why are people with confirmed cases of WN virus infection allowed to donate blood again after eight weeks? 0-9 What happens when people with symptoms of WN virus infection offer to donate blood? 0-10 Will the screening test be available in time? D-11 What is being done in the interim (before the commercial test is available)? 0-12 What is being done to reduce the risk of transmitting WN virus through organs and tissues? Section E: Animals and WNv (Including Horses) ........................... Page 15 E-1 Can animals other than birds be infected with West Nile virus? _ E-2 How do animals become infected with WN virus? E-3 What signs do infected animals have? E-4 Can people become infected by touching or being around animals infected with WN virus? E-5 Is there a treatment for animals infected with WN virus? E-6 Are there vaccines to protect animals from WN virus? E-7 Besides mosquitoes, can you get West Nile virus directly from other insects or ticks? E-8 Can you get West Nile virus directly from birds? E-9 Has West Nile virus caused severe illness or death in horses? E-10 How do the horses become infected with West Nile virus? E-11 How does the virus cause severe illness or death in horses? E-12 Can I get infected with West Nile virus by caring for an infected horse? . . . v E-13 Can a horse infected with West Nile virus infect horses in neighboring stalls? E-14 My horse is vaccinated against eastern equine encephalitis (EEE), western equine encephalitis (WEE), and Venezuelan equine encephalitis (VEE). Will these vaccines protect my horse against West Nile virus infection? E-15 Can I vaccinate my horse against West Nile virus infection? E-16 How long will a horse infected with West Nile virus be infectious? E-17 What is the treatment for a horse infected with West Nile virus? Should it be destroyed? E-18 What are the plans for horse surveillance? E-19 Can squirrels infected with West Nile virus transmit the virus to humans? E-20 Can you get WNV from eating game birds or animals that have been infected? E-21 Are duck and other wild game hunters at risk for West Nile virus infection? E-22 What should wild game hunters do to protect against West Nile virus infection? Section F: Personal Protection and Source Reduction .................. Page 19 F-1 What can I do to protect myself and my family? F-2 How about using pesticides around my home? F-3 What can I do around my property to discourage mosquitoes? Section G: Mosquito Repellents .................................................. Page 21 G-1 Why should I use insect repellent? G-2 When should I use mosquito repellent? G-3 What time of day should I wear mosquito repellent? vi G-4 How often should repellent be reapplied? G-5 Should I wear repellent while I am indoors? G-6 How does mosquito repellent work? G-7 Which mosquito repellent works the best? G-8 How does the percentage of DEET in a product relate to the amount of protection it gives? G-9 Why is OEET recommended? G-10 Are non-DEET repellents effective (e.g. Skin-So-Soft, plant-based repellents)? G·11 00 products in the store say "DEET" on the package? G-12 Is DEET safe? G-13 What are some general considerations to remember in order to use products containing OEET safely? G-14 How should products containing DEET be used on children? G-15 Is OEET safe for pregnant or nursing women? G-16 Are there any risks due to using repellents containing OEET? G-17 Should parents spray insect repellent on their children before they go to school? G-18 Should children be given repellent to use during the day? Section H: Surveillance - Birds ................................................... Page 25 H-1 What surveillance activities will the Elgin St. Thomas Health Unit doing in 2003? H-2 What is Bird Surveillance? H-3 What types of birds carry West Nile virus? . . . vii H-4 Do birds infected with West Nile virus die or become ill? H-5 Why are dead crows monitored? H-6 How can I report a sighting of dead bird(s) in my area? H-7 Why do some areas stop collecting dead birds? H-8 How do I dispose of a dead bird that isn't going to be sent away for testing? Section I: Mosquitoes and Mosquito Habitats ............................... Page 27 1-1 What types of mosquitoes spread West Nile virus? 1-2 What is "amplification" and "bridging vectors"? 1-3 I understand West Nile virus was found in "overwintering" mosquitoes in early 2000. What does this mean? 1-4 What are stormwater ponds? 1-5 What stormwater facilities are potential breeding grounds for mosquitoes that carry West Nile virus? Section J: Surveillance - Mosquitoes and Mosquito Larvae .......... Page 30 J-1 What is Mosquito Surveillance? Section K: Surveillance - Human ................................................ Page 31 K-1 What is Human Surveillance? K-2 What are the plans for human surveillance? Section L: Pesticides ................................................................. Page 32 L-1 Who decides whether to use pesticides to control the spread of WN virus? L-2 What about using pesticides to control mosquitoes in our community? L-3 What are larvicides? L-4 What are adulticides? L-5 If provincial and local authorities decide to spray, what products would they use? viii L-6 Which type of pesticide product do authorities prefer to use? L-7 What is methoprene? L-B What is Bti? L-9 What steps do provincial/local health authorities take to ensure public safety when pesticides are used? L-10 Are mosquito control products safe? Section M: Provincial WNv Plans ................................................ Page 36 M-1 What is the Ontario Government's 7 Point Action Plan for West Nile virus? Section N: Additional Resources ............................................... Page 37 N-1 How do I find out more about WNv? Source documents for Questions and Answers include: www.health.gov.on.ca www.HealthyOntario.com http://www.hc-sc.gc.ca/english/index.html http://www.cdc.gov/ncidod/dvbid/westnile/index.htm . . . 1 Section A: General Information A-1 Q. What is West Nile virus? A. West Nile virus belongs to a family of viruses called Flaviviridae. It is spread by mosquitoes that have fed on the blood of infected birds. West Nile virus is closely related to the viruses that cause Dengue fever, Yellow fever and St. Louis encephalitis. A-2 Q. How is West Nile virus spread? A. West Nile virus is spread to humans by the bite of an infected mosquito. A mosquito becomes infected by biting a bird that carries the virus. You or your child cannot get West Nile virus from a person who has the disease. West Nile virus is not spread through person-to-person contact such as touching, kissing or caring for someone who is infected. A-3 Q. Where did West Nile virus come from? A. The virus was first isolated in 1937 in the West Nile district of Uganda. Since then, there have been outbreaks in Egypt, Israel, South Africa, and in parts of Europe, Asia and North America. The first recorded outbreak in North America happened in New York City in 1999. A-4 Q. How did West Nile virus get to North America? A. No one knows for sure how the virus made its way to North America. There are many theories, including one that suggests the virus arrived on this continent through an infected migratory or imported bird, or through an infected mosquito that was transported to North America by accident. During 2002, more than 4,000 people in North America became ill after being infected with WN virus. This is the largest outbreak of West Nile virus infection ever recorded. A-5 Q. What areas of Canada have been affected? A. In 2002 the WNv spread into five Canadian provinces: Nova Scotia, Quebec, Manitoba, Saskatchewan, and Ontario. A-6 Q. Is West Nile virus now established in the Western Hemisphere? A. The continued expansion of West Nile virus in the United States and Canada indicates that it is permanently established in the Western Hemisphere. 2 A-7 Q. Is the disease seasonal in its occurrence? A. In the temperate zone of the world (i.e., between latitudes 23S and 66S north and south), West Nile encephalitis cases occur primarily in the late summer or early fall. In the southern climates where temperatures are milder, West Nile virus can be transmitted year round. . A-8 Q. How long does it take to get sick if bitten by an infected mosquito? A. Being bitten by an infected mosquito will not necessarily make you sick. Most people who are infected with West Nile virus have no symptoms or experience only mild illness. if illness occurred, it would occur within 3 to 15 days of being bitten by an infected mosquito. A-9 Q: What are West Nile virus, West Nile fever, and West Nile encephalitis? A.west Nile virus is a flavivirus commonly found in Africa, West Asia, and the Middle East. It is closely related to St. Louis encephalitis virus found in the United States. The virus can infect humans, birds, mosquitoes, horses and some other mammals. West Nile fever is a mild disease in people, characterized by flu-like symptoms. West Nile fever usually lasts only a few days and does not appear to cause any long-term health e¡ffects. West Nile encephalitis, West Nile meningitis or West Nile meningoencephalitis are more serious diseases that may result from West Nile virus. Encephalitis refers to an inflammation of the brain, meningitis is an inflammation of the membrane around the brain and the spinal cord, and meningoencephalitis refers to inflammation of the brain and the membrane surrounding it. , e A-10 Q. How many cases of West Nile disease in humans have occurred in the U.S.? A. In 2001, there were 66 human cases of severe disease and 9 deaths. In 2000, 21 cases were reported, including 2 deaths in the New York City area. In 1999,62 cases of severe disease, including 7 deaths, occurred in the New York area. In 2002 there were 4156 cases of human illness and 284 deaths linked to the WNv. No reliable estimates are available for the number of cases of West Nile encephalitis that occur worldwide. A-11 Q. What is the history of WN virus in Canada? A. The first reports of West Nile virus activity in Canada came in August 2001, when the virus was found in dead birds and mosquito pools in southern Ontario (Windsor). Canada had its first confirmed human cases in 2002, after people tested positive for West Nile virus in parts of Quebec and Ontario. The virus was also found in birds, horses or mosquitoes in Nova Scotia, Quebec, Ontario, Manitoba and Saskatchewan. In addition, two people from Alberta became infected, but these cases are thought to be travel- at related. ., 3 A-12 Q. How many cases of WNv disease in humans have occurred in Canada? A. The Ontario Ministry of Health and Long-Term Care reported 392 human cases of West Nile virus infection in 2002. This included probable cases (84) as well as laboratory confirmed (325) diagnosis. West Nile virus involvement was suspected in 17 deaths in Ontario. A-13 Q. What proportion of people with severe illness due to West Nile virus die? A. Among those with severe illness due to West Nile virus, case-fatality rates range from 3% to 15% and are highest among the elderly. Less than 1 % of persons infected with West Nile virus will develop severe illness. A-14 Q. Who is more likely to get sick after being infected with WN virus? A. Evidence shows that many people infected with WN virus have mild symptoms, or no symptoms at all. People with weaker immune systems and people with chronic diseases, are at greater risk for serious health effects. While persons of any age or health status can be at risk of serious health effects associated withWest Nile virus infection, the overall risk of serious health effects increases with age. This is why it is so important to protect yourself. A-15 Q. When is the risk greatest? A. The risk of becoming infected is greatest during mosquito season. In Canada, this can start as early as mid-April and last until the first hard frost in late September or October. A-16 Q. How do people get infected with West Nile virus (WNV)? A. The principle route of human infection with West Nile virus is through the bite of an infected mosquito. Mosquitoes become infected when they feed on infected birds, which may circulate the virus in their blood for a few days. The virus eventually finds its way into the mosquito's salivary glands. During subsequent blood meals, the virus may be injected into humans and animals, where it can multiply and possibly cause illness. Additional routes of infection have become apparent during the 2002 West Nile epidemic. It is important to note that these other methods of transmission represent a very small proportion of cases. A recent investigation has confirmed WNV transmission through transplanted organs. Investigations of other patients who developed WNV infection within several weeks of receiving blood products or organs are ongoing to determine whether WNV was transmitted by transfusion or transplantation in any of these cases. There is one reported case of transplacental (mother-to-child) WNV transmission. Although transmission of WNV and similar viruses to laboratory workers is not a new phenomenon, two recent cases of WNV infection of laboratory workers have been reported. 4 A-17 Q. What is the basic transmission cycle of West Nile virus? · A. Mosquitoes become infected when they feed on infected birds, which may circuiate the virus in their blood for a few days. Infected mosquitoes can then transmit West Nile virus to humans and animals while biting to take blood. The virus is located in the mosquito's salivary glands. During blood feeding, the virus may be injected into the animal or human, where it may multiply, possibly causing illness. A-18 Q. How does West Nile virus actually cause severe illness and death in humans? A. Following transmission by an infected mosquito, West Nile virus multiplies in the person's blood system and crosses the blood-brain barrier to reach the brain. The virus then interferes with normal central nervous system functioning and causes inflammation of brain tissue. A-19 Q. How long does the West Nile virus remain in a person's body after he or she is infected? A. There is no scientific evidence indicating that people can become chronically infected with West Nile virus. Antibodies and "memory" white blood cells (T-Iymphocytes) that the body produces to the virus may remain in a person's body for a long period of time. These antibodies and T-Iymphocytes can last for years, and may iast for the rest of a person's life. When laboratory testing Is performed, diagnostic tests look for antibodies. Both antibodies and "memory" T-iymphocytes provide future protection from the virus. · A-20 Q. If a person contracts West Nile 'ifirus, does that person develop a natural immunity to future infection by the virus? A. It is assumed that immunity will be lifelong; however, it may lessen in later years. A-21 Q. How do I find out if I have immunity? A. Your doctor can arrange for a blood test to determine if you have immunity. A-22 Q. Who is at risk of getting infected with West Nile virus? A. Everyone who is active and outside during the summer months doing such activities as gardening, golfing, walking or camping, should take precautions to avoid mosquito bites. Everyone is at risk from WNv and should make sure they use all the protection measures to avoid contact with mosquitoes. People who like to work outside should avoid early morning and late evening when mosquitoes are most active. · 5 A-23 Q. Who is at risk for serious health effects from WN virus? A. While persons of any age and health status can be at risk for serious health effects associated with West Nile virus infection, the overall risk of serious health effects increases with age. People with weaker immune systems are considered to be at greater risk for serious health effects. This higher risk group includes: . people with chronic diseases, such as cancer, diabetes, alcoholism, or heart disease . people that require medical treatment that may weaken the immune system, i.e. chemotherapy. Although individuals with weaker immune systems are at greater risk, WN virus can cause severe health effects for people of any age and any health status. This is why it is so important to reduce the risk of getting bitten by mosquitoes. Anyone exposed to mosquitoes in an area where WN virus has been detected is at some degree of risk for infection. A-24 Q. What are the symptoms of West Nile virus infection? A. Many infected people have no symptoms and do not get sick or have only mild symptoms. When infection does cause illness, symptoms will usually appear within two to 15 days. The extent and severity of symptoms vary widely from person to person. In mild cases, there may be flu-like symptoms, including fever, headache and body aches. Some people may also develop a mild rash, or swollen lymph glands. ( Some individuals have weaker immune systems, and they are at greater risk of developing symptoms and health effects that are more serious, including meningitis and encephalitis. Meningitis is inflammation of the lining of the brain or spinal cord. Encephalitis is inflammation of the brain itself. These conditions can be fatal. In such cases, symptoms could include the rapid onset of severe headache, high fever, stiff neck, nausea, difficulty swallowing, vomiting, drowsiness, confusion, loss of consciousness, lack of coordination, muscle weakness and paralysis. During 2002, several other symptoms of WN virus were identified including movement disorders, parkinsonism, poliomyelitis-like syndrome and muscle degeneration. Anyone who has a sudden onset of these symptoms should seek immediate medical attention. A-25 Q. What is the incubation period in humans (i.e., time from infection to onset of disease symptoms) for West Nile encephalitis? A. Usually 3 to 14 days. A-26 Q. How long do symptoms last? A. Symptoms of mild disease will generally last a few days. Symptoms of severe disease may last several weeks. Neurological effects may be permanent. 6 A-27 Q. What are the long-term effects of WN virus? A. Because WN virus is an emerging disease, the long-term effects are not fully understood. Studies to date show that some people with serious symptoms and health effects recover completely, while others experience prolonged health problems. These problems can include: . · physical effects, such as long-term muscle weakness and paralysis, fatigue and headache · cognitive effects, such as confusion, depression, problems with concentration and memory loss · functional effects, such as difficulty with preparing meals, going out, shopping, etc. Scientists do not know why some people recover while others continue to have varying degrees of health problems. A-28 Q. I think I have symptoms of West Nile virus. What should I do? A. If you or your family members develop symptoms such as high fever, confusion, muscle weakness, and severe headaches, you should see your doctor immediately. A-29 Q. Is there a vaccine for WN virus? A. At this time, there is no licensed vaccine to protect people against WN virus. For several years, the National Institute of Allergy and Infectious Diseases (NIAID) in the . United States has supported research to develop a vaccine against West Nile virus. In 1999, NIAID funded a fast-track project to develop a West Nile virus vaccine with private industry. Since then, scientists have developed a prototype vaccine that has shown promise in animal tests. The company is moving forward with Phase I trials. Vaccine is now being produced and an investigátional new drug application will be filed with the Food and Drug Administration. Human trials are anticipated to begin in early 2003. Health Canada is monitoring these developments closely. A vaccine licensed in the U.S. does not receive an automatic license in Canada. Manufacturers or importers who wish to sell a vaccine in Canada must apply to Health Canada for a license. They must also provide Health Canada with scientific evidence that the vaccine is safe and effective when used as directed. A-30 Q. How do doctors diagnose West Nile virus infection? A. The first thing doctors look for are symptoms of WN virus infection. The type of symptoms and their severity can vary widely from case to case. In mild cases, there may be flu-like symptoms, including fever, headache and body aches. Some people may also develop a mild rash or swollen lymph glands. Individuals of all age ranges may develop more severe symptoms and health effects including meningitis and encephalitis but this is particularly true for people with weakened immune systems and the elderly. Meningitis is inflammation of the lining of the brain or spinal cord. Encephalitis is inflammation of the brain itself. In these cases, symptoms include the rapid onset of severe headaches, high fever, stiff neck, nausea, difficulty swallowing, vomiting, drowsiness, confusion, loss of consciousness, lack of coordination, muscle weakness and paralysis. . 7 A-31 Q. How are blood samples tested for WN virus? A. The test of choice for patients is for the presence of antibodies to West Nile virus. There are two categories of antibody blood tests for WN virus that may be done: a) front- line testing; and b) confirmatory testing. Front-Line Testing: Doctors use the results of frontline tests to decide on treatments and therapies for patients. These tests look for antibodies to WN virus and are generally done on two separate blood samples taken about three weeks apart. If the first test is positive, it could mean that the person was exposed to WN virus or possibly other viruses in the Flavivirus family recently or sometime in the past. (Other Flaviviruses include St.Louis encephalitis and Dengue fever). If antibodies in the second sample increase by four times or more, it means that the infection is recent. This means a "probable" case of WN virus infection. If West Nile cases are confirmed in a given locality and antibodies of a certain minimal titre are demonstrated in the first blood sample (the acute serum), it is acceptable to consider this to be a case of West Nile as a guide to doctors for patient treatment. In 2002, the frontline tests were handled by Health Canada's National Microbiology Laboratory (NML) in Winnipeg and by some laboratories in Ontario and Quebec. Because we anticipate a higher demand for front-line tests in 2003, the NML is providing provincial laboratories with testing technology and training so that they can diagnose WN infection in people more quickly. So far, labs in Newfoundland and Labrador, Quebec, Ontario, Alberta and British Columbia have been equipped and trained. There are two main tests used for frontline testing in North America: the HI test and the ELISA test. Both tests work equally well and produce results within 48 hours. Last year, most labs in Canada used the HI test. This year, the NML has negotiated with the US Centres for Disease Control and Prevention to obtain raw materials for the ELISA test. The NML plans to make kits for ELISA testing available to labs across the country, so labs will have both tests available to them. Confirmatory Testing: Once a front-line test shows that a case is "probable", the samples can be sent to Health Canada's NML to confirm the diagnosis. It is important to note that doctors to not need the results of confirmatory tests to begin treating patients. Confirmatory tests are done to provide researchers and public health officials with important information about WN virus such as: · whether the virus is turning up again in an area where cases were previously recorded · whether the virus has spread to new areas · the geographical distribution of the virus as it spread · new ways the virus can be spread (i.e. through blood transfusions) · who may be at greater risk for serious health effects. A-32 Q. How is West Nile encephalitis treated? A. There is no specific treatment for West Nile virus infection. In more severe cases, intensive supportive therapy is indicated, often involving hospitalization, intravenous fluids, airway management, respiratory support (ventilator), prevention of secondary infections (pneumonia, urinary tract, etc.), and good nursing care. 8 A-33 Q. If I live in an area where birds or mosquitoes with West Nile virus have been reported and a mosquito bites me, am I likely to get sick? A. No. Even in areas where the virus is circulating, very few mosquitoes are infected with the virus. Even if the mosquito is infected, less than 1 % of people who get bitten and become infected will get severeiy ill. The chances you will become severely ill from any one mosquito bite are extremely small. A-34 Q. Can you get West Nile encephalitis from another person? A. No. West Nile encephalitis is NOT transmitted from person-to-person. For example, you cannot get West Nile virus from touching or kissing a person who has the disease, or from a health care worker who has treated someone with the disease. A-35 a. What can people do to reduce their risk of WN virus infection? A. If WN virus is found in birds, mosquitoes, horses or people in your area, you can take steps to reduce the risk of getting mosquito bites. For example, wear protective clothing when outdoors, and use insect repellents that contain DEET or other approved ingredients. Insect screens on doors and windows will reduce the chance of mosquitoes entering your home; make sure screens have no holes and fit tightly. Also, take steps to reduce mosquito populations around your home and property. For example, reduce standing water around your home e.g., dispose of old car tires, empty bird baths twice a week, and empty pool covers regularly. For most Canadians, the risk of WN virus infection is low, and the risk of serious health effects from the virus is even lower. However, anyone exposed to mosquitoes in an area where WN virus has been detected is at risk for infection. Anyone who becomes infected is at risk for serious health effects. · · · 9 Section B Pregnancy and Breastfeeding ~ , B-1 Q. Does pregnancy increase the risk of becoming infected with WN virus? A. Being pregnant does not increase a woman's risk of getting WN virus. Pregnant women who have concerns about WN virus or their general health, should speak with their doctor or health care provider. B-2 Q. Is a woman's pregnancy at risk if she gets infected with West Nile virus? A. There is one documented case of transplacental (mother-to-child) transmission of WNV in humans. Although the newborn in this case was infected with WNV at birth and had severe medical problems, it is unknown whether the WNV infection itself caused these problems or whether they were coincidental. More research will be needed to improve our understanding of the relationship - if any - between WNV infection and adverse birth outcomes. Nevertheless, pregnant women should take precautions to reduce their risk for WNV and other arboviral infections by avoiding mosquitoes, using protective clothing and repellents containing DEET. When WNV transmission is occurring in an area, pregnant women who become ill should see their health care provider. If their symptoms are consistent with acute WNV infection they should undergo appropriate diagnostic testing. B-3 Q. Can a pregnant woman pass WN virus to her unborn baby? A. There is one known case in the United States of a mother passing West Nile virus to her unborn baby. In this case, the child was born with serious medical problems. However, it is not known whether the problems were caused by WN virus or by other factors. Since the evidence shows it is possible to pass WN virus to an unborn child, pregnant women should take immediate steps to reduce their risk of mosquito bites if they are in an area where WN virus is active. If they develop symptoms of WN virus infection, they should call their doctor or health care provider right away. B-4 Q. Can WN virus be passed to a child through breast milk? A. There is evidence that this is possible. In one case in the United States, a woman was infected with WN virus after the birth of her child. She breast-fed her baby, and the baby later tested positive for WN virus infection. Laboratory tests determined that WN virus was present in the breast milk. Investigators looking into the case believe it is unlikely that the baby was infected by a mosquito bite.They concluded that breast milk was the most likely source of infection. Despite being infected with WN virus, the child had no symptoms and remained healthy. { \,--- 10 B-5 Q. Should women with symptoms of WN virus continue to breastfeed their children? . A. Women who are breast-feeding their children should contact their doctors for advice if they have symptoms of any illness, including WN virus. It appears that WN virus can be passed through breast milk, but the level of risk is still unknown. On the other hand, the health benefits of breast-feeding are well known. Women who have concerns about the potential to transmit WN virus through breast-feeding should consult their doctor for advice In their specific situation. B-6 Q. What steps should pregnant and breast-feeding women take to reduce their risk of getting WN virus? A. Since there is evidence that WN virus could be passed through breast milk and from a mother to her unborn child, it is important for pregnant and breast-feeding women to take steps to reduce their risk of WN virus infection. The best way to reduce the risk of infection is to reduce the risk of mosquito bites. If WN virus activity is detected in your neighbourhood, town or region: · Limit time spent outdoors at dawn and dusk, when many mosquitoes are most active. · Wear light-coloured long-sleeved shirts, long pants, and a hat when outdoors in areas where mosquitoes are present. · Make sure that door and window screens in the home fit tightly and have no holes. . · Use insect repellents that contain DEET or other approved ingredients. Read and follow the directions on the label. Another way to reduce the risk of mosquito bites is to reduce mosquito populations around your home and surrounding property. Mosquitoes need standing pools of water to breed, so it is a good idea to get rid of standing water from such items as pool covers, saucers under flower pots, pet bowls, wading pools, and old tires. Empty bird baths twice a week. Cover rain barrels with screens, and clean eaves troughs regularly to prevent clogs that can trap water. B-7 Q. Is it safe for pregnant and breastfeeding women to use insect repellents that contain DEET? A. There is no evidence that the use of DEET by pregnant or breastfeeding women poses a health hazard to unborn babies or children who are nursing. However, as a safety precaution, women in these situations may wish to consider the use of non- chemical methods to prevent mosquito bites as a first line of defense against WN virus. . 11 Section C: Occupational Risks C-1 Q. Are laboratory workers in contact with WNV-positive specimens at risk for WNV infection? A. Yes, and approximately 20 laboratory-acquired WNV infections have been reported in the medical literature over many decades. In the two most recently reported cases, WNV infection of two microbiologists working with WNV-positive samples resulted from percutaneous inoculation (pierced through the skin). Both persons had mild, self-limited illnesses. More laboratories have recently become involved in WNV diagnostic and reference activities. This has probably increased the risk for laboratory acquired WNV infections. Laboratory workers handling materials that are potentially infected with WNV should use every precaution to minimize their risk for exposure C-2 Q. How should health care workers protect themselves if they are caring for patients with WNv illness? A. WNv is not spread from person to person unless there is exposure to blood. Usual universal precautions will protect the health care worker from WNv illness. C-3 Q. Do people who work outdoors need to change their safety practices? A. It is not necessary to limit usual outdoor work or change standard outdoor health and safety practices, unless there is evidence of mosquito-borne disease in the area you are working. Workers should wear protective clothing such as long pants, long-sleeved shirts, and socks. C-4 Q. If I have to wear protective clothing, how can I avoid heat stress on hot, humid days? A. If you wear a long-sleeved shirt, long pants, shoes and socks to reduce the risk of mosquito bites, you may be at greater risk for heat stress on hot, humid days. To avoid symptoms of heat stress, you should: · Wear light-coloured, breathable clothing that allows moisture to evaporate quickly · Use extra caution if you are required to wear clothing on the job that limits evaporation - you could develop heat stress more quickly · Drink plenty of non-alcoholic and non-caffinated liquids to maintain body hydration 12 Section D: Blood Transfusions and Transplants e D-1 Q. Can West Nile (WN) virus be transmitted through blood? A. Yes. There have been confirmed cases in Canada and the United States of West Nile virus being spread through blood transfusions and organ transplants. D-2 Q. Does the risk of getting WN virus mean that people should be concerned about receiving transfusions or transplants? A. The risk of getting WN virus through these procedures is considered to be very low, and there are only a few confirmed cases. The benefits of blood transfusions and organ transplants outweigh the risk of becoming infected with WN virus. People scheduled to receive transfusions or transplants should discuss any concerns they have with their doctor or surgeon. Viruses of the family to which West Nile virus belongs cannot be transmitted through fractionated blood products, such as immune globulins, because these viruses are inactivated or removed during the manufacturing process. D-3 Q. What has Health Canada done to ensure blood safety since it became known that WN virus could be transmitted through blood? A. In September 2002, Health Canada gave blood operators instructions to minimize the risk of spreading West Nile virus through the blood supply. This involved deferral or withdrawal of blood from donors suspected or shown to be infected with the West Nile virus. e In January, 2003, HC opened up a dialogue with industry during a HC sponsored Workshop to foster development of a blood donor screening test for WN virus. HC met with industry on several occasions during the period between Jan-April to review the progress of the commercial WN virus test and to provide options for priority review and approval of the test. A complete submission for the WNV blood donor screening test was received from industry on April 30th. It is currently under priority review with a target date for implementation for investigational purposes on July 1 st. As well, since September 2002, HC has met with blood operators on a regular basis to review contingency plans for the interim period before the test Is available. HC has been working with CBS and HQ to transfer WN virus testing technology "know- how" to the blood operators to assist them in developing in-house West Nile virus testing capability in case the commercial WN virus test is delayed. HC will continue to provide up-to-date surveillance information to CBS and HQ to assist with contingency plans. The surveillance data helps to identify low-risk areas that the blood operators could focus on for donations in the case of a shortage, or high-risk areas of Canada that they would avoid. e 13 D-4 Q. What does Health Canada do to ensure the safety of the blood supply in Canada? A. Health Canada regulates blood under the Food and Drugs Act and Regulations, which are aimed at maximizing the safety of blood in Canada. Health Canada's role includes: · assuring that blood operators follow current laws and reguiations · conducting regular inspections of blood establishments · licensing the blood establishments · monitoring the blood system for emerging pathogens · identifying potential safety threats · assessing and managing risks related to blood safety · assuring that laws and regulations address current safety needs D-5 Q. Can someone get WN virus by giving blood? A. No. Donating blood is a safe procedure and the West Nile virus cannot be transmitted in that way. D-6 Q. What happens if someone with a probable case of WN virus has donated blood? A. In this situation, Health Canada has instructed blood operators to: · Quarantine transfusion products that contain the donor's blood. · Quarantine products that are awaiting pooling for further manufacture. · Defer the donor from giving blood. If further tests indicate the person is not infected with WN virus, the quarantined products can be released and the person can become an active donor, unless deferred for some other reason. D-7 Q. What happens if someone with a confirmed case of WN virus has donated blood? A. In this situation, Health Canada has instructed blood operators to: · Withdraw any transfusion products that contain the donor's blood. · Withdraw any products that were awaiting pooling for further manufacture. · Defer the donor from giving blood for a period of eight weeks from the date of probable infection. D-S Q. Why are people with confirmed cases of WN virus infection allowed to donate blood again after eight weeks? A. West Nile virus only stays in the blood of an infected person for four to seven days. After that, the person's blood contains antibodies to the virus, but does not contain the virus itself. WN virus infection is only spread through blood if the blood contains live virus. Donors can donate blood again after a period of eight weeks, which is the normal donation cycle. This period also permits an extra margin of safety to ensure that the virus is no longer present. 14 0-9 Q. What happens when people with symptoms of WN virus infection offer to donate blood? . A. When people have symptoms of WN virus infection, their blood may contain an infectious WN virus. Therefore, Health Canada has instructed blood operators to defer potential donors who have symptoms that suggest possible WN virus infection. It is important to remember, however, that many people infected with WN virus have no symptoms, so It is difficult to identify them and defer them from donating blood. D-10 Q. Will the screening test be available in time? A. The test was submitted on April 30th, and is currently under priority review. Because the test is new, it will take some time for the blood system operators to famiiiarize their staff with the use of the new equipment. The target date for implementing the test on an investigational basis remains July 1, 2003. Everyone is on schedule for meeting this date. 0-11 Q. What is being done in the interim (before the commercial test is available)? A. The blood operators will be using blood components that were collected and stockpiled during the winter season which is considered mosquito-free and therefore also "WN virus free". There should be sufficient frozen plasma collected to cover the interim period. There will also be limited testing on fresh blood components that cannot be stored for long periods of time, and must be collected and used before the test is available. 0-12 Q What is being done to reduce the risk of transmitting WN virus through organs and tissues? A. When the risk of transmission through blood and tissues was established last summer, . the first priority for the Department was to address the risk of transmission through blood, since this is where the greatest risk lies, and the greatest number of people potentially affected, including organ and tissue recipients. We are now focusing intensely on the specific risks of WNV transmission through organ and tissue transplantation. Health Canada has been meeting with the transplantation communitý; a number of enhanced safety measures have been identified, and are being discussed with the transplant centres, industry and blood operators. These safety measures include the testing of blood from live and cadaveric donors. There are existing safeguards. Tissue and organ donors are currently subject to an intense screening protocol to ensure that the donor is free of any infectious disease. As part of this screening, live organ and tissue donors have their blood tested, much as a blood donor's blood would be tested. By implementing the WNV blood test in the screening of the blood system, live organ and tissue donors would also be screened for WNV. As well, organ recipients often receive blood transfusions following their surgery. Therefore, much of the risk for transplant recipients is addressed by having the WNV testing implemented in the blood system. Where circumstances are a matter of life-or-death, the benefits of a transplant outweigh the risk of WNV transmission. We will continue to communicate to the public about developments in the strategy for addressing the risks of WNV transmission through tissues and organs as they become available. Health Canada is currently in active discussion with the transplant community, industry and operators. For information about the blood operators, visit their Web sites or call their toll-free numbers. Canadian Blood Services: 1-888-236-6283 www.bloodservices.ca . 15 Section E: Animals and WNv (Including Horses) E-1 Q. Can animals other than birds be infected with West Nile virus? A. Yes. Horses are very susceptible to WN virus. There have been thousands of confirmed cases of infected horses across the United States. There have also been confirmed and/or probable cases of infected horses in Quebec, Ontario, Manitoba and Saskatchewan. In the U.S., there have also been small numbers of confirmed cases in cats, dogs, domestic rabbits and in certain types of squirrels, chipmunks, skunks and bats. E-2 Q. How do animals become infected with WN virus? A. The source of infection for animals is the same as the source for most people who become infected - the bite of an infected mosquito. When there are reports of infected dead birds, or other animals in the area, it means there are likely infected mosquitoes too, and people should take action to reduce the risk of exposure to mosquitoes. E-3 Q. What signs do infected animals have? A. Some may have no signs at all. Others may have a range of signs including fever, muscle spasms, weakness, lack of coordination, seizures and changes in temperament or personality. For horses, signs of WN virus infection may include stumbling, weakness in hind limbs, inability to stand, paralysis of the limbs, listlessness and head shaking. In severe cases, horses may die or need to be euthanized. E-4 Q. Can people become infected by touching or being around animals infected with WN virus? A. There have been no recorded cases of animals passing West Nile virus infection to other animals or to people. However, people who handle dead birds or animals should still follow standard health and safety practices. For example, cover any open wounds, and wear protective gloves and a mask. These health and safety practices are also important for people who work with animals at risk for WN virus infection, such as horses and flocks of domestic birds. Health Canada has issued an Occupational Health Advisory for people whose jobs may put them at risk for WN virus infection. E-5 Q. Is there a treatment for animals infected with WN virus? A. There is no specific treatment, but supportive therapies may reduce the severity and duration of clinical signs. People who suspect that horses, other animals or pets have become infected with WN virus should contact a veterinarian for information and advice. 16 E-6 Q. Are there vaccines to protect animals from WN virus? A. In 2002, a vaccine for horses was given a provisional license in Canada and was available from veterinarians. There is no Vaccine at this time for other animais or pets. · E-7 Q. Besides mosquitoes, can you get West Nile virus directly from other insects or ticks? A. Infected mosquitoes are the primary source for West Nile virus. Ticks infected with West Nile virus have been found in Asia and Africa. Their role in the transmission and maintenance of the virus is uncertain. There is no information to suggest that ticks played any role in the cases identified in the United States or Canada. E-8 Q. Can you get West Nile virus directly from birds? A. There is no evidence that a person can get the virus from handling live or dead infected birds. However, persons should avoid bare-handed contact when handling any dead animals and use gloves or double plastic bags to place the carcass in a garbage can. E-9 Q. Has West Nile virus caused severe illness or death in horses? A. Yes. While data suggest that most horses infected with West Nile virus recover, results of investigations indicate that West Nile virus has caused deaths in horses in the United States and Canada. · E-10 Q. How do the horses become infected with West Nile virus? A. The same way humans become infected-by the bite of infectious mosquitoes. The virus is located in the mosquito's salivary glands. When mosquitoes bite or "feed" on the horse, the virus is injected into its blood system. The virus then multiplies and may cause illness. The mosquitoes become infected when they feed on infected birds or other animais. E-11 Q. How does the virus cause severe illness or death in horses? A. Following transmission by an infected mosquito, West Nile virus multiplies in the horse's blood system, crosses the blood brain barrier, and infects the brain. The virus interferes with normai centrai nervous system functioning and causes inflammation of the brain. E-12 Q. Can I get infected with West Nile virus by caring for an infected horse? A. West Nile virus is transmitted by infectious mosquitoes. There is no documented evidence of person-to-person or animal-to-person transmission of West Nile virus. Normal veterinary infection control precautions should be followed when caring for a horse suspected to have this or any virai infection. · 17 E-13 Q. Can a horse infected with West Nile virus infect horses in neighboring stalls? A. No. There is no documented evidence that West Nile virus is transmitted between horses. E-14 Q. My horse is vaccinated against eastern equine encephalitis (EEE), western equine encephalitis (WEE), and Venezuelan equine encephalitis (VEE). Will these vaccines protect my horse against West Nile virus infection? A. No. EEE, WEE, and VEE belong to another family of viruses for which there is no cross-protection. E-15 Q. Can I vaccinate my horse against West Nile virus infection? A. A West Nile virus vaccine for horses was recently approved, but its effectiveness is unknown. E-16 Q. How long will a horse infected with West Nile virus be infectious? A. We do not know if an infected horse can be infectious (i.e., cause mosquitoes feeding on it to become infected). However, previously published data suggest that the virus is detectable in the blood for only a few days. E-17 Q. What is the treatment for a horse infected with West Nile virus? Should it be destroyed? A. There is no reason to destroy a horse just because it has been infected with West Nile virus. Data suggest that most horses recover from the infection. Treatment would be supportive and consistent with standard veterinary practices for animals infected with a viral agent. E-18 Q. What are the plans for horse surveillance? A. The Canadian Food Inspection Agency, along with Provincial Veterinary Laboratories, veterinarians and other members of the animal health community, will take the lead in monitoring for West Nile virus in horses. E-19 Q. Can squirrels infected with West Nile virus transmit the virus to humans? A. A small number of squirrels have tested positive for the West Nile virus. There is no evidence that people could become infected with the West Nile virus by being near an infected squirrel or in the yard with a dead one. However, the presence of an infected squirrel does mean that there could be infected mosquitoes nearby, and people should use protective clothing and repellent, and avoid maintaining mosquito-breeding sites on their property. 18 E-20 Q. Can you get WNV from eating game birds or animals that have been infected? A. There is no evidence that WNV virus can be transmitted to humans through consuming infected birds or animals. In keeping with overall public health practice, and due to the risk of known food-borne pathogens, people should always follow procedures for fully cooking meat from either birds or mammals. E-21 Q. Are duck and other wild game hunters at risk for West Nile virus infection? A. Because of their outdoor exposure, game hunters may be at risk if they become bitten by mosquitoes in areas with West Nile virus activity. The extent to which West Nile virus may be present in wild game is unknown. E-22 Q. What should wild game hunters do to protect against West Nile virus infection? A. Hunters should follow the usual precautions when handling wild animals. If they anticipate being exposed to mosquitoes, they should apply insect repellents to clothing and skin, according to label instructions, to prevent mosquito bites. Hunters should wear gloves when handling and cleaning animals to prevent blood exposure to bare hands and meat should be cooked thoroughly. . e e 19 Section F: Personal Protection and Source Reduction F-1 Q. What can I do to protect myself and my family? A. To avoid being bitten by mosquitoes, you can take action on two fronts: 1. Minimize your exposure to mosquitoes: · When going outdoors, use insect repeiJents that contain OEET or other approved ingredients. · Try to avoid spending time outdoors at dawn and at dusk when mosquitoes are most active. · Wear protective ciothing such long-sleeved shirts, long pants and a hat. Light coloured clothing is best because mosquitoes tend to be more attracted to dark colours. · Make sure that door and window screens fit tightly and have no holes that may allow mosquitoes indoors. 2. Eliminate Mosquito Breeding Sites Around your Home and Cottage: Mosquitoes lay eggs in standing water and it takes about four days for the eggs to grow into adults that are ready to fly. Even a small amount of water, for example, in a saucer under a flower pot, is enough to act as a breeding ground. As a result, it is important to eliminate as much standing water around your property as possible by: · Regularly draining standing water from items like pool covers, saucers under flower pots, recycle bins, garbage cans etc. · Remove old unused items from around your property including oid tires, that have a tendency to collect water. · Change the water in wading pools, bird baths, pet bowls and livestock watering tanks twice a week. · Cover rain barrels with screens. · Clean out eaves troughs reguiarly to prevent clogs that can trap water. · If you have an ornamental pond, consider getting fish that will eat mosquito larvae. F-2 Q. How about using pesticides around my home? A. Over the counter products that are designed to get rid of garden pests arent' effective for overaiJ mosquito control. Regarding the use of other pesticides, only workers who are licensed by provincial authorities and are trained in the safe use of pesticies can carry out mosquito control programs. Decisions on whether or not to use pesticides to control the spread of West Nile virus in your community will be made by local and provincial health authorities. F·3 Q. What can I do around my property to discourage mosquitoes? / , \ A. The best way to keep mosquitoes away is to clean up areas where they like to breed. Unlike birds or other insects, mosquitoes do not fly very far and tend to stay close to their breeding sites and normal habitat. Take a look around your house and property and get rid of places that are mosquito friendly that would make good breeding sites or resting places for mosquitoes. 20 Anv type of standino water: · Clean up and empty containers of standing water such as old tires, flower pots, wheelbarrows, barrels or tins cans that are outdoors · Drill holes in the bottoms of used containers so water can't collect · Change water in bird baths every other day . Swimmino or wadino pools: · Immediately remove water that collects on pool covers · Make sure the pool's pump is circulating · Turn over wading pools when not in use Check eaves and drains: · Don't let things pile up. Clear leaves and twigs from eavestroughs, storm and roof gutters throughout the summer · Make sure drainage ditches are not clogged · Check flat roofs frequently for standing water Yard and lawn maintenance: Think mosquito prevention when working in the yard. Lawn cuttings, raked leaves or other decaying debris such as apples or berries that fall from trees should be collected and recycled or mulched so that organic matter does not end up in storm sewers as a food source for mosquito larvae. . · Turn over compost frequently · Fill in low depressions in lawn areas · Clear out dense shrubbery where mosquitoes like to rest · Spread the word. Point out potential mosquito breeding areas to your neighbours The best way to keep mosquitoes away is to clean up areas where they are likeiy to breed. Check windows: · Check window screens for holes and make sure they fit snugly into the window frame so mosquitoes will not get indoors If you don't have screens, consider keeping windows closed between the hours of dusk and dawn . 21 Section G: Mosquito Repellents I \ G-1 Q. Why should I use insect repellent? A. Insect repellents help people reduce their exposure to mosquitos that may carry potentially serious viruses such as the West Nile virus, allowing them to continue to play and work outdoors. G-2 Q. When should I use mosquito repellent? A. Apply repellent when you are going to be outdoors and will be at risk for being bitten by mosquitoes. G.3 Q. What time of day should I wear mosquito repellent? A. Many of the mosquitoes that carry the West Nile virus are especially likely to bite around dusk and dawn. If you are outdoors around these times of the day, it is important to apply repellent. In many parts of the country, there are mosquitoes that also bite during the day, and these mosquitoes have also been found to carry the West Nile virus. The safest decision is to apply repellent whenever you are outdoors. G-4 Q. How often should repellent be reapplied? A. Follow the directions on the product you are using in order to determine how frequently you need to reapply repellent. Sweating, perspiration or getting wet may mean that you need to re-apply repellent more frequently. If you are not being bitten, it is not necessary to re-apply repellent. Repellents containing a higher concentration of active ingredient (such as DEET) provide longer-lasting protection. G-5 Q. Should I wear repellent while I am indoors? A. Probably not. If mosquitoes are biting you while you are indoors, there are probably better ways to prevent these bites instead of wearing repellent all the time. Check window and door screens for holes that may be allowing mosquitoes inside. If your house or apartment does not have screens, a quick solution may be to staple or tack screening (available from a hardware store) across the windows. G-6 Q. How does mosquito repellent work? ( \ ',.~- A. Female mosquitoes bite people and animals because they need the protein found in blood to help develop their eggs. Mosquitoes are attracted to people by skin odors and carbon dioxide from breath. Many repellents contain a chemical, N,N-diethyl-m-toluamide (DEET), which repels the mosquito, making the person unattractive for feeding. DEET does not kill mosquitoes; it just makes them unable to locate us. Repellents are effective only at short distances from the treated surface, so you may still see mosquitoes flying nearby. As long as you are not getting bitten, there is no reason to apply more DEET. 22 G-7 Q. Which mosquito repellent works the best? e A. The most effective repeilents contain DEET (N,N-diethyl-m-toluamide), which is an ingredient used to repel pests like mosquitoes and ticks. DEET has been tested against a variety of biting insects and has been shown to be very effective. The more DEET a repeilent contains the longer time it can protect you from mosquito bites. A higher percentage of DEET in a repellent does not mean that your protection is better-just that It will last longer. DEET concentrations higher than 50% do not increase the length of protection. G-8 Q. How does the percentage of DEET in a product relate to the amount of protection it gives? A. Based on a recent study: · A product containing 23.8% DEET provided an average of 5 hours of protection from mosquito bites. · A product containing 20% DEET provided almost 4 hours of protection · A product with 6.65% OEET provided almost 2 hours of protection · Products with 4.75% DEET and 2% soybean oil were both able to provide roughiy 1 and a half hours of protection Choose a repellent that provides protection for the amount of time that you will be outdoors. A higher percentage of OEET should be used if you will be outdoors for several hours while a lower percentage of OEET can be used if time outdoors will be limited. You .. can also re-apply a product if you are outdoors for a longer time than expected and start . to be bitten by mosquitoes. G-9 Q. Why is DEET recommended? A. OEET is the most effective and best-studied insect repeilent available. Studies involving humans and mosquitoes report that only products containing DEET offer long- lasting protection after a single application. G-10 Q. Are non-DEET repellents effective (e.g. Skin-So-Soft, plant-based repellents)? A. Some non-DEET repellent products that are intended to be applied directly to skin also provide some protection from mosquito bites. Studies have suggested that other products do not offer the same level of protection, or that protection does not last as long as products containing DEET. A soybean-oil-based product has been shown to provide protection for a period of time similar to a product with a low concentration of OEET (4.75%) People should choose a repeilent that they will be likely to use consistently and that will provide sufficient protection for the amount of time that they will be spending outdoors. Product labels often indicate the length of time that one can expect the product to protect them. Persons who are concerned about using DEET may wish to consult their health care provider for advice. e 23 G-11 Q. Do products in the store say "DEET" on the package? A. Most insect repellents that are available in stores are labeled with the chemical name for DEET. Look for N,N-diethyl-m-toluamide or, sometimes, N,N-diethly-3- methylbenamide. Choose a repellent that offers appropriate protection for the amount of time you will be outdoors. A higher percentage of DEET should be used if you will be outdoors for several hours while a lower percentage of DEET can be used if time outdoors will be limited. G-12 Q. Is DEET safe? A. Yes, products containing DEEr are very safe when used according to the directions. Because DEET is so widely used, a great deal of testing has been done. When manufacturers seek registration for products such as DEET, laboratory testing regarding both short-term and long-term health effects must be carried out. Over the long history of DEET use, very few confirmed incidents of toxic reactions to DEET have occurred when the product is used properly. G-13 Q. What are some general considerations to remember in order to use products containing DEET safely? A. Read the manufacturer's instructions on the label carefully. · Do not use repellent on open wounds, or if skin is irritated or sunburned. · Do not get in eyes - if this happens, rinse with water right away. · Wash skin with soap and water when you return indoors or when protection is no longer needed. · Avoid breathing mist from spray-type repellent. Always apply in a well-ventilated area: never apply spray repellent inside a tent. Do not use near food. · Check for sensitivity - apply repellent to a small area of skin on the arm and wait for 24 hours before use. G-14 Q. How should products containing DEET be used on children? A. Health Canada advises that DEET containing repellents not be used on children under 6 months of age. · It recommends that, where there is a high risk of complications to the child from insect bites, DEET may be considered for children aged 6 months to 2 years. (Apply only once a day) · Use sparingly, avoid the face and hands, apply only once a day, and use the least concentrated product (10% or less). · Health Canada also advises not applying DEET more than three times a day to children between 2 and 12 years of age. Always follow the recommendations appearing on the product label when using repellent. . When using repellent on a child, apply it to your own hands and then rub them on your child. Avoid chiidren's eyes and mouth and use it sparingly around their ears. . Do not apply repellent to children's hands. (Children tend to put their hands in their mouths.) 24 . Do not allow young children to apply insect repellent to themseives; have an adult do it for them. Keep repellents out of reach of children . . Do not apply repellent to skin under clothing. If repellent is applied to clothing, wash treated clothing before wearing again Using repellents on the skin is not the only way to avoid mosquito bites. Children and adults can wear clothing with long pants and long sleeves while outdoors. DEET or other repellents such as permethrin can also be applied to clothing (don't use permethrin on skin), as mosquitoes may bite through thin fabric. Mosquito netting can be used over infant carriers. Finally, it may be possible to reduce the number of mosquitoes in the area by getting rid of containers with standing water that provide breeding places for the mosquitoes. G-15 Q. Is DEET safe for pregnant or nursing women? A. There are no reported adverse events following use of repellents containing OEET in pregnant or breastfeeding women. G-16 Q. Are there any risks due to using repellents containing DEET? A. Use of these products may cause skin reactions in rare cases. If you suspect a reaction to this product, discontinue use, wash the treated skin, and seek medical attention. If you go to a doctor, take the product with you. Cases of serious reactions to products containing OEET have been related to misuse of the product, such as swallowing, using over broken skin, and using for multiple days without washing skin in between use, for example. Always follow the instructions on the product label. . G-17 Q. Should parents spray insect repellent on their children before they go to school? A. Whether children spend time outside during the school day should determine the need for applying repellent. If children will be spending time outdoors (for example, in recreational activities, walking to and from school), parents may wish to apply repellent. Mosquito repellent containing DEET is the most effective in providing long-lasting protection from mosquito bites. G.18 Q. Should children be given repellentto use during the day? A. The age and maturity of the child should be taken into account before giving repellent to children for their own use. As with many other chemicals, care should be taken that DEET is not misused or swallowed. Parents should find out if a child will be outside during the school day, and should discuss proper use of the product with their children. Parents should also consult local school officials to obtain policies and procedures specific to bringing repellent to school. . 25 Section H: Surveillance - Birds H-1 Q. What surveillance activities will the Elgin St. Thomas Health Unit doing in 2003? A. West Nile virus was confirmed in 6 crows in Elgin County in 2002. The Elgin St. Thomas Health Unit will continue with dead bird, mosquito and human surveillance in 2003 as a way of tracking the virus. Larval testing and potentially, larviciding will be added to the local activities in 2003. Just as importantly, you need to take precautions to protect yourself and your family from mosquitoes by reducing breeding grounds and by using protection against mosquito bites. H-2 Q. What is Bird Surveillance? A. Staff at the health unit began a dead bird surveillance program in April as a way of tracking the virus. Crows are especially sensitive to the strain of West Nile virus now circulating, which is why they are being monitored for the virus by the health unit. Last year, neighbouring regions reported a dramatic increase in dead bird sightings in a particular geographic areas about two weeks prior to a human case. Residents across the county are asked to report sightings of dead or ill crows to the health unit at (519) 631-9900. í '. The Canadian Cooperative Wildlife Health Centre, along with provincial laboratories and Health Canada's National Microbiology Laboratory in Winnipeg, will test dead birds for West Nile virus from late April until the first hard frost. The tests will be done mainly on crows, jays, magpies and ravens. Experience from past outbreaks has shown that these species are very susceptible to West Nile virus. This makes them the best indicator for determining whether people in particular areas are at risk. H-3 Q. What types of birds carry West Nile virus? A. The virus has been found in more than 150 bird species in North America. Some species may have no obvious signs of illness when infected. Others, such as crows, blue jays, magpies and ravens, get sick more often and can die. H-4 Q. Do birds infected with West Nile virus die or become ill? A. In the 1999 New York area epidemic, there was a large die-off of American crows. Since then, West Nile virus has been identified in more than 100 species of birds found dead in North America. Most of these birds were identified through reporting of dead birds by the public. H-5 Q. Why are dead crows monitored? A. Nearly 100% of crows that are infected with WNv die from their infection. Monitoring dead crows therefore provides a very good indicator or WNv activity in the community. Experience has shown that dead bird sightings peak just before human cases begin to appear. 26 H-6 Q. How can I report a sighting of dead bird(s) in my area? A. You can call the Elgin-St.Thomas Health Unit at (519) 631-9900 to report dead birds. Not all birds will be collected for testing. Only crows that are freshly dead, have no evidence of decay and no evidence of trauma are suitable for testing. H-7 Q. Why do some areas stop collecting dead birds? A. Some areas are no longer collecting dead birds because they have sufficiently established that the virus is in an area, and additional testing will not reveal any more information. Shifting resources away from testing of dead birds allows those resources to be devoted elsewhere in surveillance and control. H-8 Q. How do I dispose of a dead bird that isn't going to be sent away for testing? A. To dispose of a dead bird, use plastic or latex gloves to carefully place it in a double plastic bag. You may also use a double plastic bag as a glove to pick up the bird. Then wrap the bird in the bag, tie it off and place it in the outdoor trash. Wash your hands with soap and water when finished. . . e 27 Section I: Mosquitoes and Mosquito Habitats 1-1 Q. What types of mosquitoes spread West Nile virus? A. There are 74 known species of mosquitoes in Canada. West Nile virus infection has been found in 10 of these, but it is more common in species that feed on birds. Examples include Culex pipiens, Culex restuans and Culex tarsalis. Not all of the 74 different species in Canada are found in all parts of the country. The actual numbers of mosquitoes in different areas will vary according to the time of year. Temperature and rainfall can also have a dramatic effect on mosquito populations. It is estimated that fewer than 1 % of mosquitoes in any given area are infected with WN virus. This means the risk of being bitten by an infected mosquito is low. However, it could happen to anyone in areas where WN virus is active. The best way to reduce your risk is to avoid getting mosquito bites. 1-2 Q. What is "amplification" and "bridging vectors"? A. Mosquitoes become infected with West Nile virus by biting infected birds. Infected mosquitoes then bite other birds and transmit the infection to these birds. These birds then become a source of infection for other mosquitoes. This repetitive process is called "amplification". It begins in the early spring and by mid-summer a large number of infected mosquitoes and birds can result. The main mosquitoes involved in the amplification process in Ontario are Culex pipiens and Culex restuans. These mosquitoes prefer to feed on birds but may also bite humans or animals under certain circumstances. Culex pipiens and Culex restuans tend to lay eggs in man made structures that contain water such as street side catch basins, road side ditches, and man made containers (tires, bottles, buckets, bird baths, roof gutters, swimming pool covers, etc.) In these structures, the eggs develop into larvae, then pupae and then flying adult mosquitoes. Adult Culex pipiens and Culex restuans tend to fiy between Y. mile to one mile and bite between dusk and dawn. Later in the spring and summer other mosquitoes called "bridging vectors" emerge. These mosquitoes will feed on birds, humans and animals. They can therefore bite a bird that has been infected with West Nile virus and then transmit this infection to humans with their next bite. A common "bridging vector" in Ontario is Aedes vexans . Aedes vexans prefers to breed in temporary pools created by rainfall and in marshes and swamps. The adult mosquito can fly five miles or more, and bites anytime of the day or night. 1·3 Q. I understand West Nile virus was found in "overwintering" mosquitoes a in early 2000. What does this mean? A. One of the species of mosquitos found to carry West Nile virus is the Culex species. This species survived through the winter, or "overwintered," in the adult stage. The fact that the virus survived along with the mosquitoes was documented by the widespread transmission during the summer of 2000. 28 1-4 Q. What are stormwater ponds? · A. When land is developed to create homes, roads, businesses and other improvements, the natural system of trees and dense vegetation is replaced with pavement, hard surfaces and compacted lawns. As a result, less rainwater soaks Into the ground and more of it runs off the hard surfaces at a faster rate, contributing to combined sewer overflows, flooding and water pollution. Stormwater picks up oil, fertilizers, pesticides, bacteria and other pollutants as it runs off parking lots, streets, rooftops, lawns and other hard surfaces. Stormwater ponds detain and slow the rate of runoff from developed areas and remove pollutants that are collected in the runoff. These stormwater ponds are commonly used to reduce flooding, erosion, landslides, and pollution. These facilities help protect public health and safety, public and private property, and water quality in local rivers and streams. 1-5 Q. What stormwater facilities are potential breeding grounds for mosquitoes that carry West Nile virus? A. · Catch Basins Mosquitoes that carry the West Nile virus can breed in standing water. Many catch basins are designed to trap pollution and hold a small amount of stormwater after a rainfall event. These catch basins can be breeding grounds for mosquitoes that carry West Nile virus. The Elgin-St. Thomas Health Unit will be sampling water from these types of catch basins in the urban area to monitor them for the presence of mosquitoes carrying West Nile virus. · · Stormwater Ponds and Water Quality Facilities Stormwater ponds and water quality facilities are designed to filter pollution from stormwater runoff and reduce flooding. Most of the facilities built into residential and commercial developments are designed to drain in a few days, which prevents mosquito larvae from completing their development. Some stormwater ponds and water quality facilities are designed to hold water most of the year or may retain small pools of water. These facilities are generally designed to provide habitat for many species of frogs, birds, fish and aquatic insects that feed on mosquitoes and their larvae. If mosquitoes carrying the West Nile virus are detected, the Health Unit and authorities in the affected municipality will provide guidance to residents on more aggressive control measures. · Wetlands Although healthy wetlands can provide habitat for mosquitoes, typical water conditions, water quality, and natural predators deter mosquito use and minimize larval success if egg laying occurs. Predators - including other aquatic insects, amphibians, and birds - feed on any mosquitoes present. Wetlands are a critical element in a healthy ecosystem that benefits people, water quality and wildlife. Wetlands clean and slowly release rainwater, provide flood protection, and wildlife habitat. Many wetlands recharge groundwater and prevent streams from drying up during the summer. We will not eliminate mosquitoes by draining wetlands. We could · 29 actually increase the mosquito population if their natural predators are destroyed by draining a wetland. Many mosquito species need only a small puddle or depression in which to breed. Rivers and Streams Under normal circumstances, mosquitoes cannot breed successfully in flowing water, and therefore streams and rivers can only produce mosquitoes when they dry up and leave shallow, stagnant puddles in the stream bed or in backwater areas. Streams and rivers provide good habitat for predators that feed on mosquitoes and mosquito larvae. 30 Section J: Surveillance - Mosquitoes and Mosquito Larvae J-1 Q. What is Mosquito Surveillance? A. Mosquito surveillance is being used to help determine the presence and abundance of the types of mosquito responsible for transmitting WNv. This information can be used to point to areas of high risk and will help in the planning of prevention and control strategies. Because mosquitoes feed on birds, it is possible to find the virus in mosquitoes. Mosquitoes caught in traps can be tested to identify the species, count the number of mosquitoes trapped and identify if any of the mosquitoes carry the virus. Traps, set out weekly in selected, secure locations, use light and carbon dioxide to attract mosquitoes in the early evening. When attracted to the trap, a fan draws the mosquito into a netted container. The live mosquitoes are collected the next morning and sent to a laboratory for testing. · · · 31 Section K: Surveillance - Human K-1 Q. What is Human Surveillance? A. Health Units are working closely with hospitals and health care providers to determine if cases of serious illness might be related to WNv infections. K-2 12 What are the plans for human surveillance? A. As in previous years, health care providers will watch for symptoms of WN virus infection in their patients. They will request laboratory tests where appropriate. They will also report all probable and confirmed cases of West Nile virus infection to local! provincial health authorities. Health Canada is working in collaboration with the provinces so that they can do the initial tests themselves. This will improve the time-frame for test results. So far, Health Canada has provided training and technology transfer to labs in Newfoundland and Labrador, Quebec, Ontario, Alberta and British Columbia. Discussions are ongoing with other provinces. Human surveillance information is used in a number of important ways. Knowing that WN virus is in an area puts doctors and the general public on alert. It also provides more clues about who may be at risk for serious health effects from WN virus. In addition, human surveillance provides information to help ensure the safety of the blood supply in Canada 32 Section L: Pesticides e L-1 Q. Who decides whether to use pesticides to control the spread of WN virus? A. Provincial and local health authorities are responsible for deciding whether to use pesticides to control the spread of WN virus. Some of the factors they may consider include the following: · the number of mosquitoes in the area · the extent of WN virus activity in local mosquito populations · the degree of risk the mosquitoes pose to people in the area · the size of the area to be treated · the number of people who live nearby · whether it is early or late in the mosquito season · whether other options for mosquito control would be effective in reducing risks to people · how the community feels about pesticide programs · the extent of local WN virus activity in birds, horses, other animals and people L-2 Q. What about using pesticides to control mosquitoes in our community? A. Registered pesticides can be used at two different points in the life cycle of a mosquito: larvicides at the larva stage and aduiticides at the adult stage. e A decision to use mosquito larviciding or adulticiding in a community requires a local risk assessment along with consultation from the Medical Officer of Health and provincial authorities. In Canada, all pesticides are registered by Health Canada's Pest Management Reguiatory Agency (PMRA). Once this agency has made a decision to register a pesticide product in Canada, the Ontario Ministry of the Environment is responsible for regulating its saie and use mainly through training, licensing and permit requirements. L-3 Q. What are larvicides? A. In the larva stage, pesticide products called larvicides are placed in stagnant water which is where mosquitoes prefer to lay their eggs (e.g. storm sewers). Larvicides can only be sold at licensed vendor outlets and applied by trained and licensed applicators or trained technicians. The licensed applicator must obtain a permit issued by the Ontario Ministry of the Environment. There are a number of larvicides registered by Health Canada. Larvicides that cause minimal impact to the environment and do not present unacceptable risks to human health will be permitted by the Ontario Ministry of the Environment. The public must receive advance notice before the application of a larvicide in their community. e 33 L-4 Q. What are adulticides? A. Control of adult mosquitoes involves the application of pesticides called adulticides in late evening when adult mosquitoes are most active and mosquito control is most effective. There are a number of pesticides to control adult mosquitoes registered by Health Canada. For disease control programs Health Canada supports the use of malathion applied by ground equipment in urban areas. Adulticides are applied by trained and licensed applicators. Advance notice must be given to the public before an adulticides is applied in a community. The use of adulticides might be necessary only where there is a significant risk to human health from WNv and when other disease prevention or mosquito control measures either have failed or would clearly be inadequate to stop the spread of the virus. L·5 Q. If provincial and local authorities decide to spray, what products would they use? A. That depends on the time of year and the current stage of development for local mosquito populations. There are four stages in a mosquito's life cycle: egg, larva, pupa and adult. Egg: Mosquitoes lay eggs in clusters, in standing water. The eggs float on the water's surface, sometimes in rafts of a hundred or more. Most eggs hatch into larvae within 48 hours. Larva: Larvae live in the water and come to the surface to breathe. They shed their skin four times and become larger each time. Afler the fourth molt, a larva becomes a pupa. Pupa: This is a resting, nonfeeding stage that lasts for about two days. When the mosquito is fully developed, the pupal skin splits and an adult mosquito emerges. Adult: The adult mosquito rests on the water's surface while all of its parts harden and its wings dry. After this, it is ready to fiy. Mosquitoes can only be controlled when they are larvae or adults. Products that control larvae are called larvicides. Products that control adult mosquitoes are called adulticides. L-G Q. Which type of pesticide product do authorities prefer to use? A. In general, the use of larvicides is preferred to the use of adulticides, for the following reasons: · Larvicides are more targetted because they are applied directly to mosquito breeding areas. · Larvicides control mosquito populations before they become blood-feeding adults. · Larvicides may reduce the need to use adulticides. This may result in an overall reduction in pesticide use. Larvicides and adulticides are part of an integrated approach to mosquito control that also includes surveillance and reducing sources of standing water where the larvae live. It may be necessary to use adulticides where there are large numbers of adult mosquitoes, or where there is an imminent risk of human infection. 34 L-7 Q. What is methoprene? A. Methoprene (Altosid) is very effective against Culex species and is recommended for use in catch basins, since catch basins contain a high density of Culex larvae. Methoprene comes in briquettes that look like hockey pucks. These briquettes are heavy and so are not washed away by rain water coming into catch basins. The briquettes release the Methoprene for up to 30 days although even longer acting briquettes are available in the United States. . Methoprene is called an "insect 9rowth regulator" or "biorational larvacide". This means it mimics a natural hormone in the insect and so prevents the larvae from maturing into adult mosquitoes. Methoprene has been registered by the United States Environmental Protection Agency (US EPA) since 1975. The US EPA has placed Methoprene in the "lease toxic" category with regards to humans stating that it "does not pose unreasonable risk to human health". Methoprene has no known serious health risks. As well, the public should have no exposure to Methoprene since the briquettes will be placed mainly in catch basins, and Methoprene dissipates rapidly in the environment once it is released from the briquette. Methoprene is rapidly broken down by sunlight. It breaks down quickly in water and soil, and will not leach into groundwater. It is classified by the US EPA as not posing an unreasonable risk to wildlife or the environment. The effect of Methoprene has been studied on a great number of species. It has been found to have no effect on bees or dragonflies. Methoprene has been found to be acutely toxic to some species of freshwater, estuarine and marine invertebrates such a crayfish. However, there appears to be few long lasting effects after treatment. Reports of frog abnormalities have been widely circulated but have not stood up to scientific scrutiny. Most of the studies done on . Methoprene toxicity involve much higher concentrations than would be found using Methoprene for mosquito control. The US EPA in 2001 concluded that exposure to Methoprene will not reach levels toxic to aquatic non-target organisms. L-8 Q. What is Bti? A. Bti (Vectobac, Aquabac, Teknar) is the product that would be used in woodland lots, natural ponds and boggy areas. It is used in a granular form that is applied by hand or using a hand held applicator device. Aerial application may be necessary in remote, otherwise inaccessible bodies of water which are found to be a source of "bridging vector" larvae. Bti is a "microbial larvicide". This means it is a naturally occurring bacteria that produces a crystallized toxin. When the larvae eat the bacteria, the specific conditions in the mosquitoes stomach causes the crystallized toxin to be released resulting in the death of the larvae. Bti has been registered by the US EPA since 1983. Bti is effective against mosquitoes and black fiies, and may affect some midges. Extensive studies by the EPA have found that Bti is essentially nontoxic to humans and so there are no concerns for human health effects. As well, extensive studies have shown that Sti does not pose a risk to wildlife, non-targeted species, or the environment, when used according to label directions. . 35 L-9 Q. What steps do provincial/local health authorities take to ensure public safety when pesticides are used? A. All workers who carry out mosquito control programs are licensed by provincial authorities and are trained in the safe use of pesticides. If local authorities decide that the risk of WN virus infection warrants the use of pesticides in a certain area, they will notify the public in advance. This will enable people to take precautions and minimize their exposure to pesticide products. L-10 Q. Are mosquito control products safe? A. Pesticides are carefully regulated and must be registered with the Pest Management Regulatory Agency before they can be used in Canada. As part of the registration process, the products undergo a rigorous scientific assessment to determine whether they are safe. The assessment looks into many areas, including risks to human health and the environment and whether the product is effective. The Pest Management Regulatory Agency refuses to register pesticide products that are ineffective or pose unacceptable risks. 36 Section M: Provincial WNv Plans M-1 Q. What is the Ontario Government's 7 Point Action Plan for West Nile virus? A. Ontario's Ministry of Health and Long Term Care (MOHL TC) launched a seven point action plan to combat WNv over the next five years. 1. New lab capabilities - Addition of new staff and equipment to provide new provincial testing capabilities, reducing the time it takes to get WNv test results. 2. Tracking the virus - tracking the migration of the virus through reporting of infected birds, livestock and mosquitoes. 3. Education - keeping the public informed of developments with WNv and advising about protection of yourself and your family. 4. Mosquito control - funding is being made available to every public health unit to retain mosquito control personnel for larviciding and, as a last resort, adultlciding. 5. Early warning - a pilot project is being implemented for an early warning system to better track the outbreak of the virus and to be able to make more timely decisions on its management 6. Community exposure study - in Halton Region a voluntary blood testing study is being conducted to determine how widespread the disease is and the potential it has for spreading. 7. Research - the MOHL TC continues to consult with communities and with national and international health care professionals to advance and maintain an ongoing fiow of information on WNv. · · · 37 Section N: Additional Resources N-1 Q. How do I find out more about WNv? A. Health services and other resources Include: www.health.qov.on.ca www.HealthvOntario.com Open during business hours, these services provide general information on health care: INFOiine: 1-877-234-4343 TTY: 1-800-387-5559 T eiehealth Ontario: 1-866-797-0000; TTY 1-866-797-0007 Open 24/7, this service uses nurses to answer immediate health concerns. Health Canada: 1-866-999-7612; TTY 1-800-267-1245 www.hc-sc.qc/enqlish/diseases/westniie.htm I Centers for Disease Control and Prevention, Atlanta, Georgia Tel: 1-404-639-3311 www.cdc.qov/ncidod/dvbid/westnile/index/htm Ministry of the Environment Tel: 1-800-565-4923 www.ene.gov.on.ca ~",- RÊPORT TO COUNTY COUNCIL CLAYTON WATTERS, MANAGER ENGINEERING SERVICES DEPARTMENT JUNE 16, 2003 TERRACE LODGE - UPDATE 2 FROM: DATE: SUBJECT: APPENDIX 'A' TERRACE LØDGE HØME FØR SENIORS - UPGRADES PUBLIC MEETING PUBLIC INPUT I CONCERNS I QUESTIONS INTRODUCTION The public meeting tòr the proposed Upgrades to the Terrace Lodge Home For Seniors was advertised in the "Aylnrer Express," "S1. Thomas Times Journal," and "The Chronicle" (Dutton/West Lome) newspapers and occurred on Saturday, May 10,2003 at the East EJgin Seeondary School in Aylmer. Bus transportation was provide to transport resIdents, staffand the public from Terrace Lodge to the secondary school and return. Though well ;illvertis~ only $Orne 40 individuals attended. This included the members of the Consultant's team. The presentation of the proposed upgrades by the Consultant included a four (4) page 1ypevmtten handout, various illustrations (plates) and a thoroughverbal description; Fo!lowingthe presentation a question and answer period affurded the residents, theír caregivers and the public, the opportunity of ;illvising the Consultant on any and all of their concerns. ------.. ---- Attached to this report is a copy of the sign-in sheets for those in attendance. Previously a fuur (4) page "handout" pIns a "comment sheet" fur the interested public to complete and IDr;:v;¡rd to the Cons:uJtant advising on any questions, concerns or other input was mailed to each of the residents and/or theír caregivers. Included on the "comment sheet" 'ÇI."'as me Consultant's: street address, fux nuniber, e-mail address and telephone JIUJDber. It is interesting to note thai the dead line for responses was May 16, 2003 and as ofto-day's date (May 22, 2003) not a single response has been received by the Con&1ltant. What follows are the questions,. concerns and input .lì:omthose in attendance. PD"BLIC INPUf ¡CGN(:ERNSl QUESTIONS Q (Question) Q.l Have you cons.idered how to getther floor residents Gntina. hurry given an emergency should arise? The fuci!itybas oniy 0tJ.ß elevator. The residents. know how long: it talœs to. get!o the diningrooma:nd are conœmed witbrespect to íhe$ingJe elevator. What about ararnp ftotn2"dflooT togt'()und? Terrace L09Æ_ 9.. .~:1f_y'bJ!£...M.€'.ê!iDg¡;"4_. 1.~____.L _ "__'-,~__ ..=_ ,____ _L.L ,,___ù ___, "L' Page 9 of 33 REPORT TO COUNTY COUNCIL CLAYTON WATTERS, MANAGER ENGINEERING SERVICES DEPARTMENT JUNE 16, 2003 TERRACE LODGE-UPDATE2 FROM: DATE: SUBJECT: PETER T. MITCHES & ASSOCIATES LIMITED Page 2 of7 Firemen respond to a fire alarm within ten (10) minutes. Ai> part of theupgrndes a complete and new automatic sprinkler system will be instaIJed w!ûch will have the affect of assisting in the controlling of any given:fire and will, in particular, give more time tor the evacuation of residcnts. In all = the existing fire alarm evacuation plan mU5t be followed during a fire or fire alarm. As it relates to a ramp it would not be feasib1e as it wood need to be in excess of30 metres (100 feet) in length to accommodate the safe slope for wheel chairs. When the firemen 3ITÏve they wilt control the elevator and resident evacuation if deemed appropriate or necessary. Q.2 Please keep in mind that the V ON office being relocated is not just for Terrace Lodge residents but also serves the entire sUlTounàing community. This facility (Terrace Lodge) is the hub of the services for seniors in the community as well as the residents. (i.e. meals on wheels). Resporu;e; We are aware and acknowledge these requirements, the need for varÍOu:¡ programmes and that Terrace Lodge is the hub for services tor seniors in the community. A new and Jarger YON office is being constructed as part of the proposed upgrades. The other community fucilities such as hair dressing for seniors and adult day care are being continued, enhanced and improved. An additional new tub room is being constructed as part oftbe upgrades. The new tub room will be used for the adult day oeare programme and thus will ease the strain on the existing tub rDOID$ and will allow the existing tub rooms to be used exclusively for the residents. Q.3 Regarding fumtdoors and door openers - has a keypad entry be.enconsidered for after hours entry as part of the door upgrades? Response: We are aWare ofthis requirement and this feature is being Ímplemented into the upgrades. Whether this fuatnre will bepassedÖlltOthe~nts and/or their caregivers will be It decision that will be made by theàd1ninì&ration. Q.4 Has the effect ofthe1>nìlding upgrade on theresîðentsbeen considered - noise, dislocation, dust, particularly those with sight or bearing impairments or those with O.ervOl.!5COnditiOns? Response: PresentIythe prøPœed work in the residential wings will be accompaníed by relocating four (4) residents at a,fime to temporaryunitswiìhiíithe Terrance Lodge while their two Terrace Lo~GIIJ!è~.mIí:tSU1d contaminates in attics and ceiling spaces will be vacuumed: Page 10 of 33 REPORT TO COUNTY COUNCIL CLAYTON WATTERS, MANAGER ENGINEERING SERVICES DEPARTMENT JUNE 16, 2003 TERRACE LODGE-UPDATE2 FROM: DATE: SUBJECT: PETER T. MITCHES & ASSOCIATES IJMITED Page 3 of7 most of the aggravmion for there:sídents but not fur every single resident. It may well be that certain residents because of their unîque condition may vel)' well have to be transferred temporarily to an other facility until all upgrades are completed. Q.5 Willrt kind of air di.fiùsers are going to be used, as some residents are very draught sensitive? Response: A long ceiling window diffuser will spread the air down the WÍndowand wìll significantly reduce efre.cts of dmught. Q.6 How is the difference in people's tolerance or co:tIIÍÙrt revet¡ in individual rooms going to be addressed, particu]arly regarding draughts and temperature. Response: See Response for Q.5. In addition jj; is to be noted that each room will have its own thermostat ,,,hich can be set to the individual requirements of the resident(s). Q.7 Will the room windows still be abJe to he opened? Response: Yes. Q.8 Why must secured patients (residents) be isolated ftomüthenesidents, as some appreciate being part of a larger group such as in the dining room? Response: The "Ministry" requires that those residents deemed or cJassified to be in a Secured RILA. (R~'ÍdentiaI Home Area) must have their own Dinning Room and their own Lounge Roomí Area. Q.9a Whenwilfthe ontsidtdèoce rebuilt (for the secured residents)? Access to the otitsideis very. important fur the secured patients (residents). Response: This.Js planned für· this $pring. Q.9b Provìding a secured exterior area fòr thoseofilie secured wing. ItsbouJd not be so secure as to have the resident thereindbel they areheId c;¡ptive. This situation or conditiønis very:sad. Response: See response fur.Q.9a. Terrace Loge Update 2 - Public Meetings Page 11 of33 REPORT TO COUNTY COUNCIL CLAYTON WA TIERS, MANAGER ENGINEERING SERVICES DEPARTMENT JUNE 16, 2003 TERRACE LODGE-UPDATE2 FROM: DATE: SUBJECT: PETER T. MITCBES & ASSOCL>\.TES LIMITED Page 4 of7 Q.10 Disruption for the residents, while upgrades are being undertaken, ftom their normal routines will require extra staff guidance. Response: This requirement will be flagged when the Consultant reports to County CounciL Q.Il Why must the future upgrade be to single rooms? Many people Me accustomed to roommates; depend on roommates; like their roommates? Response: In the "Ministry's" Design ManuaJ, design standards allow for tbree (3) types of bedrooms: a private bedroom, a semi-private bedroom and a basic (standard) bedroom, See page 15 of the manual. The mix would be directed by County Council to the "designers" and subsequently approved by the ''Ministry''. Q.12 Wül future change to single penron rooms lead to!righer costs and if so how will they be paid? Response: See response for Q.11. In addition the mix oftbree (3) different types of rooms is yet to be finalized and would only be doræ in the future when and if major rehabilitation were to take place. We will bring this Ítem to the attention of County CounciL Q.BWill the items on the list (all) (actually) be done? Respo!J$e: Atthis iliœ all the items 1 through 11 as stated fur 1003 Complianœ Requirements. are part of the proposed upgrades. Similarly withe items 12 through 14 <IS stated fur 2003 End.of-Life Cycle Requirements are part of the proposed upgrades. County Council will however make the final deei¡¡ion. Q.14 There is a need to educatetheeommunityouthe need for change (at Terrace Lodge),. Response: The purpo.se of the advertíseme.nts and the public meeting was inpart a process of education though the mampUi:pose was to elicit the residents, qu-egjvers and the public, opfuions and· concerns withresþect tathe proposed.Upgrades, Q..ì5 Cønnnunitymust supporttnis Wòrk. Response: The purpose fur advertising and having the PUblicmeetingWasJO elicit the advice, oomments and support ornet only the tesîdents but also the public at kg;: {community). Terrace Loge Update 2 - Public Meetings Page 12 of 33 REPORT TO COUNTY COUNCIL CLAYTON WATTERS, MANAGER ENGINEERING SERVICES DEPARTMENT JUNE 16, 2003 TERRACE LODGE-UPDATE2 FROM: DATE: SUBJECT: PETER T_ MITCHES & ASSOCIATES lJMlTED Page 5 of7 Q. 16 Why the long waits for the fi'ont door to be opened after hours - up to håJ.f an hour even:in bad weather? Response: The new card access system for the building (Item 9 & 10) of the 2003 Compliance Requirements ViiI.! address, in part, this deiìdency. Q.17 Will the conmnmìcations upgrade improve the nurse call system so that it can handle (identifÿ the existence oJ) more than one call at a time? Response; The "simple" or "short" answer is yes. Q.18 Some residents like to share rooms- must they be put in single rooms? Response: See responses tor Q.ll & Q.12. Q.19 You must be concerœd over the effèct of construction dust/dirt on re~'Ídents' heaJth? Have you considered that some of the residents maybe somewhat confused at times and therefore special precautions would need to be taken to ensure their safety? All products, procedures and methods should be fully researched to endure they do not impact health and safety of residents and workers through inc!usion of offensive chemícaJs. lksponse: See response to Q.4 for genera! construction and certain umque resident.s. A.dditîona} staff will be required during construction to assist !hose particular residents qualifying under this (Q.19) question. The use ûfenvìronmentalJy safe produc1:Sare standard requírement.s fur oonstruction (residents and workers) but we IIlUStbarein mind that certain uniquel'esidents can not tolerate any.construction d.u:.-t!dirt and these would have to be temporarí!y relocated fur the duration of the construction. Q.20 \'Vhat choieeisthe1'ewithooropJianeeissues? Response: Mdt relates to "coropJiance" these are ¡m¡i¡datoryrequirèl11ents.ofthe "Ministry's" CompJianç¡:: l:)rder$. Q21 There m.u¡,"tœ an effort to reduce/minimize there!ease of¥ÓlatÜe organic compounds Terrace LO!ÍW(!¡íèI~ køiñJ~~ used in .const:ruction. Page 13 of 33 REPORT TO COUNTY COUNCIL CLAYTON WATTERS, MANAGER ENGINEERING SERVICES DEPARTMENT JUNE 16, 2003 TERRACE LODGE - UPDATE 2 FROM: DATE: SUBJECT: PETER.T. MITCHES & ASSOCIATES LIMITED Page 6 of7 Response: All methods and materials utilized in the upgrades (construction, construction materials and finished materiaJs) will adhere to the latest environmentally sound practices.. Tills will not however safe guard each and every individual resident - see response to Q.4 and Q.l9. Q.22 When the room on each floor of each wing, which is presently used as a kitchenette and laundry room, is converted to a nurses station, where can the resident get a cup of tea, coffee or juicc and maybe make toast, if they wish, in the evening? Response: As it relates to the secured area (north residential wing, ground floor) there will be a serveryin which the kitchenette ,functions can be perfunned. As it relates to the other three (3) residential floors we will recommend that the adjoining single room be converted to a kitchenette to replace the room being converted into a nurses station. Q.23 Could not the doors of the units be made ]arge enough to wheel out the beds? Response: Yes tills could be done bntis not part of the present upgrades. In the future, when and if; the complete rehabilitation and wing addition or the complete new .fucility is: undertaken then all unit doors will be wide enough to fuc'Jitate the passage of a bed (112ûmm or 44 inches door width). 3011"'£ other points ofconccrn; - People issues are sígnliicæ1t when reviewing what will be done and when; . Concerns were raised as to thecomormity issues and why the need to spend Il10œy onrepJacing goodfloor5, the front door and such other items. SUMMARY In order to .deìiver the requiredseMce tofue resiilènts, cerfuia standm'ds must be inet,and upgrades to servièeand t.'le p!iy.sièàlplant arerequii'eij. Fol!owing t.\e MinistrY of Health and Long-TennC¡¡re's annualrevíew,TerraeeLodgeHome fOr Seníors bas heen advised to initiate s~ific upgrades to serviee areas; As well, the pbysical plant, which pro,vìdesoomfòrt to theresìdents is nearing itslilè".expectancy ,andrequit.es replàeemertt. Terrace Loge Update 2 - Public Meetings Page 14 of 33 REPORT TO COUNTY COUNCIL CLAYTON WATTERS, MANAGER ENGINEERING SERVICES DEPARTMENT JUNE 16,2003 TERRACE LODGE-UPDATE2 FROM: DATE: SUBJECT: PETER T. MlTCHES & ASSOCIATES LIMITED Page7of7 newsp¡¡pers <I!ld the public meeting; taken all together, constitute a good forum for obtaining the opÍDÍons, conc= <I!ld public input for the proposed upgrades. As stated publicly, we wìsh to bring to your attention the following questions <I!ld/or responses which warr:mt consider¡¡tion by administration and in particuJar diredion by County Council: QA, Q.lO, Q.11, Q.12 & Q.22. We are pleased to conclude that the residents, the public, and the community 'It large, are in agreement with the proceeding of both the 2003 Compliance Requirements and the 20{}3 End· of·Life Cycle Requirements. -- -- --- PETER T. MITCHES & ASSOCIATES LIMITED Consulting Engineers 350 ,Ridout Street South London, Ontario ~ Peter T. Mitd1es, P, Eng., Project ì\1Ianager Our File No. 6487/AOI May 22, ZO03 Terrace Loge Update 2 - Public Meetings Page 15 of 33 REPORT TO COUNTY COUNCIL CLAYTON WA TIERS, MANAGER ENGINEERING SERVICES DEPARTMENT JUNE 16, 2003 TERRACE LODGE - UPDATE 2 FROM: DATE: SUBJECT: Peter T. Mitches & Associates Limited Summary of Estimated EXDendJtures to Brittce from Current P9rlod to Time of Maior Bulldina RenovationJRec1aCément f Ye:ars 10 to 15 ) Mav 2003 Item DescriptiOn 2003 Expenditures (S) Near Future Future No. Expenditures Expenditures ($\ ($' Ccmo!tBf1.<:é End--of..Life 2~3 Years 4.15Y""rs 200,3 Compliance- RequiremontS: j MaiiJ Floor VinyJ Replacement 140.000 · ExîstJng flooroovering cra-cked ~ s.anilation concerns. 2 Resídent Room lighting 30,000 · GeJTing fIXture required over each bed to impro'le care 3 Staff Room 30.000 .. Required to replace room fOS\ for new laundry 4 Laundry Room 150,000 .. Requited to meet compliance requirements 5 Secured Adult Day Care 15,000 ¡ · Require:d to repfa<:G area Jost Tor I1~W slaff rào;¡m , 6 N'ursin.g StalÎol1-5 {4} 120.000 · One on, each Hoor of each r«sÎd2nt!.a1 wing 7 SetüredAré:a Dining Room.'l..òunge & C(nf~rellce Roan 206,000 - · To ze"Út:e secured residatHial area 3 Lower North Door En!r¡ 15,000 · For secured residen!fal area ¡ 9 Cart;! Access System ¡=or Building 30,000 10 Front Door Op?oers 15,000 -Both sets of doors now open au~omatica¡:y 11 Front Reception .Renovation 30.000 2003 E.nd-Q-f~lffÐ Cycle R-equiraments 12 Window Repfacement 10,000 20,000 120,000 13 Kjtche.n A!f Conditioning & :Ð:ñatlS( 35,000 14 HVAC. $pril1lder&Ftre Alarm 1.265,000 · Naw HVAC syst"m !oroojld¡ng · Sprink/è1' s1~tem for comp(ete_ buî!dïng .' NevI fire at~rm':System f-or rfiain -and emersern:y generator buildings .':NeWfr¡tegratètfeommuníeðtion system futuro Requirements 15 Ännuat archltecturaf 10,000 ôO;OOO !S Aru1íral pfumbing :and HVAG 10,1)00 60,000 17 Annual ~!ectñcal.and Jif-e safety 10.000 60,000 Terrae Log Update 2 - Public Meetíngs Page 16 of 33 REPORT TO COUNTY COUNCIL FROM: CLAYTON WATTERS, MANAGER ENGINEERING SERVICES DEPARTMENT DATE: JUNE 16, 2003 SUBJECT: TERRACE LODGE - UPDATE 2 Name ,/J 'L- J.."" d"':zL V'- 'vÜ6..eLº-... )e..no...ce..- lod ''0 . /! êt1AAd. \Ý~ df Nt ) '1:~ J:;d~ ~' " ., ,t),,~'1 -----r' I l-eA'r ~ ¿ Ö d9.( J{:~ ~ c;~: ([LIS w ~ Sheet LofK Resident Non- Resident 0 8- 0 ~ 0 g/ 0 [J;y'" [] tv' 0 ¡;¡/'" 0 c/ 0 If r...... 0 c! [I [] 0 [] 0 0 [] 0 0 0 Terrace Loge Update 2 - Public Meetings Page 17 of 33 REPORT TO COUNTY COUNCIL FROM: CLAYTON WA TIERS, MANAGER ENGINEERING SERVICES DEPARTMENT DATE: JUNE 16, 2003 SUBJECT: TERRACE LODGE - UPDATE 2 Sheet 2. of 8' Name Resident Non· Resident f/?NEST vLÌ L A(1f3¡ 0 X ¡ " Î, C?a ,--to' 0 ~ ,) Ú,..i¿1U- tJ¡Jrl. ) A/ ,,rJ ~ o ' .);1" A .. /(f/~· P 0 /...." tI ~ I ~ " rfwv kÆX-"7~NÙ I I I [] I I I 0 j . . . ! . I 0 0 ¡ I 1 , , I I i [] 0 ¡ I I ! I 0 0 I I 0 0 , [] [] 0 0 0 n I ,¡;;....> , 0 I [] Terrace Loge Update 2 - Public Meetings Page 18 of 33 REPORT TO COUNTY COUNCIL FROM: CLAYTON WATTERS, MANAGER ENGINEERING SERVICES DEPARTMENT DATE: JUNE 16, 2003 SUBJECT: TERRACE LODGE - UPDATE 2 Sheet.3 of..8.. J~' 11""ØfiL Name Resident Non- Resident !Þ¡/ /1 s,'¡ ¡: l A / .~ dJì. . L-~ 0 If M I 0 I I 0 ì 0 0 0 0 0 [] 0 0 0 I 0 0 I , I 0 0 I [] 0 0 0 I 0 [) 0 0 0 0 . Terrace Loge Update 2 - Public Meetings Pege 19 of 33 REPORT TO COUNTY COUNCIL FROM: CLAYTON WATTERS, MANAGER ENGINEERING SERVICES DEPARTMENT DATE: JUNE 16, 2003 SUBJECT: TERRACE LODGE - UPDATE 2 Sheet £ arK Name Resident Non- Resident ¡.J¿,.J 0 Æ/f 3K(P ~ L.----"" 0 J21', L--- J,/tK //'/1"'- 0 ;i 0 ø 0 0 0 0 0 [] 0 0 0 0 0 [] 0 0 0 0 0 0 [] [] -. Terrace Loge Update 2 - Public Meetings Page 20 of 33 REPORT TO COUNTY COUNCIL FROM: CLAYTON WATTERS, MANAGER ENGINEERING SERVICES DEPARTMENT DATE: JUNE 16, 2003 SUBJECT: TERRACELODGE-UPDATE2 Name ''-.. t.T.¡;" ~/' c $. ~ Sb.eèt 6". óff{ Resident Non- Resident 0 [v 0 IJU 0 V 0 0 0 0 0 o , ¡ o o o o o Terrace Loge Update 2 - Public Meetings Page 21 of 33 REPORT TO COUNTY COUNCIL FROM: CLAYTON WATTERS, MANAGER ENGINEERING SERVICES DEPARTMENT DATE: JUNE 16, 2003 SUBJECT: TERRACE LODGE - UPDATE 2 Sheet 6 of 8' Name Resident Non- Resident D!tv I D ,,-loEer:=- D ß. /!l3k-/V G ;Fsh¡- e c4 7- 0 tY <7 N ô ß¿.e D ¡y- t:;5Ôß D D ¡ D D I ¡ ¡ D D I D D I D D D 0 0 I 0 0 0 0 0 0 0 0 0 Terrace Loge Update 2 - Public Meetings Page 22 of 33 REPORT TO COUNTY COUNCIL FROM: CLAYTON WATTERS, MANAGER ENGINEERING SERVICES DEPARTMENT DATE: JUNE 16, 2003 SUBJECT: TERRACE LODGE - UPDATE 2 Sheet 2 of.IL Name I Resident Non- ,I Resident ,1Þ4 ¡J/ c I C4iJlP-éS¿:L 0 .Æl ¡ ¡ , j /"Î , 'I f2.,.:.--y..] é:' -R \ N'-..N '-.{ 1\';<" 0 F I , +<,0 Ñ ~ I ; -..J I 0 0 i ! ~ 0 0 ì ! I , I I 0 0 0 0 I .. I 0 0 I I 0 0 . 0 0 0 0 I 0 0 0 0 0 GI 0 0 Terrace Loge Update 2 - Public Meetings Page 23 of 33 REPORT TO COUNTY COUNCIL CLAYTON WATTERS, MANAGER ENGINEERING SERVICES DEPARTMENT JUNE 16, 2003 TERRACE LODGE - UPDATE 2 FROM: DATE: SUBJECT: Sheet 8 of g Name Resident Non- Resident :;;; ti I iZl...é'. Y FÃUf...DS 0 W Tkt.û.. F/q u.t- D ;5 0 w J-Ia.øv ¡Joil?; [) IZÝ I [) 0 0 [) 0 0 [) 0 0 0 I ! [) 0 1 I 0 0 D m I 0 0 IB ill 0 0 Terrace Loge Update 2 - Public Meetings Page 24 of 33 REPORT TO COUNTY COUNCIL CLAYTON WATTERS, MANAGER ENGINEERING SERVICES DEPARTMENT JUNE 16, 2003 TERRACE LODGE-UPDATE2 FROM: DATE: SUBJECT: APPENDIX 'B' TERRACE LODGE HOME FOR SENIORS - UPGRADES PUBLIC I STAFF DISPLAY MEETJNG - JUNE 6,2003 PUBLIC/STAFFINPUT/CONCERNS/QUESTIONS INTRODUCTION This dispJay I meeting was hosted at the Temœ Lodge Home For Seniors. to receive input ñ:om the st3ff with respect to the proposed Upgndes and occurred on Friday, June 6, 2003 at Terrace Lodge. Some 12 staff members attended and a copy of the sign-in sheet is attached. Various illustrations (plates) were mounted to stimulate questions and discussions. PUBLICÆTAFF INPUT I CONCERNS I QUESTIONS Everyone was encouraged to ask questions, to speak:tieely and to submit written conœrns if applicable. Only three (3) a:reas of concern were addressed by individuaJs in attendance and the onJy other concerns were expressedina written letter:fi'omthe Terrace 4ò.g" Auxiliary. We ~ have incJuded these at t1i.e end of this our report. Ve:rbal ques60ns asked were sirniJar In those expxessed at the previous Public Meeting and we would refer you to the report of that public meeting for the appropriat" answers. SUMMARY We at" pleased to conclude that the residents, the public, the staff and tbf: community at large, are in agreement with the proceeding of both the 2003Complîance Requirements and the 2003 J5:od-ot-L¡te Cycle Reqnirements. PETER T. MlTCHES&:ASSOCIATES L1M:rt'ED COJ/SlllJingE"gÙl~ei$ 3SllRid)ut.StreetSouth ~lf1ntario 7. j¿¿- . PehKT. Mit¢b.es, P.:Eng.. 1>rojeet Mauager o..d'ik.No. ó437/AtJl June 12, 2003 Terrace Loge Update 2 - Public Meetings Page 25 of 33 -.. . -, :;. ::. ~ Or.....'.. REPORT TO COUNTY COUNCIL CLAYTON WATTERS, MANAGER ENGINEERING SERVICES DEPARTMENT JUNE 16, 2003 TERRACE LODGE-UPDATE2 FROM: DATE: SUBJECT: Name Sb,eet - of - Resident Non- Resident 0 ac 0 f'1J [J IX. 0 [¡/'" 0 g.-/ 0 V 0 g---- 0 0 ~ 0 V 0 0 0 0 0 0 kß..¡ BEEN w~ ¿;-'J1'~ 3c...JFfed Terrace Loge Update 2 - Public Meetings Page 26 of 33 FROM: DATE: SUBJECT: REPORT TO COUNTY COUNCIL CLAYTON WATTERS, MANAGER ENGINEERING SERVICES DEPARTMENT JUNE 16, 2003 TERRACE LODGE-UPDATE2 6'''' ~ ' . ,.. , . ~. ..~ A TERRACE LODGE HOME FOR SENIIORS - UPGRADES County of Elgin PUBLIC MEETING - COMMENTS PUBliC INPUT AND COMMENTS ARE INVITED for incorporation into the planning and design of this project. Please contact the unden¡igned at Peter T. Mitches & Associates for addíIJonal information. Comments should be reœived by FRIDAY, May 16, 2003 to ::.: ·.:;c;;zidered in the current phase of this project. PeterT. Mitches. P. Eng., Project Manager Peter T. Mitches & Associates Umited, 350 Ridout Steet South. London, On. N6C 3Z5 Phone: (519) 663-5550 Fax: (519) 663-9770 E-mail;pmitches@belInet.ca ~ rJ~ ç r-fo-r (n ì ~;OO"A.:J-C..... ~+- ~1YvU'v- Phone: lì~- S'?"h~ Name: I ir0e< - Address: Posta! Code: Date: Comments: ~S~ ( ~ ~ðOr{\..:S CJ'v\........- W\'O' --* IOc..Ker Sf ace.. foí p:mø.{e iUØ~(3 F>r .~ ctI'Y'ØUt\t Melt£. (to t' enoUCt... 5KJf !ot.kDr~ ~ Page 27 of 33 Terrace Loge Update 2 - Public Meetings REPORT TO COUNTY COUNCIL CLAYTON WATTERS, MANAGER ENGINEERING SERVICES DEPARTMENT JUNE 16, 2003 TERRACE LODGE-UPDATE2 FROM: DATE: SUBJECT: 6 .. :\.:.': " '-,': f"" TERRACE LODGE HOME FORSENIIORS - UPGRADES County of ElgIn PUBUC MEETING· COMMENTS PUBLIC INPUT AND COMMENTS ARE INVITED for incorporation into the planning and design of this project. Prease contact the undersigned at Peter T. Mitches & Associates for additional information. Comments should be received by FRIDAY, May 16, 2003 to be considered in the current phase of this project. PeterT. Mitches, P. Eng., Proje;:tManager Peter T. Mitches & Associates Limited, 350 Ridout Steet South, London, On. N6C 3Z5 Phone: (519) 663-.5550 Fax: (519) 663-9770 E-mail: pm~cheS@bellnet.ca Name: \ L ,/" . '( ()ÓIl\''l€... \..:::>t\..vtAí . Address: JO~ >+-=-~).,Ù 5+- Ptvd hJ:> Jí \ Phone: ~l q r Î '\ $-1331 Date: Po~ICode: N:>¡'¡-(4~~ g~ bf(')~-. Comments: ik sf1oLJd..'b.cz- a.n e{~~ ~ ouJzIœrs {Vúrn NWJ ~.JU5õ'rr\ . ~~\~l~~.~k ~~. ~ J..Qd-v ~ \ ~, ~ ~ t~~ JJXJm.. J4J ~? --W~ c¡L()JX) Vl LAJ·· ~. ~ w~ ~ ~ I ðO¥Y\e.. C£!Y'Ce..tY'\ u.X~~ ~ 5vJ'¡~ Oh ~..... .:..../. ( Terrace Loge Update 2 - Public Meetings Page 28 of 33 REPORT TO COUNTY COUNCIL CLAYTON WATTERS, MANAGER ENGINEERING SERVICES DEPARTMENT JUNE 16, 2003 TERRACE LODGE-UPDATE2 ~~'tt.aœ -'!CJg4 ø1uxÚla.tty CJo T_lDdge 475 ToIbotSl. Eaat A)'lmer, On!llllc N5H 31\5 FROM: DATE: SUBJECT: 5:éþv. ~ ~ ~Ó(;~~~, k'~J ~W NS-R trv¡ , , ~ ~ Ã¿;,::;g " JUN 4 ~O] 0.. -~¿.. _d?z.~ ; ... eÞ= ~.' ':- ~ ~.P-d, -7n.<:'¿'~$.~ ~~ ~ ~~,(~ ~ 4 .-d.rrl-ø<.-tI·7.s::~ ..~-->¢~ ~4--;.r..ÚQ'~þ¿J,. .~-¡A1.- ~~J'~~~~~ '..~ '~~~--Z;~-a d...''ft(.~'-/n--~.:d~~ ~.,.¡t.n.~ ---M.-~--I'~ ~~.~ ~~.t:t.- ~, .d-A~~~~.Ai~~k~. _ cµ-<,.,w..'-~-4"-k ~~~ 4.U ~ &~L:.. ~.~. . . ....Þ1.¡. ~-?.a¿. /?- /-" 2' --: ~ --L ! !1 "":h... ...'. :::;,. / .:1, . ..<Cb¡.~c.t~p -<A- ~ ~ -1'C. ~~1 ....<;.....: q/,¿, , .J/r.-w; ~¿¿Ii.~þ -:I~~~~þ~v :4.d a¿~ -1' '1"~ ~ --4? - G-r-'O.-L'~_~ ~....:?:4~ -e~~_ Cj:¿- --<-~ -,;;...,~. .:1J>-é1l-»U!, .at.. ~. ~~ q~w~~_-"''''<I-' ~~~-u.~~~ d ff~~---U¿-1 ~7.1Z4 ~~ ~~~~..~ -<t~.J~-t7. .~~ ~.4Z~.' . . ¡,.. _. tff--p ~ ~ ~~,(>LL. ~~~.~4~'~~a:~~k .... ..~~ ~-~..¿"<,A.,~".,.¿¿-?....z.=::2<:~~ ~.~-d. ~~~~ . 12 ~.J~';'~"'>~~ r:('!~ Terrace Loge Update 2 - Public Meetings Page 29 of 33 REPORT TO COUNTY COUNCIL FROM: CLAYTON WATTERS, MANAGER ENGINEERING SERVICES DEPARTMENT DATE: JUNE 16, 2003 SUBJECT: TERRACE LODGE - UPDATE 2 , . -~- ry&'tw.: ~¿ dll.lZrlia~ <:IQ~UldQe ",'ST.nmst. EuI, ~_.<:ntIIIcN5H3AS ~ ~_~___.I!~_~,_...J ~, /. I -~ _ ..",j..,. /.,.t?~.~~~ 4.A...U.. ,.~.~. ~ f~ ak.JUU-rv~Jd ~-.~ ~A~~-4 -L.I'~-.M- ~.4 ~£-0... T. ~~:...Qž../~ ~ I .-M ~ ~r -;r4'·~~...&nd4 " ~~ '-':;~~~þ~, ~ ~ ~.t.;, -~V-a:.. -I~ --t...z¿. ~~~ --'ýru ~ ~k. ~ -d- ~/--J_.~ -.,.-./ . ~ ~ Terrace Loge Update 2 - Public Meetings Page 30 of 33 REPORT TO COUNTY COUNCIL CLAYTON WATTERS, MANAGER ENGINEERING SERVICES DEPARTMENT JUNE 16, 2003 TERRACE LODGE-UPDATE 2 FROM: DATE: SUBJECT: APPENDIX C - Relevant pages of the annual review from the Compliance Advisor -"" -R--:' ;ù~~· ;.--ACjj , I (j G&.r,;¿.. .P'l:. u .~rálOI'oì!liIl4 -'Nè.m..;:oucr!t4m f!1.1! 17 \ ./-J J (/ ~ '¿¿,V, ¿.;Çtl ,Aj.-. ~ ß:>J-,-, _,' ..-"., '" -. t~ /./7 ~'l.../'.Æ_ ~ ...,'........¡._~,_:Þ ···AL~ _-'/1"/ ~-?;¿'¡ r"'/:~' AJt/' "'A./· ) CLt ./1"/ I' 1 i!-·;:t~Á~ '? '-~"(;-{P.A:J:~:-¿ I Yk.-. ¡) . .-:, . J ~¿',J//-:/.-?..-.¡ / '-<' ,)0'; flAY!." .Æ Q_";~IC/2-;?l-f.£;y/~~/T¿-o ~,.;j}4<# A /.f :2 ',--, ...,' ~"/"-B-r .R ""...{.:1..; /;. j-,""'::"'+ ./...-t' '_L;...~~7i1-3>_-; ;--2~¿-?¿....t:-:7/·¿_'¿~,,;L/Ll' d-- ""'..ç.....- -..~ v· ~¿.{ _~L·/ ()_ .,).;/ /.1' ;'",,,,~b --19:£ ~ ../.x./ .JL "t '} /? .,' "/7?~l._.r%./. ?-:;z./_~-) ¿,' ." ';( L/o/~-7<"'-/ ,¢.-;ç-'y;4], -c..¿~.;;[ d.J 1./ v ...', ~ 47~ ".f' ,,:.:. " 7¿"t;-.(j/7-;..L (~) V. 3/ /_/(1 r:,::·:/.;~~;, _r' ,,-;>.-':-¿~::/.f~::. .~'l,;~_i{,.:7. ~?'~, _ ,,' , ~~-c.i.~J2(¿., .;t- /?r.~-r1-i~~ ~ç±...Y j;:-,·t~LY. ~-~ ;~. . - --- /.) . .../.?:~4- '}I""¿ _,.../-,....~..."...~~~. / p~;;,. _..,¡,~;", ;, -1% .,if... ~t'f8Óforlha~ç¡It)'b)Y~pCUMr,¡j\'$~tpr;r Terrace Loge Update 2 - Public Meetings Page 31 of 33 FROM: DATE: SUBJECT: REPORT TO COUNTY COUNCIL CLAYTON WATTERS, MANAGER ENGINEERING SERVICES DEPARTMENT JUNE 16, 2003 TERRACE LODGE-UPDATE2 - '......, AP¡:>,ENDIX D - Releval1t Section of the MOH Environmental Services and Criteria (W) ~Inlstry ~JnIStère~,:,~ , f:iealth la Santé 1013-01: ; Ontario Teb/OnOiet STANDARDS: PROG Secúcn '-X'f-f -\/",,~lLi,;i_¡ -"::c';:;-'/50, i"<>;;' :..,-- '---- -'--',->i,'''C_~"'~C''''~'''';;;:;;-'C5'''Þi':!:?:':':::;:'i<;_: O. ENVIRONMENTAr; SERVlCESc:,,: -""-/\-->'"-" --"--, .....".._, ""'"oct/Objet STANDARDS AND CRITERIA Referenca IR6Iér"nc-.o Criteria FACILITY INTERIOR 02_09F1oo~.sballbe~omposed of a *' }:~;d;äf~?~f¿i~~n::~ams. ',> ;-'{;j';'-2<" open STANDARD 3: JIOUsEKEEl'ING 'SERYICES" . ::1' 02. 10· CarpelS -: seams,;-re intaìned uck/ing. :<'i:.:'-"."" ,',-..--,". ".: .."".,_.: 02.11;\Ýa!i." œìíiIÍg5<ahã'iroors shall be rèpàit. -.-- .. .-.-- 02.12 All furnisllings and equipment shall be maJnrained il) ,good ROpaìt and safe' for use. 02.13 The surface- of toilet, and bathing fixtures shall be maintained'smooth and free of cra~lcs. 02.14 All grab bars shall be'securely fastened. Terrace Loge Update 2 - Public Meetin9s Page 32 of 33 REPORT TO COUNTY COUNCIL CLAYTON WATTERS, MANAGER ENGINEERING SERVICES DEPARTMENT JUNE 16, 2003 TERRACE LODGE - UPDATE 2 FROM: DATE: SUBJECT: '''.-" " ò"'- , ;~.. , ,ealih ,,' ,,,' -.- "-,_.".',:-" ,',. ','-",,-- Ontarioi. ----~,- ,,---";'_:-';;:--~,{:l(;;:; ':L-~-~~¡':_:\,<_,,- TabJO<>glet STANDARDS: PROG~ÅND_VJ:eE$; __ . ;, _ _ _ .'," '," '·:c'o:';:', ":.';< <_--_:;:'-';';-:0;:;'X-';~±'i';;;;:~,7,,~:;'~_,-:é1>51':"_-,_,,~,,;,_:::,-y:,": S..~.nO. ENVnU)NMEN:t~Pi~~!V!Ç¥~:" Sub¡"'JO~¡'1 STANDARDS AND CRrrEÌÜÀ.' , Aaførence I Ré1érence ,',-","'""",-,..,. , "-"."....,'--' ",', ..'0->.,'" ..','"., ;.,,- ",":".,,--0"'" '/'.' _-v',' .'C",'- <''0:;-./,: ,,«.', .;.. -~-_:~-, -" Criteria LINEN (CONT'D) . ',. . . 04.27 There are procedures, for e]early identifying, handJing and WBShfug linen used by residentS who have communicable diseases or inféèííòns rec¡uiríng pr<:cautions. ' '-,., 2f: . - ' . - , '. , ~". , ' 04.28 The laundry areà¿Shall,tiè,lbèJœa:W!1en,no¡;ìriúse'.," 04.29 Where laundry se.vi;;"s'm conducÎed:in- equipment shallbe:pro,<:idedaití¥iììírin&' , linen. and pefSol1a1eloÌ1iing, neèds,amho, 1ª\!.ndnr ..!)andlíng. _ _ , 04-.30' Where.th", laundry,'scmce is províd&:i·iin-ho!'s.e¡,'.:, " " industrial washers and dryerssnaIt becprovidèd·tomèet Ìbe IaÙndry serviceS needs. '. , Note:' Fiici1iÍiIlS,'s1rá1t!je'e.rpecred to'meeriAis requiremèir1'by Ji1nuarj, 1997: SERVICE AREA ANDEQUIPJ\.ŒNT ,'ii6'NÒ'mnœr';i99S , ' *:- Terrace Loge Update 2 - Public Meetings Page 33 of 33