Orange County Vector Control District-A Study in Little Known Services*

The laboratories of the Agricultural Commissioner, Health Care Agency, and Vector Control have little inter-relationship with respect to their functions and specialized equipment. Little or no communication exists among the labs for sharing of disease information impacting the public. (R2) Response: Disagrees wholly with the finding. There is a history of joint cooperation and interaction between the three laboratories; however, the laboratories may benefit by exploring whether there is a potential for sharing additional information. The three laboratories and their specialized functions (see below) are defined by separate State and Federal regulations: The Orange County Vector Control District (OCVCD) laboratory is charged with . investigating insect and rodent transmitted diseases. The Orange County Public Health Laboratory (OCPHL) and Water Quality laboratory (programs of the Orange County Health Care Agency [HCA]) are charged with investigating human infectious diseases as follows: . OCPHL - provides specialized, high quality laboratory testing for detection and control of infectious and environmental diseases including agents of Bioterrorism. Water Quality Laboratory - conducts drinking and recreational water testing. The Agricultural Commission laboratory of OC Public Works is charged with • investigating plant and agricultural animal diseases. The type and scope of laboratory procedures performed in the three laboratories are quite different. The educational and job experience requirements for professional staff to work in each of these laboratories are unique, and required State certifications are not reciprocal. The interaction between the Agricultural Commissioner laboratory and the OCVCD laboratory, and between the Agricultural Commissioner laboratory and the OCPHL has generally been limited to when there was a specific need and could vary in frequency during any time period. There has always been cooperation between the three laboratories to work jointly or assist each other when a need arises. Currently the Agricultural Commissioner laboratory does not share any program responsibilities with the Vector Control District that would require a regular laboratory W 1 meeting. Several years ago, when the Red Imported Fire Ant was introduced into Orange County, Agricultural Commissioner laboratory staff and OCVCD laboratory staff would meet once a month or once a quarter to discuss program responsibilities. Now that the program has become routine, it is only necessary to meet or communicate on an as needed basis. OCVCD and HCA have maintained effective communications for many years. Most of this coordination is led by the Epidemiology and Assessment program (Epidemiology) within HCA's Public Health Services and centers on preventing and controlling human disease. Physicians, clinical laboratories, and hospitals are required by State law to report every human case of vector-borne disease (such as West Nile Virus, typhus, or Lyme disease) for cases identified or reported in Orange County to HCA's Public Health Services. Epidemiology contacts OCVCD to discuss the circumstances of each case and to develop a collaborative plan to investigate potential sources of vector-borne disease to mitigate further transmission. As a result of these discussions, OCVCD conducts targeted field investigations at sites of potential exposure. Epidemiology, OCPHL, and OCVCD also conduct regularly scheduled West Nile Virus meetings, from April through October, where programs share summaries of data collected and coordinate future plans. These meetings frequently center on West Nile, as it is the most prominent cause of severe vector-borne human disease seen currently, but typhus, Lyme disease, or any emerging vector-borne pathogens are discussed as well. OCVCD consistently shares their surveillance data with Epidemiology to allow for an effective public health response. The OCPHL also reports all of its laboratory results of public health significance to the Epidemiology Program. Responses to Recommendation R.2