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Home My WebLink About20113129.tiff Donna Bechler From: Trevor Jiricek Sent: Monday, April 16, 2012 5:37 PM To: Donna Bechler Cc: Talya DeAngelis Subject: RE: Unsigned Document Donna, The contract with the Colorado Department of Public Health and Environment regarding West Nile Virus has been withdrawn. We won't be receiving a signed doc from them. The other contract has to do with immunizations. I don't know about that one. I've copied Talya on this email so hopefully she can provide some insight. Please let me know if you have any questions. THANKS! Trevor Jiricek Director Department of Planning& Environmental Health Services 1555 N. 17th Avenue Greeley,Colorado 80631 Email: tiiricek@co.weld.co.us Office#:970-353-6100, Extension 2214 Fax#:970-304-6498 • LO4,1-- .1. Confidentiality Notice:This electronic transmission and any attached documents or other writings are intended only for the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise protected from disclosure. If you have received this communication in error, please immediately notify sender by return e-mail and destroy the communication.Any disclosure,copying, distribution or the taking of any action concerning the contents of this communication or any attachments by anyone other than the named recipient is strictly prohibited. From: Donna Bechler Sent: Monday, April 16, 2012 4:43 PM To: Trevor Jiricek Subject: FW: Unsigned Document And here is the second one. Donna Bechler Deputy Clerk to the Board 1150 O Street P.O. Box 758 Greeley, Colorado 80632 970-336-7215 Ext 4227 iThl w r! r; _ ti rj 1" 1 RESOLUTION RE: APPROVE AMENDMENT #2 TO TASK ORDER CONTRACT FOR DISEASE SURVEILLANCE PROGRAM(WEST NILE VIRUS SURVEILLANCE AND TESTING)AND AUTHORIZE CHAIR TO SIGN WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to Colorado statute and the Weld County Home Rule Charter, is vested with the authority of administering the affairs of Weld County, Colorado, and WHEREAS,the Board has been presented with Amendment#2 to the Task Order Contract for Disease Surveillance (West Nile Virus Surveillance and Testing) between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County,on behalf of the Weld County Department of Public Health and Environment, and the Colorado Department of Public Health and Environment,commencing January 1,2012,and ending December 31, 2012,with further terms and conditions being as stated in said Task Order Amendment, and WHEREAS,after review,the Board deems it advisable to approve said Amendment, a copy of which is attached hereto and incorporated herein by reference. NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld County, Colorado, that Amendment#2 to the Task Order Contract for Disease Surveillance (West Nile Virus Surveillance and Testing) between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Weld County Department of Public Health and Environment, and the Colorado Department of Public Health and Environment be, and hereby is, approved. BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to sign said Task Order Amendment. The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 7th day of December, A.D., 2011. BOARD OF COUNTY COMMISSIONERS WELD COUNTY, CO ORADO arbara Kirkmeye , Chair Weld County Clerk to the Board 4 1 7 n P. C , Pro-Tem BY: �v� ��. ., t. . •'�; %�J Deputy Clerk to the Board ° {�4np Y'Y am F. Ga7dier �^ AP DASTO we/ eta .46 avid E. Long ou ty ; ne a �wt�G.c 4� D uggl+3s Radema er Date of signature: /_5_ /a 2011-3129 1Z- S-II HL0038 1 86 1 20 1 I Memorandum TO: Barbara Kirkmeyer, Chair Board of County Commissioners W E L DEC O U N T 7 FROM: Mark E. Wallace, MD, MPH, Director Department of Public Health and Environment DATE: November 14, 2011 SUBJECT: Amendment for Task Order (Renewal) for Disease Surveillance Program (West Nile Virus Surveillance and Testing) Enclosed for Board review and approval is an Amendment for Task Order (renewal) from the Colorado Department of Public Health and Environment (CDPHE) for surveillance activities for West Nile Virus. These activities include the collection, identification and submission of dead birds and vector mosquitoes for testing. The funds for this contract have not been secured yet by CDPHE. If funds are secured, the anticipated amount for this Amended Task Order (renewal) are anticipated to be $21,350. The funds are passed through the Colorado Department of Public Health & Environment from the Centers for Disease Control. The term for the Task Order is January 1, 2012, through December 31, 2012. I recommend your approval of this Amended Task Order (renewal). Enclosure 2011-3129 DEPARTMENT OR AGENCY NAME COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT DCEED-DSI DEPARTMENT OR AGENCY NUMBER FHA JNTi/^.CT ROUTING NUMBER I 2-37800 AMENDMENT FOR TASK ORDERS#2 This Amendment is made this 25th day of October, 2011, by and between the State of Colorado,acting by and through the DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT, whose address or principal place of business is 4300 Cherry Creek Drive South, Denver,Colorado 80246.hereinafter referred to as the"State"; and, Board of County Commissioners of Weld County, (a political subdivision of the State of Colorado), whose address or principal place of business is 915 1O Street,Greeley,CO 80632, for the use and benefit of Weld County Department of Public Health and Environment,whose address or principal place of business is 1555 North 17`x'Avenue,Greeley,CO 80631,hereinafter referred to as the"Contractor". FACTUAL RECITALS The parties entered into a Master Contract,dated January 27,2007,with contract routing number 08 FAA 00052. Pursuant to the terms and conditions of the Master Contract, the parties entered into a Task Order Contract, dated March 25.20W, with contract encumbrance number PO FHA EPI1014076,and contract routing number 10 FHA 14376, referred to herein as the"Original Task Order Contract, whereby the Contractor was to provide to the State the following: West Nile Virus(WNV) surveillance including collection, identification, and submission of dead birds and vector mosquitoes for testing,public education on prevention,and human case investigation. The State promises to increase the amount of funds to be paid to the Contractor by Twenty One Thousand,Three Hundred Fifty Dollars,($21.350.00)for the renewal term of one year,ending on December 31,2012, in exchange for the promise of the Contractor to perform the increased work described herein. NOW THEREFORE,in consideration of their mutual promises to each other,stated below,the parties hereto agree as follows: I. Consideration for this Amendment to the Original Task Order Contract consists of the payments and services that shall be made pursuant to this Amendment, and promises and agreements herein set forth. 2. It is expressly agreed to by the parties that this Amendment is supplemental to the Original Task Order Contract,contract routing number 10 FHA 14076, as amended by Task Order Amendment#1,routing number 11 FHA 23984 collectively referred to herein as the Original Contract, which is by this reference incorporated herein. All terms,conditions,and provisions thereof;unless specifically modified herein,are to apply to this Amendment as though they were expressly rewritten, incorporated,and included herein. 3. It is expressly agreed to by the parties that the Original Task Order Contract is and shall be modified, altered,and changed in the following respects only: A. This Amendment is issued pursuant to paragraph 5 of the Original Task Order Contract identified by contract routing number 10 FHA 14076. This Amendment is for the renewal term of January I,2012, through and including December 31,2012. The maximum amount payable by the State for the work to be performed by the Contractor during this renewal term is Twenty One Page 1 of4 Rev 3/16/2010 Thousand,Three Hundred Fifty Dollars,($21.350.00)for an amended total financial obligation of the State of SIXTY FOUR THOUSAND,FIFTY DOLLARS,($64,050.00). This is an increase/decrease of Twenty One Thousand,Three Hundred Fifty Dollars, ($21350.00)of the amount payable from the previous term. The revised Statement of Work is incorporated herein by this reference and identified as"Exhibit D The revised Budget is incorporated herein by this reference and identified as"Exhibit E". The Original Task Order Contract is modified accordingly. All other terms and conditions of the Original Task Order Contract are reaffirmed. 4. The effective date of this Amendment is January 1,2012,or upon approval of the State Controller, or an authorized delegate thereof,whichever is later. 5. Except for the Special Provisions and other terms and conditions of the Master Contract and the General Provisions of the Original Task Order Contract, in the event of any conflict,inconsistency,variance,or contradiction between the terms and provisions of this Amendment and any of the terms and provisions of the Original Task Order Contract,the terms and provisions of this Amendment shall in all respects supersede,govern,and control. The Special Provisions and other terms and conditions of the Master Contract shall always control over other provisions of the Original Task Order Contract or any subsequent amendments thereto. The representations in the Special Provisions to the Master Contract concerning the absence of personal interest of state of Colorado employees and the certifications in the Special Provisions relating to illegal aliens are presently reaffirmed. 6. FINANCIAL OBLIGATIONS OF THE STATE PAYABLE AFTER THE CURRENT FISCAL YEAR ARE CONTINGENT UPON FUNDS FOR THAT PURPOSE BEING APPROPRIATED,BUDGETED, AND OTHERWISE MADE AVAILABLE. Page 2 of 4 Rev 3/16/2010 IN WITNESS WHEREOF, the parties hereto have executed this Amendment on the day first above written. * Persons signing for Contractor hereby swear and affirm that they are authorized to act on Contractor's behalf and acknowledge that the State is relying on their representations to that effect. CONTRACTOR: STATE: card of C.mitty Comm!ssioners of Weld County (. olitical subdivision of the state of Colorado) STATE OF COLORADO for e use and benefit of the John W. Hickenlooper,Gove or Weld County Department of Public Health and Environ nt I \nu"tit ' ti By: Signature of .thorized its a Fo the Executive Director Ut.1 u 7 2011 PARTM ENT OF PUBLIC HEALTH AND ENVIRONMENT Barbara Kirkme er Print Name of Authorize. fficer Chair Print Title of Authorized Officer PROGRAM APPROVAL: B ' ALL CONTR CTS MUST BE APPROVED BY THE S TE CONTROLLER CRS §24-30-202 require the State Controller to approve all State Contract This Contract is not valid until signed and dated •elow by the State Controller or delegate.Contractor not authorized to begin performance until ch time.If Contractor begins performing prior thereto, a State of Colorado is not obligated to pay r ontractor for such performance or for any goods and/or sery es provided hereunder. STATE CONTROLLER David J.McDermott,CPA By: Date: Page 3 of 4 Rev 3/16/2010 CD// /af This page left intentionally blank. Page 4 of 4 Rev 3/16/2010 Exhibit D STATEMENT OF WORK To Task Order Amendment Dated 10/25/2011 I. Project Description: The contract supports WNV surveillance including collection, identification and submission of vector mosquitoes and dead birds for testing,public education on prevention and human case investigation.The results of these surveillance efforts allows local public health agencies to most efficiently direct resources for control efforts to geographic areas of highest risk for transmission to humans(e.g.recommending integrated pest management of mosquito population),and to direct resources for prevention education during critical time periods of high risk(e.g. when to alert the public to take preventative measures). II. Definitions: WNV--West Nile Virus CEDRS—Colorado Electronic Disease Reporting System Active Surveillance Season—Defined as June 1-September 30 CDPHE-Colorado Department of Public Health &Environment CDEP-Communicable Disease Epidemiology Program III. Performance Requirements/Deliverables: a. The Contractor shall adhere to the following CDPHE guidelines: "Guidelines for WNV Human Case Investigation","Attachment D-1"; "WNV Mosquito Testing Sentinel Zone Protocol", "Attachment D-2"; and the"Mosquito Trapping and Handling Protocol","Attachment D- 3". These guidelines are subject to revision,and the Contractor agrees to comply with the most recent revisions. Complete text of the current version of these guidelines are incorporated herein by this reference made a part hereof b. The contractor shall complete CEDRS records for human cases investigation,including entering the data collected in the extended record tab. c. The contractor shall ensure that data is correctly submitted on records of environmental samples submitted for WNV testing,to ensure that the data is compatible for uploading into the zoonoses database in CEDRS. d. The contractor shall maintain sentinel mosquito trap zones following the CDPHE"WNV Mosquito Testing Sentinel Zone Protocol". e. The contractor shall collect and submit mosquito samples for testing to CDPHE Laboratory,CSU, or CDC in Fort Collins. f. The contractor shall investigate human cases reported by laboratories and healthcare providers, in adherence with the CDPHE"Guidelines for WNV Human Case Investigation" g. The contractor shall provide public education in the form of radio advertisements, interviews on local TV or radio stations,news releases for local publications,and/or maintaining prevention messages on local agency website when indicated by a high level of mosquito-borne disease transmission risk to humans for the season during the mosquito-borne disease season. A high level of transmission risk to humans is defined within the CDPHE plan titled"Response to Mosquito- borne Arboviral Activity"as sustained mosquito infection rates of>3.0 per thousand(0.3%)for two consecutive weeks; vector index> 0.5 for two consecutive weeks. Page 1 of 3 Exhibit D h. The contractor shall submit a progress report to the State Public Health Veterinarian by February 15th for the previous contract period(see below), and by Aug. 15"' for January through June of the current contract period: i. The progress report shall be submitted via email. ii. The progress report can be submitted in any format the contractor chooses. iii. The progress report shall include a brief description of any subcontracts to complete the performance requirements and shall include types of activities performed by the subcontractor(e.g. mosquito collection,identification, and submission;types of vector control activities conducted). iv. The progress report shall include a summary of the amount of contract funding expended on the following categories: 1. Supplies 2. Equipment 3. Travel 4. other expenditures(please specify) v. The progress report shall include a summary of the estimated amount of contract funding expended on the following activities: I. Human surveillance(e.g. investigation of reported cases and viremic blood donors and other epidemiologic activities related of WNV and other arboviral diseases) 2. Environmental surveillance(e.g.mosquito collection/testing,dead bird submission to CDC for WNV testing) 3. Education/community outreach 4. Vector control,and 5. Other expenditures(please specify). If human surveillance or vector control activities are completed without contract funding, this shall be reported separately in text only within the progress report. vi. The progress report in February will be a summary of these expenditures for previous contract period(January l" —December 3l9'), as outlined above.The progress report in August will be a summary of these expenditures for January through June 30`x'of the current contract period. vii. Sample formats for the reporting of expenditures are provided as"Attachment D-4". IV. Personnel: a. Contract representative for the state shall be the State Public Health Veterinarian. In the absence of the State Public Health Veterinarian,the WNV Epidemiologist of CDEP of CDPHE shall be the designee. b. Contract representative for the vendor shall be the Environmental Health Manager. This representative shall have either environmental or epidemiology training to provide the vendor the capacity to fulfill the performance requirements listed herein. c. If the contract representative for the vendor becomes vacant,the State Public Health Veterinarian or West Nile virus epidemiologist at CDPHE shall be notified via phone within 14 days. d. If the vacancy for the key contract representative for the vendor is filled,the new vendor shall notify CDPHE within 14 days with the contact information for that person. V. Monitoring: CDPHE's monitoring of this contract for compliance with performance requirements will be conducted throughout the contract period by the Program's WNV epidemiologist. Methods used will include review of documentation reflective of performance to include progress reports,review of human case Page 2 of 3 Exhibit D data in CEDRS,review of data of mosquito submissions, review of invoicing,and may include site visits. The Contractor's performance will be evaluated three times per contract period at set intervals and communicated to the contractor. A Final Contractor Performance Evaluation will be conducted at the end of the life of the contract. VI. Payment: a. During active WNV surveillance season,defined as June ls`through September 30`s,invoices shall be submitted monthly, within 45 days of the end of the billing period. b. The contractor shall submit copies of receipts for equipment purchases. VII.Remedies: The Contractor will be notified by email or telephone within 14 calendar days of discovery of a compliance issue. Within 30 calendar days of discovery, the Contractor and the State will collaborate, when appropriate,to determine the actions)necessary to rectify the compliance issue and determine when the action(s) must be completed. The action(s)and time line for completion will be documented by email and agreed to by both parties. If extenuating circumstances arise that requires an extension to the time line, the Contractor must email a request to the WNV Epidemiologist and receive approval for a new due date.The State will oversee the completion/implementation of the actions)to ensure time lines are met and the issue(s) is resolved. If the Contractor demonstrates inaction or disregard for the agreed upon compliance resolution plan, the State may exercise its rights under the Remedies section in the general provisions of this contract. Page 3of3 Attachment D-1 Cdossdo Department of Pub&Health and Environment Guidelines for West Nile Virus Human Case Investigation Colorado Department of Public Health and Environment Communicable Disease Epidemiology Program May 18, 2011 The following procedures will be used for the investigation of West Nile virus (WNV) human cases in Colorado in 2011. A system for tracking and reporting cases should be defined in each county or region with specific duties and responsibilities assigned to an individual or team. In many counties there will be a substantial caseload to manage and a systematic approach will be essential. CASE ASCERTAINMENT WNV is a seven-day reportable condition by all laboratories in Colorado. Cases are reported to either the state health department or local public health agencies, and are entered into the Colorado Electronic Disease Reporting System (CEDRS)under the diagnosis "West Nile Virus". Some laboratories and hospitals enter cases directly into CEDRS. The CDPHE laboratory will be performing WNV IgM tests, along with numerous private clinical laboratories. Test results from private clinical laboratories will be accepted and cases should be investigated without subsequent verification at the CDPHE laboratory. We will not be confirming all private lab tests this season. However, if during the investigation there is reason to suspect a false positive test result (incompatible illness, onset during off-season, test being attributed to past illness, no other WNV activity in the area, etc), then specimens should be submitted for confirmatory testing at CDPIIE. Please note on the lab submission form that the specimen is part of a public health investigation to waive the laboratory fee. Note on WNV IgM testing: In neuroinvasive disease (meningitis or encephalitis), specimens collected within 7 days of onset usually test 1gM positive. In milder cases of WNV infection, seroconversion may take up to two weeks or longer in some patients. If specimens collected within a week of onset are 1gM negative, but the diagnosis of WNV infection is still being considered, a second specimen collected 3-4 weeks post-onset should be tested. WNV 1gM antibody levels have been shown to persist in some patients for greater than 500 days. Positive serologic tests must be correlated with clinical presentation, season, and potential exposure to WNV. Due to.low test specificity, a single positive IgG antibody test result on serum or CSF, either alone or in conjunction with a negative 1gM test, is NOT diagnostic for acute infections and is NOT considered a case of WNV. Cross-reactions can occur from past infection with St. Louis encephalitis (SLE), dengue fever, and several other viruses. In some parts of Colorado 5- 10% of the population, especially older patients, may have antibody against SLE from prior 1 Page 1 of 6 Attachment D-1 exposure to this endemic virus. Documentation of a seroconversion from negative to positive IgG antibody status on paired sera (i.e. acute and convalescent) would be diagnostic. CLINICAL DESCRIPTION Most arboviral infections are asymptomatic. Clinical disease ranges from mild febrile illness to severe encephalitis. For the purpose of surveillance and reporting, based on their clinical presentation, arboviral disease cases are often categorized into two primary groups: ncuronl.'asive disease and non-neuroinvasive disease. Neuroinvasive Disease Many arboviruses cause neuroinvasive disease such as aseptic meningitis, encephalitis, or acute flaccid paralysis (AFP). These illnesses are usually characterized by the acute onset of fever with stiff neck, altered mental status, seizures, limb weakness, cerebrospinal fluid (CSF) plcocytosis, or abnormal neuroimaging. AFP may result from anterior("polio") myelitis, peripheral neuritis, or post-infectious peripheral demyclinating neuropathy (i.e., Guillain-Barre syndrome). Less common neurological manifestations, such as cranial nerve palsies, also occur. Non-neuroinvasive Disease Most arboviruses are capable of causing an acute systemic febrile illness (e.g., West Nile fever) that may include headache, myalgias, arthralgias, rash, or gastrointestinal symptoms. Rarely, myocarditis, pancrcatitis, hepatitis, or ocular manifestations such as chorioretinitis and iridocyclitis can occur. CLINICAL CRITERIA FOR DIAGNOSIS A clinically compatible case of arboviral disease, with onset during WNV transmission season (May—0ct)*, defined as follows: Neuroinvasive Disease • Fever(> 100.4 F or 38 C) as reported by the patient or a health-care provider, -AND- • Meningitis, encephalitis, acute flaccid paralysis, or other acute signs of central or peripheral neurological dysfunction, as documented by a physician, -AND- • Absence of a more likely clinical explanation. Non-neuroinvasive Disease • Fever(> 100.4 F or 38 C) as reported by the patient or a health-care provider, -AND- • Absence of neuroinvasive disease, -AND- • Absence of a more likely clinical explanation. * Exceptions to criteria of"onset during WNV transmission season(May—Oct)" are: if transmission occurred during travel outside of Colorado where transmission season is longer or different(e.g.tropical areas such as Florida,South America) OR transmission to patient was through non-mosquito-borne routes such as through blood product,tissue, or organ. 2 Page 2 of 6 Attachment D-1 CASE CLASSIFICATION CONFIRMED: Neuroinvasive Disease A case that meets the above clinical criteria for neuroinvasive disease and one or more of the following laboratory criteria for a confirmed case: • Isolation of virus from, or demonstration of specific viral antigen or nucleic acid in tissue, blood, CSF, or other body fluid, - OR- • Four-fold or greater change in virus-specific quantitative antibody titers in paired sera, - OR- • Virus-specific IgM antibodies in serum with confirmatory virus-specific neutralizing antibodiest in the same or a later specimen, - OR- • Virus-specific IgM antibodies in CSF and a negative result for other IgM antibodies in CSF for arboviruses endemic to the region where exposure occurred. Non-neuroinvasive disease A case that meets the above clinical criteria for non-neuroinvasive disease and one or more of the following laboratory criteria for a confirmed case: • Isolation of virus from, or demonstration of specific viral antigen or nucleic acid in, tissue, blood, CSF, or other body fluid, - OR- • Four-fold or greater change in virus-specific quantitative° antibody titers in paired sera, - OR- • Virus-specific 1gM antibodies in serum with confirmatory virus-specific neutralizing antibodiest in the same or a later specimen, - OR- • Virus-specific IgM antibodies in CSF and a negative result for other IgM antibodies in CSF for abroviruses endemic to the region where exposure occurred. PROBABLE: Neuroinvasive Disease A case that meets the above clinical criteria for neuroinvasive disease and the following laboratory criteria: • Virus-specific IgM antibodies in CSF or serum but with no other testing. Non-neuroinvasive Disease A case that meets the above clinical criteria for non-neuroinvasive disease, onset during WNV transmission season (May—Oct)* and the laboratory criteria for a probable case: • Virus-specific IgM antibodies in CSF or serum but with no other testing. quantitative antibody titers are not provided through optical density results such as 0.9 or 1.2 with no units expressed. Examples of quantitative results include semm dilutions(e.g. 1:80)or neutralizing antibody potency expressed in international units(e.g. IU/mL). t"confirmatory virus-specifrc neutralizing antibodies": confirmatory testing involves the detection of arborviral- specific neutralizing antibodies utilizing assays such a plaque reduction neutralization test(PANT). Assays for the detection of IgM and IgG antibodies commonly include enzyme linked immmnosorbent assay(ELISA),microsphere 3 Page 3 of 6 Attachment D-1 immunoassay(MIA),or immunofluorescence assay(IFA). These assays provide a presumptive diagnosis and should have confirmatory testing performed,as described above if confirmation is needed. Only confirmed and probable cases will be included in state and national case counts. Suspect cases will not be included. To avoid confusion for the public and media, we will not make a distinction between confirmed and probable cases in publicly released information. CASE INVESTIGATION AND INTERVIEW All ituormatio:a required for case verhication and counting must be entered into the CEDRS record. Local public health agencies can choose to use CDPHE's standardized human case investigation form that corresponds to required information for CEDRS entry or a more detailed form developed in house to gather additional information on cases in their jurisdiction. All reported cases of WNV should be investigated promptly. The regional epidemiologists will work with the local agencies to ensure that proper follow up takes place shortly after the case was reported. Agencies may choose to interview the case's health care provider, the patient or both depending on information needs and resources. At the minimum, the following information should be gathered and entered into the CEDRS record: • Verify the diagnosis (asymptomatic blood donor, fever, meningitis, encephalitis or meningoencephalitis); meningitis, meningoencephalitis and encephalitis cases will be reported as neuroinvasive to the CDC. • Obtain an illness onset date. • Verify if the patient survived or died. - IF DIED - obtain the date of death and notify CDPHE. • Is the patient diagnosed with physician diagnosed acute flaccid paralysis? • Is the patient an organ donor or a transplant recipient in the four weeks prior to onset? - IF YES -notify CDPHE. • Did the patient donate blood in the four weeks prior to onset? - IF YES - obtain the date and place of the donation and notify CDPHE. • Did the patient receive a blood transfusion in the four weeks prior to onset? - IF YES -obtain the date and place of the transfusion and notify CDPHE. • Is the patient pregnant? -IF YES- obtain the expected delivery date. Determination of whether an infant was infected in-utero will be made later as part of a special study by CDC. • If the patient is an infant or toddler, is he/she breastfed? This question does not pertain to infected women who are currently breastfeeding their infant. CEDRS /CASE VERIFICATION AND COUNTING A reported case will be verified and officially counted if the following criteria are met: I) The patient has a compatible illness and a positive IgM test on serum and/or CSF. 2) The case has been entered into CEDRS and classified by definition (uncomplicated fever, meningitis, encephalitis, or meningoencephalitis). 3) The following variables have been entered into the CEDRS record: county, age, sex, onset date and serum and/or CSF test result. 4 Page 4 of 6 Attachment D-1 If any of these variables are missing information, including onset date, the case will not be counted until that information is available. If a county does NOT want to officially count a case, one of the required variables should be left blank in the CEDRS record (such as onset date or case definition). This insures that the posted summary statistics, epi-curve, map of human cases, and local, state and national totals agree. When a reported case has met the above criteria for verification and counting, it will be added to the state and national official totals and will be included in the website summary data. This will be done automatically without a subsequent call to the county! The website is located at: http:/Avww.cdphe.state.co.us/dc/Zoonosis/wnv/indcx.html Cases will be counted and the website updated Monday through Friday by 4:00 pm during the WNV season. In order to have a case counted, the data must be entered into CEDRS by 3:00 pm. Any case information entered after this time will be added to the following day's count. All other CEDRS variables are not required for case verification and counting at the state level. However, many of these variables are required by CDC. All variables in the Extended Record section should be completed in a timely manner to insure comprehensive reporting of required data to CDC. FLAGGING CEDRS RECORDS Two indicators in the CEDRS record will serve as flags for local public health agencies to determine which cases have been included in the official case count: I) CDPHE will enter"WNVl I"in the"Outbreak Name" field in the Case Information section of the CEDRS record 2) CDPHE will enter"YES" in the"Case Counted" field and the date the case was added to the official case count in the "Date Case Counted"field on the Extended Record section of the CEDRS record. Agencies can run a line list in CEDRS that lists the cases that have been officially counted: • Go to the CEDRS Main Menu • Under"Reports/Queries", click on"Line Listing of Cases by Selected Variables". • At the"Outbreak Name" field, select"Is Exactly"and type in WNVI 1 (no spaces). • Enter any other search parameters you would like, and then click on"Create Line Listing" at the bottom of the page. The generated line list will contain those cases that have been officially counted. This list can be compared against all reported cases in the county to determine which cases have not been officially counted. SUMMARY- STEPS FOR HUMAN CASE INVESTIGATION 1) Upon receiving a case or laboratory report, verify that the patient has a positive IgM antibody test on serum or CSF. If the IgM test is negative, no further action is necessary. If the medical provider still feels WNV infection is the diagnosis, advise them to submit another specimen. 2) If the test result is IgM positive, consider the person a case, enter the case into CEDRS under the diagnosis "West Nile Virus", and proceed with case investigation. If during the 5 Page 5 of 6 Attachment D-1 investigation a false positive test result is suspected attempt to obtain the original or a second specimen for verification at CDPHE or CDC. The original or second specimen should be sent to CDPHE with a notation that this is a confirmation specimen that is part ofa public health investigation so that a lab fee will not be charged. Clinically compatible cases during WNV transmission season with a positive IgM antibody test of illness onset do not need further laboratory confirmation. 3) Interview the physician and/or patient and complete the required fields in the CEDRS record (age, sex, county, onset iiat.% case status, lab/medical testing information, and c:aic?] (. ,vairomc). 4) Complete all other fields in CEDRS in a timely manner, especially those in the Extended Record section. 5) If the patient provides a history of donating or receiving blood or an organ, being pregnant,has been breastfed, or dies notify CDPHE immediately. For questions or additional information, please contact your regional epidemiologist or CDPHE. 6 Page 6 of 6 Attachment D-2 017 no West Nile Virus Mosquito Testing 2011 Colorado Department of Public Health SENTINEL ZONE PROTOCOL of and Environment Sentinel Zone Concept The goal of surveillance for mosquito-borne viruses (WNV, SLE, WEE) is to determine the human transmission risk in order to implement control and prevention strategies. To facilitate a standardized method of data collection and ensure continued operation during budget reductions, the mosquito sentinel site concept was launched in 2004. However, there were concerns that a single site poorly represented the region's mosquito populations and was vulnerable to environmental changes that could reduce its effectiveness. To address theses issues, the program was modified into a "Sentinel Zone"approach. Within a defined"sentinel zone"mosquito traps arc set in strategic locations to ensure successful trapping of adequate numbers of mosquitoes throughout the WNV season. In the event your combined trapped mosquito collection numbers for the week are low, it is recommended that they are saved and combined with the following trap night within the same trap week. If one trap or site becomes inoperable, mosquitoes from other traps in the zone can still be tested and the poor trap site can be relocated to another location within the zone. Following standardized trapping and testing protocols, a sentinel zone would provide data about mosquito population density, species make-up and arboviral activity that is comparable over the years. Furthermore, this approach will provide sufficient mosquito testing volume for calculating accurate infections rates to allow control decisions to be made (i.e. to spray or not to spray) in time to have a public health benefit. All Culex species mosquitoes collected in the sentinel zones will be tested for WNV by RT-PCR and a sample of the submitted pools will also be tested for Western equine encephalitis (WEE) and St. Louis encephalitis (SLE). Scope of Work 1) Defining a zone: Local agencies can determine where a zone will be located and what geographic area it will encompass within the following parameters: A zone will be a circle with a minimum radius of 1.5 miles and a maximum radius of 5 miles 4 The center point of the circle will be used as the geo reference point for the zone (latitude/longitude). 2) Trap placement: Each zone will consist of five CO2 baited light traps. Local agencies can determine where within the zone these traps are located. 4 Gravid traps or additional light traps can be maintained in the zone, however mosquitoes from other traps cannot be combined with the five zone traps for either testing or calculation of infection rates. 4 The same location for each trap must be used throughout a season. However, when necessary a non-producing trap can be moved to another location within the zone although this should be minimized and occur early in the season. 1 Page 1 of 3 ,U( Y � Attachment D-2 �w; Colorado Department of Public Health and Environment 3) Trapping schedule: To better reflect the WNV transmission season in Colorado AND ensure the majority of samples (≥60%) arc tested during the peak of the transmission season the following schedule will be used. This schedule will result in— 60 to 90 trap/nights per zone for the season. Agencies can decide which night of the week to use although the same day should be used each week when possible. 4 Weeks of June 13th through July I', 2011 —trap one night per week TV-oks of July 4th through AugL:st 5th, 2011 — ➢ for jurisdictions with mosquito control programs where decisions on adulticiding arc made based on trapping & testing results- trap two nights per week ➢ for jurisdictions without mosquito control programs- trap one night per week 4 Weeks of August 8th through August 31st, 2011 —trap one night per week 4 Agencies can trap mosquito mosquitoes prior to June 13th or after August 31st (for identification, mosquito counts, internal RAMP, control decisions) or more frequently (for control decisions), but if these mosquitoes are submitted to CDPHE Laboratory, the submitting agency will be billed. 4) Mosquito Submission: The 5 traps within the sentinel zone could be viewed as one large mosquito trap from which the pooled infection rate and vector index will be calculated. 4 All female Culex mosquitoes trapped in a sentinel zone must be submitted to the state lab. 4 Submit mosquitoes in separate pools by C. taralis and other Culex(i.e. C.pipiens, C eiythrothorax, C resturans combined). 4 Pool size can be up to 65 mosquitoes per vial. ➢ CRITICAL -- the exact number of mosquitoes per vial must be recorded as this affects the infection rate calculations. 4 Culex mosquitoes captured in the 5 zone traps and the captures from the 2 nights per week during the peak of the trapping period should be co-mingled into the minimum number of pools. This will extend limited testing resources. 4 Agencies can submit mosquito samples/pools prior to June 13th for WNV testing, but the agency will be billed. + Due to the possibility of limited WNV funding (for both the local health departments and CDPHE Laboratory), CDPHE laboratory may have to cease testing of mosquitoes before the season is complete. CDPHE staff will alert local health departments f this occurs. Until that time, there is no reason to call CDPHE to ask whether funding is still available. 5) Data Maintenance: Accurate records of trapping results must be maintained to allow year- to-year comparisons and monitor trends in mosquito populations. Dramatic changes in Culex population densities can provide an early indication of increasing human risk. 4 It is recommendedthat all mosquitoes in the traps be identified to species and that population data be maintained for all species. Estimating numbers is acceptable for non-Culex 4 At a minimum, data to maintain should include: trapping dates, #mosquitoes in the zone traps, Culex population density by species (C. tarsalis and other Culex at a minimum), and weather conditions on night of mosquito trapping. 2 Page 2 of 3 Attachment D-2 6) Other Considerations: 4 Sentinel zones should contain areas that are suitable for Culex mosquitoes to breed and are in close proximity to human populations. 4 Sentinel zone traps should not be located in an area with regular, heavy spraying operations for adult mosquito or other arthropod control (orchards, tree farms/nurseries, or agriculture areas). Areas with ongoing larviciding are OK. 4 Traps within a zone should have an availability of mosquito resting sites and protection from wind (i.c. culverts, fences, shrubbery, trees, sheds, etc) and should be placed away from competing sources of light and carbon dioxide (e.g., livestock, including equine, bovine, and swine). 4 Traps should be placed on the leeward side of obstacles if possible. For example, if the prevailing wind is generally from the west just after dusk, try to place the trap on the east side of trees, sheds, etc. 3 Page 3 of 3 Attachment D-3 Mosquito Trapping and Handling Protocol (4/29/05) 1. CDC CO' Baited Light Traps: Used to capture female mosquitoes seeking a blood meal (i.e., Cx. tarsalis) 1.1 Depending on humidity and temperature, bait trap w/2—3 lbs. of dry ice per ht of ti Aping. • Dry ice can be placed in a large padded manila envelope (no holes!), tightly wrapped in newspaper, insulated, plastic thermos jug w/holes drilled in bottom (keep spout open when using to keep condensate from freezing and plugging holes), or insulated, re-usable, nylon lunch bag w/ holes punched in bottom. • If using a plastic, insulated, thermos jug or insulated nylon lunch bag, the light trap can be suspended from the bottom of jug or lunch bag, which in turn is suspended from the tree limb via its handle. • If using a padded envelope or newspaper, suspend the dry ice just above the trap. 1.2 Placement and setup considerations: • Protection from morning sun. • A 13 gal. plastic trash bag with a hole cut in the bottom to fit over the trap body, fan, etc. and placed over the collection net will protect mosquitoes from rain. • Place trap set-up away from competing light sources (non-full moon nights best), smoke /fume emitting areas (e.g., industrial plants), areas of high wind, and public view and away from livestock • Place trap in an open area near good mosquito resting surfaces (e.g., abundant vegetation (i.e., trees, shrubs, sheds, stables, sewers/culverts, etc.) and/ or areas where birds congregate (e.g., grain storage, livestock feeding areas, etc.). 1.3 Place light trap 5' —6' above the ground. 1.4 Recommend running traps a minimum of 2 consecutive nights to maximize catch and minimize the influence of adverse weather. 2 Gravid Traps: Used to capture female mosquitoes seeking to oviposit(i.e., Cx. pipiens complex). 2.1 Trap baited w/ an infusion of water, fresh horse/cow manure, and straw/hay. • Infusion recipe: softball size amount of fresh horse/cow manure, an algaecide such as Microbe-Lift(Industrial formulation) (www.microbelift.com), a handful of straw/hay per gallon of water and let ferment for approx. 4 to 5 days. • Infusion in the gravid trap will require changing when it begins to produce its own mosquitoes. • Fill trap infusion reservoir/tub to within 1" to 1.5"of bottom of vertical suction tube. c:/tanda/gen-mosq.nfo/mosq trap & molecular handling proto 6-3-02.doc Page 1 of 3 Attachment D-3 • Suggest an overflow hole be drilled into the wall of the reservoir tub at the maximum infusion level to keep the level of the infusion below the suction tube (i.e., rain). • To maintain consistency of the infusion from week to week, it is recommended that you save the infusion by placing it back in the bulk container it was fermented between uses. • To avoid creating a mosquito-breeding source, the infusion can be treated w/Bti. 2.2 Placement considerations: • Protection from the morning sun • A 13 gal. plastic trash bag placed over the collection net will protect mosquitoes from rain. Place holes in bag to allow air to vent out. • Place near mosquito resting areas (e.g., abundant vegetation, outbuildings, sheds, sewers/culverts, etc.), areas where birds congregate (e.g., grain storage, livestock feeding areas, etc.), and/or near oviposition sites, but not near enough that such sites compete (e.g., adjacent to a livestock water tank). 2.3 Traps must be run a minimum of 2 nights to maximize catch and minimize the affects of adverse weather conditions. 3. Trap Collection: 3.1.Collect traps early A.M. to minimize damage and morbidity to captured mosquitoes. Harvest your catch by pinching off the capture net while the fan is still running. 3.2.On a piece of white medical tape, identify the capture net with trap I.D., location/ site I.D., collection date,method of collection(i.e.,light trap vs. gravid trap) and collector's name and stick it on the net for later reference. 3.3. After the mosquitoes are anesthetized or killed, transfer them from the collection nets to specimen tubes identified by trap site and freeze on dry ice. Recommend contents of collection net be emptied into a white, plastic tray where mosquitoes are separated from non-mosquito captures and placed into the specimen vial. Anesthetized mosquitoes will stay down for approximately 10 min. during the transfer process. 3.4. Complete the "Field Arthropod Collection Record" form or similar data sheet that will identify the sample collection and other pertinent data. Forms should include the following data fields: Trap I.D., Date Collected, Trap Location, Site I.D.#, Trap Method (light trap, gravid trap, etc.), Collected by, and a remarks field (optional) to record pertinent information, e.g., light bulb out, batteries dead, etc. (see 3.2). 3.5. At the lab / sorting facility, identify and sort mosquitoes into pools (max. 50 mosquitoes per pool)by species. Speciating and pooling mosquitoes should be • done as soon as possible to minimize damage to mosquitoes (e.g., broken parts, missing legs, desiccation, loss of scales, etc.). 3.6. Record mosquito identification information on the Laboratory Services Division (LSD) Request for Analytical Services form that records the following information: Assigned Pool I.D. #, Collection Date (mm/day/yr), County, c:/tanda/gen-mosq.nfo/mosq trap & molecular handling proto 6-3-02.doc Page 2 of 3 Attachment D-3 Site/Trap I.D., Trap Method (light, gravid, etc.), Genus, Species, Pool size, and Remarks (optional). 3.7. Complete the LSD Request for Analytical Services form and adding an "S", "F", or"P"prefix to the lab collection ID number on the provided stickers to designate the pool as coming from a sentinel,Jloater, or permanent trap. 3.8 Submit sorted Culex mosquito pools with the completed Request for Analytical Form toINJ i ro1"'L 1 - a' y for testing. 3.9 Mosquito pool submissions do not require refrigeration during shipment to the lab. However, if mosquito pools are not going to be shipped to the lab the same day, they should be kept refrigerated until they are shipped. All submissions should be shipped via FedEx, bus line, or UPS to: Laboratory Services Division (LSD) Attn: Hugh Maguire 8100 Lowry Blvd. Denver, Colorado 80220 3.10 For sentinel trap operated in Mesa, Moffat, and Delta counties, Culex pools shall submit their pools to: State Lab Attn: Labertta Cano 510 29'/ Rd. Grand Junction, Colorado 81504 Note: The above laboratory services apply to Culex spp. mosquitoes collected at Sentinel Trap Sites, Floater Traps, and Permanent Trap Culex pools collected before July l" Note: Culex pools collected from Floater and Permanent Traps after July a will be submitted to the appropriate regional laboratory for VecTest® analysis. All sentinel trap pools will be submitted to the Laboratory Services Division (LSD). Caution: Do not ship samples after Thursday or the day before a holiday to avoid having them delivered over the weekend or on a holiday. Note: there are no requirements to mark the package as a biohazard since it is not known if any of the mosquitoes are infected. In the event it is known that the samples are infected/ infective, then appropriate biohazard markings and other considerations would be appropriate. c:/tanda/gen-mosq.nfo/mosq trap & molecular handling proto 6-3-02.doc Page 3 of 3 Attachment D-4 Sample Progress Report Table 1. WNV ELC expenditures by category Spending category Amount ($) Supplies* $ Equipment* $ Travel* $ Other expenditures (please specify below) $ Unspent S Total FY12 WNV award $ See Table 2 on next page Page 1 of 4 Attachment D-4 Table 2. WNV ELC expenditures by activity (Estimated or Actual) Program activity Amount($) Human surveillance* $ Environmental surveillancet $ Education/community outreach $ Vector control $ Other expenditures (please specify below) Unspent $ Total FY11 WNV award $ Please check one: Activity reporting based on: Actual costs Estimates *Includes all human surveillance activities (e.g., epidemiology and reporting of human disease cases, viremic blood donors) t'Includes all environmental surveillance activities (e.g., mosquito collection/testing, dead bird collection/testing, veterinary cases, etc.) Page 2 of 4 I j 2 o o o •O ft En Ct a to 0 / \ g § 4 @ o -on k O •\ ) k > o k \ 6.0 ci / Co, - - 0 @ § \ § ) G [ ? \ CI © \ ®cip a) \ � -4 '% \ g / } »ae \ E \ t.5 8 -o k \ * _ § ' ( \ j ) \ \ / ® § 2w m = = 32 [ = w \ .$ \ / { 5 z le & ( 3- w ! \ � / 7 \ \ J « 334 j Q = / 2 / 3 / w 3 j \ ` \ '0 715 \ \ / \ \ \ \ - 54) o 07 cr - o bb Cat a) \ ) • Ca ( j ca § * Exhibit E WELD COUNTY WNV 2012 BUDGET PERSONNEL TOTAL $0 FRINGE TOTAL $0 TRAVEL TOTAL $0 SUPPLIES TOTAL $0 EQUIPMENT $0 OTHER TOTAL $21,350 Paid to private contractor for mosquito trapping, identification and submission 301.34 traps @$70.85/trap=$21,350 TOTAL DIRECT $0 TOTAL INDIRECT $0 TOTAL WNV SURVEILLANCE BUDGET $21,350 Page 1 of 1 Hello