This process, called integrated pest management, is funded and implemented by local and state agencies. In Brown’s area, it includes sending his team out to test mosquito pools for West Nile virus, limiting populations using biological control measures such as mosquito fish, and launching a massive public awareness campaign about the disease.
“We really don’t want to depend on human cases” to prompt abatement measures, Brown says, pointing out that once human cases have been identified, an outbreak has already begun. By that time, the only way to deal with the problem is to spray pesticides to kill the mosquitoes.
But Brown says that combating mosquito eruptions is like weather reporting: there are many variables are involved, not to mention irregular funding. The funding models across the country vary greatly, but in his district, as in most of California, the money comes from property taxes. When the economy collapsed, Brown says, so did his agency’s income. If future revenues are inadequate, “we won’t be able to maintain high levels of response,” he says.
Lyle Petersen, director of the division of vector-borne infectious diseases for the CDC, says that surveillance systems for detecting emerging West Nile virus outbreaks vary in quality throughout the country. They are certainly much better than they were several years ago, but “capacities are eroding due to budget cuts at local, state, and federal levels.”
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On Monday, September 16, 2013, at around 5 a.m., my grandfather received a phone call from rehabilitation facility staffer who told him that my grandmother had fallen out of bed and could not be revived. Oma was taken by ambulance to the nearest emergency room and then transferred to Northbay Hospital in Fairfield, California. My aunt called me a little before 8 a.m.
“Hey, how are you?” I asked brightly.
“Well, um … not so good, actually,” she replied. I froze. “Oma had a stroke this morning,” she said, her voice cracking. “You need to come now.”
Oma lay motionless on the hospital bed, her eyes closed, the intermittent hiss of the ventilator filling the room. Over the next few hours, my family trickled into the intensive care unit. Every time a relative arrived and took it all in, the tears began anew. Over the course of the day, four doctors told us that Oma was brain-dead. Opinions differed on whether it was related to her West Nile infection (two said unequivocally yes, two said absolutely not), but they all agreed that nothing more could be done. At around 6 p.m., my grandfather made the decision to take Oma off life support. Two nurses came in, muted the vitals monitor, and began removing the tubes. They placed a box of tissues on the table and left, sliding the glass door shut.
A version of this piece was previously published in Brink magazine, a publication of the Berkeley Graduate School of Journalism.