Internship Diary by Steven Moberly, IU Southeast Student

I was awarded this internship in March 2004 based on my history of volunteer assistance with Professor Baker, and my extraordinary effort in his classes. My first volunteer service with Professor Baker goes back to 1997. At that time, I had just graduated high school and my older brother was doing field research with IU Southeast and Professor Baker. I spent most of the summer waking up early to study the herpetofauna on the Indiana Knobs. [Editor’s Note: frogs, tuatara, lizards, turtles and snakes] With Professor Baker’s letter of recommendation, the Clark County Health Department did not hesitate to hire me as an environmental health specialist intern.

I feel it is very important to also extend my gratitude to Eli Lilly III, Community Partners Program. They have supported my internship since January 2005.

My internship as an environmental health specialist covers a large range of duties, including: Attending educational conventions, and even presenting our work at these conventions; inspecting restaurant, public pools, septic systems, and housing conditions; collecting specimens from various materials (e.g., food, water, and animals) to be tested for infectious pathogens; and a long list of other responsibilities.

However, most of my summer will be dedicated to research and service in mosquito-borne pathogens, particularly West Nile virus. I will be coordinating a student workforce from IU Southeast to trap mosquitoes across southern Indiana. These specimens will be brought to the university mosquito laboratory, identified to a species level, tested for West Nile virus and potentially other disease-causing pathogens, and all data will be then entered into a database at IU Southeast. All locations testing positive for infectious pathogens will immediately be treated with corrective and preventative measures, and reported to state and federal officials.

In addition to these duties, I will be working in the laboratory to improve our pathogen-testing procedures; preparing literature for presentation and publication; working on press releases; training students on mosquito biology, medical importance, and identification; and giving seminars to local groups of children on basic mosquito biology, identification, and things to be done at home to eliminate mosquito breeding sites and to protect individuals from mosquito-borne diseases.

The work I am conducting this summer is necessary for our citizens to live in a healthy and safe environment. Data collected from past years clearly show the trend of West Nile virus being detected in mosquito specimens two to three weeks before the first reported human infections occur. These data support our idea that if we can detect the virus in mosquitoes and treat the areas appropriately, we can greatly reduce the risk of human infections.

The work and research I will be conducting has a proven history of significance. For example, in 2004, mosquitoes from 24 of our sampling locations tested positive for West Nile virus, and yet no human infections were reported for our collection range. In addition, as part of our service we collected the first Indiana specimens of the Asian rock pool mosquito (Ochlerotatus japonicus). This mosquito is a potential vector of many pathogens, including those responsible for West Nile virus, Japanese encephalitis, and St. Louis encephalitis. Our discovery of this new species stimulated a statewide search that resulted in this invading species being found in 13 counties by January 2005.

This year, I will build upon the base that has been established, and attempt to make 2005 the most productive and significant year to date.

This internship has proved to be a very important tool in the development and practice of the skills needed for scientists in today’s world. I have integrated my internship and classes into one experience, and feel that one alone would not be sufficient in preparing me for my future goal of continuing my work in an M.D./Ph.D. program as a medical research scientist. I plan to complete an M.D./Ph.D. program with a specialization in infectious and emerging infectious diseases. After completion of the program, I plan to continue researching infectious diseases, and begin medical practice. I am also interested in maintaining a long-term professional relationship with the public and environmental health departments. My service may be extended in public health as a health officer.

Sunday, June 5, 2005
New Albany, Indiana

I am challenged by my internship on a daily basis. I continually try to improve upon my previous performance, and the West Nile virus project has become very large and demanding. There are currently more than 20 IU Southeast students working on the project this year, and we have purchased a lot of new mosquito trapping equipment. With all the traps and student participation, there is a steady stream of mosquitoes coming to the IU Southeast laboratory on a daily basis. All these mosquitoes must be identified to a species level, recorded in our database, and tested for West Nile virus. Last year, I identified over 20,000 mosquitoes, following up with West Nile virus testing and data entry. Fortunately, the Indiana State Department of Health does some of the West Nile virus testing for all Indiana County Health Department. This has been a tremendous help. There are also many talented, hard-working, students who are willing to assist in all aspects of our work.

In addition, I give seminars on our research and take time to analyze the data. We submit a final report every year and recently entered a manuscript for publication with the Indiana Academy of Science. I am now certified as a pesticide applicator and am working on innovative methods of mosquito population control. One of our newest methods of treatment is to introduce “mosquito fish” into small private pools of water that are rearing mosquitoes. These fish are small and look very similar to guppies. They thrive in our Indiana climate and have proved very effective in eliminating mosquito problems in many situations.

I also spend a fair amount of time working as a restaurant inspector. The demand for food service inspectors is very large, and this is a vital and necessary part of my work in public health.

As a student myself, I am continually feeling the pressure of trying to maintain top performances in the classroom, as well as on the job. It is very difficult to balance these responsibilities and it requires very long days, and more often than not long hours on the weekends as well. I am honored to be involved in such an important line of work, and with the combined efforts of many people my responsibilities are met both on the job and in the classroom.

The single most important lesson I have learned is to appreciate the value and importance of teamwork. Although I work constantly to improve upon my own ability to serve the needs of public health, I am in no way equipped to fill the tall order that is placed on our local health departments. The more people you can bring together for a common goal, the better off you are. Professor Claude D. Baker has been very instrumental in helping me work as part of a team. He has an uncanny ability to bring people together, and is an ideal model of unselfish service.

Wednesday, June 8, 2005
New Albany, Indiana

Two newspapers released articles this week on the work I am doing with the internship. On June 6, the Jeffersonville Evening News and The New Albany Tribune published a story about our work. On June 4, the Courier-Journal in Louisville, Kentucky, also wrote an article.

Sunday, June 26, 2005
New Albany, Indiana

Last September, I was literally in the eye of a hurricane—Hurricane Frances in Florida. I was one of three students from IU Southeast who helped with hurricane cleanup. Now I feel like a human hurricane—working up to 90 hours a week solving mosquito problems in four southern Indiana counties.

With the recent dry weather, significant stagnant water has become prime habitat for Culex mosquito breeding. These mosquitoes really love this weather. Culex (also known as house mosquitoes) is the most common mosquito genus in the area, and reaches very high population densities when it is hot and dry. Culex has adapted to really bad water allowing these mosquitoes to reproduce in waters that many others avoid. I find that Vicks Vaporub in the nose sometimes helps dampen the smell in some of these funky places.

The intense heat has decreased the amount of time that it takes mosquito larvae to mature into an adult. Culex is a significant vector for West Nile virus, and it is believed that during times when rainfall is low and temperatures are high, we are at an increased risk for West Nile virus infection. This is likely due to the increased reproduction rate of Culex, and the fact that many birds acting as a reservoir host of the virus are pressured into drinking from the small pools of stagnant water mentioned above. In some bird species, the virus can reach high levels without killing them (reservoir host). When a mosquito feeds on this bird, the virus is transmitted to the mosquito, which then becomes a vector for the virus. The mosquito, unharmed by the virus, may then pass it to other animals and humans. And do I really have to state an obvious fact—mosquitoes really love human blood!

Recently, I have increased the amount of time spent treating mosquito larvae, and as a result, we have been able to keep population numbers down in some problem locations. The traps set out to collect mosquitoes are monitored, and if they collect a high number of specimens, that location is treated. We then reassess the location by setting more traps to determine if our treatments are effective. The plan appears to be working exceptionally well.

My supervisor for the Eli Lilly III internship at the Clark County Health Department, Doug Bentfield, will often help me treat problem sites. He is very well-organized and systematic in his approach to treating sites that are spread over a very large area. I think we are saving Clark County a significant amount of money.

We find many times that nature is already at work. Some drainage ditches or other shallow pools of water will become populated with small fish that are apparently introduced when the rivers and streams flood. These fish are trapped in the pools when the river recedes and act as biological pest control agents by eating the larvae; thus eliminating the need for other treatment methods. We often dip out a sample of the water to verify the presence of mosquito larvae before proceeding with our treatments.

In another mosquito control method, we use mosquito fish (Gambusia) that we are rearing in small ponds in Floyds Knobs to treat a problem. If the pools of water are too small and numerous for fish, another option is to use the bacteria (Bacillus thuringiensis). This bacterium has become a popular larvicide because it is very effective in killing mosquito larvae, and if used properly, also is environmentally safe. The ingested bacteria work by blocking up the intestinal tracts of the larvae.

In other cases, all that is required is for individuals to take action in eliminating water filled containers such as tires and buckets that are holding water. We have handed out hundreds of brochures this year to stress the importance of individuals doing their part at home to eliminate any unnecessary containers, and to use repellant if mosquitoes become a problem. Local newspapers citing IU Southeast and my work have published articles indicating that containers should be emptied on a regular basis.  

It has been a very busy summer. Last week, I was invited to present my work at the annual meeting of the Indiana Environmental Health Association. In addition to my regular duties, I have given three guest lectures on mosquito biology in an “environment and people” class, worked with over 20 individual study students, assisted state intern Jessica Mallory with her work on West Nile virus, and successfully completed a summer politics class. I made an A!

We have collected, sorted, counted, identified, and mailed over 5,000 mosquito specimens to the Indiana State Department of Health to be used in RT-PCR (Reverse Transcriptase Polymerase Chain Reaction) to detect infectious pathogens, and also have plans to carry out our annual recertification procedures for our biohazard level II West Nile virus laboratory at IU Southeast next week.

The Clark County Health Department has just purchased a new mosquito pathogen testing kit (Vec Test) that will be used this summer to test mosquitoes for West Nile virus and the pathogen responsible for Saint Louis encephalitis. The testing procedure is fairly quick, and I used a very similar test (immunochromatographic assay) last year to test for West Nile virus. By performing these tests at the IU Southeast laboratory, we can ease some of the burden placed on the Indiana State Department of Health, and potentially obtain very fast test results. If a mosquito pool tests positive, the location at which it was collected is immediately evaluated, and the test results are entered into a local, state, and national database.

In summary, this hurricane hasn't lost its punch, but I look forward to late August when I can take a vacation. Hopefully, Professor Claude Baker and his ecology class can then assist with the mosquito monitoring

Monday, July 18, 2005
New Albany, Indiana

Boy, the summer is flying by! The last couple of weeks have been both demanding and rewarding for this environmental health specialist intern. The yearly recertification for the IU Southeast Biosafety level II West Nile virus and Saint Louis encephalitis testing laboratory and personnel went very well. The biosafety professionals from the IU Bloomington campus were very insightful, and their visit was a great contribution to our program.

Our West Nile virus and Saint Louis encephalitis testing will undoubtedly intensify. The Indiana State Department of Health has reported that mosquito samples from our southern Indiana area have tested positive for West Nile virus at their lab in Indianapolis. This is a pressing concern, and I am comforted to have a great team of people from the local health departments and IU Southeast working relentlessly to improve the situation at hand.

The local health departments receive many phone calls from individuals concerned about the mosquitoes on their own residential properties. Many of these complaints are forwarded to me so that I will investigate the problem and determine a good plan of action. Recently, while calling a residence that had made a complaint, a woman answered the phone and while talking with her I was taken by the seriousness in her voice when she stated, “I am warning you ahead of time, they are really ugly out here.” I knew this would not be my usual outing, and I came prepared with repellant and traps.

When I arrived at the house, I was met with a gentleman, and as I was looking around the property, he decided to take me back about 50 yards into the woods behind the house. Being my usual self, I decided to get off the path and look for the breeding pools. I started through a stand of tall weeds, and very quickly I realized that I was trespassing! This stand of weeds in the forest belonged to thousands of very aggressive mosquitoes that were awakened by my presence and hungry for blood!! The repellent helped with the bites, but I was surrounded by the most amazing display of mosquito biodiversity I had ever seen.

I could not find a good source of water. There may have been some “tree holes” since it was a forested setting. Tree holes form when trees fork and form indentions in which water can stand or a dead branch falls off leaving an empty depression. Besides potential tree holes, I noticed that I was in a flood plain, and I remembered that many “floodwater mosquitoes” have a long flight range and can be found far from where they are hatching. This idea was supported and very evident when the stealthy little devils chased me back to my truck hoping to make a meal from my blood!

The traps were set and worked well. This kept me busy identifying thousands of mosquitoes to species level. This forested site was found to hold 11 species of mosquitoes. One species was the Asian Rock Pool Mosquito (Ochlerotatus japonicus), which had been found in Indiana for the first time last year by myself, and a team of student researchers from IU Southeast. Another species was Psorophora ferox, the Gallinipper. These are EXTREMELY large mosquitoes that feed readily during all hours of the day and have a painful bite. The residents here were very familiar with the Gallinipper, and exclaimed that they were the worst. I was interested in these large and aggressive, yet beautiful, creatures, so I did some investigating. I found that although they are very troublesome with their aggression toward people, they are not known to transmit any infectious pathogens. This information brought relief for both me and the residents. To the comfort of these people, the health department interceded by providing treatment with mosquito adulticides in an attempt to ensure the health of this family by winning another battle with the resilient mosquito.

Back at the lab, I was also reading some material on National Incident Management Systems. This material was provided by the All Hazards Control Planner for Clark County and IU Southeast alumnus, DeLynn Rutherford. Her office is at the Environmental Division of the Clark County Health Department, and she works to ensure the county’s preparedness in the case of a major incident. This is serious scary stuff. What would we do if a terrorist released a biohazard like smallpox into our area? She brings everyone in the department up to speed with the latest training and information. I appreciate her contribution to the department and am happy to receive the training.

A fellow student at IU Southeast, Eric Lovan, has shown considerable interest in my internship as an environmental health specialist. Eric is helping with the mosquito pathogens program and has been very helpful. I have been providing him with literature on all sorts of public health issues that will help him gain certifications relevant to the work of an environmental health specialist, and he has been learning first hand about the demands placed on health departments through his involvement in the program. It is encouraging to meet people with an interest in public health.

Finally, on a personal note, I am beginning to understand that successful scientists work far beyond a 40-hour work week. I've been up all night more than once this summer. I wonder if Einstein, while working on his Nobel Prize–winning stuff, burned the midnight oil. I'll bet he did!

Sunday, August 7, 2005
New Albany, Indiana

The heat is on! Excellent IU Southeast students are pouring on the heat! The heat is on and so is the level of West Nile virus in Indiana.

I recently received an e-mail from the Indiana State Department of Health informing me that the number of mosquito collections testing positive for West Nile virus has increased significantly. In addition, several dead birds have tested positive for the virus. Last week, I received a call from a Clark County resident who found a dead hawk in his yard. I went to his place, and found the hawk that had recently died. I was very careful to avoid making any skin contact with the animal, and prepared it for shipment to the Indiana State Department of Health Molecular Lab.

Our team of student researchers from IU Southeast has been relentless in its quest to find new mosquito breeding sites, and the list of places I treat for mosquito problems has grown considerably over the summer. Many places are on a periodic treatment schedule, and others have been corrected on a more permanent scale.

For example, locations where we placed mosquito fish have not required any further treatments, and in other places, we have been able to eliminate the standing water. I have been fortunate to get the much needed student assistance, and have found it very true that, “Given time the cream will rise to the top” as said by Dr. Bill Forsyth. Many students have taken such an interest in our proceedings that they have extended their individual study requirements, and are now working on a strictly volunteer basis. We are really making a difference. In my opinion, we really can't have a strong community without a strong service-oriented university.

We have now identified more than 18,722 mosquitoes, and any species that is a potential transmitter of West Nile virus is tested. Fortunately, our mosquito control efforts have been very effective in lowering the number of mosquitoes to be tested, and to date only one West Nile virus positive site was found in southern Indiana—in Floyd's Knobs.

In addition to my work in mosquito borne disease control, I have taken to the task of furthering my education in emergency preparedness. My supervisor at the Clark County Health Department (Doug Bentfield), two IU Southeast students (Eric Lovan and David Fletcher), and myself have all enrolled in an intensive four-day training exercise in a community-based emergency response program. The program has been presented to me with the highest recommendation, and instructors will include employees with the CDC (Centers for Disease Control and Prevention), the FBI, various medical institutions, and many other professional institutions. It is very exciting to be part of a growing team developed for community-wide emergency response.

I have also been involved in a number of other summer activities. I am coordinating a stream research team from IU Southeast, to evaluate the ecological health of some small streams in Jennings County; with the summer heat we've been having, a stream project was pretty appealing. My responsibilities in this project include: team organization, fish and macroinvertebrate collection and identification, bacteria evaluations, water chemical analysis, and equipment maintenance. Other IU Southeast students involved include Tim Deatrick (director of stream research) and Emerald Ash (borer survey summer intern), Eric Loven (summer IU Southeast intern in professional practice, individual study student in the West Nile virus program and stream research volunteer), and Eric Raes (individual study student in the West Nile virus program and volunteer assistant in stream research). It has been fun to get out in nature with these fine students, and I am enjoying the task of expanding my identification skills.

Paul Raney, another IU Southeast student intern with the Clark County Health Department, has been working diligently to build a thorough and user-friendly Web site for the health department. I will be meeting with him soon to add all the information on our mosquito control and West Nile virus monitoring program to the site. Paul is a senior biology major who plans to attend dental school upon his graduation from IU Southeast. In addition to his skills as a student and Web designer, he is an excellent photographer, taking most of the photographs covering my summer internship.

This summer has been very fulfilling. Not only have I enjoyed helping area residents combat infectious disease, but I have also enjoyed the camaraderie of my fellow students and health department employees as we have worked together to achieve a new standard of excellence. I will be back in the classroom soon, building more skills for the future, but I will also continue to analyze the data from this summer and present our work to other scientists and health professionals. I have established long-lasting relationships with many of the people I have worked with this year, and I will certainly vouch for them if they are ever in need of a recommendation. I am very thankful for my mentor and professor, Claude D. Baker, Ph.D., who has played a key role in making this opportunity possible.

IU Southeast Vice Chancellor Larry Mand and Chancellor Sandra Patterson-Randles also should be commended for their support of my program. This has been a true team service project. My years as a student and intern at IU Southeast will certainly be some of the greatest times in my life. I hope to look back and gain inspiration from the heat we applied to a community problem.

Friday, August 12, 2005
New Albany, Indiana

WHAT A WEEK! I'm calling this discovery week!

As some of you might remember, on July 10, 2005, student researchers from IU Southeast trapped, in Clark Country, the first specimens of the Asian rock pool mosquito (Ochlerotatus japonicus) ever found in Indiana. Now, I have captured the first specimens of this mosquito to test positive for West Nile virus in Indiana.

This is a serious matter. The mosquito previously has been found to carry the virus in eastern states. The Asian rock pool mosquitoes are sometimes called “super mosquitoes” because they can thrive in very cold conditions. This means they will be biting late in the year, and they will come out very early next year. In Japan, the larvae can overwinter in ice-covered pools.  

Two specimens of the newly introduced mosquito were trapped on July 20 near the intersection of Highway 60 and Highway 111. I identified the specimens and sent them to the reference lab in Indianapolis for West Nile virus testing. The positive West Nile virus results were reported to the Clark County Health Department late on August 8, 2005. Earlier that day, I was treating the site with mosquito larvicides, unaware of the positive test results and working on a prevention basis.

Since our initial discovery of Ochlerotatus japonicus in Indiana, I have been able to study some of its specific characterizations. I find this mosquito most frequently in or very near forested areas. It is also trapped in high abundance, relative to other species, in early spring and late fall. It is a proven vector of many infectious pathogens including West Nile virus and those responsible for Saint Louis encephalitis, Eastern Equine encephalitis, and Japanese encephalitis.

I have also witnessed that it will readily feed off humans who venture into its territory in daylight hours. Our role in uncovering the recent emergence of this invasive mosquito in Indiana has reinforced the importance of the program between IU Southeast and the local health departments. Early detection is a key to preparedness and prevention, and our team is on the front line.