Figure of Sound in Prose and Poetry

A figure of speech that relies primarily on the sound of a word or phrase (or the repetition of sounds) to convey a particular effect is known as a figure of sound. Although figures of sound are often found in poetry, they can also be used effectively in prose. Common figures of sound include alliteration, assonance, consonance, onomatopoeia, and rhyme. Examples and Observations: AlliterationA moist young moon hung above the mist of a neighboring meadow.(Vladimir Nabokov, Speak Memory: An Autobiography Revisited, 1966)AssonanceShips at a distance have every mans wish on board. For some they come in with the tide. For others they sail forever on the same horizon, never out of sight, never landing until the Watcher turns his eyes away in resignation, his dreams mocked to death by Time. That is the life of men.(Zora Neale Hurston, Their Eyes Were Watching God, 1937)ConsonanceThis earth is tough stuff, he said. Break a mans back, break a plow, break an oxs back for that matter.(David Anthony Durham, Gabriels Story. Doubleday, 2001)OnomatopoeiaFlora left Franklin’s side and went to the one-armed bandits spread along one whole side of the room. From where she stood it looked like a forest of arms yanking down levers. There was a continuous clack, clack, clack of levers, then a click, click, click of tumblers coming up. Following this was a metallic poof some times followed by the clatter of silver dollars coming down through the funnel to land with a happy smash in the coin receptacle at the bottom of the machine.(Rod Serling, The Fever. Stories From the Twilight Zone, 2013)RhymeA veritable fusillade of smells, compounded of the pungent odors of deep fat, sharks fin, sandalwood, and open drains, now bombarded our nostrils and we found ourselves in the thriving hamlet of Chinwangtao. Every sort of object imaginable was being offered by street hawkers--basketwork, noodles, poodles, hardware, leeches, breeches, peaches, watermelon seeds, roots, boots, flutes, coats, shoats, stoats, even early vintage phonograph records.(S.J. Perelman, Westward Ha! 1948)Figures of Sound in Poes ProseDuring the whole of a dull, dark, and soundless day in the autumn of the year, when the clouds hung oppressively low in the heavens, I had been passing alone, on horseback, through a singularly dreary tract of country, and at length found myself, as the shades o f evening drew on, within view of the melancholy House of Usher.(Edgar Allan Poe, The Fall of the House of Usher, 1839)Figures of Sound in Dylan Thomass ProseThere was no need, that holiday morning, for the sluggardly boys to be shouted down to breakfast; out of their jumbled beds they tumbled, and scrambled into their rumpled clothes; quickly at the bathroom basin they catlicked their hands and faces, but never forgot to run the water loud and long as though they washed like colliers; in front of the cracked looking-glass, bordered with cigarette cards, in their treasure-trove bedrooms, they whisked a gap-tooth comb through their surly hair; and with shining cheeks and noses and tidemarked necks, they took the stairs three at a time.But for all their scramble and scamper, clamour on the landing, catlick and toothbrush flick, hair-whisk and stair-jump, their sisters were always there before them. Up with the lady lark, they had prinked and frizzed and hot-ironed; and smug in their b lossoming dresses, ribboned for the sun, in gym-shoes white as the blancod snow, neat and silly with doilies and tomatoes they helped in the higgledy kitchen. They were calm; they were virtuous; they had washed their necks; they did not romp, or fidget; and only the smallest sister put out her tongue at the noisy boys.(Dylan Thomas, Holiday Memory, 1946. Rpt. in The Collected Stories. New Directions, 1984)Figures of Sound in John Updikes Prose- Do you remember a fragrance girls acquire in autumn? As you walk beside them after school, they tighten their arms about their books and bend their heads forward to give a more flattering attention to your words, and in the little intimate area thus formed, carved into the clear air by an implicit crescent, there is a complex fragrance woven of tobacco, powder, lipstick, rinsed hair, and that perhaps imaginary and certainly elusive scent that wool, whether in the lapels of a jacket or the nap of a sweater, seems to yield when the cloudless fa ll sky like the blue bell of a vacuum lifts toward itself the glad exhalations of all things. This fragrance, so faint and flirtatious on those afternoon walks through the dry leaves, would be banked a thousandfold and lie heavy as the perfume of a flower shop on the dark slope of the stadium when, Friday nights, we played football in the city.(John Updike, In Football Season. The New Yorker, November 10, 1962)- By rhyming, language calls attention to its own mechanical nature and relieves the represented reality of seriousness. In this sense, rhyme and allied irregularities like alliteration and assonance assert a magical control over things and constitute a spell. When children, in speaking, accidentally rhyme, they laugh, and add, Im a poet / And dont know it, as if to avert the consequences of a stumble into the supernatural. . . .Our mode is realism, realistic is synonymous with prosaic, and the prose writers duty is to suppress not only rhyme but any verbal accident that would mar the textual correspondence to the massive, onflowing impersonality that has supplanted the chiming heavens of the saint.(John Updike, Rhyming Max. Assorted Prose. Alfred A. Knopf, 1965)Poetic Functions of Language[English poet] Gerard Manley Hopkins, an outstanding searcher in the science of poetic language, defined verse as speech wholly or partially repeating the same figure of sound. Hopkins subsequent question, but is all verse poetry? can be definitely answered as soon as the poetic function ceases to be arbitrarily confined to the domain of poetry. Mnemonic lines cited by Hopkins (like Thirty days hath September), modern advertising jingles, and versified medieval laws, mentioned by Lotz, or finally Sanskrit scientific treatises in verse which in Indic tradition are strictly distinguished from true poetry (kavya)--all these metrical texts make use of the poetic function without, however, assigning to this function the coercing, determining role it carries in poetry.(Roman Jakobson, Language in Literature. Harvard University Press, 1987)Word Play and Sound Play in a Poem by E.E. Cummingsapplaws)fellowsitisnts(a paw s(E.E. Cummings, Poem 26 in 1 X 1, 1944)The False Dichotomy Between Sound and SenseIn plain expository prose, such as this book is written in, says [literary critic G.S. Fraser], both writer and reader are consciously concerned not mainly with rhythm but with sense. This is a false dichotomy. The sounds of a poem connected by rhythm are indeed the living body of thought. Take the sound as poetry and there is no further stage of interpretation into poetry. Just the same is true of periodic prose: the rhythm of the period organizes sound into a unit of sense.My criticism of the logical tradition in grammar is just that stress, pitch, attitude, emotion are not suprasegmental matters added to the basic logic or syntax but other glimpses of a linguistic whole which includes grammar as usually understood. . . . I accept the now unfashionable vie w of all the old grammarians that prosody is a necessary part of grammar. . . .Figures of thought like understatement or emphasis are no more and no less expressed in sound than anything else.(Ian Robinson, The Establishment of Modern English Prose in the Reformation and the Enlightenment. Cambridge University Press, 1998)Figures of Sound in 16th-Century Prose- Suspicion that an inordinate attraction to figures of sound was likely to tyrannise a writers style, that the claims of the ear threatened to dominate those of the mind, has always dogged analysis of Tudor prose, especially in the case of [John] Lyly. Francis Bacon indicted [Roger] Ascham and his followers for precisely this failing: for men began to hunt more after words than matter; more after the choiceness of the phrase, and the round and clean composition of the sentence, and the sweet falling of the clauses, and the varying and illustration of their works with tropes and figures, than after the weight of the matter, wor th of subject, soundness of argument, life of invention, or depth of judgment [The Advancement of Learning].(Russ McDonald, Compar or Parison: Measure for Measure. Renaissance Figures of Speech, ed. by Sylvia Adamson, Gavin Alexander, and Katrin Ettenhuber. Cambridge University Press, 2007)- Shall my good will be the cause of his ill will? Because I was content to be his friend, thought he me meet to be made his fool? I see now that as the fish scolopidus in the flood Araris at the waxing of the moon is as white as the driven snow, and at the waning as black as the burnt coal, so Euphues, which at the first increasing of our familiarity was very zealous, is now at the last cast become most faithless.(John Lyly, Euphues: the Anatomy of Wit, 1578) See also: 10 Titillating Types of Sound Effects in LanguageEuphonyEuphuismExercise in Identifying Sound Effects in Poetry and ProseFigures of SpeechHomoioteleutonHomophonesOronymProsodyReduplicativeRhythmSound Symbolism

Community Policing And The Community Essay - 1561 Words

What is community policing? Particularly, community policing is a strategy employed by numerous departments in order to establish and cultivate a relationship between the law enforcement agency and the community being patrolled. Moreover, community policing is composed of three analytical components; community partnerships, organizational transformation, and problem solving (Gardiner, 154, 2016). Notably, community partnerships are essential in community policing since they increase public trust and generate an enhanced relationship in law enforcement agencies better serving the community (Gardiner, 87, 2016). These community partnerships offer public input as well as encourage the public to cooperate with their local law enforcement agencies in order to minimize crime within their community (Gardiner, 88, 2016). Different from the traditional strategies of policing, community oriented policing has been adopted by two-thirds of agencies in order to enhance public safety and cont rol crime. (Gardiner, 148, 2016). In the first place, this innovative strategy allows law enforcement officers to accomplish a level of respect and cooperation of the community through close working relationships between the citizens and the agency. â€Å"The key to infusing community policing throughout the department is by restructuring agency management, in particular making changes to the agency’s climate and culture, leadership, decision-making methods, labor relations, strategic planning,Show MoreRelatedCommunity Policing1234 Words   |  5 Pagesï » ¿Community policing The renowned Sir Robert Peel who helped found the London Metropolitan Police unit that was meant to be closer to the people than any other time before. 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During this time, a burst of new ideas and changes in the political and economic structure began to occur that would eventually bring about a new kindRead MoreThe Succesfull of Community Policing908 Words   |  4 Pagesthese are the role of citizen to build peace and order around society become the strategic way on citizen empowerment. Last but not least, the concept of community policing itself where the government through the Police give trust to the society to prevent their own environment and create peace independently, however the process of community policing itself is still under supervision of Police Institution. Police is one of the leading government agencies in maintaining safety and comfort for societyRead MoreCommunity Policing Essay1034 Words   |  5 Pages Community policing is a policy and a strategy aimed at achieving more effective and efficient crime control, reduced fear of crime, improved quality of life, improved police services and police legitimacy, through a proactive reliance on community resources that seeks to change crime causing conditions. This assumes a need for greater accountability of police, greater public share in decision-making and greater concern for civil rights and liberties. The key characteristics of community policing

Bottled Water Issues free essay sample

The most important issue is the health impact not only for humans, but for watersheds. Bottled water companies pump 75 gallons per minute in some places (Hopey). Bottling companies take water from different areas that sometimes need the water for municipal uses. For example in the small town, Bakersville, the bottling company in Somerset County wants to come in and bottle up the water from Laurel Hill Creek that supports it. By bottling the water in this small river, the water levels are dropping, which is causing fish and other species to die off (Hopey). In this small river there is a fish hatchery, which breeds a breed of salmon that is close to being an endangered species. By drawing too much water, the fish in this hatchery won’t survive and all the efforts will be lost. In addition the water is being consumed faster than the regions near the bodies of water can replenish the water tables. Examples where this is being seen is in the Great Lakes are and Texas. Farmers and Fishermen are directly affected by these drops. (Arnold) Also by shipping the water off, the water is not returning to its original watershed and doesn’t replenish its original watershed. This can cause drought and lakes and rivers begin to run dry. Bottled water is being purchased on a larger scale all over the United States. In 2007, every five minutes citizens used $11. 7 million and 2 million bottles. In that whole year alone 8. 8 billion plastic water bottles were used. With numbers this large and climbing, it’s understandable that companies like Nestle wants to bottle from Lake Michigan. Several small towns in Michigan see how big of an issue this could turn into. Nestle is currently pumping 200 million gallons a minute to be bottled. Many cities are trying â€Å"think outside the bottle,† campaigns to keep the water within the watershed. They want to promote protection of the ground water and surface water. Cities see the issues with pulling water from their resources and shipping it off to other parts of the country. (Gibney) Some of these issues include: water tables dropping, water levels decreasing, and drought. Sometimes mud flats are created which can turn in to sever drought land area. Another issue with bottled water is fossil fuel usage. The oil that is used for the production of the plastic for the bottle is tremendous. To make enough bottles for the demand in the United States, it requires more than 17 million barrels of oil annually. (Arnold) That amount is enough to fuel 1 million cars in America for a year. (Arnold) In addition to that, When these bottles are produced they release toxic gases which contaminate the air and in the water. This problem continues when they aren’t properly disposed of. The Container Recycling Institute says that 86% of the bottles used in America become litter or in landfills. Bottled water can take over 1000 years to biodegrade if in a landfill. Arnold) Another issue is incineration. When bottles are incinerated they release even more toxic gases into our atmosphere. Bottled water has also been the source of many unseen health problems. Bottled water has been linked to cancers because of the plastic bottles slowly breaking down. The plastic bottles have also been linked to many other health related issues. Some of these other health issues include: hormone dis ruption, immune deficiencies, obesity, miscarriage and lowered fertility. (Thompson) Also some studies have shown that most bottled water is nothing more than bottled tap water. Arnold) Bottled water has also been known to have other contaminates like fertilizers, caffeine, heavy metals, pharmaceuticals, industrial solvents, and other harmful chemicals. (Ochel) Bottled water has many more issues than it has benefits for people in most cases. By changing certain things, bottled water could become a problem of the past and water resources can be properly used. Solving the Problem of bottled water is more complicated than it may seem. The â€Å"simplest† solution is banning bottled water. Facts show that by banning bottled water, the general population will save money because the water bottles are more expensive than tap water. In some places cities are banning bottled water and installing public fountains and encouraging people to bring their own bottle. An example of this is the town of Bundanoon in Australia. (Foley) They were the first to ban bottled water in the world. In the United States, several cities are working on banning bottled water. San Francisco, Los Angeles, Chicago, St. Louis, Phoenix, along with many other cities, are working on banning bottled water. They have done this by making it illegal to spend their city funding on bottled water. (Doss) While Bundanoon†s story is a success; we must look deeper and look at the whole picture. By banning bottled water, a lot of jobs will have to be cut. With our economy like it is can we as a nation really afford to cut all those jobs? Also to ban bottled water there would need to be cooperation with the bottling companies to stop selling the product. That will not be an easy task since it is a growing product. Companies will be losing top sales if bottled water is banned nationwide. Bottling companies will most likely not be pleased with the outcome of this. By slowly banning bottled water in certain areas of the country, and following to others, the transition will be easier on everyone including these companies. Also there will need to be some sort of system to monitor that these companies to make sure they don’t produce anymore and to track the movement of products all over the country. Reducing production numbers, bottled water will be less available and companies will have to move towards bottling or packaging other products. By first reducing the number that can be produce by companies; the population can learn to use alternatives such as refillable water bottles. An easier step or smaller scale project that can be done. By banning stores and gas stations to sell this consumer good in cities by individual basis, people will have to work a little harder to get this to work and start moving in to leaving the plastic bottle behind. To make that kind of transition easier on the citizens a solution to the convenience of bottled water is reusable bottles. There are several types of reusable bottles. There Plastic ones, Aluminum ones, and now there are glass ones as well. Sadly research shows that even plastic reusable water bottles release BPA which is Bisphenol A into drinking water. (Doss) BPA is an industrial chemical used primarily to make polycarbonate plastic and epoxy resins. Polycarbonate plastic is the plastic used for plastic reusable water bottles. Aluminum bottles are better than plastic ones but glass is so far the best solution. (Doss) Glass bottles are less expensive than the others. They also are recyclable if broken and don’t take as much energy to produce. In addition to banning bottled water in towns and cities, is to build public fountains. Public fountains can be installed into any building that has municipal water connected to it. Fountains in the long run are a great investment for buildings. Unfortunately they are expensive. Their cost ranges from $500 to over $1000. (Barrier-Free) With prices like these many cities may be uncertain about installing fountains in public buildings. There is also a chance of up keep and maintenance. Several public buildings already have drinking fountains installed but need work done or turned back on. By keeping these and doing repair work, public buildings will no longer need to stock bottled water in vending machines to make strides in banning bottled water. By providing drinking fountains this reduces the need of bottled water. Another way to solve the paranoia about bottled water being cleaner or safer than tap water is to install a water purification system on your faucets. Home water filtration is very logical not only to clean water even more but in the end it is much cheaper when used with refillable bottles. Home filtration systems also take out more than municipal tap does. Home filtration systems costs anywhere from $20 to even $120. (Strand) Some top brands of filters include: Brita, PUR, Crystal Quest, and Aquasana. (Strand) Families who are concerned about tap water and bottled water are recommended to purchase these filter systems. These filters are convenient and through my research have shown to be the biggest thing that can be done to solving the problem of bottled water. In conclusion I believe that eventually we as a country, and eventually as a world will be able to move completely away from plastic water bottles and into other solutions. Bottled water is overpriced and is quickly destroying ecosystems if nothing is done, this problem will most defiantly amplify. Even though bottled water may seem like a convince, it is very inconvenient to our bodies and to the environment. Bottled water’s effect on the environment is tremendous and all aspects of bottled water is negative in relation to our environment. Everything from the production, the bottling, the shipping, and disposal has harmful effects. There are many ways the United States and other countries can work to move away from bottled water and into healthier and safer solutions. The first step is to start using reusable bottles, preferably glass ones, and getting water filtration systems for our tap water. These two steps do not have to cost that much. Both are ways that are easy and beneficial for the health of people and t the same time work on saving our environment. Also public buildings can work towards repairing and installing municipal fountains and promote â€Å"banning the bottle† by doing this. As a result of doing these few things, strides to helping the world water crisis will defiantly be done. Works Cited Page Arnold, Emily and Larsen, Janet. â€Å"Bottled Water: Pouring Recourses Down the Drain. † Earth Policy Institute. February 2, 2006. lt; http://www. erth-policy. org/plan_b_updates/2006/updates51gt; â€Å"Barrier-Free Water Cooler† Drinking Fountain Doctor. Kully Supply Store. 2010. lt; http://www. drinkingfountaindoctor. com/complete-units/by-style/water-coolers/barrier-freegt; Doss Holdings Inc. and Strand, Charles. â€Å"Bottled Water- Healthy or Hoax? † Bottled Water Blues. Doss Holdings Inc. Sun Water Inc. 2011. Foley, Meraiah. â€Å"Ban on Bottled water, Apparently a first, ect. † New York Times. 17 July 2009. A9(L) Gale Science in Context. Web. 3 Dec 2010. Hopey, Don. â€Å"Somerset Company’s Proposal to bottle Water from Creek stirs controversy. † Pittsburg Post-Gazette. July 5, 2009. Ochel, Evita. â€Å"Bottled Water: Not worth The Price or Your Health. † Evolving Wellness. October 18, 2008. Strand, Charles. â€Å"Water Filter Comparisons. † Sun Water Systems, Inc. 2010. Thompson, Kati. â€Å"Un-bottling Our Water Supply. † Celsias.

Promotional report campaign for DMO

Introduction The report was about a tourism promotion campaign that involved the reopening of the Africa Lion Safari performed by the Greater Western Sydney (GWS) tourism in Warragamba, Sydney in Australia achieved between 2008 and 2012.Advertising We will write a custom report sample on Promotional report campaign for DMO specifically for you for only $16.05 $11/page Learn More The GWS consisted of 14 local government areas (LGA) that comprised of Auburn council, Wallondilly Share, Camden Council, City of Pernith, City of Campbell town, City of Parramatta, City of Bankslown, City of Liverpool, City of Blue mountains, City of Holroyd, City of Fairfield and City of Hawkesbury. The GWS was estimated to have a population of1.9 million according to the 2006 census. The population covered a locality of over 9000km squared including residential, rural and industrial zones. As the marketing manager of the GWS tourism promotion team, I sent the campaign report t o the management team for its consent on the campaign ideas and expenditure. The marketing strategy comprised of the following subunits; brief discussion of the DMO campaign in terms of size, turnover, visitation, number and occupancy rates and data information, promotion in campaign strategy, target marked profile, competition and channels of distribution (Haney Perry,2004). Objectives To reopen the African Lion Safari in Warragamba. -To promote domestic tourism in Sydney. -To increase tourism by 10% annually. -To increase the GDP of Sydney by boosting tourism and hospitality. The DMO campaign The tourism promotion campaign was carried out in Sydney, New South Wales, Australia with the target population of 1.9 million individuals. The population comprised mostly of the working class. The employment concentration was in industrial and trade networks like the Parramatta Town Hall, Appian Way in Bankslown and the showground hall at Sydney Olympic Park. The chief tourist attraction it ems involved the Sydney Olympic Park, the Blue Mountains and the Western Sydney Parklands that contained sites like the Westfield Penrith, Westfield Parramatta, Eastern Creek Raceway and the Black Town Olympic Park. The campaign targeted a fraction of about 30% of the Australian $85 billion in GDP per annum contributed by the 14 LGA.Advertising Looking for report on business economics? Let's see if we can help you! Get your first paper with 15% OFF Learn More In this case, the African Lion Safari in Sydney focused on becoming the 3rd largest contributor to the Australian economy after Melbourne and the Sydney CBD. The campaign also targeted the University Western Sydney, University of Sydney Cumberland Campus and the Western Sydney institute of TAFE. Promotion campaign strategy The aim of the promotion was to recreate an African savanna within Sydney. The GWS team aimed at availing the African Lion Safari to the people of Sydney, an item they once enjoyed in 2001. The GWS had to make the people of Sydney enjoy what the people in Africa relish without their going to Africa (Lewis Roehrich, 2009). It was like bringing Africa to Sydney. The promotion strategy involved different measures with certain of them incorporating advertisements on social sites, promotional trade fairs and use of external links (Plunkett, 2008). The adverts were channeled through Face book, Tweeter and Friendster. The radio and television media houses were used in creating awareness on this great tourism initiative. The promotion campaign in terms of advertisement and awareness creation used about 1 billion Australian dollars. The channeling was not only for the people of Sydney but for the whole of Australia and the rest of the world. Target market The campaign targeted primarily the people of Western Sydney who were about 1.9 million in number. The region was believed to house 1 in every 11 Australians. The integration of events like the Rotary Observatory, Katromba Stamp Fair and the riverside theatre would ensure integration of local market in the campaign. The African Lion Safari project was able to provide a supplementary tourist resort for those who liked adventure and possessed interest in wildlife, especially the lion. The initiative was also able to target Australians who enjoyed tasty food ranging from African to Asian delicacies. The GWS was able to provide hospitable hotels and restaurants to complement the existing Chifley Hotel Penrith, St. Mary’s Park View Motel and the Grand Mercure Hills Lodge by availing better, convenient and comfortable facilities.Advertising We will write a custom report sample on Promotional report campaign for DMO specifically for you for only $16.05 $11/page Learn More Competition No business can sustain itself without competition and the Sydney tourism campaign for the African lion safaris faced a lot of competition. Competition ranged from hotels to tourist destinations. The major competitors in terms of hotels and motels included Windsor Motel, Windsor Terrace Motel, Crown Plaza Norwest Hotel, Sydney Gateway Holiday Park and the Chifley Hotel Eastern Creek. The hotels and motels were able to provide exquisite and luxurious facilities thus posing challenges for the campaign. The other tourist destinations included national parks like Cattail, Nattai, Blue Mountains, Yembo and Scheyville, University of Sydney, Sydney Superdome, and Sydney Aquatic Center, Sydney International Shooting Center, Liverpool CBD and the George’s river. The promotion succeeded by 55% in spite of competition. Channels of distribution The lions were acquired from Africa like in Kenya, DRC Congo and Uganda through the airline network. From the African savanna, the lions were carried by road to their respective airstrip (Barrow, 2005). On arrival in Australia, different modes of transport were used in transporting them. Road transport involved the Hills Motorway, South W estern Motorway, West Link, Great Western Highway and the Cumberland Highway. The railway line was also involved to a certain extent and especially in transporting the lions’ food. All the costs amounted to 5 billion Australian dollars. Communication objective The DMO situated in Sydney and the communication link involved the satellite system that was interlinked within Sydney like from the North Narembura and Antarmon to the south of Paddington and Woolharla. The communication objective of the campaign was to link all the regions, cities and towns within Sydney (Jeong Nor, 2007).Advertising Looking for report on business economics? Let's see if we can help you! Get your first paper with 15% OFF Learn More The communication networks like telephones and internet were necessary tools in creating awareness of the African lion safaris and attracting interest from all of Australia. All the costs of the communication initiative amounted to 3 billion Australian dollars. Promotion and media mixes In the promotion of the initiative, the GWS employed different techniques in creating awareness of the African Lion Safari in Sydney (Dumville, 2001). The aspects included advertisements, public relations, and direct customer promotions. The advertisements involved radio and television advertisements that were aimed at the regular radio listeners and TV fans (Fry, 2003). The public relations exercise was aimed at spreading information on the initiative between the GWS and the public. The organization employed topics of public interest to capture the attention of the public. The public relation activities exploited included conferences, press briefings and industrial awards (Saylor, 2012). Direct cust omer contact employed the use of posters, brochures and fliers stating the purpose of the initiative and its objective. This fact was to convince the immediate customers that they were also appreciated (Brown, 2001).The promotion of sales just like in advertisements used the media, face to face communication, telephone and posters in creating awareness. The media mix employed different media in promoting the campaign. The television houses, magazines, telephone directories, billboards and supermarket shopping carts were consolidated to facilitate the success of the campaign. In the midst of the advertisement or promotion, creative elements were integrated to enhance the campaign (Armstrong, 2002). The elements involved giving of discounts, offering of after sale services and provision of resource materials (Cohen, Wells, 2001). Discounts were offered to hotels and restaurants for regular customers, tour and parking fees. For instance, a 50% discount was offered to the first 100 tour ists both at domestic and international levels. The after sale services included servicing of the tourist vehicles, consultation services and rewards that ensured that any visitor was satisfied with the organization’s provisions (John, 2010). All these creative elements were reflected in the advertisement and promotion links enabling the visitors to have full information of what the initiative was all about. The promotion and advertisement cost about 10 billion Australian dollars. Key performance indicators (KPIs) The performance indicators were used to show the performance measurement in evaluating the success and achievement of the campaign. The following table shows the various indicators employed in the campaign. Indicator type performance Quantitative 10% of the total population of Sydney visited the African Lion Safari (i.e. 0.19 million) Qualitative 0.10 million of the 0.19 million visitors came from Sydney Leading A predictable 1.0 million was expected to hav e visited the African Lion Safari in 10 years Lagging The success of the campaign stood at 70% in the next 5 years Input A total of 36 billion Australian dollars were consumed in the project Process The campaign proved productive based on its power to target a large tourist market (0.19 million) Output A total of 50 million Australian dollars were accrued by the end of 2012 Practical The campaign necessitated the success of the promotion despite the competition by 55% Directional The GWS African Lion Safari improved with an estimated 10% increase in income annually Financial The financial prospects seemed promising with a 50 billion output in 2012 Budget Value in Australian dollars in billions Promotion and advertisement 10 Transport 5 Communication 3 Insurance 2 Hotels and restaurants 10 Tour guides and security 1 Others 5 Total 36 Media release Lions in Sydney 2nd March, 2008 The Greater Western Sydney Agency is reopening the African Lion Sa fari in Warragamba, Sydney ,in 2008. The initiative is to welcome both the local and foreign tourists to this great destination. An estimated 0.19 million visitors are expected. Be the first, and come in large numbers. Discounts will be given to the first 100 visitors in the day of opening i.e. 10th March, 2008. You can contact us by paying us a visit in Warragamba, New South Wales, Australia. Executive summary The promotion campaign was carried out between 2008 and 2012 to necessitate the reopening of the African Lion Safari in Warragamba, New South Wales, Australia. This initiative was engineered by the Greater Western Sydney (GWS) tourism unit and it brought together 14 LGA. The aim was to target 0.19 million visitors annually. The channels for distribution involved the road networks and the railway line which consumed a total of 5 billion Australian dollars. The communication links facilitated communication throughout the greater western region fetching visitors from Antarman, Narembura, Paddington and Woolharla. The promotion and media mixes were employed to improve the creativity in the campaign. The promotion was aimed at creating awareness on the various services and facilities to be enjoyed by the visitors. Sales promotions, direct customer contact, public relations and advertisements were part of the links employed. An estimated 10 billion Australian dollars were invested for the purpose of promotions and advertisements. Key performance indicators were used to assess and measure the performance of the campaign and the success of the initiative. The aim of the campaign was to rekindle the once thriving industry of the African Lion Safari. The industry was known to have attracted a total of 200,000 visitors annually. This aspect was marginally crucial towards Sydney’s GDP and revenue. A total of 0.19 million was expected. The industry was expected to enjoy global acceptance. Conclusion Following the indicators outlined in the report campaign, the project has proven to be successful in tourism and interests have been realized by the government, people of Sydney and the GWS. It has however been noted that challenges have strengthened the basis of the campaign and have helped in the creation of better policies and strategies towards a self-sustaining industry (Aaker McLoughlin, 2010). The inclusion of better, fairer and convenient infrastructure and utilities will ensure the existence of a trustworthy tourist venture like the Warragamba project in Sydney. I would advise the government to establish measures that can help in the recovery of ventures and enterprises that have been because of issues that can be addressed. References Aaker, A McLoughlin, D 2010,Strategic Market Management – Global Perspectives, John Wiley Sons Ltd,West Sussex. Armstrong, J 2002, The London Assurance Company and the Marine Insurance Market of the Eighteenth Century, Lengthen Press, London. Barrow, W 2005, Robert Bruce the Community of the Realm of Scotland (4th ed.), Edinburgh University Press, Edinburgh. Brown, D 2001, â€Å"Kenneth mac Alpin†. In M. Lynch. The Oxford Companion to Scottish History, Oxford University Press, Oxford. Cohen, D Wells,J 2001, The USA Patriot Act of 2001, Balancing Civil Liberties And National Security, ABC Clio Publishers, New York. Dumville, D 2001, â€Å"St Cathrà ³e of Metz and the Hagiography of Exoticism†. Irish Hagiography: Saints and Scholars, Four Courts Press, Dublin. Fry, B 2003, Mastering Public Administration; from Max Weber to Dwight Waldo, Chatham, Chatham House Publishers, Inc., New Jersey. Haney, D Perry, W 2004, International Business: Introduction and Essentials, Longman Press, London. Jeong, C Nor, F 2007, Principles of Public Administration: An Introduction, Karisma Publications, Kuala Lumpur. John, R 2010, Network Nation: Inventing American Telecommunications 520 pages; traces the evolution of the country’s telegraph and telephone networks, Harvard University Press, Harvard. Lewis, M Roehrich, J 2009, Contracts, Relationships and Integration: Scheduling, and Controlling, John Wiley Sons, New York City. Plunkett, J W 2008, Plunkett’s Telecommunications Industry Almanac Etisalat Financials, Choice Magazine, Houston. Saylor, M 2012, The Mobile Wave: How Mobile Intelligence Will Change Everything, Perseus Books/Vanguard Press, New York. This report on Promotional report campaign for DMO was written and submitted by user Bryant T. to help you with your own studies. You are free to use it for research and reference purposes in order to write your own paper; however, you must cite it accordingly. You can donate your paper here.

An Overview of Sociopathy, Psychopathy, and Antisocial Behavior Professor Ramos Blog

An Overview of Sociopathy, Psychopathy, and Antisocial Behavior https://docs.google.com/presentation/d/1HgW0zEKOhVPNEfgXXJWTuS4WoJmwe1nd5RJR35Fowwg/edit?usp=sharing

Transitional Expressions - Definitions and Examples

Transitional Expressions s Definition A transitional expression is a word or phrase that shows how the meaning of one sentence is related to the meaning of the preceding sentence. Also called a  transition, transitional word, or signal word. Though important for establishing cohesion in a text, transitional expressions can be overworked to the point that they distract readers and obscure ideas. Overuse of these signals can seem heavy-handed, says Diane Hacker. Usually, you will use transitions quite naturally, just where readers need them (The Bedford Handbook, 2013). See Examples and Observations below. Also see: Exercise in Identifying Transitional ExpressionsTransitionCoherenceCohesion Exercise: Combining and Connecting SentencesCohesion Strategies: A List of Transitional Words and PhrasesCue WordSample Paragraphs: Junk Food Junkie and Confessions of a Slob Paragraph Transition Transitional Paragraph Examples and Observations Far to his left, in the northeast, beyond the valley and the terraced foothills of the Sierra Madre Oriental, the two volcanoes, Popocatepetl and Ixtaccihuatl, rose clear and magnificent into the sunset. Nearer, perhaps ten miles distant, and on a lower level than the main valley, he made out the village of Tomalà ­n, nestling behind the jungle, from which rose a thin blue scarf of illegal smoke, someone burning wood for carbon. Before him, on the other side of the American highway, spread fields and groves, through which meandered a river, and the Alcapancingo road.(Malcolm Lowry, Under the Volcano, 1947)The secret is that our holidays should rest not only our minds and bodies but our characters too. Take, for example, a good man. His goodness wants a holiday as much as his poor weary head or his exhausted body.(E.V. Lucas, The Perfect Holiday, 1912)Over the years his family had turned ironical and lost its gift for action. It was an honorable and violent family, but eventually the violence had been deflected and turned inward.(Walker Percy, The Last Gentleman, 1966) Santayana was the last aesthetician to describe beauty without self-consciousness; and that was in 1896. As a result, we now live in a relativists world where one mans beauty is another mans beast.(Gore Vidal, On Prettiness, 1978)If Larry shoots field goals at 0.6 probability of success, he will get five in a row about once every thirteen sequences (0.65). If Joe, by contrast, shoots only 0.3, he will get his five straight only about once in 412 times. In other words, we need no special explanation for the apparent pattern of long runs.(Stephen Jay Gould, The Streak of Streaks, 1988) Using But as a Transitional ExpressionLearn to alert the reader as soon as possible to any change in mood from the previous sentence. At least a dozen words will do the job for you: but, yet, however, nevertheless, still, instead, thus, therefore, meanwhile, now, later, today, subsequently, and several more. I cant overstate how much easier it is for readers to process a sentence if you start with but wh en youre shifting direction. . . .Many of us were taught that no sentence should begin with but. If thats what you learned, unlearn ittheres no stronger word at the start.(William Zinsser, On WritingWell, Collins, 2006) Using Specific TransitionsTransitional expressions within a paragraph and between paragraphs help the reader move from one detail or supporting point in an essay to the next. When first learning to organize an essay, beginning writers may start each body paragraph and every new example with a transitional expression (first, for example, next). These common transitions are useful and clear, but they can sound mechanical. To improve the flow of your ideas and the strength of your written voice, try to replace some of these expressions with specific phrases (at the start of the meeting or in some peoples minds) or with dependent clauses (when drivers use cell phones or as I approached the intersection).(Paige Wilson and Teresa Ferster Glazier, The Least You Should Know about English, Form A: Writing Skills, 11th ed. Wadsworth, 2012) It turns out . . .Incidentally, am I alone in finding the expression ‘it turns out’ to be incredibly useful? It allows you to make swift, succ inct, and authoritative connections between otherwise randomly unconnected statements without the trouble of explaining what your source or authority actually is. It’s great. It’s hugely better than its predecessors ‘I read somewhere that . . . or the craven they say that . . . because it suggests not only that whatever flimsy bit of urban mythology you are passing on is actually based on brand new, ground breaking research, but that it is research in which you yourself were intimately involved. But again, with no actual authority anywhere in sight.(Douglas Adams, Hangover Cures. The Salmon of Doubt: Hitchhiking the Galaxy One Last Time. Macmillan, 2002)

Max Weber Research Paper Example | Topics and Well Written Essays - 4000 words

Max Weber - Research Paper Example The major thesis of concern was the Protestant and the Spirit of Capitalism where he discussed economical sociology and sociology of religion. This thesis dealt with ascetic Protestantism as one of the main â€Å"elective affinities† which relates the rise of Western market which was driven by capitalism and rational-legal national-state. Weber emphasized on cultural influences as the bedrock of capitalism (Kalberg, 2002). In search for religion insight, Weber’s publication of protestant ethics, he was able to identify the non-development of capitalism in the societies: ancient Judaism, religion of China and religion of India and was able to analyze the social stratification of such societies. Weber’s methodological works were influential in launching the self-identity in modern social science as a field of inquiry. Empirical positivists and hermeneutic detractors got their inspiration from Weber. The most important of Weber’s work are the â€Å"Protestant Ethic thesis† which was about a non-Marxist genealogy of present capitalism and â€Å"Rationalization thesis† which talked about the analysis of the dominance of west in the present times. On top of these two works, his contribution to politics is only comparable to that of Machiavelli and Hobbes. Weber entered politics after the World War 1 and ran for a seat in parliament which he failed to capture. He served as an advisor to the ill-fated democratic draft of 1919 that is Weimar Constitution. His work was cut shot by the untimely death which occurred at a tender age of 56 in 1920. He contacted a Spanish flu and died of pneumonia. Weber was the eldest of the Max Weber Sr. born in 1884 in Erfurt, Thuringia. Weber sr. was a prominent civil servant and wealthy. He was the National Liberal Party member and married to Helene who was from French Huguenot and had strong ethical absolutist

Substitution and Income Effects Essay Example | Topics and Well Written Essays - 1000 words

Substitution and Income Effects - Essay Example Substitution effect pertains to the substitution that a consumer resorts to by substituting one product for other owing to the change in the relative prices of the two products (Pass, Lowes & Davies, 1993). Usually the shrinking in the price of a commodity is accompanied by an enhanced demand for it. A fraction of this increased demand occurs owing to the substitution effect. For instance, a fall in the price of gasoline, considering that the price of some alternate fuels like ethanol or LPG remains the same will make gasoline more attractive to me, thereby inducing me to substitute gasoline for the relatively more expensive fuel options. My choice of fuel for my auto also depends on the income impact effect by the change in the price of a fuel option. For instance, a fall in the price of gasoline will make me purchase more of it owing to a rise in my real income (Pass, Lowes & Davies, 1993). If my budget for auto fuel is $100 and say the price of gasoline is $10 per gallon, I can pu rchase 10 gallons of gasoline. Now, if the price of gasoline falls to $5 per gallon, I can buy 20 gallons of gasoline from the same budgetary allocation of $100 or in other words I can buy 10 gallons of gasoline for $50. Hence, I am left with an extra $50 to spend on purchasing more of gasoline or other goods I need. It is the substitution effect combined with income effect that explain as to why demand curves are mostly downward sloping. For instance, I can explain the substitution effect and income effect for a price increase in gasoline (X) on my fuel purchasing preferences by the below given graph. An increase in the price of gasoline causes my budget line for fuel to shift from B1 to B2. Suppose that my auto could run on both gasoline (X) and ethanol (Y). So I change my fuel consumption from the bundle of gasoline and ethanol represented by A to the bundle of gasoline and ethanol represented by B. This shift from A to B is indicative of the total effect of the change in the pri ce of gasoline. This fall in the amount purchased of gasoline from X1 to X2 occurs owing to two reasons. First it is the substitution effect because gasoline is now costlier than ethanol. Second it’s the income effect because my real budge

Persuasive reseach paper Essay Example | Topics and Well Written Essays - 1000 words

Persuasive reseach paper - Essay Example If a person goes against the nature or predetermined notions linked to the dog’s breed, it is an obvious phenomenon to face the negative reaction from that creature. In this context, judging the dog or any other animal as vicious or even dangerous does not qualify. The owner is somehow responsible for the dog’s negative reaction and not the guiltless animal. Before keeping a dog as a pet, the owner must read and research about that breed of dog. If there are certain factors which may hinder with the natural priorities of the dog, the owner should dismiss the idea of keeping it. The food requirements, living requirements, taming needs as well as attention requirements differ from one breed of dog to the other. Pit Bull dogs are not born to fight but they are tamed and motivated to do so. The recent incident where owner was accused of malnourishment of the Pit Bull dogs is linked to the NFL star Michael Vick. Vick has been found guilty of being cruel with animals when Pit Bull dogs were observed to be mistreated in his territory. The pit Bull dogs are observed to be wounded by fighting and were found to be half-starved. They were not taken care as was observed by their health and apparent condition. Vick was also accused of burying Pit Bulls on his property that lost their lives due to extremely violent fighting wounds. The example of Vick’s cruelty is evident in explaining how dogs are misused and misguided to perform cruel acts. It is obviously not the dog’s will to fight and get those serious wounds but for the entertainment and pleasure of the owner, the dogs are tamed to do such vicious acts. It should be noted that 47 Pit Bulls were saved from Vick’s property and 45 of them were rehabilitated effectively. One of the remaining 2 was euthanized for health risking factors and the other because of

Preventing Dengue Fever in the Mauritius

Preventing Dengue Fever in the Mauritius INTRODUCTION Mauritius is a small tropical island located at latitude 20à ¸ 18 0 S and longitude 57à ¸ 34 60 E. It has a tropical climatic condition. Mauritius has an area of about 2,040 sq km and is located to about 2000 kilometers from east west of Africa and some 800 kilometers from Madagascar. The positioning of Mauritius makes the latter a tropical country with moderately lofty temperature throughout the year. Winter and summer are the seasons that manifest onto the island. The island of Mauritius finds itself as one of the most accessible islands in the Indian Ocean. Situated amid R‚union island and Rodrigues island, the island of Mauritius has gained the reputation, through the course of time of that of the key and star of the Indian Ocean. The Mauritian population estimates for the year 2008 was about 1, 260, 781 with an annual growth rate of 0.7 %. Since the country is undergoing major developmental changes many industries have implanted here and thus the number of expatriates in the country is on the rise. These people may be a carrier of the disease and of course those Mauritians visiting the dengue endemic areas can also become infected and bring the disease in the country. It is an indisputable fact that during the lapsed decades, Mauritius has witnessed a multitude of diseases. The most prominent and recent one being Chikungunya which has infested merely about 12000 Mauritians. Furthermore, the history of diseases in Mauritius is marked with Malaria epidemics since colonial regimes and through the intensive effort of the Public Health sector, the latter has been proclaimed eradicated by the World Health Organization in 1973. Some years ago many of the realms citizens were not aware of what was dengue fever even though it had already occurred in the country but there was not mass infection by the virus. Providentially, the number of cases reported beforehand was only one or two and through the close collaboration between the Ministry Of Health and the infected person the situation was under control and hence no further positive case of dengue were recorded. The Mauritian government is putting forward all steps to prevent an epidemic rather than to rush for controlling it when it has already hit the population. The Ministry of Health is working on a list which highlights all water retaining sites and is identifying the hotspots of such sites that are liable to cause proliferation of mosquitoes; this process is carried out each year. Furthermore, an action plan is being prepared by the ministry which gives a layout of which and what job is to be done by which section of the ministry or other stakeholders (anonymous, 2009). Dengue viruses are transmitted by the Aedes species. Two known species the Aedes aegypti and Aedes albopictus are vectors of the disease. The Aedes albopictus can be found in large quantity all around the island whereas Aedes aegypti is said to be eradicated from the country. Surveillance on the abundance of mosquitoes is carried out by the entomological section throughout the year. All sites where mosquitoes that can be vectors of disease are seen, they are referred to the nearby health office for a larviciding to be carried out at that place and in the vicinity. Aedes albopictus (Skuse) is known as the Asian Tiger mosquito (Robertson and Hu, 1988). Aedes albopictus is native to Southeast Asia, but now occurs throughout the world. The worldwide spread of Aedes albopictus during the precedent 20 years has caused apprehension in the midst of public health officers and scientists over the possibility that the introduction of this species will amplify the risk of epidemic dengue fever and other arboviruses in countries where it has become established (Gubler, 2003). Aim The aim of this study is mainly to evaluate the effectiveness of the control measures taken to prevent dengue fever in Mauritius. Emphasis will be laid on the steps taken before, during and after the disease occurrence. This might highlight the shortcomings that Mauritius face in order to manage outbreaks of diseases. Objectives of study The objectives of this dissertation are to evaluate the management, procedures and legislation that are implemented in Mauritius during outbreaks of dengue fever. Furthermore, most interest is geared towards the application of chemicals, preventive measures, and health education of the public carried out by the Ministry of Health Quality of Life to prevent the occurrence of the disease and also to annihilate if ever found in the island. To elucidate the effectiveness of fogging, larviciding carried out in the country and health education of the public. CHAPTER TWO LITERATURE REVIEW 2.0 Dengue 2.0.1 General considerations Dengue fever and dengue hemorrhagic fever were first identified in the 1950s, during the dengue epidemics in Philippines and Thailand and by 1975 it had become a leading cause of hospitalization and death among children in many countries found in that region (Lloyd, 2003). In the year 1779 Egypt and Java had dengue-like epidemics, but it is thought that they were caused by the chikungunya virus (Carey, 1971). Dengue virus belongs to the genus Flavivirus, Family Flavivaridae and there are four serotypes of the virus (DEN-1, DEN-2, DEN-3 and DEN 4). All the four serotypes can cause dengue fever, dengue hemorrhagic fever and even dengue shock syndrome (Ramchurn et al, 2009). The four viruses are closely related but are distinct. Millions of people residing in tropical areas of the world are affected by epidemics of dengue fever. Dengue fever is associated with the severe form dengue hemorrhagic fever/ dengue shock syndrome (DHF/DSS) that is seen mostly in children and nevertheless adults also are attained by the disease. In the 19th and early 20th centuries dengue or dengue-like epidemics were reported in the Americas, Southern Europe, North Africa, the Middle East, Asia and Australia and on various islands in the Indian Ocean, South and Central Pacific and the Caribbean (Ehrenkranz et al, 1971). Generally these epidemics consisted of nonfatal feverish illnesses, often coupled with rash and either muscle or joint pains (Carey, 1971). Deaths occurred during dengue epidemics in Australia in 1897 and in Greece in 1928, when over 1000 deaths were reported (Halstead, 1980). Hemorrhagic demonstrations, including gastrointestinal bleeding, were described during dengue epidemics in Texas and Louisiana in 1922 (Scott, 1923). Nevertheless through the first half of the 20th century, dengue was generally described as a self-limited, nonfatal febrile illness, with occasional hemorrhagic manifestations such as red spots, acute hemorrhage from the nostril, nasal cavity, or nasopharynx, gingival bleeding and menorrh agia that only once in a blue moon resulted in more stern or fatal outcomes. During the last decade, dengue infection along with its complications has been on the rise all over the world. Their geographical spread is increasing: only 5 countries documented dengue in the 1950s but to date there are more than 100 countries reporting the incidence of dengue fever and dengue hemorrhagic fever (Guha -Sapi Schimmer, 2005). Dengue is found in tropical and sub-tropical climates worldwide, mostly in urban and semi-urban areas (WHO, 2009). Dengue fever is a very infectious mosquito borne viral disease characterized by either a mild febrile syndrome or the classic incapacitating disease with abrupt onset of high fever, severe headache, pain behind the eyes, muscle and bone or joint pains, nausea and vomiting and rash. Skin hemorrhages are not uncommon. Leukopenia is usually seen and thrombocytopenia may be observed (WHO 1997). Dengue is a flu-like mosquito-borne disease and has a soaring capacity for epidemic outbreaks, which according to the World Health Organization (2009) affects 50-100 million people each year in the tropical and sub-tropical areas of the world. Dengue is cited as being one of the most significant mosquito-borne disease affecting humans and as a major international public health concern (WHO 2009). Dengue fever is predominantly transmitted by Aedes species which have adapted themselves to living near human habitation (Hales et al., 2002). The dengue virus is a member of the family Flaviviridae virus, transmitted through the biting of infected Aedes aegypti and Aedes albopictus mosquito. The Aedes aegypti mosquito normally bites indoor and late in the afternoon whereas the proficient mosquito Aedes albopictus is an aggressive daytime biter, which is also known to bite early in the morning, late afternoon (Knight and Hull, 1952) and at night (Murray and Marks, 1984). This biter is usually an outdoor biting mosquito, but it also bites indoors (Hawley, 1988). Generally the mosquitoes bite at ground level (MacDonald and Traub, 1960, cited in Hawley, 1988). Females will bite any area of exposed skin, but prefer the ankles and knees (McClelland et al., 1973; Robertson and Hu, 1935). The time amid the bite of a mosquito carrying dengue virus and the apparition of symptoms ranges from 4 to 6 days, with a range of 3 to 14 days. 2.0.2 Pathogenicity of Dengue fever: 1. Asymptomatic and mild infection It is very common. 2. Dengue Fever (primary infection) Dengue fever is characterized by increase in body temperature; severe aching of the forehead; retro-ocular pain; muscle and joint pain; and widespread maculopapular inflammation. Conjunctiva may become red. Other common problems that may arise are diarrhea, vomiting, nausea and abdominal pain. Fear of light, sore throat, increase in the size of the lymph node and bleeding tendencies may also happen. The illness lasts 5 to 7 days. Immunity is lifelong. On the other side the incidence of Dengue Hemorrhagic Fever or Dengue Shock syndrome increases if the person has immunity or has already been infected before with a different serotype. Even after several months of recovery some patients may experience depression and fatigue. 3. Dengue Hemorrhagic fever The well-known feature is bleeding. It happens when a person is infected twice but with a different dengue virus serotypes or infrequently by primary infection is common in kids Under 15 years of Age (Rigall-Pewrez et al.1998). There is sudden rise in temperature and other manifestations of Dengue fever. Petechiae, effortless bruising, gingival bleeding and epistaxis are common. In severe cases bleeding of the gastrointestinal tract can be observed. In children, we can have an increase in the size of the spleen and the liver. 4. Dengue Shock Syndrome The prominent feature is hypotension. It normally occurs in people below 15 years of age. The clinical features include weak pulse with narrow blood pressure, cold and clammy skin (Rigall-Pewrez et al.1998). 2.0.3 Mode of transmission of dengue virus: Chikungunya and dengue viruses are transmitted to humans by the bites of infected mosquitoes. In contrast, Aedes albopictus is abundant and may be the only important vector of these viruses on the islands. Both species bite mainly during the daytime, particularly in the early hours after dawn and for 2-3 hours before darkness. Aedes albopictus is more active outdoors whereas Ae. aegypti typically feeds and rests more indoors (WHO 2008). In the cycle of dengue, the vertebrate host is man and the Aedes species the vectors. The disease is acquired only when bitten by female mosquitoes, as the female feed on blood in order for the development of their eggs whereas the male mosquitoes are not infectious due to the fact that they feed only on nectars rather than blood. In 8-10 days the infected mosquito is able to transmit the virus to other people. Thus the cycle of transmission takes only 14 days. One dengue-infected female mosquito is capable of biting and infecting several people during one feeding session. The dengue mosquito frequents backyards in search of containers holding water inside and outside the home, such as: cans, buckets, jars, and vases, pot plant dishes, birdbaths, boats, tyres discarded with no rims, roof gutters blocked by leaves striking containers, tarpaulins and black plastic. It can also breed in natural containers like: bromeliads fallen palm fronds. In drier conditions it also breeds in water inà ¿subterranean sites such as: wells, telecommunication pits, sump pits, gully traps. Transmission cycle of dengue results from a complex system based on several main constituents like: the density of susceptible hosts, environmental conditions and the presence of one or more serotypes of the dengue virus. The number of confirmed dengue cases has been increasing owing to the fact that the world is undergoing rapid urbanization and its population is also on the rise, disposal of non-biodegradable containers, rapid transportation and poor living conditions such as poor water supply and very rare scavenging services at squatter areas (Satwant, 2001). Various studies have shown that the Aedes albopictus is able to transmit all the 4 serotypes of dengue. Aedes albopictus mosquito can serve as an important maintenance vector of dengue viruses in endemic areas, and new endemic areas may be initiated by importation of vertically infected eggs (Gubler, 2002). That is the infected Aedes mosquito can pass the dengue virus to its progeny and when the eggs will develop into mature mosquitoes they will be already infected, hence capable of causing infection of human beings or even pass the virus to their progeny. Transmission cycle of dengue virus by the Aedes aegypti mosquito starts with a person infected with the dengue virus. The blood of the person will contain the virus thus circulating in his body and this is called a viremia which will last for about 5 days. During this period, an uninfected female Aedes aegypti mosquito bites the infected person and acquires the dengue virus. Within the mosquito, replication of the dengue virus occurs and this process usually takes between 8-12 days, after which the female mosquito can transmit the virus upon a blood meal. Once infected the virus takes 4-7 days to replicate within the new host (the person whom the infected mosquito bite) before inception of symptoms. Symptoms may last from three to 10 days, with an average of five days, after the onset of symptoms. Hence, the disease persists several days after apparition of symptoms (CDC Dengue Slideset). 2.0.4 Lifecycle of Aedes mosquito: The mosquito goes through four separate and distinct stages of its life cycle and they are as follows: Egg, Larva, pupa, and adult. Each of these stages can be easily recognized by their special appearance. Egg: Eggs are laid one at a time and they float on the surface of the water. Aedes species do not make egg rafts but lay their eggs separately. Aedes lay their eggs on damp soil that will be flooded by water. Most eggs hatch into larvae within 48 hours. Larva: The larva lives in the water where they eventually undergo a molting process to become a pupa. Pupa: The pupal stage is a resting, non-feeding stage and is the time the mosquito turns into an adult. It takes about two days before the adult is fully developed and upon complete development, the pupal skin splits and the mosquito emerges as an adult. Adult: The newly emerged adult rests on the surface of the water for a short time before flying away. In the Aedes mosquito family only the female bites because it requires protein to develop eggs, therefore if it bites a person infected with the dengue virus the mosquito becomes infectious after approximately 7 days. The mosquitoes are known to be biting at a highest frequency at dawn and dusk. Some more facts: The average lifespan of a mosquito of the genus Aedes in Nature is 2 weeks Mosquitoes may lay eggs about 3 times in his life, and about 100 eggs are produced each time. The eggs can live in dry conditions until approximately 9 months, after which they can hatch if it is subject to conditions, i.e food and water Source:http://dengue-feverdisease.blogspot.com/2008/02/lifecycle-of-aedes-mosquito.html [accessed on 05.12.09] 2.0.5 Investigation for dengue infections: Laboratory results Decrease in the number of white blood cell and peripheral neutrophils in the blood, abnormal increase in the number of lymphocytes in bloodstream and very low amount of platelets in the blood. Radiology X-ray of the chest normally shows pleural effusion and seldom pericardial effusion Ultrasound Used to detect pericardial effusion and 2) presence of excess fluids in the gap amid the tissues lining the abdomen and abdominal organ. Tests Laboratory diagnosis is done by detection of virus in specimen-serum at the virology laboratory. Culture is done in cell line derived from A. albopictus cell. Immunoflurescent techniques are used to detect viral replications. The virus can be isolated in patients with fever. Serology IgM is detectable in 90 % of patients by the 6th days of illness. Serum collected early may give false negative result. IgM can also be detected 2-3 months after. It is not possible to identify serotype with serological tests. In case where the IgM test is Positive it may imply recent infection with Dengue fever. However definitive diagnosis can only be made if the virus is isolated or the virus genome is detected by PCR. Seroconversion or boost in titer may indicate fresh infection. The appropriate samples for PCR test include plasma and serum. Molecular test is highly sensitive but it can be used in patients only with viraemia (Rigall-Pewrez et al.1998). 2.0.6 Treatment: The managing of dengue fever can be enhanced with bed rest, passable fluid intake, plus control of fever and pain with antipyretics in addition to analgesics (e.g. paracetamol). For the supplementary ruthless manifestations of dengue virus infection, correct management requires early identification and swift intravenous fluid substitution. Blood transfusion may be necessary in cases. There is currently no vaccine is available to shield against dengue infection. The current lack of a booming vaccine against the dengue virus causes prevention methods to be approached by plummeting disease vector population, with Integrated Pest Management programs for mosquito control. These employ a mishmash of control strategies, including mosquito surveillance, source diminution, eradicating larvae and eradicating adult mosquitoes (Ooi et al. 2007). Eradicating adult mosquitoes alone is fruitless in controlling mosquito populations because it is complex to treat the unattainable habitat of the adults. Mosquito larvae are left to carry on their development, and they quickly swap the adults. Nevertheless, mosquitoes can become resistant if pesticides are overused. 2.0.7 Dengue fever in Mauritius: Dengue virus infections are emerging as the major ones in Southeast Asia. Global warming may worsen the occurrence of dengue fever. Since very last few years mixed outbreak of chikungunya and periodic cases of dengue fever have been reported on R‚union Island and other South West Indian Ocean countries. From March 2005 till March 2006 it is estimated that about 204000 people in R‚union Island may have been infected by the chikungunya virus, which furthermore shows that there is presence of the transmitting vectors of the disease on the island which are also the vectors of dengue fever as well. Hereafter, the other South West Indian ocean countries were not spared from infection from the chikungunya virus. An outbreak of dengue fever was reported in Madagascar more specifically in the city of Toamasina that started mid-January 2006 and rare cases of chikungunya were also reported mid-February. Maldives also have suffered from a dengue outbreak in year 2006 where 602 people were suspected to be infected among which there were some severe form of dengue fever that is 64 dengue hemorrhagic fever cases and 9 cases of dengue shock syndrome (WHO 2006). In Mauritius the first case of dengue fever dates to the 1976s and it was contained thus limiting the disease from spreading. Then we had a case of imported dengue from a person who visited an endemic dengue area in January 2008 (CDCU). The main vectors of the disease remain the Aedes mosquitoes, among which the Aedes aegypti mosquito is the primary vector and Aedes albopictus the secondary one. The mosquito found to be spreading dengue fever and Chikungunya in Mauritius is the Aedes albopictus (CDCU 2009). It is to be noted that in Mauritius we had both the Aedes aegypti and Aedes albopictus mosquitoes, due to the intense anti-malaria campaign during the year 1952 the primary carrier of the dengue fever, the Aedes aegypti have been successfully eradicated. Still very minute amounts of this mosquito can be seen whereas the Aedes albopictus is abundant. Dengue is transmitted from person to person through the biting of infected mosquitoes. Most recently we had a short-lived epidemic of re-emerged dengue fever in Mauritius that started in the month of June 2009 which was imported. The mild fever was first localized in the city of Port Louis, where there were 192 cases and then we did have some sporadic cases in other regions of the island. Mosquito fogging and larviciding in whole Port Louis started on 3rd June 2009, and were repeated every seven days. Fogging was carried out outdoors early in the morning, early evenings and sometimes till late in the evenings (Dengue Unit 2009). The Ministry of Health and Quality of Life of Mauritius took the situation as being severe and all medium possible to contain the disease were put into action. Like the Special Mobile Force and manpower from other Ministries which joined the Ministry of Health to fight the dengue fever. Public alertness campaigns on the requisite to hunt and eliminate mosquito breeding sites at home and in the neighbourhood and to protect oneself against mosquito bites were carried out through radio, television and the press through a public private partnership. Detailed information leaflets were also distributed, door to door distribution of pamphlets showing pictures of possible breeding sites for mosquitoes and products to be used to prevent mosquito bite were carried out by the primary health care personnels. Target groups included the public, community groups and school children (Ramchurn et al, 2009). By the end of the month August no new or suspected cases of dengue were recorded in any of the countrys hospital. But still the control and prevention program were continued throughout the island as the summer season was coming near hence reappearance of the dengue fever was possible due to the ambient temperature, favorable for larvae development. The fear of having the virus again was due to the possibility of the infected mosquitoes to pass the virus to their progeny. Fortunately, till February 2010 no suspected case of dengue fever was reported from any in the country (Dengue Unit 2010). 2.1 Vector surveillance and control program Ever since mosquitoes are capable of transmitting diseases like dengue and chikungunya, till now it has not been possible to eradicate the mosquitoes completely from their originating site. The best way to monitor or control vector-borne diseases is to control or limit the population of the vector to such an extent that disease transmission is very low or even stopped. In order to achieve this goal, it is imperative to know all about the mosquito involved in the transmission of the disease. Detailed knowledge of all aspects such as the breeding sites, different features of the mosquito at different stages, feeding habits, mating, resting and structure and most importantly without forgetting the lifecycle of the mosquito, are the main required things in order to be able to break the chain of transmission. Furthermore, the only way to prevent infection of people who have not suffered from dengue is to control the population of dengue vector (Ooi et al.2001) and of course personal precaution has also proved to be effective in reducing the risk of being infected by a mosquito. Since no vaccine is yet available for dengue the only mode to control dengue fever is the control the amount of the disease vector that is of the Aedes mosquitoes. The control strategies of these mosquitoes are 1) carrying out larviciding -spraying a chemical called abate in any water retaining place which kill the larvae of the mosquitoes hence interrupting the cycle to be completed, 2) fogging operation- a thermal fogger is used to propel fumes of Aqua K-Othriner which when is in contact with a mosquito kills it, thus the amount of developed or simply mature mosquitoes are reduced and 3) health education- talks are organized for the members of the public, for children in schools, colleges, etc. Entomological survey is an important and integral part of dengue prevention and control. The effect of the intervention by the community can directly affect the ecology of the vectors that is the Aedes mosquitoes. The Communicable Disease Control Unit (CDCU) is the unit which is mostly concerned for the control of communicable diseases such as Malaria, Dengue fever, Chikungunya, and other infectious diseases. In Mauritius, surveillance, disease prevention and education of infectious diseases are mainly carried out by the Health Inspectorate Cadre. In Mauritius, we have the Public Health Act (Section 32A) which is used in case where there is presence of a mosquito borne disease in the island. The potential for predation to prevent pathogen invasion or reduce disease prevalence in a host population also has implications for the biological control of vector populations. Predators have been introduced, or proposed, as biological control agents of vectors for various diseases such as malaria, dengue fever and Lyme disease (Jenkins 1964; Legner 1995; Stauffer et al. 1997; Samish Rehacek 1999; Scholte et al. 2005; Kumar Hwang 2006; Ostfeld et al. 2006; Walker Lynch 2007). Several recent studies suggest that predator introductions led to a decline in local cases of dengue fever in Vietnam and Thailand (Kay Nam 2005; Kittayapong et al. 2008), and malaria in India (Ghosh et al. 2005; Ghosh Dash 2007). 2.2 Biology of Aedes albopictus (Skuse) Aedes albopictus are two winged insects from the family Culicidae of the order Diptera. They are among the best known groups due to their importance as pests and as vectors of diseases. They are easily identified due to a combination of the following characters: long trunk projecting head; charisma of scales on the wing veins, a tassel of scales along the posterior boundary of the wing, and the typical wing venation, the second, fourth and fifth longitudinal veins being branched (Miyagi and Toma 2000). Female mosquitoes feed on blood and they have highly specialized mothparts for piercing host skin and blood sucking (Wahid et al. 2002). Aedes species are normally day-time bitters and active during the day. During this time, they have peaks of landing and biting activity. The peak time for Aedes albopictus occurred about one hour after sunrise and then before sunset (Abu Hassan et al. 1996). Nevertheless, the rate of biting varies depending on the mosquito age and time of the day (Xue and Barnard 1996). CHAPTER 3 DATA COLLECTION 3.1 Introduction In this chapter, a summary of the various steps that was undertaken to finalize the research is attempted. The research work was started as from the month of September 2009 to the end of January 2010. 3.2 METHODOLOGY In order to assess the effectiveness of the control measures taken to prevent dengue fever, data were collected from the different partners who are involved in the control and prevention of dengue fever in Mauritius. Such data were collected from books, newspapers, published articles, magazines and official statistics from the Central Statistics Office, Dengue Unit, Communicable Disease Control Unit and the Ministry of Health Quality of Life. Moreover, constructive discussions were entertained with people who are in touch with the matters connecting to the piece of work. Search through the internet, review of available documents and properly classifying the information that would be used during the study. 3.3 METHODS OF ANALYSIS OF THE DATA OBTAINED Questions related with the way of application of the different control measures were selected for analysis from the filled questionnaires. Moreover, each particular question was analyzed by using SPSS software which provided the frequency and percentages and hence Microsoft Excel 2007 was used to express the data in forms of percentages, tables, figures, graphs, pie charts and charts. Chapter 4 Part I-Data Analysis 4.01 Introduction This chapter of the thesis will be dealing with the data collected from different stakeholders involved in the fight against dengue fever. Data collected mainly from the Communicable Disease Control Unit, Dengue Unit, and certain Health Offices of the country and the media will be expressed in figures. This section will be divided in to two parts: data analysis and press cot analysis. Much attention will be oriented towards the control measures in Port Louis, as the maximum number of cases occurred there and eventually the island in whole. 4.02 Progress of the disease through June 2009 in Port Louis Figure 4.1: Number of cases each day during the month of June 2009 From figure 4.1 it can be seen that the first case was detected on 2nd June 2009 and the maximum number of cases reported to the hospitals was around the 10th to 13th day of the same month. The number of confirmed cases by the end of June 2009 had decreased to less than five. 4.03 Age of people infected with dengue virus From the above chart (Fig 4.2) it can seen that about 34.55 % of the total number of cases (246 confirmed) of dengue were vulnerable ones that is the young and the elderly. 4.04 Aqua K Othriner used for fogging process Aqua K Othriner is a chemical used in mixture with another chemical substance called Nebolr, in thermal foggers to kill adult mosquitoes. Normally, the fogger produces fumes which in fact are fine droplets of the mixture which when in contact with a mosquito causes its death. The first day of fogging was started on 2nd June 2009 with a minimum cubic centimeter of Aqua K Othriner used, on the 7th day the maximum and throughout the rest of the days varying just a little in amount except for the 14th day. 4.05 Number of inspections carried out during the past 8 years throughout the Country Starting from the year 2001 till 2005 from the graph (fig 4.4) the number of inspections carried out by the health inspectorate cadre shows a slight decrease and suddenly in 2006 the number increases to approximately 3 fold than that in 2005. In year 2007, the amount of inspections carried again decreases to 112,087 and eventually for 2008 the number decreases a bit more. 4.06 Number of sanitary notices served during the past 8 years Public Health Act Sanitary notices are normally issued to the author of nuisance, as for in this case the notices served were to cause removal of water collected in used tyres, drums, roof tops, etc. From the year 2001 till 2005 the number of such type of notices served was ranging between 4933 and 8013. For 2006 the figure was the highest with 10657 of notices served and for the remaining 2 years a gradual decrease was noted. 4.07 Number of contraventions taken for none compliance with the Public Health Laws Notices Figur Preventing Dengue Fever in the Mauritius Preventing Dengue Fever in the Mauritius INTRODUCTION Mauritius is a small tropical island located at latitude 20à ¸ 18 0 S and longitude 57à ¸ 34 60 E. It has a tropical climatic condition. Mauritius has an area of about 2,040 sq km and is located to about 2000 kilometers from east west of Africa and some 800 kilometers from Madagascar. The positioning of Mauritius makes the latter a tropical country with moderately lofty temperature throughout the year. Winter and summer are the seasons that manifest onto the island. The island of Mauritius finds itself as one of the most accessible islands in the Indian Ocean. Situated amid R‚union island and Rodrigues island, the island of Mauritius has gained the reputation, through the course of time of that of the key and star of the Indian Ocean. The Mauritian population estimates for the year 2008 was about 1, 260, 781 with an annual growth rate of 0.7 %. Since the country is undergoing major developmental changes many industries have implanted here and thus the number of expatriates in the country is on the rise. These people may be a carrier of the disease and of course those Mauritians visiting the dengue endemic areas can also become infected and bring the disease in the country. It is an indisputable fact that during the lapsed decades, Mauritius has witnessed a multitude of diseases. The most prominent and recent one being Chikungunya which has infested merely about 12000 Mauritians. Furthermore, the history of diseases in Mauritius is marked with Malaria epidemics since colonial regimes and through the intensive effort of the Public Health sector, the latter has been proclaimed eradicated by the World Health Organization in 1973. Some years ago many of the realms citizens were not aware of what was dengue fever even though it had already occurred in the country but there was not mass infection by the virus. Providentially, the number of cases reported beforehand was only one or two and through the close collaboration between the Ministry Of Health and the infected person the situation was under control and hence no further positive case of dengue were recorded. The Mauritian government is putting forward all steps to prevent an epidemic rather than to rush for controlling it when it has already hit the population. The Ministry of Health is working on a list which highlights all water retaining sites and is identifying the hotspots of such sites that are liable to cause proliferation of mosquitoes; this process is carried out each year. Furthermore, an action plan is being prepared by the ministry which gives a layout of which and what job is to be done by which section of the ministry or other stakeholders (anonymous, 2009). Dengue viruses are transmitted by the Aedes species. Two known species the Aedes aegypti and Aedes albopictus are vectors of the disease. The Aedes albopictus can be found in large quantity all around the island whereas Aedes aegypti is said to be eradicated from the country. Surveillance on the abundance of mosquitoes is carried out by the entomological section throughout the year. All sites where mosquitoes that can be vectors of disease are seen, they are referred to the nearby health office for a larviciding to be carried out at that place and in the vicinity. Aedes albopictus (Skuse) is known as the Asian Tiger mosquito (Robertson and Hu, 1988). Aedes albopictus is native to Southeast Asia, but now occurs throughout the world. The worldwide spread of Aedes albopictus during the precedent 20 years has caused apprehension in the midst of public health officers and scientists over the possibility that the introduction of this species will amplify the risk of epidemic dengue fever and other arboviruses in countries where it has become established (Gubler, 2003). Aim The aim of this study is mainly to evaluate the effectiveness of the control measures taken to prevent dengue fever in Mauritius. Emphasis will be laid on the steps taken before, during and after the disease occurrence. This might highlight the shortcomings that Mauritius face in order to manage outbreaks of diseases. Objectives of study The objectives of this dissertation are to evaluate the management, procedures and legislation that are implemented in Mauritius during outbreaks of dengue fever. Furthermore, most interest is geared towards the application of chemicals, preventive measures, and health education of the public carried out by the Ministry of Health Quality of Life to prevent the occurrence of the disease and also to annihilate if ever found in the island. To elucidate the effectiveness of fogging, larviciding carried out in the country and health education of the public. CHAPTER TWO LITERATURE REVIEW 2.0 Dengue 2.0.1 General considerations Dengue fever and dengue hemorrhagic fever were first identified in the 1950s, during the dengue epidemics in Philippines and Thailand and by 1975 it had become a leading cause of hospitalization and death among children in many countries found in that region (Lloyd, 2003). In the year 1779 Egypt and Java had dengue-like epidemics, but it is thought that they were caused by the chikungunya virus (Carey, 1971). Dengue virus belongs to the genus Flavivirus, Family Flavivaridae and there are four serotypes of the virus (DEN-1, DEN-2, DEN-3 and DEN 4). All the four serotypes can cause dengue fever, dengue hemorrhagic fever and even dengue shock syndrome (Ramchurn et al, 2009). The four viruses are closely related but are distinct. Millions of people residing in tropical areas of the world are affected by epidemics of dengue fever. Dengue fever is associated with the severe form dengue hemorrhagic fever/ dengue shock syndrome (DHF/DSS) that is seen mostly in children and nevertheless adults also are attained by the disease. In the 19th and early 20th centuries dengue or dengue-like epidemics were reported in the Americas, Southern Europe, North Africa, the Middle East, Asia and Australia and on various islands in the Indian Ocean, South and Central Pacific and the Caribbean (Ehrenkranz et al, 1971). Generally these epidemics consisted of nonfatal feverish illnesses, often coupled with rash and either muscle or joint pains (Carey, 1971). Deaths occurred during dengue epidemics in Australia in 1897 and in Greece in 1928, when over 1000 deaths were reported (Halstead, 1980). Hemorrhagic demonstrations, including gastrointestinal bleeding, were described during dengue epidemics in Texas and Louisiana in 1922 (Scott, 1923). Nevertheless through the first half of the 20th century, dengue was generally described as a self-limited, nonfatal febrile illness, with occasional hemorrhagic manifestations such as red spots, acute hemorrhage from the nostril, nasal cavity, or nasopharynx, gingival bleeding and menorrh agia that only once in a blue moon resulted in more stern or fatal outcomes. During the last decade, dengue infection along with its complications has been on the rise all over the world. Their geographical spread is increasing: only 5 countries documented dengue in the 1950s but to date there are more than 100 countries reporting the incidence of dengue fever and dengue hemorrhagic fever (Guha -Sapi Schimmer, 2005). Dengue is found in tropical and sub-tropical climates worldwide, mostly in urban and semi-urban areas (WHO, 2009). Dengue fever is a very infectious mosquito borne viral disease characterized by either a mild febrile syndrome or the classic incapacitating disease with abrupt onset of high fever, severe headache, pain behind the eyes, muscle and bone or joint pains, nausea and vomiting and rash. Skin hemorrhages are not uncommon. Leukopenia is usually seen and thrombocytopenia may be observed (WHO 1997). Dengue is a flu-like mosquito-borne disease and has a soaring capacity for epidemic outbreaks, which according to the World Health Organization (2009) affects 50-100 million people each year in the tropical and sub-tropical areas of the world. Dengue is cited as being one of the most significant mosquito-borne disease affecting humans and as a major international public health concern (WHO 2009). Dengue fever is predominantly transmitted by Aedes species which have adapted themselves to living near human habitation (Hales et al., 2002). The dengue virus is a member of the family Flaviviridae virus, transmitted through the biting of infected Aedes aegypti and Aedes albopictus mosquito. The Aedes aegypti mosquito normally bites indoor and late in the afternoon whereas the proficient mosquito Aedes albopictus is an aggressive daytime biter, which is also known to bite early in the morning, late afternoon (Knight and Hull, 1952) and at night (Murray and Marks, 1984). This biter is usually an outdoor biting mosquito, but it also bites indoors (Hawley, 1988). Generally the mosquitoes bite at ground level (MacDonald and Traub, 1960, cited in Hawley, 1988). Females will bite any area of exposed skin, but prefer the ankles and knees (McClelland et al., 1973; Robertson and Hu, 1935). The time amid the bite of a mosquito carrying dengue virus and the apparition of symptoms ranges from 4 to 6 days, with a range of 3 to 14 days. 2.0.2 Pathogenicity of Dengue fever: 1. Asymptomatic and mild infection It is very common. 2. Dengue Fever (primary infection) Dengue fever is characterized by increase in body temperature; severe aching of the forehead; retro-ocular pain; muscle and joint pain; and widespread maculopapular inflammation. Conjunctiva may become red. Other common problems that may arise are diarrhea, vomiting, nausea and abdominal pain. Fear of light, sore throat, increase in the size of the lymph node and bleeding tendencies may also happen. The illness lasts 5 to 7 days. Immunity is lifelong. On the other side the incidence of Dengue Hemorrhagic Fever or Dengue Shock syndrome increases if the person has immunity or has already been infected before with a different serotype. Even after several months of recovery some patients may experience depression and fatigue. 3. Dengue Hemorrhagic fever The well-known feature is bleeding. It happens when a person is infected twice but with a different dengue virus serotypes or infrequently by primary infection is common in kids Under 15 years of Age (Rigall-Pewrez et al.1998). There is sudden rise in temperature and other manifestations of Dengue fever. Petechiae, effortless bruising, gingival bleeding and epistaxis are common. In severe cases bleeding of the gastrointestinal tract can be observed. In children, we can have an increase in the size of the spleen and the liver. 4. Dengue Shock Syndrome The prominent feature is hypotension. It normally occurs in people below 15 years of age. The clinical features include weak pulse with narrow blood pressure, cold and clammy skin (Rigall-Pewrez et al.1998). 2.0.3 Mode of transmission of dengue virus: Chikungunya and dengue viruses are transmitted to humans by the bites of infected mosquitoes. In contrast, Aedes albopictus is abundant and may be the only important vector of these viruses on the islands. Both species bite mainly during the daytime, particularly in the early hours after dawn and for 2-3 hours before darkness. Aedes albopictus is more active outdoors whereas Ae. aegypti typically feeds and rests more indoors (WHO 2008). In the cycle of dengue, the vertebrate host is man and the Aedes species the vectors. The disease is acquired only when bitten by female mosquitoes, as the female feed on blood in order for the development of their eggs whereas the male mosquitoes are not infectious due to the fact that they feed only on nectars rather than blood. In 8-10 days the infected mosquito is able to transmit the virus to other people. Thus the cycle of transmission takes only 14 days. One dengue-infected female mosquito is capable of biting and infecting several people during one feeding session. The dengue mosquito frequents backyards in search of containers holding water inside and outside the home, such as: cans, buckets, jars, and vases, pot plant dishes, birdbaths, boats, tyres discarded with no rims, roof gutters blocked by leaves striking containers, tarpaulins and black plastic. It can also breed in natural containers like: bromeliads fallen palm fronds. In drier conditions it also breeds in water inà ¿subterranean sites such as: wells, telecommunication pits, sump pits, gully traps. Transmission cycle of dengue results from a complex system based on several main constituents like: the density of susceptible hosts, environmental conditions and the presence of one or more serotypes of the dengue virus. The number of confirmed dengue cases has been increasing owing to the fact that the world is undergoing rapid urbanization and its population is also on the rise, disposal of non-biodegradable containers, rapid transportation and poor living conditions such as poor water supply and very rare scavenging services at squatter areas (Satwant, 2001). Various studies have shown that the Aedes albopictus is able to transmit all the 4 serotypes of dengue. Aedes albopictus mosquito can serve as an important maintenance vector of dengue viruses in endemic areas, and new endemic areas may be initiated by importation of vertically infected eggs (Gubler, 2002). That is the infected Aedes mosquito can pass the dengue virus to its progeny and when the eggs will develop into mature mosquitoes they will be already infected, hence capable of causing infection of human beings or even pass the virus to their progeny. Transmission cycle of dengue virus by the Aedes aegypti mosquito starts with a person infected with the dengue virus. The blood of the person will contain the virus thus circulating in his body and this is called a viremia which will last for about 5 days. During this period, an uninfected female Aedes aegypti mosquito bites the infected person and acquires the dengue virus. Within the mosquito, replication of the dengue virus occurs and this process usually takes between 8-12 days, after which the female mosquito can transmit the virus upon a blood meal. Once infected the virus takes 4-7 days to replicate within the new host (the person whom the infected mosquito bite) before inception of symptoms. Symptoms may last from three to 10 days, with an average of five days, after the onset of symptoms. Hence, the disease persists several days after apparition of symptoms (CDC Dengue Slideset). 2.0.4 Lifecycle of Aedes mosquito: The mosquito goes through four separate and distinct stages of its life cycle and they are as follows: Egg, Larva, pupa, and adult. Each of these stages can be easily recognized by their special appearance. Egg: Eggs are laid one at a time and they float on the surface of the water. Aedes species do not make egg rafts but lay their eggs separately. Aedes lay their eggs on damp soil that will be flooded by water. Most eggs hatch into larvae within 48 hours. Larva: The larva lives in the water where they eventually undergo a molting process to become a pupa. Pupa: The pupal stage is a resting, non-feeding stage and is the time the mosquito turns into an adult. It takes about two days before the adult is fully developed and upon complete development, the pupal skin splits and the mosquito emerges as an adult. Adult: The newly emerged adult rests on the surface of the water for a short time before flying away. In the Aedes mosquito family only the female bites because it requires protein to develop eggs, therefore if it bites a person infected with the dengue virus the mosquito becomes infectious after approximately 7 days. The mosquitoes are known to be biting at a highest frequency at dawn and dusk. Some more facts: The average lifespan of a mosquito of the genus Aedes in Nature is 2 weeks Mosquitoes may lay eggs about 3 times in his life, and about 100 eggs are produced each time. The eggs can live in dry conditions until approximately 9 months, after which they can hatch if it is subject to conditions, i.e food and water Source:http://dengue-feverdisease.blogspot.com/2008/02/lifecycle-of-aedes-mosquito.html [accessed on 05.12.09] 2.0.5 Investigation for dengue infections: Laboratory results Decrease in the number of white blood cell and peripheral neutrophils in the blood, abnormal increase in the number of lymphocytes in bloodstream and very low amount of platelets in the blood. Radiology X-ray of the chest normally shows pleural effusion and seldom pericardial effusion Ultrasound Used to detect pericardial effusion and 2) presence of excess fluids in the gap amid the tissues lining the abdomen and abdominal organ. Tests Laboratory diagnosis is done by detection of virus in specimen-serum at the virology laboratory. Culture is done in cell line derived from A. albopictus cell. Immunoflurescent techniques are used to detect viral replications. The virus can be isolated in patients with fever. Serology IgM is detectable in 90 % of patients by the 6th days of illness. Serum collected early may give false negative result. IgM can also be detected 2-3 months after. It is not possible to identify serotype with serological tests. In case where the IgM test is Positive it may imply recent infection with Dengue fever. However definitive diagnosis can only be made if the virus is isolated or the virus genome is detected by PCR. Seroconversion or boost in titer may indicate fresh infection. The appropriate samples for PCR test include plasma and serum. Molecular test is highly sensitive but it can be used in patients only with viraemia (Rigall-Pewrez et al.1998). 2.0.6 Treatment: The managing of dengue fever can be enhanced with bed rest, passable fluid intake, plus control of fever and pain with antipyretics in addition to analgesics (e.g. paracetamol). For the supplementary ruthless manifestations of dengue virus infection, correct management requires early identification and swift intravenous fluid substitution. Blood transfusion may be necessary in cases. There is currently no vaccine is available to shield against dengue infection. The current lack of a booming vaccine against the dengue virus causes prevention methods to be approached by plummeting disease vector population, with Integrated Pest Management programs for mosquito control. These employ a mishmash of control strategies, including mosquito surveillance, source diminution, eradicating larvae and eradicating adult mosquitoes (Ooi et al. 2007). Eradicating adult mosquitoes alone is fruitless in controlling mosquito populations because it is complex to treat the unattainable habitat of the adults. Mosquito larvae are left to carry on their development, and they quickly swap the adults. Nevertheless, mosquitoes can become resistant if pesticides are overused. 2.0.7 Dengue fever in Mauritius: Dengue virus infections are emerging as the major ones in Southeast Asia. Global warming may worsen the occurrence of dengue fever. Since very last few years mixed outbreak of chikungunya and periodic cases of dengue fever have been reported on R‚union Island and other South West Indian Ocean countries. From March 2005 till March 2006 it is estimated that about 204000 people in R‚union Island may have been infected by the chikungunya virus, which furthermore shows that there is presence of the transmitting vectors of the disease on the island which are also the vectors of dengue fever as well. Hereafter, the other South West Indian ocean countries were not spared from infection from the chikungunya virus. An outbreak of dengue fever was reported in Madagascar more specifically in the city of Toamasina that started mid-January 2006 and rare cases of chikungunya were also reported mid-February. Maldives also have suffered from a dengue outbreak in year 2006 where 602 people were suspected to be infected among which there were some severe form of dengue fever that is 64 dengue hemorrhagic fever cases and 9 cases of dengue shock syndrome (WHO 2006). In Mauritius the first case of dengue fever dates to the 1976s and it was contained thus limiting the disease from spreading. Then we had a case of imported dengue from a person who visited an endemic dengue area in January 2008 (CDCU). The main vectors of the disease remain the Aedes mosquitoes, among which the Aedes aegypti mosquito is the primary vector and Aedes albopictus the secondary one. The mosquito found to be spreading dengue fever and Chikungunya in Mauritius is the Aedes albopictus (CDCU 2009). It is to be noted that in Mauritius we had both the Aedes aegypti and Aedes albopictus mosquitoes, due to the intense anti-malaria campaign during the year 1952 the primary carrier of the dengue fever, the Aedes aegypti have been successfully eradicated. Still very minute amounts of this mosquito can be seen whereas the Aedes albopictus is abundant. Dengue is transmitted from person to person through the biting of infected mosquitoes. Most recently we had a short-lived epidemic of re-emerged dengue fever in Mauritius that started in the month of June 2009 which was imported. The mild fever was first localized in the city of Port Louis, where there were 192 cases and then we did have some sporadic cases in other regions of the island. Mosquito fogging and larviciding in whole Port Louis started on 3rd June 2009, and were repeated every seven days. Fogging was carried out outdoors early in the morning, early evenings and sometimes till late in the evenings (Dengue Unit 2009). The Ministry of Health and Quality of Life of Mauritius took the situation as being severe and all medium possible to contain the disease were put into action. Like the Special Mobile Force and manpower from other Ministries which joined the Ministry of Health to fight the dengue fever. Public alertness campaigns on the requisite to hunt and eliminate mosquito breeding sites at home and in the neighbourhood and to protect oneself against mosquito bites were carried out through radio, television and the press through a public private partnership. Detailed information leaflets were also distributed, door to door distribution of pamphlets showing pictures of possible breeding sites for mosquitoes and products to be used to prevent mosquito bite were carried out by the primary health care personnels. Target groups included the public, community groups and school children (Ramchurn et al, 2009). By the end of the month August no new or suspected cases of dengue were recorded in any of the countrys hospital. But still the control and prevention program were continued throughout the island as the summer season was coming near hence reappearance of the dengue fever was possible due to the ambient temperature, favorable for larvae development. The fear of having the virus again was due to the possibility of the infected mosquitoes to pass the virus to their progeny. Fortunately, till February 2010 no suspected case of dengue fever was reported from any in the country (Dengue Unit 2010). 2.1 Vector surveillance and control program Ever since mosquitoes are capable of transmitting diseases like dengue and chikungunya, till now it has not been possible to eradicate the mosquitoes completely from their originating site. The best way to monitor or control vector-borne diseases is to control or limit the population of the vector to such an extent that disease transmission is very low or even stopped. In order to achieve this goal, it is imperative to know all about the mosquito involved in the transmission of the disease. Detailed knowledge of all aspects such as the breeding sites, different features of the mosquito at different stages, feeding habits, mating, resting and structure and most importantly without forgetting the lifecycle of the mosquito, are the main required things in order to be able to break the chain of transmission. Furthermore, the only way to prevent infection of people who have not suffered from dengue is to control the population of dengue vector (Ooi et al.2001) and of course personal precaution has also proved to be effective in reducing the risk of being infected by a mosquito. Since no vaccine is yet available for dengue the only mode to control dengue fever is the control the amount of the disease vector that is of the Aedes mosquitoes. The control strategies of these mosquitoes are 1) carrying out larviciding -spraying a chemical called abate in any water retaining place which kill the larvae of the mosquitoes hence interrupting the cycle to be completed, 2) fogging operation- a thermal fogger is used to propel fumes of Aqua K-Othriner which when is in contact with a mosquito kills it, thus the amount of developed or simply mature mosquitoes are reduced and 3) health education- talks are organized for the members of the public, for children in schools, colleges, etc. Entomological survey is an important and integral part of dengue prevention and control. The effect of the intervention by the community can directly affect the ecology of the vectors that is the Aedes mosquitoes. The Communicable Disease Control Unit (CDCU) is the unit which is mostly concerned for the control of communicable diseases such as Malaria, Dengue fever, Chikungunya, and other infectious diseases. In Mauritius, surveillance, disease prevention and education of infectious diseases are mainly carried out by the Health Inspectorate Cadre. In Mauritius, we have the Public Health Act (Section 32A) which is used in case where there is presence of a mosquito borne disease in the island. The potential for predation to prevent pathogen invasion or reduce disease prevalence in a host population also has implications for the biological control of vector populations. Predators have been introduced, or proposed, as biological control agents of vectors for various diseases such as malaria, dengue fever and Lyme disease (Jenkins 1964; Legner 1995; Stauffer et al. 1997; Samish Rehacek 1999; Scholte et al. 2005; Kumar Hwang 2006; Ostfeld et al. 2006; Walker Lynch 2007). Several recent studies suggest that predator introductions led to a decline in local cases of dengue fever in Vietnam and Thailand (Kay Nam 2005; Kittayapong et al. 2008), and malaria in India (Ghosh et al. 2005; Ghosh Dash 2007). 2.2 Biology of Aedes albopictus (Skuse) Aedes albopictus are two winged insects from the family Culicidae of the order Diptera. They are among the best known groups due to their importance as pests and as vectors of diseases. They are easily identified due to a combination of the following characters: long trunk projecting head; charisma of scales on the wing veins, a tassel of scales along the posterior boundary of the wing, and the typical wing venation, the second, fourth and fifth longitudinal veins being branched (Miyagi and Toma 2000). Female mosquitoes feed on blood and they have highly specialized mothparts for piercing host skin and blood sucking (Wahid et al. 2002). Aedes species are normally day-time bitters and active during the day. During this time, they have peaks of landing and biting activity. The peak time for Aedes albopictus occurred about one hour after sunrise and then before sunset (Abu Hassan et al. 1996). Nevertheless, the rate of biting varies depending on the mosquito age and time of the day (Xue and Barnard 1996). CHAPTER 3 DATA COLLECTION 3.1 Introduction In this chapter, a summary of the various steps that was undertaken to finalize the research is attempted. The research work was started as from the month of September 2009 to the end of January 2010. 3.2 METHODOLOGY In order to assess the effectiveness of the control measures taken to prevent dengue fever, data were collected from the different partners who are involved in the control and prevention of dengue fever in Mauritius. Such data were collected from books, newspapers, published articles, magazines and official statistics from the Central Statistics Office, Dengue Unit, Communicable Disease Control Unit and the Ministry of Health Quality of Life. Moreover, constructive discussions were entertained with people who are in touch with the matters connecting to the piece of work. Search through the internet, review of available documents and properly classifying the information that would be used during the study. 3.3 METHODS OF ANALYSIS OF THE DATA OBTAINED Questions related with the way of application of the different control measures were selected for analysis from the filled questionnaires. Moreover, each particular question was analyzed by using SPSS software which provided the frequency and percentages and hence Microsoft Excel 2007 was used to express the data in forms of percentages, tables, figures, graphs, pie charts and charts. Chapter 4 Part I-Data Analysis 4.01 Introduction This chapter of the thesis will be dealing with the data collected from different stakeholders involved in the fight against dengue fever. Data collected mainly from the Communicable Disease Control Unit, Dengue Unit, and certain Health Offices of the country and the media will be expressed in figures. This section will be divided in to two parts: data analysis and press cot analysis. Much attention will be oriented towards the control measures in Port Louis, as the maximum number of cases occurred there and eventually the island in whole. 4.02 Progress of the disease through June 2009 in Port Louis Figure 4.1: Number of cases each day during the month of June 2009 From figure 4.1 it can be seen that the first case was detected on 2nd June 2009 and the maximum number of cases reported to the hospitals was around the 10th to 13th day of the same month. The number of confirmed cases by the end of June 2009 had decreased to less than five. 4.03 Age of people infected with dengue virus From the above chart (Fig 4.2) it can seen that about 34.55 % of the total number of cases (246 confirmed) of dengue were vulnerable ones that is the young and the elderly. 4.04 Aqua K Othriner used for fogging process Aqua K Othriner is a chemical used in mixture with another chemical substance called Nebolr, in thermal foggers to kill adult mosquitoes. Normally, the fogger produces fumes which in fact are fine droplets of the mixture which when in contact with a mosquito causes its death. The first day of fogging was started on 2nd June 2009 with a minimum cubic centimeter of Aqua K Othriner used, on the 7th day the maximum and throughout the rest of the days varying just a little in amount except for the 14th day. 4.05 Number of inspections carried out during the past 8 years throughout the Country Starting from the year 2001 till 2005 from the graph (fig 4.4) the number of inspections carried out by the health inspectorate cadre shows a slight decrease and suddenly in 2006 the number increases to approximately 3 fold than that in 2005. In year 2007, the amount of inspections carried again decreases to 112,087 and eventually for 2008 the number decreases a bit more. 4.06 Number of sanitary notices served during the past 8 years Public Health Act Sanitary notices are normally issued to the author of nuisance, as for in this case the notices served were to cause removal of water collected in used tyres, drums, roof tops, etc. From the year 2001 till 2005 the number of such type of notices served was ranging between 4933 and 8013. For 2006 the figure was the highest with 10657 of notices served and for the remaining 2 years a gradual decrease was noted. 4.07 Number of contraventions taken for none compliance with the Public Health Laws Notices Figur