Puerto Rico Is Fighting Zika With Cloud Technology

(Bloomberg Businessweek) -- There are more than 30 species of mosquitoes in Puerto Rico. Most are considered nuisances, not health threats. But one, the Aedes aegypti, spreads chikungunya, dengue, Zika, and other viral diseases. Zika, after having been first reported in Puerto Rico in 2015, infected more than 35,000 people across the island the following year. When Hurricane Maria devastated Puerto Rico in September 2017, scientists worried the A. aegypti population could soar because of breeding sites created by storm debris and residents storing buckets of water to flush toilets during blackouts.

To assess the threat, researchers are counting how many females—the sex that bites—are caught in more than 1,300 traps across the island. The initiative, which is being undertaken by the Puerto Rico Vector Control Unit, is also studying insecticide resistance, applying larvicides to breeding sites, and educating residents. The PRVCU stores all data on remote Microsoft Azure servers and relies on the cloud to share information quickly between research teams in the field and the laboratory.

Each of the PRVCU's 24 field workers collects mosquitoes from the traps and uses an iPhone app to pinpoint their locations. This gives their supervisor, José Sánchez, the ability to see where they are at all times and how many traps they've checked. If there's an unusually high number of A. aegypti in a specific location, software can automatically assign some of Sánchez's workers to go there to identify breeding sites and collect samples. Mapping software pulls data from the cloud to determine which traps have attracted the most female A. aegypti and to identify the homes where larvicides have been applied. Cloud technology also allows software to automatically complete time-consuming tasks overnight using the data that the workers gathered during the day, then use the findings to figure out which traps and homes to check the following day.

Instead of waiting for someone to get infected and then marking the location, as Puerto Rico's Department of Health has done for years, “we're being proactive,” mapping where the mosquitoes are so we can reduce their numbers, says César Piovanetti, who oversees the PRVCU's information technology architecture. “It wouldn't be possible to do this project without the cloud,” he says. “We need to process a huge amount of data and make it available to workers quickly.”

The nonprofit Puerto Rico Science, Technology, & Research Trust established the PRVCU in 2016 in Río Piedras. It expects to receive $65 million from the Centers for Disease Control and Prevention over five years for the project, which has about 100 employees. The PRVCU “can be agile in its operations in ways that often government organizations cannot be,” said Angi Harris, the CDC's technical adviser to the project, in an email.

From January to September, field workers collected more than 300,000 A. aegypti females. “We confirmed we have a huge problem of Aedes on the island, and we need to do more to control it,” says Nicole Nazario, the PRVCU's laboratory manager. The insect has become resistant to traditional insecticides, and new ways of controlling it are necessary, she says.

While “very low numbers of Zika, dengue, and chikungunya cases have been identified” since the island regained normal testing capacity around January, mosquito-borne diseases still pose a major threat, according to Harris. “I know mosquito-borne illnesses are being underreported in Puerto Rico,” says Arturo Leis, a neurologist and senior scientist at Methodist Rehabilitation Center in Jackson, Miss. Leis has traveled to the island frequently since Hurricane Maria to evaluate children with microcephaly and Zika fetal syndrome and establish a partnership with clinicians in the University of Puerto Rico's pediatrics department.

“What the PRVCU is doing could be a game winner, but we actually have to do more,” says Leis, to help clinicians diagnose and treat victims of mosquito-borne diseases.

The PRVCU is using special algorithms to speed up the mind-numbing process of counting mosquito eggs, which are no bigger than grains of salt. The algorithms are being developed for the PRVCU by Wovenware, a Puerto Rican company that makes predictive analytics software. Rather than manually count the eggs that Sánchez's field workers collect, lab technicians upload photos of them to a program running in the cloud. The photos are then analyzed by Wovenware software, which provides a count, giving lab workers more time to process samples, research insecticide resistance, and expand surveillance areas.

Five of Wovenware's roughly 80 employees are working on the PRVCU project on a part-time, pro bono basis. They're building on models that the 15-year-old company developed to detect objects in satellite images for clients such as U.S. Department of Defense.

The software they are working on will eventually assess whether an egg has hatched and also count and identify adults by species and sex, says Carlos Meléndez, co-founder and chief operating officer of Wovenware. Speeding up the workflow in this way will be useful to others dealing with mosquito-borne diseases around the world. “The nature of being an island in the Caribbean is that we're going to have mosquitoes,” says the PRVCU's Piovanetti. “Our goal is to understand why they breed so well in some places and what we can do as a society to drastically reduce their populations.”

To contact the editor responsible for this story: Dimitra Kessenides at dkessenides1@bloomberg.net

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