Climate change may enable Aedes aegypti infestation in major European cities by 2100

Presence and infestation waves of hematophagous arthropod species

The invasion of hematophagous arthropod species in human settlements represents a threat, not only to the economy but also to the health system in general. Recent examples of this phenomenon were seen in Paris and Mexico City, evidencing the importance of understanding these dynamics. In this work, we present a reaction-diffusion model to describe the invasion dynamics of hematophagous arthropod species. The proposed model considers a denso-dependent growth rate and parameters related to the control of the invasive species. Our results illustrate the existence of two invasion levels (presence and infestation) within a region, depending on control parameter values. We also prove analytically the existence of the presence and infestation waves and show different theoretical types of invasion waves that result from varying control parameters. In addition, we present a condition threshold that determines whether or not an infestation occurs. Finally, we illustrate some results when considering the case of bedbugs and brown dog ticks as invasion species.

In-vitro assessment of cutaneous immune responses to aedes mosquito salivary gland extract and dengue virus in Cambodian individuals

Dengue virus (DENV) poses a global health threat, affecting millions individuals annually with no specific therapy and limited vaccines. Mosquitoes, mainly Aedes aegypti and Aedes albopictus worldwide, transmit DENV through their saliva during blood meals. In this study, we aimed to understand how Aedes mosquito saliva modulate skin immune responses during DENV infection in individuals living in mosquito-endemic regions. To accomplish this, we dissociated skin cells from Cambodian volunteers and incubated them with salivary gland extract (SGE) from three different mosquito strains: Ae. aegypti USDA strain, Ae. aegypti and Ae. albopictus wild type (WT) in the presence/absence of DENV. We observed notable alterations in skin immune cell phenotypes subsequent to exposure to Aedes salivary gland extract (SGE). Specifically, exposure lead to an increase in the frequency of macrophages expressing chemokine receptor CCR2, and neutrophils expressing CD69. Additionally, we noted a substantial increase in the percentage of macrophages that became infected with DENV in the presence of Aedes SGE. Differences in cellular responses were observed when Aedes SGE of three distinct mosquito strains were compared. Our findings deepen the understanding of mosquito saliva's role in DENV infection and skin immune responses in individuals regularly exposed to mosquito bites. This study provides insights into skin immune cell dynamics that could guide strategies to mitigate DENV transmission and other arbovirus diseases.

Projection of dengue fever transmissibility under climate change in South and Southeast Asian countries

Vector-borne infectious disease such as dengue fever (DF) has spread rapidly due to more suitable living environments. Considering the limited studies investigating the disease spread under climate change in South and Southeast Asia, this study aimed to project the DF transmission potential in 30 locations across four South and Southeast Asian countries. In this study, weekly DF incidence data, daily mean temperature, and rainfall data in 30 locations in Singapore, Sri Lanka, Malaysia, and Thailand from 2012 to 2020 were collected. The effects of temperature and rainfall on the time-varying reproduction number (Rt) of DF transmission were examined using generalized additive models. Projections of location-specific Rt from 2030s to 2090s were determined using projected temperature and rainfall under three Shared Socioeconomic Pathways (SSP126, SSP245, and SSP585), and the peak DF transmissibility and epidemic duration in the future were estimated. According to the results, the projected changes in the peak Rt and epidemic duration varied across locations, and the most significant change was observed under middle-to-high greenhouse gas emission scenarios. Under SSP585, the country-specific peak Rt was projected to decrease from 1.63 (95% confidence interval: 1.39-1.91), 2.60 (1.89-3.57), and 1.41 (1.22-1.64) in 2030s to 1.22 (0.98-1.51), 2.09 (1.26-3.47), and 1.37 (0.83-2.27) in 2090s in Singapore, Thailand, and Malaysia, respectively. Yet, the peak Rt in Sri Lanka changed slightly from 2030s to 2090s under SSP585. The epidemic duration in Singapore and Malaysia was projected to decline under SSP585. In conclusion, the change of peak DF transmission potential and disease outbreak duration would vary across locations, particularly under middle-to-high greenhouse gas emission scenarios. Interventions should be considered to slow down global warming as well as the potential increase in DF transmissibility in some locations of South and Southeast Asia.

Updates in Air Pollution: Current Research and Future Challenges

Background

The United Nations has declared that humans have a right to clean air. Despite this, many deaths and disability-adjusted life years are attributed to air pollution exposure each year. We face both challenges to air quality and opportunities to improve, but several areas need to be addressed with urgency.

Objective

This paper summarises the recent research presented at the Pacific Basin Consortium for Environment and Health Symposium and focuses on three key areas of air pollution that are important to human health and require more research.

Findings and conclusion

Indoor spaces are commonly places of exposure to poor air quality and are difficult to monitor and regulate. Global climate change risks worsening air quality in a bi-directional fashion. The rising use of electric vehicles may offer opportunities to improve air quality, but it also presents new challenges. Government policies and initiatives could lead to improved air and environmental justice. Several populations, such as older people and children, face increased harm from air pollution and should become priority groups for action.

Spatial model of Dengue Hemorrhagic Fever (DHF) risk: scoping review

BACKGROUND

Creating a spatial model of dengue fever risk is challenging duet to many interrelated factors that could affect dengue. Therefore, it is crucial to understand how these critical factors interact and to create reliable predictive models that can be used to mitigate and control the spread of dengue.

METHODS

This scoping review aims to provide a comprehensive overview of the important predictors, and spatial modelling tools capable of producing Dengue Haemorrhagic Fever (DHF) risk maps. We conducted a methodical exploration utilizing diverse sources, i.e., PubMed, Scopus, Science Direct, and Google Scholar. The following data were extracted from articles published between January 2011 to August 2022: country, region, administrative level, type of scale, spatial model, dengue data use, and categories of predictors. Applying the eligibility criteria, 45 out of 1,349 articles were selected.

RESULTS

A variety of models and techniques were used to identify DHF risk areas with an arrangement of various multiple-criteria decision-making, statistical, and machine learning technique. We found that there was no pattern of predictor use associated with particular approaches. Instead, a wide range of predictors was used to create the DHF risk maps. These predictors may include climatology factors (e.g., temperature, rainfall, humidity), epidemiological factors (population, demographics, socio-economic, previous DHF cases), environmental factors (land-use, elevation), and relevant factors.

CONCLUSIONS

DHF risk spatial models are useful tools for detecting high-risk locations and driving proactive public health initiatives. Relying on geographical and environmental elements, these models ignored the impact of human behaviour and social dynamics. To improve the prediction accuracy, there is a need for a more comprehensive approach to understand DHF transmission dynamics.

Praemonitus praemunitus: can we forecast and prepare for future viral disease outbreaks?

Understanding the origins of past and present viral epidemics is critical in preparing for future outbreaks. Many viruses, including SARS-CoV-2, have led to significant consequences not only due to their virulence, but also because we were unprepared for their emergence. We need to learn from large amounts of data accumulated from well-studied, past pandemics and employ modern informatics and therapeutic development technologies to forecast future pandemics and help minimize their potential impacts. While acknowledging the complexity and difficulties associated with establishing reliable outbreak predictions, herein we provide a perspective on the regions of the world that are most likely to be impacted by future outbreaks. We specifically focus on viruses with epidemic potential, namely SARS-CoV-2, MERS-CoV, DENV, ZIKV, MAYV, LASV, noroviruses, influenza, Nipah virus, hantaviruses, Oropouche virus, MARV, and Ebola virus, which all require attention from both the public and scientific community to avoid societal catastrophes like COVID-19. Based on our literature review, data analysis, and outbreak simulations, we posit that these future viral epidemics are unavoidable, but that their societal impacts can be minimized by strategic investment into basic virology research, epidemiological studies of neglected viral diseases, and antiviral drug discovery.

Decision-support tools to build climate resilience against emerging infectious diseases in Europe and beyond

Climate change is one of several drivers of recurrent outbreaks and geographical range expansion of infectious diseases in Europe. We propose a framework for the co-production of policy-relevant indicators and decision-support tools that track past, present, and future climate-induced disease risks across hazard, exposure, and vulnerability domains at the animal, human, and environmental interface. This entails the co-development of early warning and response systems and tools to assess the costs and benefits of climate change adaptation and mitigation measures across sectors, to increase health system resilience at regional and local levels and reveal novel policy entry points and opportunities. Our approach involves multi-level engagement, innovative methodologies, and novel data streams. We take advantage of intelligence generated locally and empirically to quantify effects in areas experiencing rapid urban transformation and heterogeneous climate-induced disease threats. Our goal is to reduce the knowledge-to-action gap by developing an integrated One Health-Climate Risk framework.

Fertility decline in female mosquitoes is regulated by the orco olfactory co-receptor

Female Aedes aegypti mosquitoes undergo multiple rounds of reproduction, known as gonotrophic cycles. These cycles span the period from blood meal intake to oviposition. Understanding how reproductive success is maintained across gonotrophic cycles allows for the identification of molecular targets to reduce mosquito population growth. Odorant receptor co-receptor (orco) encodes a conserved insect-specific transmembrane ion channel that complexes with tuning odorant receptors (ORs) to form a functional olfactory receptor. orco expression has been identified in the male and female mosquito germline, but its role is unclear. We report an orco-dependent, maternal effect reduction in fertility after the first gonotrophic cycle. This phenotype was removed by CRISPR-Cas9 reversion of the orco mutant locus. Eggs deposited by orco mutant females are fertilized but the embryos reveal developmental defects, reduced hatching, and changes in ion channel signaling gene transcription. We present an unexpected role for an olfactory receptor pathway in mosquito reproduction.

Invasive mosquito vectors in Europe: From bioecology to surveillance and management

Invasive mosquitoes (Diptera: Culicidae) play a key role in the spread of a number of mosquito-borne diseases worldwide. Anthropogenic changes play a significant role in affecting their distribution. Invasive mosquitoes usually take advantage from biotic homogenization and biodiversity reduction, therefore expanding in their distribution range and abundance. In Europe, climate warming and increasing urbanization are boosting the spread of several mosquito species of high public health importance. The present article contains a literature review focused on the biology and ecology of Aedes albopictus, Ae. aegypti, Ae. japonicus japonicus, Ae. koreicus, Ae. atropalpus and Ae. triseriatus, outlining their distribution and public health relevance in Europe. Bioecology insights were tightly connected with vector surveillance and control programs targeting these species. In the final section, a research agenda aiming for the effective and sustainable monitoring and control of invasive mosquitoes in the framework of Integrated Vector Management and One Health is presented. The WHO Vector Control Advisory Group recommends priority should be given to vector control tools with proven epidemiological impact.

Climate Change and Travel: Harmonizing to Abate Impact

Purpose of Review

With climate change being the single biggest health threat facing humanity, this review aims to identify the climate-sensitive health risks to the traveler and to recognize the role that travel plays in contributing to the detrimental effects of climate change. With this understanding, adaptations for transformational action can be made.

Recent Findings

Travel and tourism, including transportation, food consumption, and accommodation, is responsible for a large percentage of the world’s carbon emissions which is contributing to the climate change crisis at an alarming rate. Climate change is a health emergency that is resulting in a rise of significant health impacts to the traveler including increased heat illnesses; food-, water-, and vector-borne diseases; and increasing risk of exposure to emerging infectious diseases. Patterns of future travel and destination choices are likely to change due to climactic factors such as temperature and extreme weather events, forced migration, degradation, and disappearance of popular and natural tourist destinations.

Summary

Global warming is and will continue to alter the landscape of travel medicine with expansion of transmission seasons and geographic ranges of disease, increased risk of infections and harmful marine toxins, and introduction of emerging infections to naïve populations. This will have implications for pre-travel counseling in assessing risk and discussing the environmental influences on travel. Travelers and stakeholders should be engaged in a dialogue to understand their “climate footprint,” to innovate sustainable solutions, and be empowered to make immediate, conscientious, and responsible choices to abate the impact of breaching critical temperature thresholds.

Octopamine and tyramine signalling in Aedes aegypti: Molecular characterization and insight into potential physiological roles

In insects, the biogenic amines octopamine (OA) and tyramine (TA) are involved in controlling several physiological and behavioural processes. OA and TA act as neurotransmitters, neuromodulators or neurohormones, performing their functions by binding to specific receptors belonging to the G protein-coupled receptor (GPCR) superfamily. OA and TA along with their receptors are involved in reproduction, smell perception, metabolism, and homeostasis. Moreover, OA and TA receptors are targets for insecticides and antiparasitic agents, such as the formamidine Amitraz. In the dengue and yellow fever vector, Aedes aegypti, limited research has been reported on their OA or TA receptors. Here, we identify and molecularly characterize the OA and TA receptors in A. aegypti. Bioinformatic tools were used to identify four OA and three TA receptors in the genome of A. aegypti. The seven receptors are expressed in all developmental stages of A. aegypti; however, their highest transcript abundance is observed in the adult. Among several adult A. aegypti tissues examined, including the central nervous system, antennae and rostrum, midgut, Malpighian tubules, ovaries, and testes, the type 2 TA receptor (TAR2) transcript is most abundant in the ovaries and the type 3 TA receptor (TAR3) is enriched in the Malpighian tubules, leading us to propose putative roles for these receptors in reproduction and diuresis, respectively. Furthermore, a blood meal influenced OA and TA receptor transcript expression patterns in adult female tissues at several time points post blood meal, suggesting these receptors may play key physiological roles associated with feeding. To better understand OA and TA signalling in A. aegypti, the transcript expression profiles of key enzymes in their biosynthetic pathway, namely tyrosine decarboxylase (Tdc) and tyramine β-hydroxylase (Tβh), were examined in developmental stages, adult tissues, and brains from blood-fed females. These findings provide information for better understanding the physiological roles of OA, TA, and their receptors in A. aegypti, and additionally, may help in the development of novel strategies for the control of these human disease vectors.

Chikungunya: risks for travellers

RATIONALE FOR REVIEW

Chikungunya outbreaks continue to occur, with changing epidemiology. Awareness about chikungunya is low both among the at-risk travellers and healthcare professionals, which can result in underdiagnosis and underreporting. This review aims to improve awareness among healthcare professionals regarding the risks of chikungunya for travellers.

KEY FINDINGS

Chikungunya virus transmission to humans occurs mainly via daytime-active mosquitoes, Aedes aegypti and Aedes albopictus. The areas where these mosquitoes live is continuously expanding, partly due to climate changes. Chikungunya is characterized by an acute onset of fever with joint pain. These symptoms generally resolve within 1-3 weeks but at least one-third of the patients suffer from debilitating rheumatologic symptoms for months to years. Large outbreaks in changing regions of the world since the turn of the 21st century (e.g. Caribbean, La Réunion; currently Brazil, India) have resulted in growing numbers of travellers importing chikungunya, mainly to Europe and North America. Viremic travellers with chikungunya infection have seeded chikungunya clusters (France, United States of America) and outbreaks (Italy in 2007 and 2017) in non-endemic countries where Ae. albopictus mosquitoes are present. Community preventive measures are important to prevent disease transmission by mosquitoes. Individual preventive options are limited to personal protection measures against mosquito bites, particularly the daytime-active mosquitos that transmit the chikungunya virus. Candidate vaccines are on the horizon and regulatory authorities will need to assess environmental and host risk factors for persistent sequelae, such as obesity, age (over 40 years), and history of arthritis or inflammatory rheumatologic disease to determine which populations should be targeted for these chikungunya vaccines.

CONCLUSIONS/RECOMMENDATIONS

Travellers planning to visit destinations with active CHIKV circulation should be advised about the risk for chikungunya, prevention strategies, the disease manifestations, possible chronic rheumatologic sequelae, and if symptomatic, seek medical evaluation and report potential exposures.

Considering waning immunity to better explain dengue dynamics

Life-long serotype-specific immunity following dengue virus infection may not always occur, but the true extent of this effect is unknown. Analysis of more than 20 years of monotypic epidemics in the isolated French Polynesian islands revealed that whilst the risk of symptomatic dengue infection did conform to the classical paradigms of homotypic immunity and increased disease risk in heterotypic secondary infections, incorporation of waning immunity improved the ability of epidemiological models to capture the observed epidemic dynamics. Not only does this show how inclusion of waning immunity into classical models can reveal important facets of the immune response to natural dengue virus infection, it also has significant ramifications for vaccine development and implementation in dengue endemic areas.

Past, present and future distribution of the yellow fever mosquito Aedes aegypti: The European paradox

The global distribution of the yellow fever mosquito Aedes aegypti is the subject of considerable attention because of its pivotal role as a biological vector of several high profile disease pathogens including dengue, chikungunya, yellow fever, and Zika viruses. There is also a lot of interest in the projected future species' distribution. However, less effort has been focused on its historical distribution, which has changed substantially over the past 100 years, especially in southern Europe where it was once widespread, but largely disappeared by the middle of the 20th century. The present work utilises all available historical records of the distribution of Ae. aegypti in southern Europe, the Near East within the Mediterranean Basin and North Africa from the late 19th century until the 1960's to construct a spatial distribution model using matching historical climatic and demographic data. The resulting model was then implemented using current climate and demographic data to assess the potential distribution of the vector in the present. The models were rerun with several different assumptions about the thresholds that determine habitat suitability for Ae. aegypti. The historical model matches the historical distributions well. When it is run with current climate values, the predicted present day distribution is somewhat broader than it used to be particularly in north-west France, North Africa and Turkey. Though it is beginning to reappear in the eastern Caucasus, this 'potential' distribution clearly does not match the actual distribution of the species, which suggests some other factors are responsible for its absence. Future distributions based on the historical model also do not match future distributions derived from models based only on present day vector distributions, which predict little or no presence in the Mediterranean Region. At the same time, the vector is widespread in the USA which is predicted to consolidate its range there in future. This contradiction and the implication for possible re-invasion of Europe are discussed.

dynamAedes: a unified modelling framework for invasive Aedes mosquitoes

Mosquito species belonging to the genus Aedes have attracted the interest of scientists and public health officers because of their capacity to transmit viruses that affect humans. Some of these species were brought outside their native range by means of trade and tourism and then colonised new regions thanks to a unique combination of eco-physiological traits. Considering mosquito physiological and behavioural traits to understand and predict their population dynamics is thus a crucial step in developing strategies to mitigate the local densities of invasive Aedes populations. Here, we synthesised the life cycle of four invasive Aedes species (Ae. aegypti, Ae. albopictus, Ae. japonicus and Ae. koreicus) in a single multi-scale stochastic modelling framework which we coded in the R package dynamAedes. We designed a stage-based and time-discrete stochastic model driven by temperature, photo-period and inter-specific larval competition that can be applied to three different spatial scales: punctual, local and regional. These spatial scales consider different degrees of spatial complexity and data availability by accounting for both active and passive dispersal of mosquito species as well as for the heterogeneity of the input temperature data. Our overarching aim was to provide a flexible, open-source and user-friendly tool rooted in the most updated knowledge on the species' biology which could be applied to the management of invasive Aedes populations as well as to more theoretical ecological inquiries.

Survivorship-Reducing Effect of Propylene Glycol on Vector Mosquito Populations and Its Potential Use in Attractive Toxic Sugar Baits

Simple Summary

Mosquitoes (Diptera: Culicidae) spread disease and pose a significant risk to public health around the world. While there are currently many control measures available, many are typically unsafe for humans and other animals, and they are becoming less effective against mosquitoes. We tested a compound called propylene glycol (1,2 propanediol) for its toxicity to three species of mosquitoes that serve as vectors of human pathogens. Propylene glycol is a compound that the FDA has designated as generally regarded as safe (GRAS) for human consumption, meaning it is approved for use in everyday household products. Through a series of assays in which we fed mosquitoes propylene glycol, we found that this compound is highly toxic to all three mosquito species examined and can drastically reduce the survivorship of laboratory populations. Our results suggest that propylene glycol could be a safe and effective substance to be used in the context of attractive toxic sugar baits (ATSBs) as a means of controlling mosquitoes near human habitations.

Abstract

Arthropod control mechanisms are a vital part of public health measures around the world as many insect species serve as vectors for devastating human diseases. Aedes aegypti (Linnaeus, 1762) is a widely distributed, medically important mosquito species that transmits viruses such as yellow fever, Dengue, and Zika. Many traditional control mechanisms have become less effective due to insecticide resistance or exhibit unwanted off-target effects, and, consequently, there is a need for novel solutions. The use of attractive toxic sugar baits (ATSBs) has increased in recent years, though the toxic elements are often harmful to humans and other vertebrates. Therefore, we are investigating propylene glycol, a substance that is generally regarded as safe (GRAS) for human consumption. Using a series of feeding assays, we found that propylene glycol is highly toxic to Ae. aegypti adults and a single day of exposure significantly reduces the survivorship of test populations compared with controls. The effects are more pronounced in males, drastically reducing their survivorship after one day of consumption. Additionally, the consumption of propylene glycol reduced the survivorship of two prominent disease vectors: Aedes albopictus (Skuse, 1894) and Culex pipiens (Linnaeus, 1758). These findings indicate that propylene glycol could be used as a safe and effective alternative to pesticides in an ATSB system.

Trade-off between climatic and human population impacts on Aedes aegypti life history shapes its geographic distribution

The annual death statistics due to vector-borne diseases transmitted by Aedes mosquitoes cause a still growing concern for the public health in the affected regions. An improved understanding of how climatic and population changes impact the spread of Aedes aegypti will help estimate the future populations exposure and vulnerability, and is essential to the improvement of public health preparedness. We apply an empirically well-investigated process-based mathematical model based on the life cycle of the mosquito to assess how climate scenarios (Representative Concentration Pathways (RCP)) and population scenarios (Shared Socioeconomic Pathways (SSP)) will affect the growth and potential distribution of this mosquito in China. Our results show that the risk area is predicted to expand considerably, increasing up to 21.46% and 24.75% of China's land area in 2050 and 2070, respectively, and the new added area lies mainly in the east and center of China. The population in the risk area grows substantially up to 2050 and then drops down steadily. However, these predicted changes vary noticeably among different combinations between RCPs and SSPs with the RCP2.6*SSP4 yielding the most favorable scenario in 2070, representing approximately 14.11% of China's land area and 113 cities at risk, which is slightly lower compared to 2019. Our results further reveal that there is a significant trade-off between climatic and human population impacts on the spreading of Aedes aegypti, possibly leading to an overestimation (underestimation) in sparsely (densely) populated areas if the populations impact on the mosquito's life history is unaccounted for. These results suggest that both climate and population changes are crucial factors in the formation of the populations exposure to Aedes-borne virus transmission in China, however, a reduced population growth rate may slow down the spread of this mosquito by effectively counteracting the climate warming impacts.

Spatial Distribution of Aedes aegypti Oviposition Temporal Patterns and Their Relationship with Environment and Dengue Incidence

Simple Summary

Aedes aegypti, the mosquito species that transmits dengue virus among others, is fully adapted to thrive in urban areas. Their activity, however, varies in time and space and this might imply different transmission risk. We hypothesize that the temporal differences in mosquito activity are determined by local environmental conditions. Hence, we explore the existence of groups of temporal patterns in weekly time series of ovitraps records and we associate those patterns to environmental variables derived from remote sensing data and also to dengue incidence. We found three groups of temporal patterns that showed association with land cover diversity, heterogeneity and variability in vegetation and humidity indices estimated over 50-m radius buffer areas surrounding ovitraps. Dengue incidence on a neighborhood basis showed a weak but positive association with the percentage of pixels belonging to one of the patterns detected. The understanding of the spatial distribution of temporal patterns and their environmental determinants might then become relevant to guide the allocation of prevention and monitoring interventions.

Abstract

Aedes aegypti, the mosquito species transmitting dengue, zika, chikungunya and yellow fever viruses, is fully adapted to thrive in urban areas. The temporal activity of this mosquito, however, varies within urban areas which might imply different transmission risk. In this work, we hypothesize that temporal differences in mosquito activity patterns are determined by local environmental conditions. Hence, we explore the existence of groups of temporal patterns in weekly time series of Ae. aegypti ovitraps records (2017–2019) by means of time series clustering. Next, with the aim of predicting risk in places with no mosquito field data, we use machine learning classification tools to assess the association of temporal patterns with environmental variables derived from satellite imagery and predict temporal patterns over the city area to finally test the relationship with dengue incidence. We found three groups of temporal patterns that showed association with land cover diversity, variability in vegetation and humidity and, heterogeneity measured by texture indices estimated over buffer areas surrounding ovitraps. Dengue incidence on a neighborhood basis showed a weak but positive association with the percentage of pixels belonging to only one of the temporal patterns detected. The understanding of the spatial distribution of temporal patterns and their environmental determinants might then become highly relevant to guide the allocation of prevention and potential interventions. Further investigation is still needed though to incorporate other determinants not considered here.

The Complex Epidemiological Relationship between Flooding Events and Human Outbreaks of Mosquito-Borne Diseases: A Scoping Review

BACKGROUND

Climate change is expected to increase the frequency of flooding events. Although rainfall is highly correlated with mosquito-borne diseases (MBD) in humans, less research focuses on understanding the impact of flooding events on disease incidence. This lack of research presents a significant gap in climate change-driven disease forecasting.

OBJECTIVES

We conducted a scoping review to assess the strength of evidence regarding the potential relationship between flooding and MBD and to determine knowledge gaps.

METHODS

PubMed, Embase, and Web of Science were searched through 31 December 2020 and supplemented with review of citations in relevant publications. Studies on rainfall were included only if the operationalization allowed for distinction of unusually heavy rainfall events. Data were abstracted by disease (dengue, malaria, or other) and stratified by post-event timing of disease assessment. Studies that conducted statistical testing were summarized in detail.

RESULTS

From 3,008 initial results, we included 131 relevant studies (dengue n = 45 , malaria n = 61 , other MBD n = 49 ). Dengue studies indicated short-term (< 1  month ) decreases and subsequent (1-4 month) increases in incidence. Malaria studies indicated post-event incidence increases, but the results were mixed, and the temporal pattern was less clear. Statistical evidence was limited for other MBD, though findings suggest that human outbreaks of Murray Valley encephalitis, Ross River virus, Barmah Forest virus, Rift Valley fever, and Japanese encephalitis may follow flooding.

DISCUSSION

Flooding is generally associated with increased incidence of MBD, potentially following a brief decrease in incidence for some diseases. Methodological inconsistencies significantly limit direct comparison and generalizability of study results. Regions with established MBD and weather surveillance should be leveraged to conduct multisite research to a) standardize the quantification of relevant flooding, b) study nonlinear relationships between rainfall and disease, c) report outcomes at multiple lag periods, and d) investigate interacting factors that modify the likelihood and severity of outbreaks across different settings. https://doi.org/10.1289/EHP8887.

Projecting the risk of mosquito-borne diseases in a warmer and more populated world: a multi-model, multi-scenario intercomparison modelling study

BACKGROUND

Mosquito-borne diseases are expanding their range, and re-emerging in areas where they had subsided for decades. The extent to which climate change influences the transmission suitability and population at risk of mosquito-borne diseases across different altitudes and population densities has not been investigated. The aim of this study was to quantify the extent to which climate change will influence the length of the transmission season and estimate the population at risk of mosquito-borne diseases in the future, given different population densities across an altitudinal gradient.

METHODS

Using a multi-model multi-scenario framework, we estimated changes in the length of the transmission season and global population at risk of malaria and dengue for different altitudes and population densities for the period 1951-99. We generated projections from six mosquito-borne disease models, driven by four global circulation models, using four representative concentration pathways, and three shared socioeconomic pathways.

FINDINGS

We show that malaria suitability will increase by 1·6 additional months (mean 0·5, SE 0·03) in tropical highlands in the African region, the Eastern Mediterranean region, and the region of the Americas. Dengue suitability will increase in lowlands in the Western Pacific region and the Eastern Mediterranean region by 4·0 additional months (mean 1·7, SE 0·2). Increases in the climatic suitability of both diseases will be greater in rural areas than in urban areas. The epidemic belt for both diseases will expand towards temperate areas. The population at risk of both diseases might increase by up to 4·7 additional billion people by 2070 relative to 1970-99, particularly in lowlands and urban areas.

INTERPRETATION

Rising global mean temperature will increase the climatic suitability of both diseases particularly in already endemic areas. The predicted expansion towards higher altitudes and temperate regions suggests that outbreaks can occur in areas where people might be immunologically naive and public health systems unprepared. The population at risk of malaria and dengue will be higher in densely populated urban areas in the WHO African region, South-East Asia region, and the region of the Americas, although we did not account for urban-heat island effects, which can further alter the risk of disease transmission.

FUNDING

UK Space Agency, Royal Society, UK National Institute for Health Research, and Swedish Research Council.

Chikungunya Beyond the Tropics: Where and When Do We Expect Disease Transmission in Europe?

Chikungunya virus disease (chikungunya) is a mosquito-borne infectious disease reported in at least 50 countries, mostly in the tropics. It has spread around the globe within the last two decades, with local outbreaks in Europe. The vector mosquito Aedes albopictus (Diptera, Culicidae) has already widely established itself in southern Europe and is spreading towards central parts of the continent. Public health authorities and policymakers need to be informed about where and when a chikungunya transmission is likely to take place. Here, we adapted a previously published global ecological niche model (ENM) by including only non-tropical chikungunya occurrence records and selecting bioclimatic variables that can reflect the temperate and sub-tropical conditions in Europe with greater accuracy. Additionally, we applied an epidemiological model to capture the temporal outbreak risk of chikungunya in six selected European cities. Overall, the non-tropical ENM captures all the previous outbreaks in Europe, whereas the global ENM had underestimated the risk. Highly suitable areas are more widespread than previously assumed. They are found in coastal areas of the Mediterranean Sea, in the western part of the Iberian Peninsula, and in Atlantic coastal areas of France. Under a worst-case scenario, even large areas of western Germany and the Benelux states are considered potential areas of transmission. For the six selected European cities, June–September (the 22th–38th week) is the most vulnerable time period, with the maximum continuous duration of a possible transmission period lasting up to 93 days (Ravenna, Italy).

Comparing machine learning with case-control models to identify confirmed dengue cases

In recent decades, the global incidence of dengue has increased. Affected countries have responded with more effective surveillance strategies to detect outbreaks early, monitor the trends, and implement prevention and control measures. We have applied newly developed machine learning approaches to identify laboratory-confirmed dengue cases from 4,894 emergency department patients with dengue-like illness (DLI) who received laboratory tests. Among them, 60.11% (2942 cases) were confirmed to have dengue. Using just four input variables [age, body temperature, white blood cells counts (WBCs) and platelets], not only the state-of-the-art deep neural network (DNN) prediction models but also the conventional decision tree (DT) and logistic regression (LR) models delivered performances with receiver operating characteristic (ROC) curves areas under curves (AUCs) of the ranging from 83.75% to 85.87% [for DT, DNN and LR: 84.60% ± 0.03%, 85.87% ± 0.54%, 83.75% ± 0.17%, respectively]. Subgroup analyses found all the models were very sensitive particularly in the pre-epidemic period. Pre-peak sensitivities (<35 weeks) were 92.6%, 92.9%, and 93.1% in DT, DNN, and LR respectively. Adjusted odds ratios examined with LR for low WBCs [≤ 3.2 (x103/μL)], fever (≥38°C), low platelet counts [< 100 (x103/μL)], and elderly (≥ 65 years) were 5.17 [95% confidence interval (CI): 3.96-6.76], 3.17 [95%CI: 2.74-3.66], 3.10 [95%CI: 2.44-3.94], and 1.77 [95%CI: 1.50-2.10], respectively. Our prediction models can readily be used in resource-poor countries where viral/serologic tests are inconvenient and can also be applied for real-time syndromic surveillance to monitor trends of dengue cases and even be integrated with mosquito/environment surveillance for early warning and immediate prevention/control measures. In other words, a local community hospital/clinic with an instrument of complete blood counts (including platelets) can provide a sentinel screening during outbreaks. In conclusion, the machine learning approach can facilitate medical and public health efforts to minimize the health threat of dengue epidemics. However, laboratory confirmation remains the primary goal of surveillance and outbreak investigation.

Intersecting vulnerabilities: climatic and demographic contributions to future population exposure to Aedes-borne viruses in the United States

Understanding how climate change and demographic factors may shape future population exposure to viruses such as Zika, dengue, or chikungunya, transmitted by Aedes mosquitoes is essential to improving public health preparedness. In this study, we combine projections of cumulative monthly Aedes-borne virus transmission risk with spatially explicit population projections for vulnerable demographic groups to explore future county-level population exposure across the conterminous United States. We employ a scenario matrix-combinations of climate scenarios (Representative Concentration Pathways) and socioeconomic scenarios (Shared Socioeconomic Pathways)-to assess the full range of uncertainty in emissions, socioeconomic development, and demographic change. Human exposure is projected to increase under most scenarios, up to + 177% at the national scale in 2080 under SSP5*RCP8.5 relative to a historical baseline. Projected exposure changes are predominantly driven by population changes in vulnerable demographic groups, although climate change is also important, particularly in the western region where future exposure would be about 30% lower under RCP2.6 compared to RCP8.5. The results emphasize the crucial role that socioeconomic and demographic change play in shaping future population vulnerability and exposure to Aedes-borne virus transmission risk in the United States, and underline the importance of including socioeconomic scenarios in projections of climate-related vector-borne disease impacts.

The Role of Vector Trait Variation in Vector-Borne Disease Dynamics

Many important endemic and emerging diseases are transmitted by vectors that are biting arthropods. The functional traits of vectors can affect pathogen transmission rates directly and also through their effect on vector population dynamics. Increasing empirical evidence shows that vector traits vary significantly across individuals, populations, and environmental conditions, and at time scales relevant to disease transmission dynamics. Here, we review empirical evidence for variation in vector traits and how this trait variation is currently incorporated into mathematical models of vector-borne disease transmission. We argue that mechanistically incorporating trait variation into these models, by explicitly capturing its effects on vector fitness and abundance, can improve the reliability of their predictions in a changing world. We provide a conceptual framework for incorporating trait variation into vector-borne disease transmission models, and highlight key empirical and theoretical challenges. This framework provides a means to conceptualize how traits can be incorporated in vector borne disease systems, and identifies key areas in which trait variation can be explored. Determining when and to what extent it is important to incorporate trait variation into vector borne disease models remains an important, outstanding question.

Choice of unmanned aerial vehicles for identification of mosquito breeding sites

The disordered urban growth that may favour the emergence of the Aedes aegypti mosquito in cities is a problem of increasing magnitude in middle- and high-income countries in the tropical part of the world. Currently, the World Health Organization (WHO) considers the control and elimination of Ae. aegypti a world-wide high priority as it is the main vector of many rapidly spreading viral diseases, dengue in particular. A major difficulty in controlling the proliferation of this vector is associated with identification of the breeding sites. The use of Unmanned Aerial Vehicles (UAVs) can be an efficient alternative to manual search because of high mobility and the ability to overcome physical obstacles, particularly in urban areas where it can offer close-up images of potential breeding sites that are difficult to reach. The objective of this study was to find a way to select the most suitable UAV for the identification of Ae. aegypti habitats by providing images of potential mosquito breeding sites. This can be accomplished by a Multiple-Criteria Decision Method (MCDM) based on an Analytical Hierarchy Process (AHP) for the evaluation of weights of the criteria used for characterizing UAVs. The alternatives were analyzed and ranked using the Fuzzy Set Theory (FST) merged with the Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS). The methodology is explained and discussed with respect to identification and selection of the most appropriate UAV for aerial mapping of Aedes breeding sites.

Mosquito surveillance and disease outbreak risk models to inform mosquito-control operations in Europe

Surveillance programs are needed to guide mosquito-control operations to reduce both nuisance and the spread of mosquito-borne diseases. Understanding the thresholds for action to reduce both nuisance and the risk of arbovirus transmission is becoming critical. To date, mosquito surveillance is mainly implemented to inform about pathogen transmission risks rather than to reduce mosquito nuisance even though lots of control efforts are aimed at the latter. Passive surveillance, such as digital monitoring (validated by entomological trapping), is a powerful tool to record biting rates in real time. High-quality data are essential to model the risk of arbovirus diseases. For invasive pathogens, efforts are needed to predict the arrival of infected hosts linked to the small-scale vector to host contact ratio, while for endemic pathogens efforts are needed to set up region-wide highly structured surveillance measures to understand seasonal re-activation and pathogen transmission in order to carry out effective control operations.

Accelerating invasion potential of disease vector Aedes aegypti under climate change

Vector-borne diseases remain a major contributor to the global burden of disease, while climate change is expected to exacerbate their risk. Characterising vector development rate and its spatio-temporal variation under climate change is central to assessing the changing basis of human disease risk. We develop a mechanistic phenology model and apply it to Aedes aegypti, an invasive mosquito vector for arboviruses (e.g. dengue, zika and yellow fever). The model predicts the number of life-cycle completions (LCC) for a given location per unit time based on empirically derived biophysical responses to environmental conditions. Results suggest that the world became ~1.5% more suitable per decade for the development of Ae. aegypti during 1950–2000, while this trend is predicted to accelerate to 3.2–4.4% per decade by 2050. Invasion fronts in North America and China are projected to accelerate from ~2 to 6 km/yr by 2050. An increase in peak LCC combined with extended periods suitable for mosquito development is simulated to accelerate the vector’s global invasion potential.

Understanding how life cycles of vectors respond to climatic factors is important to predict potential shifts in vector-borne disease risk in the coming decades. Here the authors develop a mechanistic phenological model for the invasive mosquito Aedes aegypti and apply it to project shifts under climate change scenarios.

Estimating Past, Present, and Future Trends in the Global Distribution and Abundance of the Arbovirus Vector Aedes aegypti Under Climate Change Scenarios

Background:Aedes aegypti is the principal vector for several important arbovirus diseases, including dengue, chikungunya, yellow fever, and Zika. While recent empirical research has attempted to identify the current global distribution of the vector, the seasonal, and longer-term dynamics of the mosquito in response to trends in climate, population, and economic development over the twentieth and the twenty-first century remains to be elucidated.

Methods: In this study, we use a process-based mathematical model to estimate global vector distribution and abundance. The model is based on the lifecycle of the vector and its dependence on climate, and the model sensitivity to socio-economic development is tested. Model parameters were generally empirically based, and the model was calibrated to global databases and time series of occurrence and abundance records. Climate data on temperature and rainfall were taken from CRU TS3.25 (1901–2015) and five global circulation models (CMIP5; 2006–2099) forced by a high-end (RCP8.5) and a low-end (RCP2.6) emission scenario. Socio-economic data on global GDP and human population density were from ISIMIP (1950–2099).

Findings: The change in the potential of global abundance in A. aegypti over the last century up to today is estimated to be an increase of 9.5% globally and a further increase of 20 or 30% by the end of this century under a low compared to a high carbon emission future, respectively. The largest increase has occurred in the last two decades, indicating a tipping point in climate-driven global abundance which will be stabilized at the earliest in the mid-twenty-first century. The realized abundance is estimated to be sensitive to socioeconomic development.

Interpretation: Our data indicate that climate change mitigation, i.e., following the Paris Agreement, could considerably help in suppressing risks of increased abundance and emergence of A. aegypti globally in the second half of the twenty-first century.

Do we know how mosquito disease vectors will respond to climate change?

Mosquito-borne diseases are on the rise globally. Besides invasion processes and the increasing connectivity between distant regions through the trade of goods and human mobility, climate change is seen as an important driver for changing the likelihood of occurrence of vectors and diseases, respectively. Ectothermic insects respond directly to thermal conditions and thus we can expect them to follow climatic trends. However, a variety of species and different stages in their life cycles need to be considered. Here, we review the current literature in this field and disentangle the state of knowledge and the challenges and open questions for future research. The integration of diurnal temperature ranges in prospective experimental studies will strongly improve the knowledge of mosquitoes’ ecology and mosquito-borne disease transmission for temperate regions in particular. In addition, invasive mosquitoes are known to rapidly adapt to the climatic conditions, but the underlying processes are not yet fully understood.

Climate change and the rising infectiousness of dengue

The disease burden of dengue has been steadily rising over the last half-century due to a multitude of factors, including global trade and travel, urbanization, population growth, and climate variability and change, that facilitate conductive conditions for the proliferation of dengue vectors and viruses. This review describes how climate, specifically temperature, affects the vectors’ ability to cause and sustain outbreaks, and how the infectiousness of dengue is influenced by climatic change. The review is focused on the core concepts and frameworks derived in the area of epidemiology of mosquito-borne diseases and outlines the sensitivity of vectorial capacity and vector-to-human transmission on climatic conditions. It further reviews studies linking mathematical or statistical models of disease transmission to scenarios of projected climate change and provides recommendations for future research directions.