Effectiveness of Ultra-Low Volume insecticide spraying to prevent dengue in a non-endemic metropolitan area of Brazil

VectAbundance: a spatio-temporal database of Aedes mosquitoes observations

Modelling approaches play a crucial role in supporting local public health agencies by estimating and forecasting vector abundance and seasonality. However, the reliability of these models is contingent on the availability of standardized, high-quality data. Addressing this need, our study focuses on collecting and harmonizing egg count observations of the mosquito Aedes albopictus, obtained through ovitraps in monitoring and surveillance efforts across Albania, France, Italy, and Switzerland from 2010 to 2022. We processed the raw observations to obtain a continuous time series of ovitraps observations allowing for an extensive geographical and temporal coverage of Ae. albopictus population dynamics. The resulting post-processed observations are stored in the open-access database VectAbundance.This initiative addresses the critical need for accessible, high-quality data, enhancing the reliability of modelling efforts and bolstering public health preparedness.

Reporting delays of chikungunya cases during the 2017 outbreak in Lazio region, Italy

BACKGROUND

Emerging arboviral diseases in Europe pose a challenge due to difficulties in detecting and diagnosing cases during the initial circulation of the pathogen. Early outbreak detection enables public health authorities to take effective actions to reduce disease transmission. Quantification of the reporting delays of cases is vital to plan and assess surveillance and control strategies. Here, we provide estimates of reporting delays during an emerging arboviral outbreak and indications on how delays may have impacted onward transmission.

METHODOLOGY/PRINCIPAL FINDINGS

Using descriptive statistics and Kaplan-Meyer curves we analyzed case reporting delays (the period between the date of symptom onset and the date of notification to the public health authorities) during the 2017 Italian chikungunya outbreak. We further investigated the effect of outbreak detection on reporting delays by means of a Cox proportional hazard model. We estimated that the overall median reporting delay was 15.5 days, but this was reduced to 8 days after the notification of the first case. Cases with symptom onset after outbreak detection had about a 3.5 times higher reporting rate, however only 3.6% were notified within 24h from symptom onset. Remarkably, we found that 45.9% of identified cases developed symptoms before the detection of the outbreak.

CONCLUSIONS/SIGNIFICANCE

These results suggest that efforts should be undertaken to improve the early detection and identification of arboviral cases, as well as the management of vector species to mitigate the impact of long reporting delays.

Prevention of a dengue outbreak via the large-scale deployment of Sterile Insect Technology in a Brazilian city: a prospective study

Background

Dengue is a global problem that seems to be worsening, as hyper-urbanization associated with climate change has led to a significant increase in the abundance and geographical spread of its principal vector, the Aedes aegypti mosquito. Currently available solutions have not been able to stop the spread of dengue which shows the urgent need to implement alternative technologies as practical solutions. In a previous pilot trial, we demonstrated the efficacy and safety of the method 'Natural Vector Control' (NVC) in suppressing the Ae. aegypti vector population and in blocking the occurrence of an outbreak of dengue in the treated areas. Here, we expand the use of the NVC program in a large-scale 20 months intervention period in an entire city in southern Brazil.

Methods

Sterile male mosquitoes were produced from locally sourced Ae. aegypti mosquitoes by using a treatment that includes double-stranded RNA and thiotepa. Weekly massive releases of sterile male mosquitoes were performed in predefined areas of Ortigueira city from November 2020 to July 2022. Mosquito monitoring was performed by using ovitraps during the entire intervention period. Dengue incidence data was obtained from the Brazilian National Disease Surveillance System.

Findings

During the two epidemiological seasons, the intervention in Ortigueira resulted in up to 98.7% suppression of live progeny of field Ae. aegypti mosquitoes recorded over time. More importantly, when comparing the 2020 and 2022 dengue outbreaks that occurred in the region, the post-intervention dengue incidence in Ortigueira was 97% lower compared to the control cities.

Interpretation

The NVC method was confirmed to be a safe and efficient way to suppress Ae. aegypti field populations and prevent the occurrence of a dengue outbreak. Importantly, it has been shown to be applicable in large-scale, real-world conditions.

Funding

This study was funded by Klabin S/A and Forrest Innovations Ltd.

A Systematic Review of Mathematical Models of Dengue Transmission and Vector Control: 2010-2020

Vector control methods are considered effective in averting dengue transmission. However, several factors may modify their impact. Of these controls, chemical methods, in the long run, may increase mosquitoes' resistance to chemicides, thereby decreasing control efficacy. The biological methods, which may be self-sustaining and very effective, could be hampered by seasonality or heatwaves (resulting in, e.g., loss of Wolbachia infection). The environmental methods that could be more effective than the chemical methods are under-investigated. In this study, a systematic review is conducted to explore the present understanding of the effectiveness of vector control approaches via dengue transmission models.

Effectiveness of Aedes-borne infectious disease control in Latin America and the Caribbean region: A scoping review

Background

Aedes aegypti and Aedes albopictus are primary vectors of emerging or re-emerging arboviruses that threaten public health worldwide. Many efforts have been made to develop interventions to control these Aedes species populations. Still, countries in the Latin America and the Caribbean (LAC) region struggle to create/design/develop sustainable and effective control strategies. This scoping review synthesises evidence concerning the effectiveness of Ae. aegypti and Ae. albopictus prevention and control interventions performed in LAC (2000–2021). The findings can be used to evaluate, compare and develop more effective control strategies.

Methodology

The review is based on the methodology by Joanna Briggs Institute for conducting a scoping review. The MEDLINE (via PubMed and Web of Science), Cochrane Library, Scopus, EMBASE and ScienceDirect databases were used to search for articles. Grey literature was searched from governmental and non-governmental organisation websites. Four reviewers independently screened all titles and abstracts and full-text of the articles using the Rayyan web application, based on pre-defined eligibility criteria.

Results

A total of 122 publications were included in the review. Most studies focused on dengue virus infection and data on Ae. aegypti. Entomological data were mainly used to determine the intervention’s effectiveness. An integrated control intervention was the most commonly employed strategy in both regions. Biological control measures, environmental management, and health education campaigns on community participation achieved more sustainable results than an intervention where only a chemical control measure was used. Challenges to implementing interventions were insufficient financial support, resources, workforce, intersectoral collaboration and legislation.

Conclusions

Based on the synthesised data, an integrated vector (Aedes) management focused on community participation seems to be the most effective approach to mitigate Aedes-borne infectious diseases. Maintaining the approach’s effect remains challenging as it requires multisectoral and multi-disciplinary team engagement and active community participation. Future research needs to address the barriers to program implementation and maintenance as data on this topic is lacking.

Geographic Partitioning of Dengue Virus Transmission Risk in Florida

Dengue viruses (DENVs) cause the greatest public health burden globally among the arthropod-borne viruses. DENV transmission risk has also expanded from tropical to subtropical regions due to the increasing range of its principal mosquito vector, Aedes aegypti. Focal outbreaks of dengue fever (dengue) in the state of Florida (FL) in the USA have increased since 2009. However, little is known about the competence of Ae. aegypti populations across different regions of FL to transmit DENVs. To understand the effects of DENV genotype and serotype variations on vector susceptibility and transmission potential in FL, we orally infected a colony of Ae. aegypti (Orlando/ORL) with low passage or laboratory DENV-1 through -4. Low passage DENVs were more infectious to and had higher transmission potential by ORL mosquitoes. We used these same DENVs to examine natural Ae. aegypti populations to determine whether spatial distributions correlated with differential vector competence. Vector competence across all DENV serotypes was greater for mosquitoes from areas with the highest dengue incidence in south FL compared to north FL. Vector competence for low passage DENVs was significantly higher, revealing that transmission risk is influenced by virus/vector combinations. These data support a targeted mosquito-plus-pathogen screening approach to more accurately estimate DENV transmission risk.

Spatial connectivity in mosquito-borne disease models: a systematic review of methods and assumptions

Spatial connectivity plays an important role in mosquito-borne disease transmission. Connectivity can arise for many reasons, including shared environments, vector ecology and human movement. This systematic review synthesizes the spatial methods used to model mosquito-borne diseases, their spatial connectivity assumptions and the data used to inform spatial model components. We identified 248 papers eligible for inclusion. Most used statistical models (84.2%), although mechanistic are increasingly used. We identified 17 spatial models which used one of four methods (spatial covariates, local regression, random effects/fields and movement matrices). Over 80% of studies assumed that connectivity was distance-based despite this approach ignoring distant connections and potentially oversimplifying the process of transmission. Studies were more likely to assume connectivity was driven by human movement if the disease was transmitted by an Aedes mosquito. Connectivity arising from human movement was more commonly assumed in studies using a mechanistic model, likely influenced by a lack of statistical models able to account for these connections. Although models have been increasing in complexity, it is important to select the most appropriate, parsimonious model available based on the research question, disease transmission process, the spatial scale and availability of data, and the way spatial connectivity is assumed to occur.

Spatial modes for transmission of chikungunya virus during a large chikungunya outbreak in Italy: a modeling analysis

BACKGROUND

The spatial spread of many mosquito-borne diseases occurs by focal spread at the scale of a few hundred meters and over longer distances due to human mobility. The relative contributions of different spatial scales for transmission of chikungunya virus require definition to improve outbreak vector control recommendations.

METHODS

We analyzed data from a large chikungunya outbreak mediated by the mosquito Aedes albopictus in the Lazio region, Italy, consisting of 414 reported human cases between June and November 2017. Using dates of symptom onset, geographic coordinates of residence, and information from epidemiological questionnaires, we reconstructed transmission chains related to that outbreak.

RESULTS

Focal spread (within 1 km) accounted for 54.9% of all cases, 15.8% were transmitted at a local scale (1-15 km) and the remaining 29.3% were exported from the main areas of chikungunya circulation in Lazio to longer distances such as Rome and other geographical areas. Seventy percent of focal infections (corresponding to 38% of the total 414 cases) were transmitted within a distance of 200 m (the buffer distance adopted by the national guidelines for insecticide spraying). Two main epidemic clusters were identified, with a radius expanding at a rate of 300-600 m per month. The majority of exported cases resulted in either sporadic or no further transmission in the region.

CONCLUSIONS

Evidence suggest that human mobility contributes to seeding a relevant number of secondary cases and new foci of transmission over several kilometers. Reactive vector control based on current guidelines might allow a significant number of secondary clusters in untreated areas, especially if the outbreak is not detected early. Existing policies and guidelines for control during outbreaks should recommend the prioritization of preventive measures in neighboring territories with known mobility flows to the main areas of transmission.

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.

Site Occupancy by Aedes aegypti in a Subtropical City is Most Sensitive to Control during Autumn and Winter Months

The Aedes aegypti mosquito inhabits most tropical and subtropical regions of the globe, where it transmits arboviral diseases of substantial public health relevance, such as dengue fever. In subtropical regions, Ae. aegypti often presents an annual abundance cycle driven by weather conditions. Because different population states may show varying responses to control, we are interested in studying what time of the year is most appropriate for control. To do so, we developed two dynamic site-occupancy models based on more than 200 weeks of mosquito trapping data from nearly 900 sites in a subtropical Brazilian city. Our phenomenological, Markovian models, fitted to data in a Bayesian framework, accounted for failure to detect mosquitoes in two alternative ways and for temporal variation in dynamic rates of local extinction and colonization of new sites. Infestation varied from nearly full cover of the city area in late summer, to between 10% and 67% of sites occupied in winter depending on the model. Sensitivity analysis reveals that changes in dynamic rates should have the greatest impact on site occupancy during autumn and early winter months, when the mosquito population is declining. We discuss the implications of this finding to the timing of mosquito control.

Dynamics and Distribution of the Invasive Mosquito Aedes koreicus in a Temperate European City

Aedes koreicus is a mosquito species native to Asia that has recently successfully invaded new areas in several European countries. Here, we provide important data on Ae. koreicus establishment in Pécs (Southern Hungary). Mosquito surveillance was carried out weekly between 2016 and 2019 at 10 different sites located throughout the city from May to September. We conducted a statistical analysis to evaluate the most important abiotic factors driving Ae. koreicus abundance. We then calibrated a previously developed temperature-dependent mathematical model to the recorded captures to evaluate mosquito abundance in the study area. We found that too high summer temperatures negatively affect mosquito abundance. The model accurately replicated the observed capture patterns, providing an estimate of Ae. koreicus density for each breeding season, which we interpolated to map Ae. koreicus abundance throughout Pécs. We found a negative correlation between mosquito captures and human density, suggesting that Ae. koreicus does not necessarily require humans for its blood meals. Our study provides a successful application of a previously published mathematical model to investigate Ae. koreicus population dynamics, proving its suitability for future studies, also within an epidemiological framework.

RC, Perkins TA. Optimizing the deployment of ultra-low volume and targeted indoor residual spraying for dengue outbreak response

Recent years have seen rising incidence of dengue and large outbreaks of Zika and chikungunya, which are all caused by viruses transmitted by Aedes aegypti mosquitoes. In most settings, the primary intervention against Aedes-transmitted viruses is vector control, such as indoor, ultra-low volume (ULV) spraying. Targeted indoor residual spraying (TIRS) has the potential to more effectively impact Aedes-borne diseases, but its implementation requires careful planning and evaluation. The optimal time to deploy these interventions and their relative epidemiological effects are, however, not well understood. We used an agent-based model of dengue virus transmission calibrated to data from Iquitos, Peru to assess the epidemiological effects of these interventions under differing strategies for deploying them. Specifically, we compared strategies where spray application was initiated when incidence rose above a threshold based on incidence in recent years to strategies where spraying occurred at the same time(s) each year. In the absence of spraying, the model predicted 361,000 infections [inter-quartile range (IQR): 347,000-383,000] in the period 2000-2010. The ULV strategy with the fewest median infections was spraying twice yearly, in March and October, which led to a median of 172,000 infections [IQR: 158,000-183,000], a 52% reduction from baseline. Compared to spraying once yearly in September, the best threshold-based strategy utilizing ULV had fewer median infections (254,000 vs. 261,000), but required more spraying (351 vs. 274 days). For TIRS, the best strategy was threshold-based, which led to the fewest infections of all strategies tested (9,900; [IQR: 8,720-11,400], a 94% reduction), and required fewer days spraying than the equivalent ULV strategy (280). Although spraying twice each year is likely to avert the most infections, our results indicate that a threshold-based strategy can become an alternative to better balance the translation of spraying effort into impact, particularly if used with a residual insecticide.

First report of the influence of temperature on the bionomics and population dynamics of Aedes koreicus, a new invasive alien species in Europe

BACKGROUND

Aedes koreicus was detected in northern Italy for the first time in 2011, and it is now well established in several areas as a new invasive mosquito species. Data regarding the influence of temperature on mosquito survival and development are not available yet for this species.

METHODS

We experimentally investigated the influence of different constant rearing temperatures (between 4 and 33 °C) on the survival rates and developmental times of different life stages of Ae. koreicus under laboratory conditions. The resulting data were subsequently used to inform a mathematical model reproducing the Ae. koreicus life-cycle calibrated to counts of adult females captured in the field in the autonomous province of Trento (northern Italy) between 2016 and 2018.

RESULTS

We found that temperatures above 28 °C are not optimal for the survival of pupae and adults, whereas temperate conditions of 23-28 °C seem to be very favorable, explaining the recent success of Ae. koreicus at establishing into new specific areas. Our results indicate that Ae. koreicus is less adapted to local climatic conditions compared to Ae. albopictus, another invasive species which has been invading the area for the last three decades. Warmer seasons, which are more likely to occur in the future because of climate change, might extend the breeding time and therefore increase the abundance of Ae. koreicus in the study region.

CONCLUSIONS

Our findings provide, to our knowledge, the first evidence on how temperature influences the bionomics and dynamics of Ae. koreicus and highlight the need for further studies on the phenology of this species in temperate areas of Europe.