The use of ecological niche modeling to infer potential risk areas of snakebite in the Mexican state of Veracruz

Combining species distribution models and big datasets may provide finer assessments of snakebite impacts

BACKGROUND

Snakebite is a major poverty-related neglected tropical disease. An integrated scientific approach is needed to understand the dynamics of this important health issue. Our objective was to estimate snakebite occurrence in a tropical area by using a blend of ecological modelling and robust statistical analysis.

METHODS

The present study used climatic, environmental, and human population density data to determine the area with snakebite occurrence-probability for the first time in Bangladesh. We also analysed a large, 16-year dataset of hospitalized snakebite cases to reveal the epidemiology of snakebite in the south-eastern zone of the country.

FINDINGS

Our results show that cobra bite is the most commonly occurring venomous snakebite in humans (around ~12% of the total yearly snakebite records), and men are more frequently bitten than women (2/3 of human victims are men). Most bites occur during the rainy season for cobra and green pit viper, while krait bites are not restricted to any particular season. As snakebite incidents are closely related to climate conditions, we can model snakebite risk using temperature and precipitation variables. Whereas there is a lack of snakebite reports from several parts of the study area in official records, our models predict that the entire study area is favourable for snakebite incidents. Based on the combined evidence we estimate that about 200,000 snakebite events occur every year in the south-eastern part of Bangladesh alone. Considering future global climate change, our model projections show that snakebite incidence in Bangladesh might not significantly decrease in the future (- 2070-); however, the distribution of probabilities might change, with a predicted increase of snakebite incidence in the hilly areas of the country.

CONCLUSIONS

Using climatic data to predict snakebite incidence in Bangladesh allowed us to provide estimations of the total annual number of snakebite cases in the study area. As in most countries, the scarcity of accurate epidemiological data in official records might have masked the real magnitude of this problem. Our analysis suggests that the problem of snakebite envenoming in Bangladesh might be worse than currently perceived. A long-term sustainable snakebite program plan should be designed and institutionalized, considering climatic, geographical and human demographic variables, to obtain better data and facilitate the implementation of accurate snakebite management programs for this country.

The challenge in detecting risk areas of snakebite when case rates are low: the case of Amazonian coral snakes

Identifying risk areas for envenomation by animals is relevant for public health, such as strategic distribution of antivenoms. Coral snakes are highly diverse in the Amazon, inhabit natural and human-modified environments, and the outcome of the cases tends to be serious and potentially lethal due to their neurotoxic venom. By integrating species' geographical records and environmental variables, we used species distribution modeling to predict the distribution of coral snake species in the Brazilian Amazonia. We analyzed the relationship between the predicted distribution of coral snake species, along with envenomation data in the region, to propose actions to reduce the number of cases and to provide tools for a better policy of public health. We conclude that the entire Amazon shows high environmental suitability for coral snakes, and such suitability explains little about the incidence of cases. This is probably due to the low human density in the Amazon and to coral snake traits such as secretive habits and non-agressive behavior. Differently from other venomous snakes, the scenario regarding coral snakebites precludes the detection of prominent geographical areas of concern and demands a broad and equitable availability of health centers throughout Amazonia and along other areas of occurrence of the genus Micrurus.

Snakebite epidemiology, outcomes and multi-cluster risk modelling in Eswatini

BACKGROUND

Halving snakebite morbidity and mortality by 2030 requires countries to develop both prevention and treatment strategies. The paucity of data on the global incidence and severity of snakebite envenoming causes challenges in prioritizing and mobilising resources for snakebite prevention and treatment. In line with the World Health Organisation's 2019 Snakebite Strategy, this study sought to investigate Eswatini's snakebite epidemiology and outcomes, and identify the socio-geographical factors associated with snakebite risk.

METHODOLOGY

Programmatic data from the Ministry of Health, Government of Eswatini 2019-2021, was used to assess the epidemiology and outcomes of snakebite in Eswatini. We developed a snake species richness map from the occurrence data of all venomous snakes of medical importance in Eswatini that was subjected to niche modelling. We formulated four risk indices using snake species richness, various geospatial datasets and reported snakebites. A multivariate cluster modelling approach using these indices was developed to estimate risk of snakebite and the outcomes of snakebite in Eswatini.

PRINCIPAL FINDINGS

An average of 466 snakebites was recorded annually in Eswatini. Bites were recorded across the entire country and peaked in the evening during summer months. Two cluster risk maps indicated areas of the country with a high probability of snakebite and a high probability of poor snakebite outcomes. The areas with the highest rate of snakebite risk were primarily in the rural and agricultural regions of the country.

SIGNIFICANCE

These models can be used to inform better snakebite prevention and treatment measures to enable Eswatini to meet the global goal of reducing snakebite morbidity and mortality by 50% by 2030. The supply chain challenges of antivenom affecting southern Africa and the high rates of snakebite identified in our study highlight the need for improved snakebite prevention and treatment tools that can be employed by health care workers stationed at rural, community clinics.

Potential hotspots of amphibian roadkill risk in Spain

We test a forecasting strategy to identify potential hotspots of amphibian roadkill, combining the spatial distribution of amphibians, their relative risk of collision with vehicles and data on road density in Spain. We extracted a large dataset from studies reporting road casualties of 39 European amphibian species and then estimated the 'relative roadkill risk' of species as the frequency of occurrence of casualties for each amphibian and standardized by the range of distribution of the species in Europe. Using a map with the spatial distribution of Spanish amphibians at a spatial resolution of 10 × 10 Km squares, we estimated the 'cumulative relative risk of roadkill' for each amphibian assemblage as the sum of risk estimates previously calculated for each species. We also calculated the total length of roads in each square (road density). Finally, combining all layers of information, we elaborated a forecasting map highlighting the potential amphibian roadkill risk across Spain. Our findings are relevant to suggest areas that should be focused on at more detailed spatial scales. Additionally, we found that the frequency of roadkill was unrelated to the evolutionary distinctiveness score and conservation status of amphibian species, while was positively correlated with their distribution range.

Identifying the geographic distribution pattern of venomous snakes and regions of high snakebite risk in Iran

We describe species richness patterns of venomous snakes in Iran in order to produce snakebite risk prediction maps and identify gaps in regional health care centers capable of managing snakebites. We digitized distribution maps from the literature, Global Biodiversity Information Facility (GBIF), and the results of our own field studies of 24 terrestrial venomous snake species (including 4 endemic to Iran). Species richness patterns were associated with eight environmental factors. The variables have been extracted from the WorldClim dataset (bio12 = annual precipitation, bio15 = precipitation seasonality, bio17 = precipitation of the driest quarter, bio2 = mean diurnal range, bio3 = isothermality (bio2/bio7), bio4 = temperature seasonality, bio9 = mean temperature of the driest quarter and slope). Based on spatial analyses, species richness in Iran is highly affected by three environmental variables (bio12, 15, and 17) associated with precipitation. The relationship patterns among these predictors and species richness were strong and linear. The hotspot regions for venomous snakes species are concentrated on the western to southwestern and north to northeastern regions of Iran, which is partially consistent with the known Irano-Anatolian biodiversity hotspot. Because of the high number of endemic species and climatic conditions on the Iranian Plateau, the venoms of snakes distributed in those areas may contain novel properties and components.

Identification of Risk Areas for Gloydius Snakebites in South Korea

Snakebites can pose a significant threat to human health as the destruction of natural habitats and increased human intrusion into ecosystems result in more frequent encounters with snakes. Mitigation measures for snakebites are particularly crucial for hiking trails where transportation of snakebite victims to medical facilities is challenging due to limited emergency resources and difficult access. This study employed a random forest-based species distribution model approach to investigate the potential habitats of Gloydius spp., specifically Gloydius saxatilis, Gloydius brevicaudus, and Gloydius ussuriensis, in South Korea and to assess the snakebite risk in national parks. Potential habitats of Gloydius spp. were identified and visualized by overlaying binary maps derived from species distribution models (SDMs) of each Gloydius spp. that corresponded to high-risk snakebite areas. In addition, hiking trails with high snakebite risk in the national parks were identified after demonstrating the statistical correlation between the potential habitat distribution of Gloydius spp. and the actual snakebite incidents in major regions of South Korea. The primary environmental variables determining Gloydius spp. habitat were the topographic position index, slope, and the annual average of the maximum and minimum temperatures. The potential habitat of G. saxatilis generally appeared in high-altitude mountainous areas, mostly in the eastern part of the study area. Favorable habitats for G. brevicaudus and G. ussuriensis were predominantly located in mountainous areas throughout the study area, with the exception of some high-altitude mountainous terrain in the east. The number of snakebite incidents per 10,000 people was significantly correlated with the area ratio of Gloydius spp. potential habitat (Spearman's rho = 0.638, p < 0.01). The proportion of snakebite risk areas among national parks in South Korea ranged from 18% to 57%. This study can support practical solutions to prevent injuries and fatalities among hikers due to snakebites by identifying areas with a high risk of snakebite accidents at the hiking-trail level.

Identifying high snakebite risk area under climate change for community education and antivenom distribution

Snakebite is one of the largest risks from wildlife, however little is known about venomous snake distribution, spatial variation in snakebite risk, potential changes in snakebite risk pattern due to climate change, and vulnerable human population. As a consequence, management and prevention of snakebite is hampered by this lack of information. Here we used habitat suitability modeling for 10 medically important venomous snakes to identify high snakebite risk area under climate change in Iran. We identified areas with high snakebite risk in Iran and showed that snakebite risk will increase in some parts of the country. Our results also revealed that mountainous areas (Zagros, Alborz, Kopet-Dagh mountains) will experience highest changes in species composition. We underline that in order to improve snakebite management, areas which were identified with high snakebite risk in Iran need to be prioritized for the distribution of antivenom medication and awareness rising programs among vulnerable human population.

Threatened Habitats of Carnivores: Identifying Conservation Areas in Michoacán, México

The present study contributes to bridging the gap in research related to the presence and distribution patterns of carnivore mammals in western México and identifies priority areas for biodiversity conservation in western Michoacán, México. The distribution of 11 carnivore species (Canis latrans; Urocyon cinereoargenteus; Herpailurus yagouaroundi; Leopardus pardalis; Leopardus wiedii; Puma concolor; Panthera onca; Conepatus leuconotus; Bassariscus astutus; Nasua narica; Procyon lotor) in western México was modeled through the application of a two-scale approach, including a large modeled region that corresponded to the western part of the country, for which consensus models were obtained that represent the species’ bioclimatic envelopes (historic occurrence records); and the second modeled study area that includes only the western portion of the state of Michoacán in which compounded models of the species’ habitat suitability (field occurrence records) for this region were proposed. Using species’ habitat suitability models as biodiversity units, prioritization exercises were carried out on important areas for the conservation of these species, as well as the comparison and analysis of the existing natural protected areas (NPA) and existing proposed conservation areas in the study area. The different exercises for prioritizing areas for conservation yielded similar results and show the potential percentages of the landscape that can be subjected to conservation programs. The highest conservation priority values were mainly located in the Costas del Sur and Cordillera del Sur provinces. This study signifies a flexible basis from which future studies on planning and designing a network of natural protected areas can be carried out in this region.

Climate change maladaptation for health: Agricultural practice against shifting seasonal rainfall affects snakebite risk for farmers in the tropics

Snakebite affects more than 1.8 million people annually. Factors explaining snakebite variability include farmers' behaviors, snake ecology and climate. One unstudied issue is how farmers' adaptation to novel climates affect their health. Here we examined potential impacts of adaptation on snakebite using individual-based simulations, focusing on strategies meant to counteract major crop yield decline because of changing rainfall in Sri Lanka. For rubber cropping, adaptation led to a 33% increase in snakebite incidence per farmer work hour because of work during risky months, but a 17% decrease in total annual snakebites because of decreased labor in plantations overall. Rice farming adaptation decreased snakebites by 16%, because of shifting labor towards safer months, whereas tea adaptation led to a general increase. These results indicate that adaptation could have both a positive and negative effect, potentially intensified by ENSO. Our research highlights the need for assessing adaptation strategies for potential health maladaptations.

A generalized framework for estimating snakebite underreporting using statistical models: A study in Colombia

BACKGROUND

Snakebite envenoming is a neglected tropical disease affecting deprived populations, and its burden is underestimated in some regions where patients prefer using traditional medicine, case reporting systems are deficient, or health systems are inaccessible to at-risk populations. Thus, the development of strategies to optimize disease management is a major challenge. We propose a framework that can be used to estimate total snakebite incidence at a fine political scale.

METHODOLOGY/PRINCIPAL FINDINGS

First, we generated fine-scale snakebite risk maps based on the distribution of venomous snakes in Colombia. We then used a generalized mixed-effect model that estimates total snakebite incidence based on risk maps, poverty, and travel time to the nearest medical center. Finally, we calibrated our model with snakebite data in Colombia from 2010 to 2019 using the Markov-chain-Monte-Carlo algorithm. Our results suggest that 10.19% of total snakebite cases (532.26 yearly envenomings) are not reported and these snakebite victims do not seek medical attention, and that populations in the Orinoco and Amazonian regions are the most at-risk and show the highest percentage of underreporting. We also found that variables such as precipitation of the driest month and mean temperature of the warmest quarter influences the suitability of environments for venomous snakes rather than absolute temperature or rainfall.

CONCLUSIONS/SIGNIFICANCE

Our framework permits snakebite underreporting to be estimated using data on snakebite incidence and surveillance, presence locations for the most medically significant venomous snake species, and openly available information on population size, poverty, climate, land cover, roads, and the locations of medical centers. Thus, our algorithm could be used in other countries to estimate total snakebite incidence and improve disease management strategies; however, this framework does not serve as a replacement for a surveillance system, which should be made a priority in countries facing similar public health challenges.

Favourable climatic niche in low elevations outside the flood zone characterises the distribution pattern of venomous snakes in Bangladesh

Snakes are sensitive to both environmental and climate gradients. To design conservation plans, a scientific understanding of snake habitats in light of environmental and climatic variables is an essential prerequisite. For venomous snakes, denoting favourable habitats should also be relevant for snakebite management. We have considered 18 spatial variables to portray the range of terrestrial venomous snake distribution in Bangladesh. Our results indicate that the distribution of 29 studied venomous snakes in this country is primarily driven by climatic and environmental variables. We found that especially low elevation and flood risk constrain the distribution of those terrestrial snakes, i.e. regular floods in central Bangladesh push venomous snakes towards the edges of the country. Moreover, none of these species occupies the whole of its anticipated climatically favourable area. Projections into the future indicated that 11 studied species, Amphiesma platyceps, Boiga siamensis, Chrysopelea ornata, Pseudoxenodon macrops, Rhabdophis himalayanus, Rhabdophis subminiatus, Bungarus lividus, Ophiophagus hannah, Daboia russelii, Ovophis monticola and Trimeresurus popeiorum will lose their entire climatically suitable area within the country. Therefore, we suggest establishing more protected areas in the hilly ecosystems in the eastern part and in the mangrove forests in the south-western corner of Bangladesh to mitigate future extinction risks, such as climate change, sea-level rise and increase in flood severity. Conserving village forests and croplands, which are subject to rapid change, will also need to be addressed equally, as these are inhabited by almost one-third of the studied species. The occurrence of the cobras and kraits in village forests and cropland dominant habitats demands more attention to minimise snakebite related mortality and morbidity.

VenomMaps: Updated species distribution maps and models for New World pitvipers (Viperidae: Crotalinae)

Beyond providing critical information to biologists, species distributions are useful for naturalists, curious citizens, and applied disciplines including conservation planning and medical intervention. Venomous snakes are one group that highlight the importance of having accurate information given their cosmopolitan distribution and medical significance. Envenomation by snakebite is considered a neglected tropical disease by the World Health Organization and venomous snake distributions are used to assess vulnerability to snakebite based on species occurrence and antivenom/healthcare accessibility. However, recent studies highlighted the need for updated fine-scale distributions of venomous snakes. Pitvipers (Viperidae: Crotalinae) are responsible for >98% of snakebites in the New World. Therefore, to begin to address the need for updated fine-scale distributions, we created VenomMaps, a database and web application containing updated distribution maps and species distribution models for all species of New World pitvipers. With these distributions, biologists can better understand the biogeography and conservation status of this group, researchers can better assess vulnerability to snakebite, and medical professionals can easily discern species found in their area.

Measurement(s)	Species Distributions
Technology Type(s)	Geographic Information System • Species Distribution Model (MaxEnt/kuenm)
Factor Type(s)	Occurrence Records • Environmental Data
Sample Characteristic - Organism	Crotalinae
Sample Characteristic - Location	North America • South America

A mechanistic model of snakebite as a zoonosis: Envenoming incidence is driven by snake ecology, socioeconomics and its impacts on snakes

Snakebite is the only WHO-listed, not infectious neglected tropical disease (NTD), although its eco-epidemiology is similar to that of zoonotic infections: envenoming occurs after a vertebrate host contacts a human. Accordingly, snakebite risk represents the interaction between snake and human factors, but their quantification has been limited by data availability. Models of infectious disease transmission are instrumental for the mitigation of NTDs and zoonoses. Here, we represented snake-human interactions with disease transmission models to approximate geospatial estimates of snakebite incidence in Sri Lanka, a global hotspot. Snakebites and envenomings are described by the product of snake and human abundance, mirroring directly transmitted zoonoses. We found that human-snake contact rates vary according to land cover (surrogate of occupation and socioeconomic status), the impacts of humans and climate on snake abundance, and by snake species. Our findings show that modelling snakebite as zoonosis provides a mechanistic eco-epidemiological basis to understand snakebites, and the possible implications of global environmental and demographic change for the burden of snakebite.

Use of geospatial analyses to address snakebite hotspots in mid-northern Brazil - A direction to health planning in shortfall biodiversity knowledge areas

Knowing the distribution of venomous snakes of medical importance is essential to identify areas at risk for snakebites. Thus, we used an integrative approach based on the application of geographic distribution data of venomous snakes, species distribution modeling (SDM), spatial organization of snakebites, and information on human population density for mapping the potential distribution of snakes and identifying areas at risk of snakebites in the state of Maranhão (mid-northern Brazil). From a compiled a database of venomous snake records deposited in biological collections and the literature, we predict the potential distribution of venomous snakes in Maranhão, a state whose diversity and geographic distribution of venomous snake species are poorly known. With this, we constructed potential distribution maps for each venomous snake species with at least one occurrence record within state boundaries, as well as generalized maps by family (Viperidae and Elapidae) and the total number of venomous snakes in Maranhão State. We also obtained data on the number of snakebites recorded in each municipality of Maranhão over a decade (2009-2019) and we ran a Generalized Linear Model to test for relationships between the number of venomous snakebites, the area of occurrence of snakes, and human population density. We obtained 1046 records of venomous snake species for Maranhão, represented by 17 viperid and elapid species. Most of the records were from Viperidae (mostly Bothrops atrox and B. marajoensis) and were concentrated mainly in the Amazonia of the northern portion of the state. The models showed accurate predictive performance for all modeled species. The entire area of Maranhão exhibits environmental conditions for the occurrence of venomous snakes, with higher suitability indices in the northern region, in the Amazon rainforest. The number of snakebites was positively correlated with high-risk areas (i.e., greater distribution of venomous snakes) and human population density. Our study is a pioneer in using species distribution modeling in mid-northern Brazil to address the scarcity of data on snakebite-causing species, directly contributing to the theme of neglected tropical diseases of the World Health Organization.

Spatial distribution models of seroreactive sheep to Leptospira spp. in Veracruz, Mexico

Leptospirosis is an infectious zoonotic disease of special importance in tropical regions of the world and is closely related to climatic conditions. In Mexico, at least eight Leptospira serogroups are known to affect sheep, but little is known about their distribution. The aim was to analyze the spatial distribution of seroreactive sheep to eight serogroups of Leptospira spp. through ecological niche modeling from the state of Veracruz. We carried out a cross-sectional, multi-stage, and stratified epidemiological study, sampling 405 sheep in different regions of the state (north, center, and south). The sera were analyzed using the Microscopic Agglutination Test (MAT) to identify seropositivity to eight Leptospira serogroups (Icterohaemorrhagiae, Pyrogenes, Grippotyphosa, Canicola, Pomona, Hardjo, Wolffi, and Tarassovi). Management variables in the sampled herds were evaluated through a survey among the producers, which was analyzed using the Chi-square test for cross-tabulation. Geospatial modeling was conducted using MAXENT and 19 climatic variables and the validation was carried out using the area under the curve (AUC). No positive animals were found for Pomona in any area of Veracruz and there was only one case of seroreactivity to Grippotyphosa. The total seroprevalence found was 53.83% (95% CI: 48.84-58.75). The main serogroup found was Sejroe (55.31%, 95% CI 50.32 - 60.20%), followed by Canicola (8.64%, 95% CI 6.17 - 11.92%), Icterohaemorrhagiae (4.69%, 95% CI 2.93 - 7.36%), Tarassovi (3.95%, 95% CI 2.35 - 6.47%), Pyrogenes (2.47%, 95% CI 1.26 - 4.64%), Australis (0.99%, 95% CI 0.32 - 2.69%) and Grippotyphosa (0.25%, 95% CI 0.01 - 1.59%). The predictive model for Australis was not significant. Acceptable predictive models (AUC>0.7-0.8) were found for Canicola, Icterohaemorrhagiae, Pyrogenes, and Tarassovi; while for Sejroe it was excellent (AUC> 0.85); consequently, the climatic variables that most contributed to the model were those related to precipitation. The potential distribution of Pyrogenes, Icterohaemorrhagiae, and Canicola was located to a greater extent in the three regions; Pyrogenes and Tarassovi were distributed mostly in the north and central regions and Sejroe is mostly located in the center and south of the state. Ecological niche modeling could support epidemiological control and surveillance programs for affected sheep herds in the state of Veracruz. This article is protected by copyright. All rights reserved.

Promoting co-existence between humans and venomous snakes through increasing the herpetological knowledge base

Snakebite incidence at least partly depends on the biology of the snakes involved. However, studies of snake biology have been largely neglected in favour of anthropic factors, with the exception of taxonomy, which has been recognised for some decades to affect the design of antivenoms. Despite this, within-species venom variation and the unpredictability of the correlation with antivenom cross-reactivity has continued to be problematic. Meanwhile, other aspects of snake biology, including behaviour, spatial ecology and activity patterns, distribution, and population demography, which can contribute to snakebite mitigation and prevention, remain underfunded and understudied. Here, we review the literature relevant to these aspects of snakebite and illustrate how demographic, spatial, and behavioural studies can improve our understanding of why snakebites occur and provide evidence for prevention strategies. We identify the large gaps that remain to be filled and urge that, in the future, data and relevant metadata be shared openly via public data repositories so that studies can be properly replicated and data used in future meta-analyses.

Addressing the global snakebite crisis with geo-spatial analyses - Recent advances and future direction

Venomous snakebite is a neglected tropical disease that annually leads to hundreds of thousands of deaths or long-term physical and mental ailments across the developing world. Insufficient data on spatial variation in snakebite risk, incidence, human vulnerability, and accessibility of medical treatment contribute substantially to ineffective on-ground management. There is an urgent need to collect data, fill knowledge gaps and address on-ground management problems. The use of novel, and transdisciplinary approaches that take advantage of recent advances in spatio-temporal models, 'big data', high performance computing, and fine-scale spatial information can add value to snakebite management by strategically improving our understanding and mitigation capacity of snakebite. We review the background and recent advances on the topic of snakebite related geospatial analyses and suggest avenues for priority research that will have practical on-ground applications for snakebite management and mitigation. These include streamlined, targeted data collection on snake distributions, snakebites, envenomings, venom composition, health infrastructure, and antivenom accessibility along with fine-scale models of spatio-temporal variation in snakebite risk and incidence, intraspecific venom variation, and environmental change modifying human exposure. These measures could improve and 'future-proof' antivenom production methods, antivenom distribution and stockpiling systems, and human-wildlife conflict management practices, while simultaneously feeding into research on venom evolution, snake taxonomy, ecology, biogeography, and conservation.

Implications of global environmental change for the burden of snakebite

Snakebite envenoming is a set of intoxication diseases that disproportionately affect people of poor socioeconomic backgrounds in tropical countries. As it is highly dependent on the environment its burden is expected to shift spatially with global anthropogenic environmental (climate, land use) and demographic change. The mechanisms underlying the changes to snakebite epidemiology are related to factors of snakes and humans. The distribution and abundance of snakes are expected to change with global warming via their thermal tolerance, while rainfall may affect the timing of key activities like feeding and reproduction. Human population growth is the primary cause of land-use change, which may impact snakes at smaller spatial scales than climate via habitat and biodiversity loss (e.g. prey availability). Human populations, on the other hand, could experience novel patterns and morbidity of snakebite envenoming, both as a result of snake responses to environmental change and due to the development of agricultural adaptations to climate change, socioeconomic and cultural changes, development and availability of better antivenoms, personal protective equipment, and mechanization of agriculture that mediate risk of encounters with snakes and their outcomes. The likely global effects of environmental and demographic change are thus context-dependent and could encompass both increasing and or snakebite burden (incidence, number of cases or morbidity), exposing new populations to snakes in temperate areas due to “tropicalization”, or by land use change-induced snake biodiversity loss, respectively. Tackling global change requires drastic measures to ensure large-scale ecosystem functionality. However, as ecosystems represent the main source of venomous snakes their conservation should be accompanied by comprehensive public health campaigns. The challenges associated with the joint efforts of biodiversity conservation and public health professionals should be considered in the global sustainability agenda in a wider context that applies to neglected tropical and zoonotic and emerging diseases.

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Distribution and abundance of snakes are expected to be affected by climate change.

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Land-use change may also impact snakes but at smaller spatial scales than climate.

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Human populations could experience novel patterns and morbidity of snakebite.

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Reducing snakebite should be accompanied by actions that protect snake diversity.

A Clot Twist: Extreme Variation in Coagulotoxicity Mechanisms in Mexican Neotropical Rattlesnake Venoms

Rattlesnakes are a diverse clade of pit vipers (snake family Viperidae, subfamily Crotalinae) that consists of numerous medically significant species. We used validated in vitro assays measuring venom-induced clotting time and strength of any clots formed in human plasma and fibrinogen to assess the coagulotoxic activity of the four medically relevant Mexican rattlesnake species Crotalus culminatus, C. mictlantecuhtli, C. molossus, and C. tzabcan. We report the first evidence of true procoagulant activity by Neotropical rattlesnake venom in Crotalus culminatus. This species presented a strong ontogenetic coagulotoxicity dichotomy: neonates were strongly procoagulant via Factor X activation, whereas adults were pseudo-procoagulant in that they converted fibrinogen into weak, unstable fibrin clots that rapidly broke down, thereby likely contributing to net anticoagulation through fibrinogen depletion. The other species did not activate clotting factors or display an ontogenetic dichotomy, but depleted fibrinogen levels by cleaving fibrinogen either in a destructive (non-clotting) manner or via a pseudo-procoagulant mechanism. We also assessed the neutralization of these venoms by available antivenom and enzyme-inhibitors to provide knowledge for the design of evidence-based treatment strategies for envenomated patients. One of the most frequently used Mexican antivenoms (Bioclon Antivipmyn®) failed to neutralize the potent procoagulant toxic action of neonate C. culminatus venom, highlighting limitations in snakebite treatment for this species. However, the metalloprotease inhibitor Prinomastat substantially thwarted the procoagulant venom activity, while 2,3-dimercapto-1-propanesulfonic acid (DMPS) was much less effective. These results confirm that venom-induced Factor X activation (a procoagulant action) is driven by metalloproteases, while also suggesting Prinomastat as a more promising potential adjunct treatment than DMPS for this species (with the caveat that in vivo studies are necessary to confirm this potential clinical use). Conversely, the serine protease inhibitor 4-(2-aminoethyl)benzenesulfonyl fluoride hydrochloride (AEBSF) inhibited the direct fibrinogen cleaving actions of C. mictlantecuhtli venom, thereby revealing that the pseudo-procoagulant action is driven by kallikrein-type serine proteases. Thus, this differential ontogenetic variation in coagulotoxicity patterns poses intriguing questions. Our results underscore the need for further research into Mexican rattlesnake venom activity, and also highlights potential limitations of current antivenom treatments.

Vulnerable areas to accidents with scorpions in Brazil

OBJECTIVE

To identify areas that present a higher risk of exposure to accidents with scorpions in Brazil.

METHODS

We used techniques of spatial prioritisation to determine the most vulnerable localities to envenomation by four scorpion species. Our prioritisation integrated ecological niche models with health investment, antivenin availability, access to health care facilities and metrics of human impact data.

RESULTS

The ecological niche models indicated that three scorpion species (Tityus bahiensis, Tityus serrulatus, and Tityus stigmurus) are more associated with human population density, while T. obscurus demonstrated a strong association with temperature variations during the year. Spatial prioritisation indicated that the areas with higher risk exposure to accidents with scorpions are in northern and northeastern Brazil. Alternatively, more isolated but densely populated areas in the southeastern and central regions also emerged as a priority.

CONCLUSION

Mapping areas where humans are more likely to interact with scorpions can assist in the design of efficient public health policies.

Overview of snakebite in Brazil: Possible drivers and a tool for risk mapping

Snakebite envenoming affects close to 2.7 million people globally every year. In Brazil, snakebites are reported to the Ministry of Health surveillance system and cases receive antivenom free of charge. There is an urgent need to identify higher risk areas for antivenom distribution, and to develop prevention activities. The objective of this study is to provide an overview of the epidemiological situation of snakebite envenoming in Brazil and explore possible drivers; as well as to create a flowchart tool to support decision-makers identify higher risk areas. An ecological-type study was carried out using data by municipality (2013–2017). Study parts: 1) Create a geocoded database and perform a descriptive and cluster analysis; 2) Statistical analysis to measure the association of snakebite and possible environmental and socioeconomic drivers; 3) Develop a flowchart to support decision-makers and the application of this tool in one state (Rio Grande do Sul) as an example. An average of 27,120 snakebite cases per year were reported at the country level. Clusters of municipalities with high numbers of snakebites are mostly found in the Amazon Legal Region. The negative binomial regression model showed association with the snakebite case count: the type of major habitat, tropical or non-tropical; temperature; percentage of urbanization; precipitation; elevation; GDP per capita; a weaker relation with forest loss; and with venomous snake richness. The state where the instrument was applied reported 4,227 snakebites in the period. Most municipalities were considered as medium risk and 56/496 as high risk according to the tool created. Snakebite cases are distributed across the entire country with the highest concentration in the Legal Amazon Region. This creates a complex situation both for better understanding of the association of environmental and socioeconomic factors with snakebites and for the distribution and maintenance of antivenom to remote areas. Research into types of antivenom with a longer shelf life without the need for refrigeration is needed.

It is estimated that snakebite envenoming affects around 2.7 million people every year worldwide. In Brazil, snakebite is part of the Ministry of Health surveillance system and cases receive antivenom free of charge. With a vast territory and limited production of antivenom, there is need to identify higher risk areas for its distribution and to develop preventative actions. The objective of this study is to provide an overview of the epidemiological situation of snakebite envenoming in Brazil and explore possible environmental and socioeconomic factors related to snakebites. On the basis of this information, a flowchart tool to support decision-makers identify higher risk areas was created and applied in one state as an example. An average of 27,120 snakebite cases per year were reported in Brazil, with the highest number of cases and rates in the Legal Amazon Region. The multivariable statistics analysis showed association of snakebite with environmental factors (type of major habitat, tropical or non-tropical; temperature; precipitation; elevation) and socioeconomic (lower percentage of urbanization; lower GDP per capita); also, a weaker relation with forest loss, and with venomous snake richness. The tool created to support decision-makers was applied in the state of Rio Grande do Sul, with 4,227 reported snakebites during the period. According to this tool, the majority of municipalities in this state were considered as medium risk and 56/496 as high risk. Snakebite cases are distributed across the entire country; however, the highest concentration is in the Legal Amazon Region. This creates a complex situation both for better understanding of the association of environmental and socioeconomic factors with snakebites and for the distribution and maintenance of antivenom to remote areas.

Integrating human behavior and snake ecology with agent-based models to predict snakebite in high risk landscapes

Snakebite causes more than 1.8 million envenoming cases annually and is a major cause of death in the tropics especially for poor farmers. While both social and ecological factors influence the chance encounter between snakes and people, the spatio-temporal processes underlying snakebites remain poorly explored. Previous research has focused on statistical correlates between snakebites and ecological, sociological, or environmental factors, but the human and snake behavioral patterns that drive the spatio-temporal process have not yet been integrated into a single model. Here we use a bottom-up simulation approach using agent-based modelling (ABM) parameterized with datasets from Sri Lanka, a snakebite hotspot, to characterise the mechanisms of snakebite and identify risk factors. Spatio-temporal dynamics of snakebite risks are examined through the model incorporating six snake species and three farmer types (rice, tea, and rubber). We find that snakebites are mainly climatically driven, but the risks also depend on farmer types due to working schedules as well as species present in landscapes. Snake species are differentiated by both distribution and by habitat preference, and farmers are differentiated by working patterns that are climatically driven, and the combination of these factors leads to unique encounter rates for different landcover types as well as locations. Validation using epidemiological studies demonstrated that our model can explain observed patterns, including temporal patterns of snakebite incidence, and relative contribution of bites by each snake species. Our predictions can be used to generate hypotheses and inform future studies and decision makers. Additionally, our model is transferable to other locations with high snakebite burden as well.

Geographic abundance patterns explained by niche centrality hypothesis in two Chagas disease vectors in Latin America

Ecoepidemiological scenarios for Chagas disease transmission are complex, so vector control measures to decrease human–vector contact and prevent infection transmission are difficult to implement in all geographic contexts. This study assessed the geographic abundance patterns of two vector species of Chagas disease: Triatoma maculata (Erichson, 1848) and Rhodnius pallescens (Barber, 1932) in Latin America. We modeled their potential distribution using the maximum entropy algorithm implemented in Maxent and calculated distances to their niche centroid by fitting a minimum-volume ellipsoid. In addition, to determine which method would accurately explain geographic abundance patterns, we compared the correlation between population abundance and the distance to the ecological niche centroid (DNC) and between population abundance and Maxent environmental suitability. The potential distribution estimated for T. maculata showed that environmental suitability covers a large area, from Panama to Northern Brazil. R. pallescens showed a more restricted potential distribution, with environmental suitability covering mostly the coastal zone of Costa Rica and some areas in Nicaragua, Honduras, Belize and the Yucatán Peninsula in Mexico, northern Colombia, Acre, and Rondônia states in Brazil, as well as a small region of the western Brazilian Amazon. We found a negative slope in the relationship between population abundance and the DNC in both species. R. pallecens has a more extensive potential latitudinal range than previously reported, and the distribution model for T. maculata corroborates previous studies. In addition, population abundance increases according to the niche centroid proximity, indicating that population abundance is limited by the set of scenopoetic variables at coarser scales (non-interactive variables) used to determine the ecological niche. These findings might be used by public health agencies in Latin America to implement actions and support programs for disease prevention and vector control, identifying areas in which to expand entomological surveillance and maintain chemical control, in order to decrease human–vector contact.

Applying species distribution models in public health research by predicting snakebite risk using venomous snakes' habitat suitability as an indicating factor

Snakebite envenoming is an important public health problem in Iran, despite its risk not being quantified. This study aims to use venomous snakes' habitat suitability as an indicator of snakebite risk, to identify high-priority areas for snakebite management across the country. Thus, an ensemble approach using five distribution modelling methods: Generalized Boosted Models, Generalized Additive Models, Maximum Entropy Modelling, Generalized Linear Models, and Random Forest was applied to produce a spatial snakebite risk model for Iran. To achieve this, four venomous snakes' habitat suitability (Macrovipera lebetinus, Echis carinatus, Pseudocerastes persicus and Naja oxiana) were modelled and then multiplied. These medically important snakes are responsible for the most snakebite incidents in Iran. Multiplying habitat suitability models of the four snakes showed that the northeast of Iran (west of Khorasan-e-Razavi province) has the highest snakebite risk in the country. In addition, villages that were at risk of envenoming from the four snakes were identified. Results revealed that 51,112 villages are at risk of envenoming from M. lebetinus, 30,339 from E. carinatus, 51,657 from P. persicus and 12,124 from N. oxiana. Precipitation seasonality was identified as the most important variable influencing distribution of the P. persicus, E. carinatus and M. lebetinus in Iran. Precipitation of the driest quarter was the most important predictor of suitable habitats of the N. oxiana. Since climatic variables play an important role in shaping the distribution of the four venomous snakes in Iran, thus their distribution may alter with changing climate. This paper demonstrates application of species distribution modelling in public health research and identified potential snakebite risk areas in Iran by using venomous snakes' habitat suitability models as an indicating factor. Results of this study can be used in snakebite and human-snake conflict management in Iran. We recommend increasing public awareness of snakebite envenoming and education of local people in areas which identified with the highest snakebite risk.

Snakebite envenoming from an Ecohealth perspective

Snakebite envenomings occur in complex ecological, social, economic, cultural, and political contexts. Hence, the understanding of this public health issue demands systemic and holistic approaches. Ecohealth constitutes a valuable paradigm to study snakebites, as it emphasizes on the close linkages between ecosystems, society, and health. This essay highlights some of the areas in the field of snakebite envenoming that could greatly benefit from an Ecohealth approach based on trans-disciplinary research, systems thinking, and the involvement of stakeholders at many levels. Ecohealth focuses not only on the generation of knowledge through research, but also in the translation of knowledge into actions.

Repurposing Cancer Drugs Batimastat and Marimastat to Inhibit the Activity of a Group I Metalloprotease from the Venom of the Western Diamondback Rattlesnake, Crotalus atrox

Snakebite envenomation causes over 140,000 deaths every year, predominantly in developing countries. As a result, it is one of the most lethal neglected tropical diseases. It is associated with incredibly complex pathophysiology due to the vast number of unique toxins/proteins present in the venoms of diverse snake species found worldwide. Here, we report the purification and functional characteristics of a Group I (PI) metalloprotease (CAMP-2) from the venom of the western diamondback rattlesnake, Crotalus atrox. Its sensitivity to matrix metalloprotease inhibitors (batimastat and marimastat) was established using specific in vitro experiments and in silico molecular docking analysis. CAMP-2 shows high sequence homology to atroxase from the venom of Crotalus atrox and exhibits collagenolytic, fibrinogenolytic and mild haemolytic activities. It exerts a mild inhibitory effect on agonist-induced platelet aggregation in the absence of plasma proteins. Its collagenolytic activity is completely inhibited by batimastat and marimastat. Zinc chloride also inhibits the collagenolytic activity of CAMP-2 by around 75% at 50 μM, while it is partially potentiated by calcium chloride. Molecular docking studies have demonstrated that batimastat and marimastat are able to bind strongly to the active site residues of CAMP-2. This study demonstrates the impact of matrix metalloprotease inhibitors in the modulation of a purified, Group I metalloprotease activities in comparison to the whole venom. By improving our understanding of snake venom metalloproteases and their sensitivity to small molecule inhibitors, we can begin to develop novel and improved treatment strategies for snakebites.

Exploring snake occurrence records: Spatial biases and marginal gains from accessible social media

A species' distribution provides fundamental information on: climatic niche, biogeography, and conservation status. Species distribution models often use occurrence records from biodiversity databases, subject to spatial and taxonomic biases. Deficiencies in occurrence data can lead to incomplete species distribution estimates. We can incorporate other data sources to supplement occurrence datasets. The general public is creating (via GPS-enabled cameras to photograph wildlife) incidental occurrence records that may present an opportunity to improve species distribution models. We investigated (1) occurrence data of a cryptic group of animals: non-marine snakes, in a biodiversity database (Global Biodiversity Information Facility (GBIF)) and determined (2) whether incidental occurrence records extracted from geo-tagged social media images (Flickr) could improve distribution models for 18 tropical snake species. We provide R code to search for and extract data from images using Flickr's API. We show the biodiversity database's 302,386 records disproportionately originate from North America, Europe and Oceania (250,063, 82.7%), with substantial gaps in tropical areas that host the highest snake diversity. North America, Europe and Oceania averaged several hundred records per species; whereas Asia, Africa and South America averaged less than 35 per species. Occurrence density showed similar patterns; Asia, Africa and South America have roughly ten-fold fewer records per 100 km2than other regions. Social media provided 44,687 potential records. However, including them in distribution models only marginally impacted niche estimations; niche overlap indices were consistently over 0.9. Similarly, we show negligible differences in Maxent model performance between models trained using GBIF-only and Flickr-supplemented datasets. Model performance appeared dependent on species, rather than number of occurrences or training dataset. We suggest that for tropical snakes, accessible social media currently fails to deliver appreciable benefits for estimating species distributions; but due to the variation between species and the rapid growth in social media data, may still be worth considering in future contexts.

Spatial distribution and spread potential of sixteen Leptospira serovars in a subtropical region of Brazil

Leptospirosis is a bacterial disease that represents a major problem in animal and public health due to its high prevalence and widespread distribution. This zoonotic disease is most prevalent in tropical environments where conditions favour pathogen survival. The ecological preferences of Leptospira serovars are poorly understood, limiting our knowledge of where and when outbreaks can occur, which may result in misinformed prevention and control plans. While the disease can occur consistently in time and space in tropical regions, research on the ecology of leptospirosis remains limited in subtropical regions. This research gap regarding Leptospira ecology brings public and veterinary health problems, impacting local economies. To fill this gap of knowledge, we suggest to assess geographic and ecological features among Leptospira serovars in a subtropical area of Brazil where leptospirosis is endemic to (a) highlight environmental conditions that facilitate or limit Leptospira spread and survival and (b) reconstruct its geographic distribution. An ecological niche modelling framework was used to characterize and compare Leptospira serovars in both geographic and environmental space. Our results show that despite the geographic overlap exhibited by the different serovars assessed, we found ecological divergence among their occupied ecological niches. Ecological divergences were expressed as ranges of potential distributions and environmental conditions found suitably by serovar, Sejroe being the most asymmetric (<0.15). Most important predictors for the potential distribution of most serovars were soil pH (31.7%) and landscape temperature (24.2%). Identification of environmental preferences will allow epidemiologists to better infer the presence of a serovar based on the environmental characteristics of regions rather than inferences based solely on historical epidemiological records. Including geographic and ecological ranges of serovars also may help to forecast transmission potential of Leptospira in public health and the food animal practice.

Potential distribution and ecological conditions of Lonomia obliqua Walker 1855 (Saturniidae: Hemileucinae) in Brazil

Lonomia obliqua Walker 1855 (Lepidoptera: Saturniidae) is a species of moth which larvae are responsible for the lonomism, a form of envenomation that has been occurring in Brazil since the 1980s. Despite the importance in public health, the geographical distribution and their ecological aspects are unknown. Therefore, in the present study, we present a potential geographical distribution map for L. obliqua in Brazil, based on the combination of different Ecology Niche Modelling (ENM) algorithms. A total of 38 occurrence points were distributed in the southern/ southeastern regions of Brazil and in the province of Misiones (Argentina), which were divided for calibration and evaluation of the model. Eight continuous climatic and soil variables were selected from 16 previously calculated for model calibration. The final model-map is composed of a combination of four algorithms (Gower, Mahalanobis, MAXENT and SVM), with samples of pseudo-absences outside a Bioclimatic Envelope (BIOCLIM) in quantity equal to the presences. This model-map was binarized from the Low Presence Threshold (LPT) and cut only to the Brazilian area. According to this map, the areas predicted as suitable for L. obliqua are restricted between latitudes ˜12° and ˜32°, and longitudes ˜39° and ˜57°, with extension of 1,181,604 km². The model-map was also validated with external data from samples of the species, at municipality level, in the state of Rio Grande do Sul (Brazil). From this information, we extracted the values of variables related to climate and soil, and with additional variables related to the land use and type of vegetation, in order to contribute to the ecological knowledge of the species. In general, the map and the ecological information obtained can serve as a tool for public health agents in Brazil to adequately guide preventive strategies and attention to lonomism in the country, and with addendum on habitat loss and accident conditions with the species.

Reducing Wallacean shortfalls for the coralsnakes of the Micrurus lemniscatus species complex: Present and future distributions under a changing climate

South American coralsnakes are characterized by inconspicuous and poorly known species, which are potentially very sensitive to climate change. Here, we assess the impact of future climate change on the distributions of the Micrurus lemniscatus species complex after addressing the Wallacean shortfalls and refining the knowledge about their current geographic distributions. We also evaluate the efficiency of the current reserve network to protect the species in the present and future. We applied ecological niche model tools through a carefully examined set of occurrence records to generate potential present distributions and to project these distributions into future scenarios of climate change. Specific thresholds based on occurrence records along with expert opinions were used to delineate the geographic distribution of each species. A hierarchical ANOVA was applied to evaluate the uncertainties in species distributions across niche modeling methods and climate models and nested into the time factor (present and future). Multiple regression models were used to infer the relative importance of the climatic variables to determine the species’ suitability. A gap analysis was performed to address the representativeness of species distributions into protected areas. Predicted geographic distributions were compatible with the known distributions and the expert opinions, except for M. l. carvalhoi. New areas for field research were identified. Variation in precipitation was the most important factor defining the habitat suitability for all species, except for M. diutius. All taxa (except M. l. lemniscatus) will shrink their distributions in the future; less than 50% of the present suitable areas are protected in reserve networks, and less than 40% of these areas will be held in reserves in the future. We found strong evidence that coralsnakes may be highly sensitive to the ongoing changes and must be protected.

Vulnerability to snakebite envenoming: a global mapping of hotspots

BACKGROUND

Snakebite envenoming is a frequently overlooked cause of mortality and morbidity. Data for snake ecology and existing snakebite interventions are scarce, limiting accurate burden estimation initiatives. Low global awareness stunts new interventions, adequate health resources, and available health care. Therefore, we aimed to synthesise currently available data to identify the most vulnerable populations at risk of snakebite, and where additional data to manage this global problem are needed.

METHODS

We assembled a list of snake species using WHO guidelines. Where relevant, we obtained expert opinion range (EOR) maps from WHO or the Clinical Toxinology Resources. We also obtained occurrence data for each snake species from a variety of websites, such as VertNet and iNaturalist, using the spocc R package (version 0.7.0). We removed duplicate occurrence data and categorised snakes into three groups: group A (no available EOR map or species occurrence records), group B (EOR map but <5 species occurrence records), and group C (EOR map and ≥5 species occurrence records). For group C species, we did a multivariate environmental similarity analysis using the 2008 WHO EOR maps and newly available evidence. Using these data and the EOR maps, we produced contemporary range maps for medically important venomous snake species at a 5 × 5 km resolution. We subsequently triangulated these data with three health system metrics (antivenom availability, accessibility to urban centres, and the Healthcare Access and Quality [HAQ] Index) to identify the populations most vulnerable to snakebite morbidity and mortality.

FINDINGS

We provide a map showing the ranges of 278 snake species globally. Although about 6·85 billion people worldwide live within range of areas inhabited by snakes, about 146·70 million live within remote areas lacking quality health-care provisioning. Comparing opposite ends of the HAQ Index, 272·91 million individuals (65·25%) of the population within the lowest decile are at risk of exposure to any snake for which no effective therapy exists compared with 519·46 million individuals (27·79%) within the highest HAQ Index decile, showing a disproportionate coverage in reported antivenom availability. Antivenoms were available for 119 (43%) of 278 snake species evaluated by WHO, while globally 750·19 million (10·95%) of those living within snake ranges live more than 1 h from population centres. In total, we identify about 92·66 million people living within these vulnerable geographies, including many sub-Saharan countries, Indonesia, and other parts of southeast Asia.

INTERPRETATION

Identifying exact populations vulnerable to the most severe outcomes of snakebite envenoming at a subnational level is important for prioritising new data collection and collation, reinforcing envenoming treatment, existing health-care systems, and deploying currently available and future interventions. These maps can guide future research efforts on snakebite envenoming from both ecological and public health perspectives and better target future estimates of the burden of this neglected tropical disease.

FUNDING

Bill & Melinda Gates Foundation.

Inferring space from time: On the relationship between demography and environmental suitability in the desert plant O. rastrera

Demographic analyses and ecological niche modeling (ENM) are two popular tools that address species persistence in relation to environmental conditions. Classic demography provides detailed information about the mechanisms that allow a population to grow or remain stable at a local scale, while ENM infers distributions from conditions suitable for species persistence at geographic scales by relating species' occurrences with environmental variables. By integrating these two tools, we may better understand population processes that determine species persistence at a geographic scale. To test this idea, we developed a model that relates climate to demography of the cactus Opuntia rastrera using 15 years of data from one locality. Using this model we determined the geographic area where populations would have positive growth rates given its climatic conditions. The climate-dependent demographic model showed poor performance as a distribution model, but it was helpful in defining some mechanisms that determine species' distributions. For instance, high rainfall had a negative impact on the population growth rate by increasing mortality. Rainy areas to the west of the distribution of O. rastrera were identified as unsuitable both by our climate-dependent demographic model and by a popular ENM algorithm (MaxEnt), suggesting that distribution is constrained by excessive rains due to high mortality. Areas projected to be climatically suitable by MaxEnt were not related with higher population growth rates. Instead, we found a strong correlation between environmental distance to the niche centroid (center of the niche hypervolume, where optimal conditions may occur) and population growth rate, meaning that the niche centroid approach is helpful in finding high-fitness areas.

Summary results of the 2014-2015 DARPA Chikungunya challenge

Background: Emerging pathogens such as Zika, chikungunya, Ebola, and dengue viruses are serious threats to national and global health security. Accurate forecasts of emerging epidemics and their severity are critical to minimizing subsequent mortality, morbidity, and economic loss. The recent introduction of chikungunya and Zika virus to the Americas underscores the need for better methods for disease surveillance and forecasting.

Methods: To explore the suitability of current approaches to forecasting emerging diseases, the Defense Advanced Research Projects Agency (DARPA) launched the 2014–2015 DARPA Chikungunya Challenge to forecast the number of cases and spread of chikungunya disease in the Americas. Challenge participants (n=38 during final evaluation) provided predictions of chikungunya epidemics across the Americas for a six-month period, from September 1, 2014 to February 16, 2015, to be evaluated by comparison with incidence data reported to the Pan American Health Organization (PAHO). This manuscript presents an overview of the challenge and a summary of the approaches used by the winners.

Results: Participant submissions were evaluated by a team of non-competing government subject matter experts based on numerical accuracy and methodology. Although this manuscript does not include in-depth analyses of the results, cursory analyses suggest that simpler models appear to outperform more complex approaches that included, for example, demographic information and transportation dynamics, due to the reporting biases, which can be implicitly captured in statistical models. Mosquito-dynamics, population specific information, and dengue-specific information correlated best with prediction accuracy.

Conclusion: We conclude that with careful consideration and understanding of the relative advantages and disadvantages of particular methods, implementation of an effective prediction system is feasible. However, there is a need to improve the quality of the data in order to more accurately predict the course of epidemics.

Androctonus genus species in arid regions: Ecological niche models, geographical distributions, and envenomation risk

Aim

The objective of this study was to establish environmental factors related to scorpion species occurrence and their current potential geographic distributions in Morocco, to produce a current envenomation risk map and also to assess the human population at risk of envenomation.

Materials and Methods

In this study, 71 georeferenced points for all scorpion species and nine environmental indicators were used to generate species distribution models in Maxent (maximum entropy modeling of species geographic distributions) version 3.3.3k. The models were evaluated by the area under the curve (AUC), using the omission error and the binomial probability. With the data generated by Maxent, distribution and envenomation risk maps were produced using the "ESRI^® ArcGIS 10.2.2 for Desktop" software.

Results

The models had high predictive success (AUC >0.95±0.025). Altitude, slope and five bioclimatic attributes were found to play a significant role in determining Androctonus scorpion species distribution. Ecological niche models (ENMs) showed high concordance with the known distribution of the species. Produced risk map identified broad risk areas for Androctonus scorpion envenomation, extending along Marrakech-Tensift-Al Haouz, Souss-Massa-Draa, and some areas of Doukkala-Abda and Oriental regions.

Conclusion

Considering these findings ENMs could be useful to afford important information on distributions of medically important scorpion species as well as producing scorpion envenomation risk maps.

Incidence and mortality due to snakebite in the Americas

BACKGROUND

Better knowledge of the epidemiological characteristics of snakebites could help to take measures to improve their management. The incidence and mortality of snakebites in the Americas are most often estimated from medical and scientific literature, which generally lack precision and representativeness.

METHODOLOGY/PRINCIPAL FINDINGS

Authors used the notifications of snakebites treated in health centers collected by the Ministries of Health of the American countries to estimate their incidence and mortality. Data were obtained from official reports available on-line at government sites, including those of the Ministry of Health in each country and was sustained by recent literature obtained from PubMed. The average annual incidence is about 57,500 snake bites (6.2 per 100,000 population) and mortality is close to 370 deaths (0.04 per 100,000 population), that is, between one third and half of the previous estimates. The incidence of snakebites is influenced by the abundance of snakes, which is related to (i) climate and altitude, (ii) specific preferences of the snake for environments suitable for their development, and (iii) human population density. Recent literature allowed to notice that the severity of the bites depends mainly on (i) the snake responsible for the bite (species and size) and (ii) accessibility of health care, including availability of antivenoms.

CONCLUSIONS/SIGNIFICANCES

The main limitation of this study could be the reliability and accuracy of the notifications by national health services. However, the data seemed consistent considering the similarity of the incidences on each side of national boundaries while the sources are distinct. However, snakebite incidence could be underestimated due to the use of traditional medicine by the patients who escaped the reporting of cases. However, gathered data corresponded to the actual use of the health facilities, and therefore to the actual demand for antivenoms, which should make it possible to improve their management.

Realized niche shift associated with the Eurasian charophyte Nitellopsis obtusa becoming invasive in North America

Nitellopsis obtusa (starry stonewort) is a dioecious green alga native to Europe and Asia that has emerged as an aquatic invasive species in North America. Nitellopsis obtusa is rare across large portions of its native range, but has spread rapidly in northern-tier lakes in the United States, where it can interfere with recreation and may displace native species. Little is known about the invasion ecology of N. obtusa, making it difficult to forecast future expansion. Using ecological niche modeling we investigated environmental variables associated with invasion risk. We used species records, climate data, and remotely sensed environmental variables to characterize the species’ multidimensional distribution. We found that N. obtusa is exploiting novel ecological niche space in its introduced range, which may help explain its invasiveness. While the fundamental niche of N. obtusa may be stable, there appears to have been a shift in its realized niche associated with invasion in North America. Large portions of the United States are predicted to constitute highly suitable habitat for N. obtusa. Our results can inform early detection and rapid response efforts targeting N. obtusa and provide testable estimates of the physiological tolerances of this species as a baseline for future empirical research.

Forecasting Chikungunya spread in the Americas via data-driven empirical approaches

BACKGROUND

Chikungunya virus (CHIKV) is endemic to Africa and Asia, but the Asian genotype invaded the Americas in 2013. The fast increase of human infections in the American epidemic emphasized the urgency of developing detailed predictions of case numbers and the potential geographic spread of this disease.

METHODS

We developed a simple model incorporating cases generated locally and cases imported from other countries, and forecasted transmission hotspots at the level of countries and at finer scales, in terms of ecological features.

RESULTS

By late January 2015, >1.2 M CHIKV cases were reported from the Americas, with country-level prevalences between nil and more than 20 %. In the early stages of the epidemic, exponential growth in case numbers was common; later, however, poor and uneven reporting became more common, in a phenomenon we term "surveillance fatigue." Economic activity of countries was not associated with prevalence, but diverse social factors may be linked to surveillance effort and reporting.

CONCLUSIONS

Our model predictions were initially quite inaccurate, but improved markedly as more data accumulated within the Americas. The data-driven methodology explored in this study provides an opportunity to generate descriptive and predictive information on spread of emerging diseases in the short-term under simple models based on open-access tools and data that can inform early-warning systems and public health intelligence.