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Kharwadkar S, Herath N. Clinical manifestations of dengue, Zika and chikungunya in the Pacific Islands: A systematic review and meta-analysis. Rev Med Virol 2024; 34:e2521. [PMID: 38340071 DOI: 10.1002/rmv.2521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 01/19/2024] [Accepted: 02/01/2024] [Indexed: 02/12/2024]
Abstract
Dengue, Zika and chikungunya outbreaks pose a significant public health risk to Pacific Island communities. Differential diagnosis is challenging due to overlapping clinical features and limited availability of laboratory diagnostic facilities. There is also insufficient information regarding the complications of these arboviruses, particularly for Zika and chikungunya. We conducted a systematic review and meta-analysis to calculate pooled prevalence estimates with 95% confidence intervals (CI) for the clinical manifestations of dengue, Zika and chikungunya in the Pacific Islands. Based on pooled prevalence estimates, clinical features that may help to differentiate between the arboviruses include headache, haemorrhage and hepatomegaly in dengue; rash, conjunctivitis and peripheral oedema in Zika; and the combination of fever and arthralgia in chikungunya infections. We estimated that the hospitalisation and mortality rates in dengue were 9.90% (95% CI 7.67-12.37) and 0.23% (95% CI 0.16-0.31), respectively. Severe forms of dengue occurred in 1.92% (95% CI 0.72-3.63) of reported cases and 23.23% (95% CI 13.58-34.53) of hospitalised patients. Complications associated with Zika virus included Guillain-Barré syndrome (GBS), estimated to occur in 14.08 (95% CI 11.71-16.66) per 10,000 reported cases, and congenital brain malformations such as microcephaly, particularly with first trimester maternal infection. For chikungunya, the hospitalisation rate was 2.57% (95% CI 1.30-4.25) and the risk of GBS was estimated at 1.70 (95% CI 1.06-2.48) per 10,000 reported cases. Whilst ongoing research is required, this systematic review enhances existing knowledge on the clinical manifestations of dengue, Zika and chikungunya infections and will assist Pacific Island clinicians during future arbovirus outbreaks.
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Affiliation(s)
- Sahil Kharwadkar
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
- Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Nipun Herath
- Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
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Chen LH, Marti C, Diaz Perez C, Jackson BM, Simon AM, Lu M. Epidemiology and burden of dengue fever in the United States: a systematic review. J Travel Med 2023; 30:taad127. [PMID: 37792822 DOI: 10.1093/jtm/taad127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 09/25/2023] [Accepted: 09/27/2023] [Indexed: 10/06/2023]
Abstract
BACKGROUND Dengue is currently a global concern. The range of dengue vectors is expanding with climate change, yet United States of America (USA) studies on dengue epidemiology and burden are limited. This systematic review sought to characterize the epidemiology and disease burden of dengue within the USA. METHODS Studies evaluating travel-related and endemic dengue in US states and territories were identified and qualitatively summarized. Commentaries and studies on ex-US cases were excluded. MEDLINE, Embase, Cochrane Library, Latin American and Caribbean Center of Health Sciences Information, Centre for Reviews and Dissemination and Clinicaltrials.gov were searched through January 2022. RESULTS 116 studies were included. In US states, dengue incidence was generally low, with spikes occurring in recent years in 2013-16 (0.17-0.31 cases/100,000) and peaking in 2019 (0.35 cases/100,000). Most cases (94%, n = 7895, 2010-21) were travel related. Dengue was more common in Puerto Rico (cumulative average: 200 cases/100,000, 1980-2015); in 2010-21, 99.9% of cases were locally acquired. There were <50 severe cases in US states (2010-17); fatal cases were even rarer. Severe cases in Puerto Rico peaked in 1998 (n = 173) and 2021 (n = 76). Besides lower income, risk factors in US states included having birds in residence, suggesting unspecified environmental characteristics favourable to dengue vectors. Commonly reported symptoms included fever, headache and rash; median disease duration was 3.5-11 days. Hospitalization rates increased following 2009 World Health Organization disease classification changes (pre-2009: 0-54%; post-2009: 14-75%); median length of stay was 2.7-8 days (Puerto Rico) and 2-3 days (US states). Hospitalization costs/case (2010 USD) were$14 350 (US states),$1764-$5497 (Puerto Rico) and$4207 (US Virgin Islands). In Puerto Rico, average days missed were 0.2-5.3 (work) and 2.5 (school). CONCLUSIONS Though dengue risk is ongoing, treatments are limited, and dengue's economic burden is high. There is an urgent need for additional preventive and therapeutic interventions.
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Affiliation(s)
- Lin H Chen
- Division of Infectious Diseases and Travel Medicine, Mount Auburn Hospital, 330 Mount Auburn Street Suite 413 Cambridge, MA 02138, USA
- Associate Professor of Medicine, Harvard Medical School, 25 Shattuck Street Boston, MA 02115, USA
| | - Carlos Marti
- Department of Pediatrics, San Juan City Hospital, Paseo Dr. Jose Celso Barbosa San Juan, PR 00921, Puerto Rico
| | - Clemente Diaz Perez
- Department of Pediatrics, University of Puerto Rico School of Medicine, Medical Sciences Campus, San Juan, PR 00936, Puerto Rico
| | - Bianca M Jackson
- Evidence & Access, OPEN Health, 25 Recreation Park Drive, Suite 200 Hingham, MA 02043, USA
| | - Alyssa M Simon
- Evidence & Access, OPEN Health, 25 Recreation Park Drive, Suite 200 Hingham, MA 02043, USA
| | - Mei Lu
- Takeda Pharmaceuticals U.S.A., Inc., 95 Hayden Avenue Lexington, MA 0242195, USA
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Sharp TM, Tufa AJ, Cotter CJ, Lozier MJ, Santiago GA, Johnson SS, Mataia'a M, Waterman SH, Muñoz-Jordán JL, Paz-Bailey G, Hemme RR, Schmaedick MA, Anesi S. Identification of risk factors and mosquito vectors associated with dengue virus infection in American Samoa, 2017. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001604. [PMID: 37418355 DOI: 10.1371/journal.pgph.0001604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 01/25/2023] [Indexed: 07/09/2023]
Abstract
INTRODUCTION The first outbreak of dengue in American Samoa was reported in 1911. Sporadic outbreaks have been reported since, as were outbreaks of other pathogens transmitted by Aedes species mosquitoes including Ross River, chikungunya, and Zika viruses. During an outbreak of dengue virus-type 2 (DENV-2) in 2016-2018, we conducted household-based cluster investigations to identify population-specific risk factors associated with infection and performed entomologic surveillance to determine the relative abundance of Ae. aegypti and Ae. polynesiensis. METHODS AND FINDINGS We contacted dengue patients who had tested positive for DENV infection and offered them as well as their household members participation in household-based cluster investigations. For those that accepted participation, we also offered participation to residents of households within a 50-meter radius of each case-patient's home. Questionnaires were administered and serum specimens collected for testing by RT-PCR and anti-DENV IgM ELISA. Adult female mosquitoes were aspirated from inside and outside participating households and tested by RT-PCR. We analyzed characteristics associated with DENV infection in bivariate analyses. A total of 226 participants was enrolled from 91 households in 20 clusters. Median age of participants was 34 years (range: <1-94), and 56.2% were female. In total, 7 (3.2%) participants had evidence of DENV infection by IgM ELISA (n = 5) or RT-PCR (n = 2). Factors significantly associated with DENV infection were reporting a febrile illness in the past three months (prevalence ratio: 7.5 [95% confidence interval: 1.9-29.8]) and having a household septic tank (Fisher's Exact Test, p = 0.004). Of 93 Ae. aegypti and 90 Ae. polynesiensis females collected, 90% of Ae. aegypti were collected inside homes whereas 83% of Ae. polynesiensis were collected outside homes. DENV nucleic acid was not detected in any mosquito pools. Sequencing of the DENV-2 from patient specimens identified the Cosmopolitan genotype of DENV-2 and was most closely related to virus detected in the Solomon Islands during 2016. CONCLUSIONS This investigation demonstrated that dengue is a continuing risk in American Samoa. Increased frequency of infection among residents with a septic tank suggests a need to investigate whether septic tanks serve as larval habitats for mosquito vectors of DENV in American Samoa. Future efforts should also evaluate the role of Ae. polynesiensis in DENV transmission in the wild.
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Affiliation(s)
- Tyler M Sharp
- Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico
- United States Public Health Service, Silver Springs, Maryland, United States of America
| | - A John Tufa
- Pacific Island Health Officers' Association, Honolulu, Hawaii, United States of America
- American Samoa Department of Health, Pago Pago, American Samoa
| | - Caitlin J Cotter
- Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico
- United States Public Health Service, Silver Springs, Maryland, United States of America
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Matthew J Lozier
- Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico
- United States Public Health Service, Silver Springs, Maryland, United States of America
| | - Gilberto A Santiago
- Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Stephanie S Johnson
- Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico
- Applied Epidemiology Fellowship, Council of State and Territorial Epidemiologists, Atlanta, Georgia, United States of America
| | - Mary Mataia'a
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Stephen H Waterman
- Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico
- United States Public Health Service, Silver Springs, Maryland, United States of America
| | - Jorge L Muñoz-Jordán
- Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Gabriela Paz-Bailey
- Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Ryan R Hemme
- Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | | | - Scott Anesi
- American Samoa Department of Health, Pago Pago, American Samoa
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Ryff KR, Rivera A, Rodriguez DM, Santiago GA, Medina FA, Ellis EM, Torres J, Pobutsky A, Munoz-Jordan J, Paz-Bailey G, Adams LE. Epidemiologic Trends of Dengue in U.S. Territories, 2010-2020. MORBIDITY AND MORTALITY WEEKLY REPORT. SURVEILLANCE SUMMARIES (WASHINGTON, D.C. : 2002) 2023; 72:1-12. [PMID: 37192141 DOI: 10.15585/mmwr.ss7204a1] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Problem/Condition Dengue is one of the most common vectorborne flaviviral infections globally, with frequent outbreaks in tropical regions. In 2019 and 2020, the Pan American Health Organization reported approximately 5.5 million dengue cases from the Americas, the highest number on record. In the United States, local dengue virus (DENV) transmission has been reported from all U.S. territories, which are characterized by tropical climates that are highly suitable for Aedes species of mosquitoes, the vector that transmits dengue. Dengue is endemic in the U.S. territories of American Samoa, Puerto Rico, and the U.S. Virgin Islands (USVI). Dengue risk in Guam and the Commonwealth of the Northern Mariana Islands is considered sporadic or uncertain. Despite all U.S. territories reporting local dengue transmission, epidemiologic trends over time have not been well described. Reporting Period 2010-2020. Description of System State and territorial health departments report dengue cases to CDC through ArboNET, the national arboviral surveillance system, which was developed in 2000 to monitor West Nile virus infections. Dengue became nationally notifiable in ArboNET in 2010. Dengue cases reported to ArboNET are categorized using the 2015 Council of State and Territorial Epidemiologists case definition. In addition, DENV serotyping is performed at CDC's Dengue Branch Laboratory in a subset of specimens to support identification of circulating DENV serotypes. Results During 2010-2020, a total of 30,903 dengue cases were reported from four U.S. territories to ArboNET. Puerto Rico reported the highest number of dengue cases (29,862 [96.6%]), followed by American Samoa (660 [2.1%]), USVI (353 [1.1%]), and Guam (28 [0.1%]). However, annual incidence rates were highest in American Samoa with 10.2 cases per 1,000 population in 2017, followed by Puerto Rico with 2.9 in 2010 and USVI with 1.6 in 2013. Approximately one half (50.6%) of cases occurred among persons aged <20 years. The proportion of persons with dengue who were hospitalized was high in three of the four territories: 45.5% in American Samoa, 32.6% in Puerto Rico, and 32.1% in Guam. In Puerto Rico and USVI, approximately 2% of reported cases were categorized as severe dengue. Of all dengue-associated deaths, 68 (0.2%) were reported from Puerto Rico; no deaths were reported from the other territories. During 2010-2020, DENV-1 and DENV-4 were the predominant serotypes in Puerto Rico and USVI. Interpretation U.S. territories experienced a high prevalence of dengue during 2010-2020, with approximately 30,000 cases reported, and a high incidence during outbreak years. Children and adolescents aged <20 years were disproportionately affected, highlighting the need for interventions tailored for this population. Ongoing education about dengue clinical management for health care providers in U.S. territories is important because of the high hospitalization rates reported. Dengue case surveillance and serotyping can be used to guide future control and prevention measures in these areas. Public Health Action The Advisory Committee on Immunization Practices recommends vaccination with Dengvaxia for children aged 9-16 years with evidence of previous dengue infection and living in areas where dengue is endemic. The recommendation for the dengue vaccine offers public health professionals and health care providers a new intervention for preventing illness and hospitalization in the age group with the highest burden of disease in the four territories (Paz Bailey G, Adams L, Wong JM, et al. Dengue Vaccine: Recommendations of the Advisory Committee on Immunization Practices, United States, 2021. MMWR Recomm Rep 2021;70[No. RR-6]). American Samoa, Puerto Rico, and USVI are all considered endemic areas and persons residing in these areas are eligible for the new dengue vaccine. Persons aged 9-16 years in those jurisdictions with laboratory evidence of previous dengue infection can receive the dengue vaccine and benefit from a reduced risk for symptomatic disease, hospitalization, or severe dengue. Health care providers in these areas should be familiar with the eligibility criteria and recommendations for vaccination to reduce the burden of dengue among the group at highest risk for symptomatic illness. Educating health care providers about identification and management of dengue cases can improve patient outcomes and improve surveillance and reporting of dengue cases.
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Medina FA, Vila F, Premkumar L, Lorenzi O, Paz-Bailey G, Alvarado LI, Rivera-Amill V, de Silva A, Waterman S, Muñoz-Jordán J. Capacity of a Multiplex IgM Antibody Capture ELISA to Differentiate Zika and Dengue Virus Infections in Areas of Concurrent Endemic Transmission. Am J Trop Med Hyg 2022; 106:585-592. [PMID: 34929668 PMCID: PMC8832915 DOI: 10.4269/ajtmh.20-1651] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 06/28/2021] [Indexed: 11/21/2022] Open
Abstract
Serological cross-reactivity has proved to be a challenge to diagnose Zika virus (ZIKV) infections in dengue virus (DENV) endemic countries. Confirmatory testing of ZIKV IgM positive results by plaque reduction neutralization tests (PRNTs) provides clarification in only a minority of cases because most individuals infected with ZIKV were previously exposed to DENV. The goal of this study was to evaluate the performance of a ZIKV/DENV DUO IgM antibody capture ELISA (MAC-ELISA) for discriminating between DENV and ZIKV infections in endemic regions. Our performance evaluation included acute and convalescent specimens from patients with real-time reverse transcription polymerase chain reaction (RT-PCR)-confirmed DENV or ZIKV from the Sentinel Enhanced Dengue Surveillance System in Ponce, Puerto Rico. The ZIKV/DENV DUO MAC-ELISA specificity was 100% for DENV (N = 127) and 98.4% for ZIKV (N = 275) when specimens were tested during the optimal testing window (days post-onset of illness [DPO] 6-120). The ZIKV/DENV DUO MAC-ELISA sensitivity of RT-PCR confirmed specimens reached 100% for DENV by DPO 6 and for ZIKV by DPO 9. Our new ZIKV/DENV DUO MAC-ELISA was also able to distinguish ZIKV and DENV regardless of previous DENV exposure. We conclude this novel serologic diagnostic assay can accurately discriminate ZIKV and DENV infections. This can potentially be useful considering that the more labor-intensive and expensive PRNT assay may not be an option for confirmatory diagnosis in areas that lack PRNT capacity, but experience circulation of both DENV and ZIKV.
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Affiliation(s)
- Freddy A. Medina
- Surveillance and Research Laboratory, Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Frances Vila
- Surveillance and Research Laboratory, Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Lakshmanane Premkumar
- Department of Microbiology and Immunology University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Olga Lorenzi
- Surveillance and Research Laboratory, Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Gabriela Paz-Bailey
- Surveillance and Research Laboratory, Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | | | | | - Aravinda de Silva
- Department of Microbiology and Immunology University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Steve Waterman
- Surveillance and Research Laboratory, Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Jorge Muñoz-Jordán
- Surveillance and Research Laboratory, Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico;,Address correspondence to Jorge Muñoz-Jordán, Surveillance and Research Laboratory, Dengue Branch, Centers for Disease Control and Prevention, 1324 Calle Cañada, San Juan, Puerto Rico 00920. E-mail:
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Matthews RJ, Kaluthotage I, Russell TL, Knox TB, Horwood PF, Craig AT. Arboviral Disease Outbreaks in the Pacific Islands Countries and Areas, 2014 to 2020: A Systematic Literature and Document Review. Pathogens 2022; 11:74. [PMID: 35056022 PMCID: PMC8779081 DOI: 10.3390/pathogens11010074] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 12/19/2021] [Accepted: 12/23/2021] [Indexed: 12/10/2022] Open
Abstract
Arthropod-borne diseases pose a significant public health threat, accounting for greater than 17% of infectious disease cases and 1 million deaths annually. Across Pacific Island countries and areas (PICs), outbreaks of dengue, chikungunya, and Zika are increasing in frequency and scale. Data about arbovirus outbreaks are incomplete, with reports sporadic, delayed, and often based solely on syndromic surveillance. We undertook a systematic review of published and grey literature and contacted relevant regional authorities to collect information about arboviral activity affecting PICs between October 2014 and June 2020. Our literature search identified 1176 unique peer-reviewed articles that were reduced to 25 relevant publications when screened. Our grey literature search identified 873 sources. Collectively, these data reported 104 unique outbreaks, including 72 dengue outbreaks affecting 19 (out of 22) PICs, 14 chikungunya outbreaks affecting 11 PICs, and 18 Zika outbreaks affecting 14 PICs. Our review is the most complete account of arboviral outbreaks to affect PICs since comparable work was published in 2014. It highlights the continued elevated level of arboviral activity across the Pacific and inconsistencies in how information about outbreaks is reported and recorded. It demonstrates the importance of a One-Health approach and the role that improved communication and reporting between different governments and sectors play in understanding the emergence, circulation, and transboundary risks posed by arboviral diseases.
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Affiliation(s)
- Rosie J. Matthews
- Department of Medicine, Cairns Hospital, Cairns, QID 4870, Australia
| | - Ishani Kaluthotage
- Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, QID 4870, Australia; (I.K.); (T.L.R.)
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, QID 4870, Australia
| | - Tanya L. Russell
- Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, QID 4870, Australia; (I.K.); (T.L.R.)
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, QID 4870, Australia
| | - Tessa B. Knox
- Vanuatu Country Liaison Office, World Health Organization, Port Vila, Vanuatu;
| | - Paul F. Horwood
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QID 4811, Australia;
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QID 4811, Australia
| | - Adam T. Craig
- School of Population Health, University of New South Wales, Sydney, NSW 1466, Australia
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Crava CM, Varghese FS, Pischedda E, Halbach R, Palatini U, Marconcini M, Gasmi L, Redmond S, Afrane Y, Ayala D, Paupy C, Carballar‐Lejarazu R, Miesen P, van Rij RP, Bonizzoni M. Population genomics in the arboviral vector Aedes aegypti reveals the genomic architecture and evolution of endogenous viral elements. Mol Ecol 2021; 30:1594-1611. [PMID: 33432714 PMCID: PMC8048955 DOI: 10.1111/mec.15798] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 01/05/2021] [Accepted: 01/07/2021] [Indexed: 02/06/2023]
Abstract
Horizontal gene transfer from viruses to eukaryotic cells is a pervasive phenomenon. Somatic viral integrations are linked to persistent viral infection whereas integrations into germline cells are maintained in host genomes by vertical transmission and may be co-opted for host functions. In the arboviral vector Aedes aegypti, an endogenous viral element from a nonretroviral RNA virus (nrEVE) was shown to produce PIWI-interacting RNAs (piRNAs) to limit infection with a cognate virus. Thus, nrEVEs may constitute a heritable, sequence-specific mechanism for antiviral immunity, analogous to piRNA-mediated silencing of transposable elements. Here, we combine population genomics and evolutionary approaches to analyse the genomic architecture of nrEVEs in A. aegypti. We conducted a genome-wide screen for adaptive nrEVEs and searched for novel population-specific nrEVEs in the genomes of 80 individual wild-caught mosquitoes from five geographical populations. We show a dynamic landscape of nrEVEs in mosquito genomes and identified five novel nrEVEs derived from two currently circulating viruses, providing evidence of the environmental-dependent modification of a piRNA cluster. Overall, our results show that virus endogenization events are complex with only a few nrEVEs contributing to adaptive evolution in A. aegypti.
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Affiliation(s)
- Cristina M. Crava
- Department of Biology and BiotechnologyUniversity of PaviaPaviaItaly
- Present address:
Institute of Biotechnology and BiomedicineUniversitat de ValènciaBurjassotSpain
| | - Finny S. Varghese
- Department of Medical MicrobiologyRadboud University Medical CenterRadboud Institute for Molecular Life SciencesNijmegenThe Netherlands
| | - Elisa Pischedda
- Department of Biology and BiotechnologyUniversity of PaviaPaviaItaly
| | - Rebecca Halbach
- Department of Medical MicrobiologyRadboud University Medical CenterRadboud Institute for Molecular Life SciencesNijmegenThe Netherlands
| | - Umberto Palatini
- Department of Biology and BiotechnologyUniversity of PaviaPaviaItaly
| | | | - Leila Gasmi
- Department of Biology and BiotechnologyUniversity of PaviaPaviaItaly
| | - Seth Redmond
- Institute of Vector Borne DiseaseMonash UniversityAustralia
| | - Yaw Afrane
- Department of Medical MicrobiologyUniversity of GhanaAccraGhana
| | - Diego Ayala
- MIVEGECUniv. MontpellierIRDCNRSMontpellierFrance
| | | | - Rebeca Carballar‐Lejarazu
- Department of Biology and BiotechnologyUniversity of PaviaPaviaItaly
- Present address:
Department of Molecular Biology and BiochemistryUniversity of California at IrvineIrvineCAUSA
| | - Pascal Miesen
- Department of Medical MicrobiologyRadboud University Medical CenterRadboud Institute for Molecular Life SciencesNijmegenThe Netherlands
| | - Ronald P. van Rij
- Department of Medical MicrobiologyRadboud University Medical CenterRadboud Institute for Molecular Life SciencesNijmegenThe Netherlands
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Craig AT, Kaldor J, Schierhout G, Rosewell AE. Surveillance strategies for the detection of disease outbreaks in the Pacific islands: meta-analysis of published literature, 2010-2019. Trop Med Int Health 2020; 25:906-918. [PMID: 32446271 DOI: 10.1111/tmi.13448] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Due to their tropical location, development status and the limited capacity of health systems, Pacific island counties and territories are particularly susceptible to infectious disease outbreaks; but evidence as to the optimal way in which outbreaks are detected is scarce. In this review, we synthesise evidence from literature about how outbreaks are detected in Pacific island countries and territories and critique factors identified as inhibiting surveillance practice. METHOD For this systematic review, we searched electronic databases Embase, Global Health, MEDLINE and MEDLINE Epub from 1 January 2010 and 31 March 2019 for reports describing infectious disease outbreaks occurring in the Pacific islands. Reports were included if they reported the method by which an outbreak was detected or the time between an outbreak's onset and its detection. We extracted information about the report type and authors, the outbreak and its method/s of detection, and pertinent issues inhibiting surveillance practice. RESULTS Of 860 articles identified, 37 reports describing 39 outbreaks met the inclusion criteria. Most outbreaks (n = 30) were identified through formal event-based surveillance; six through syndromic surveillance; and two by ad hoc notification from the community. Barriers to early outbreak detection included population isolation; lack of resources and infrastructure to support surveillance implementation and signal investigation; and broader health system factors such as preparedness planning and availability of laboratory services. CONCLUSION Most surveillance-related gain in the Pacific islands may be made through building formal event-based surveillance systems and streamlining reporting processes to facilitate outbreak notification. This observation is pertinent given the focus on establishing and expanding syndromic surveillance approaches for outbreak detection in the islands over the last decade.
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Affiliation(s)
- Adam T Craig
- University of New South Wales, Sydney, NSW, Australia
| | - John Kaldor
- University of New South Wales, Sydney, NSW, Australia
| | - Gill Schierhout
- The George Institute for Global Health, Newtown, NSW, Australia
| | - Alexander E Rosewell
- University of New South Wales, Sydney, NSW, Australia.,World Health Organization, Geneva, Switzerland
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Adams LE, Martin SW, Lindsey NP, Lehman JA, Rivera A, Kolsin J, Landry K, Staples JE, Sharp TM, Paz-Bailey G, Fischer M. Epidemiology of Dengue, Chikungunya, and Zika Virus Disease in U.S. States and Territories, 2017. Am J Trop Med Hyg 2020; 101:884-890. [PMID: 31436154 DOI: 10.4269/ajtmh.19-0309] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Dengue, chikungunya, and Zika viruses, primarily transmitted by Aedes species mosquitoes, have caused large outbreaks in the Americas, leading to travel-associated cases and local mosquito-borne transmission in the United States. We describe the epidemiology of dengue, chikungunya, and noncongenital Zika virus disease cases reported from U.S. states and territories in 2017, including 971 dengue cases, 195 chikungunya cases, and 1,118 Zika virus disease cases. Cases of all three diseases reported from the territories were reported as resulting from local mosquito-borne transmission. Cases reported from the states were primarily among travelers, with only seven locally acquired mosquito-transmitted Zika virus disease cases reported from Texas (n = 5) and Florida (n = 2). In the territories, most dengue cases (n = 508, 98%) were reported from American Samoa, whereas the majority of chikungunya (n = 39, 100%) and Zika virus disease (n = 620, 93%) cases were reported from Puerto Rico. Temporally, the highest number of Zika virus disease cases occurred at the beginning of the year, followed by a sharp decline, mirroring decreasing case numbers across the Americas following large outbreaks in 2015 and 2016. Dengue and chikungunya cases followed a more seasonal pattern, with higher case numbers from July through September. Travelers to the United States and residents of areas with active virus transmission should be informed of both the ongoing risk from dengue, chikungunya, and Zika virus disease and personal protective measures to lower their risk of mosquito bites and to help prevent the spread of these diseases.
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Affiliation(s)
- Laura E Adams
- Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Stacey W Martin
- Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - Nicole P Lindsey
- Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - Jennifer A Lehman
- Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - Aidsa Rivera
- Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Jonathan Kolsin
- Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - Kimberly Landry
- Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - J Erin Staples
- Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - Tyler M Sharp
- Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Gabriela Paz-Bailey
- Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Marc Fischer
- Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, Colorado
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Graves PM, Sheridan S, Fuimaono S, Lau CL. Demographic, socioeconomic and disease knowledge factors, but not population mobility, associated with lymphatic filariasis infection in adult workers in American Samoa in 2014. Parasit Vectors 2020; 13:125. [PMID: 32164780 PMCID: PMC7068921 DOI: 10.1186/s13071-020-3996-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Accepted: 02/26/2020] [Indexed: 01/21/2023] Open
Abstract
Background Prevalence of lymphatic filariasis (LF) antigen in American Samoa was 16.5% in 1999. Seven rounds of mass drug administration (MDA) programmes between 2000 and 2006 reduced antigen prevalence to 2.3%. The most efficient methods of surveillance after MDA are not clear, but testing specific at-risk groups such as adults may provide earlier warning of resurgence. The role of migration from LF endemic countries in maintaining transmission also needs investigation. Few studies have investigated knowledge about LF and how that relates to infection risk. This study aims to investigate associations between socio-demographics, population mobility, disease knowledge and LF infection risk. Methods In 2014, we surveyed 670 adults aged 16–68 years (62% female) at two worksites in American Samoa. Sera were tested for LF antigen and antibodies (Bm14 and Wb123) by rapid test and/or ELISA. Multivariate logistic regression was used to assess association between seromarkers and demographic factors, household socioeconomic status (SES), residence, travel history, and knowledge of LF. Results Overall, 1.8% of participants were positive for antigen, 11.8% for Bm14, 11.3% for Wb123 and 17.3% for at least one antibody. Recent travel outside American Samoa was not associated with positivity for any seromarker. Men had higher seroprevalence than women for all outcomes (any antibody: adjusted odds ratio (aOR) = 3.49 (95% CI: 2.21–5.49). Those aged over 35 years (compared to 15–24 years) had higher prevalence of Bm14 antibody (aOR = 3.75, 3.76 and 4.17 for ages 35–44, 45–54 and ≥ 55 years, respectively, P < 0.05). Lower SES was associated with seropositivity (antigen: aOR = 2.89, 95% CI: 1.09–7.69; either antibody: aOR = 1.51, 95% CI: 1.12–2.05). Those who knew that mosquitoes transmitted LF had lower Wb123 antibody prevalence (aOR = 0.55, 95% CI: 0.32–0.95). Conclusions Opportunistic sampling of adults at worksites provided an efficient and representative way to assess prevalence and risk factors for LF in American Samoa and in hindsight, foreshadowed the resurgence of transmission. Risk of LF infection, detected by one or more serological markers, was not related to recent travel history, but was strongly associated with male gender, older age, lower SES, and lack of knowledge about mosquito transmission. These results could guide future efforts to increase MDA participation.![]()
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Affiliation(s)
- Patricia M Graves
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, QLD, Australia. .,Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, QLD, Australia.
| | - Sarah Sheridan
- Department of Global Health, Research School of Population Health, The Australian National University, Canberra, Australia
| | - Saipale Fuimaono
- Department of Public Health, American Samoa Department of Health, Pago Pago, American Samoa
| | - Colleen L Lau
- Department of Global Health, Research School of Population Health, The Australian National University, Canberra, Australia
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11
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Curren EJ, Tufa AJ, Hancock WT, Biggerstaff BJ, Vaifanua-Leo JS, Montalbo CA, Sharp TM, Fischer M, Hills SL, Gould CV. Reverse Transcription-Polymerase Chain Reaction Testing on Filter Paper-Dried Serum for Laboratory-Based Dengue Surveillance-American Samoa, 2018. Am J Trop Med Hyg 2020; 102:622-624. [PMID: 31933466 DOI: 10.4269/ajtmh.19-0800] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Laboratory-based surveillance for arboviral diseases is challenging in resource-limited settings. We evaluated the use of filter paper-dried sera for detection of dengue virus (DENV) RNA during an outbreak in American Samoa. Matched liquid and filter paper-dried sera were collected from patients with suspected dengue and shipped to a reference laboratory for diagnostic testing. RNA was extracted from each sample and tested for DENV RNA by real-time reverse transcription-polymerase chain reaction (RT-PCR). Of 18 RT-PCR-positive liquid specimens, 14 matched filter paper-dried specimens were positive for a sensitivity of 78% (95% CI, 55-91%). Of 82 RT-PCR-negative liquid specimens, all filter paper-dried specimens were negative for a specificity of 100% (95% CI, 96-100%). Shipping of filter paper-dried specimens was similarly timely but less expensive than shipping liquid sera. Using filter paper-dried serum or blood can be a cost-effective and sustainable approach to surveillance of dengue and other arboviral diseases in resource-limited settings.
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Affiliation(s)
- Emily J Curren
- Epidemic Intelligence Service, CDC, Atlanta, Georgia.,Division of Vector-Borne Diseases, Centers for Disease Control and Prevention (CDC), Fort Collins, Colorado
| | | | | | - Brad J Biggerstaff
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention (CDC), Fort Collins, Colorado
| | | | | | - Tyler M Sharp
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention (CDC), Fort Collins, Colorado
| | - Marc Fischer
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention (CDC), Fort Collins, Colorado
| | - Susan L Hills
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention (CDC), Fort Collins, Colorado
| | - Carolyn V Gould
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention (CDC), Fort Collins, Colorado
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