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Aryaprema VS, Steck MR, Peper ST, Xue RD, Qualls WA. A systematic review of published literature on mosquito control action thresholds across the world. PLoS Negl Trop Dis 2023; 17:e0011173. [PMID: 36867651 PMCID: PMC10016652 DOI: 10.1371/journal.pntd.0011173] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 03/15/2023] [Accepted: 02/14/2023] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND Despite the use of numerous methods of control measures, mosquito populations and mosquito-borne diseases are still increasing globally. Evidence-based action thresholds to initiate or intensify control activities have been identified as essential in reducing mosquito populations to required levels at the correct/optimal time. This systematic review was conducted to identify different mosquito control action thresholds existing across the world and associated surveillance and implementation characteristics. METHODOLOGY/PRINCIPAL FINDINGS Searches for literature published from 2010 up to 2021 were performed using two search engines, Google Scholar and PubMed Central, according to PRISMA guidelines. A set of inclusion/exclusion criteria were identified and of the 1,485 initial selections, only 87 were included in the final review. Thirty inclusions reported originally generated thresholds. Thirteen inclusions were with statistical models that seemed intended to be continuously utilized to test the exceedance of thresholds in a specific region. There was another set of 44 inclusions that solely mentioned previously generated thresholds. The inclusions with "epidemiological thresholds" outnumbered those with "entomological thresholds". Most of the inclusions came from Asia and those thresholds were targeted toward Aedes and dengue control. Overall, mosquito counts (adult and larval) and climatic variables (temperature and rainfall) were the most used parameters in thresholds. The associated surveillance and implementation characteristics of the identified thresholds are discussed here. CONCLUSIONS/SIGNIFICANCE The review identified 87 publications with different mosquito control thresholds developed across the world and published during the last decade. Associated surveillance and implementation characteristics will help organize surveillance systems targeting the development and implementation of action thresholds, as well as direct awareness towards already existing thresholds for those with programs lacking available resources for comprehensive surveillance systems. The findings of the review highlight data gaps and areas of focus to fill in the action threshold compartment of the IVM toolbox.
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Affiliation(s)
- Vindhya S. Aryaprema
- Anastasia Mosquito Control District, St. Augustine, Florida, United States of America
| | - Madeline R. Steck
- Anastasia Mosquito Control District, St. Augustine, Florida, United States of America
| | - Steven T. Peper
- Anastasia Mosquito Control District, St. Augustine, Florida, United States of America
| | - Rui-de Xue
- Anastasia Mosquito Control District, St. Augustine, Florida, United States of America
| | - Whitney A. Qualls
- Anastasia Mosquito Control District, St. Augustine, Florida, United States of America
- * E-mail:
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Qian W, Harley D, Glass K, Viennet E, Hurst C. Prediction of Ross River virus incidence in Queensland, Australia: building and comparing models. PeerJ 2022; 10:e14213. [PMID: 36389410 PMCID: PMC9651042 DOI: 10.7717/peerj.14213] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 09/19/2022] [Indexed: 11/10/2022] Open
Abstract
Transmission of Ross River virus (RRV) is influenced by climatic, environmental, and socio-economic factors. Accurate and robust predictions based on these factors are necessary for disease prevention and control. However, the complicated transmission cycle and the characteristics of RRV notification data present challenges. Studies to compare model performance are lacking. In this study, we used RRV notification data and exposure data from 2001 to 2020 in Queensland, Australia, and compared ten models (including generalised linear models, zero-inflated models, and generalised additive models) to predict RRV incidence in different regions of Queensland. We aimed to compare model performance and to evaluate the effect of statistical over-dispersion and zero-inflation of RRV surveillance data, and non-linearity of predictors on model fit. A variable selection strategy for screening important predictors was developed and was found to be efficient and able to generate consistent and reasonable numbers of predictors across regions and in all training sets. Negative binomial models generally exhibited better model fit than Poisson models, suggesting that over-dispersion in the data is the primary factor driving model fit compared to non-linearity of predictors and excess zeros. All models predicted the peak periods well but were unable to fit and predict the magnitude of peaks, especially when there were high numbers of cases. Adding new variables including historical RRV cases and mosquito abundance may improve model performance. The standard negative binomial generalised linear model is stable, simple, and effective in prediction, and is thus considered the best choice among all models.
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Affiliation(s)
- Wei Qian
- The University of Queensland, UQ Centre for Clinical Research, Herston, Queensland, Australia
| | - David Harley
- The University of Queensland, UQ Centre for Clinical Research, Herston, Queensland, Australia
| | - Kathryn Glass
- Research School of Population Health, Australian National University, Acton, Australian Capital Territory, Australia
| | - Elvina Viennet
- Clinical Services and Research, Australian Red Cross Lifeblood, Kelvin Grove, Queensland, Australia,Institute for Health and Biomedical Innovation, School of Biomedical Sciences, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Cameron Hurst
- Molly Wardaguga Research Centre, Charles Darwin University, Brisbane, Queensland, Australia,Department of Statistics, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
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Qian W, Viennet E, Glass K, Harley D. Epidemiological models for predicting Ross River virus in Australia: A systematic review. PLoS Negl Trop Dis 2020; 14:e0008621. [PMID: 32970673 PMCID: PMC7537878 DOI: 10.1371/journal.pntd.0008621] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 10/06/2020] [Accepted: 07/20/2020] [Indexed: 01/18/2023] Open
Abstract
Ross River virus (RRV) is the most common and widespread arbovirus in Australia. Epidemiological models of RRV increase understanding of RRV transmission and help provide early warning of outbreaks to reduce incidence. However, RRV predictive models have not been systematically reviewed, analysed, and compared. The hypothesis of this systematic review was that summarising the epidemiological models applied to predict RRV disease and analysing model performance could elucidate drivers of RRV incidence and transmission patterns. We performed a systematic literature search in PubMed, EMBASE, Web of Science, Cochrane Library, and Scopus for studies of RRV using population-based data, incorporating at least one epidemiological model and analysing the association between exposures and RRV disease. Forty-three articles, all of high or medium quality, were included. Twenty-two (51.2%) used generalised linear models and 11 (25.6%) used time-series models. Climate and weather data were used in 27 (62.8%) and mosquito abundance or related data were used in 14 (32.6%) articles as model covariates. A total of 140 models were included across the articles. Rainfall (69 models, 49.3%), temperature (66, 47.1%) and tide height (45, 32.1%) were the three most commonly used exposures. Ten (23.3%) studies published data related to model performance. This review summarises current knowledge of RRV modelling and reveals a research gap in comparing predictive methods. To improve predictive accuracy, new methods for forecasting, such as non-linear mixed models and machine learning approaches, warrant investigation.
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Affiliation(s)
- Wei Qian
- Mater Research Institute‐University of Queensland (MRI‐UQ), Brisbane, Queensland, Australia
| | - Elvina Viennet
- Research and Development, Australian Red Cross Lifeblood, Brisbane, Queensland, Australia
- Institute for Health and Biomedical Innovation, School of Biomedical Sciences, Queensland University of Technology (QUT), Queensland, Australia
| | - Kathryn Glass
- Research School of Population Health, Australian National University, Acton, Australian Capital Territory, Australia
| | - David Harley
- Mater Research Institute‐University of Queensland (MRI‐UQ), Brisbane, Queensland, Australia
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Mayaro: an emerging viral threat? Emerg Microbes Infect 2018; 7:163. [PMID: 30254258 PMCID: PMC6156602 DOI: 10.1038/s41426-018-0163-5] [Citation(s) in RCA: 87] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 07/16/2018] [Accepted: 08/20/2018] [Indexed: 12/17/2022]
Abstract
Mayaro virus (MAYV), an enveloped RNA virus, belongs to the Togaviridae family and Alphavirus genus. This arthropod-borne virus (Arbovirus) is similar to Chikungunya (CHIKV), Dengue (DENV), and Zika virus (ZIKV). The term “ChikDenMaZika syndrome” has been coined for clinically suspected arboviruses, which have arisen as a consequence of the high viral burden, viral co-infection, and co-circulation in South America. In most cases, MAYV disease is nonspecific, mild, and self-limited. Fever, arthralgia, and maculopapular rash are among the most common symptoms described, being largely indistinguishable from those caused by other arboviruses. However, severe manifestations of the infection have been reported, such as chronic polyarthritis, neurological complications, hemorrhage, myocarditis, and even death. Currently, there are no specific commercial tools for the diagnosis of MAYV, and the use of serological methods can be affected by cross-reactivity and the window period. A diagnosis based on clinical and epidemiological data alone is still premature. Therefore, new entomological research is warranted, and new highly specific molecular diagnostic methods should be developed. This comprehensive review is intended to encourage public health authorities and scientific communities to actively work on diagnosing, preventing, and treating MAYV infection.
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Toi CS, Webb CE, Haniotis J, Clancy J, Doggett SL. Seasonal activity, vector relationships and genetic analysis of mosquito-borne Stratford virus. PLoS One 2017; 12:e0173105. [PMID: 28253306 PMCID: PMC5333861 DOI: 10.1371/journal.pone.0173105] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Accepted: 02/15/2017] [Indexed: 11/18/2022] Open
Abstract
There are many gaps to be filled in our understanding of mosquito-borne viruses, their relationships with vectors and reservoir hosts, and the environmental drivers of seasonal activity. Stratford virus (STRV) belongs to the genus Flavivirus and has been isolated from mosquitoes and infected humans in Australia but little is known of its vector and reservoir host associations. A total of 43 isolates of STRV from mosquitoes collected in New South Wales between 1995 and 2013 was examined to determine the genetic diversity between virus isolates and their relationship with mosquito species. The virus was isolated from six mosquito species; Aedes aculeatus, Aedes alternans, Aedes notoscriptus, Aedes procax, Aedes vigilax, and Anopheles annulipes. While there were distinct differences in temporal and spatial activity of STRV, with peaks of activity in 2006, 2010 and 2013, a sequence homology of 95.9%-98.4% was found between isolates and the 1961 STRV prototype with 96.2%-100% identified among isolates. Temporal differences but no apparent nucleotide divergence by mosquito species or geographic location was evident. The result suggests the virus is geographically widespread in NSW (albeit only from coastal regions) and increased local STRV activity is likely to be driven by reservoir host factors and local environmental conditions influencing vector abundance. While STRV may not currently be associated with major outbreaks of human disease, with the potential for urbanisation and climate change to increase mosquito-borne disease risks, and the possibility of genomic changes which could produce pathogenic strains, understanding the drivers of STRV activity may assist the development of strategic response to public health risks posed by zoonotic flaviviruses in Australia.
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Affiliation(s)
- Cheryl S. Toi
- Department of Medical Entomology, Centre for Infectious Diseases and Microbiology Laboratory Services, NSW Health Pathology, Westmead Hospital, Westmead, New South Wales, Australia
| | - Cameron E. Webb
- Department of Medical Entomology, Centre for Infectious Diseases and Microbiology Laboratory Services, NSW Health Pathology, Westmead Hospital, Westmead, New South Wales, Australia
- Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, New South Wales, Australia
| | - John Haniotis
- Department of Medical Entomology, Centre for Infectious Diseases and Microbiology Laboratory Services, NSW Health Pathology, Westmead Hospital, Westmead, New South Wales, Australia
| | - John Clancy
- Department of Medical Entomology, Centre for Infectious Diseases and Microbiology Laboratory Services, NSW Health Pathology, Westmead Hospital, Westmead, New South Wales, Australia
| | - Stephen L. Doggett
- Department of Medical Entomology, Centre for Infectious Diseases and Microbiology Laboratory Services, NSW Health Pathology, Westmead Hospital, Westmead, New South Wales, Australia
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Faddy H, Dunford M, Seed C, Olds A, Harley D, Dean M, Racloz V, McCarthy S, Smith D, Flower R. Seroprevalence of Antibodies to Ross River and Barmah Forest Viruses: Possible Implications for Blood Transfusion Safety After Extreme Weather Events. ECOHEALTH 2015; 12:347-353. [PMID: 25537629 DOI: 10.1007/s10393-014-1005-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Revised: 12/05/2014] [Accepted: 12/06/2014] [Indexed: 06/04/2023]
Abstract
Climate change is predicted to increase the transmission of many vector-borne pathogens, representing an increasing threat to a safe blood supply. In early 2011, Australia experienced catastrophic rainfall and flooding, coupled with increased arbovirus transmission. We used Ross River (RRV) and Barmah Forest (BFV) viruses as test cases to investigate the potential risk posed to Australia's blood supply after this period of increased rainfall . We estimated the risk of collecting an infected donation as one in 2,500-58,000 for RRV and one in 2,000-28,000 for BFV. Climate change may incrementally increase the arbovirus threat to blood safety.
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Affiliation(s)
- Helen Faddy
- Research and Development, Australian Red Cross Blood Service, Brisbane, QLD, Australia.
- School of Biomedical Science, Queensland University of Technology, Brisbane, QLD, Australia.
| | - Melanie Dunford
- Research and Development, Australian Red Cross Blood Service, Brisbane, QLD, Australia
- School of Biomedical Science, Queensland University of Technology, Brisbane, QLD, Australia
| | - Clive Seed
- Medical Services, Australian Red Cross Blood Service, Perth, WA, Australia
| | - Andrew Olds
- School of Science and Engineering, University of the Sunshine Coast, Maroochydore DC, QLD, Australia
| | - David Harley
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, ACT, Australia
| | - Melinda Dean
- Research and Development, Australian Red Cross Blood Service, Brisbane, QLD, Australia
| | - Vanessa Racloz
- School of Population Health, University of Queensland, Brisbane, QLD, Australia
| | - Suzi McCarthy
- Division of Microbiology and Infectious Diseases, PathWest Laboratory Medicine WA, Nedlands, WA, Australia
| | - David Smith
- Division of Microbiology and Infectious Diseases, PathWest Laboratory Medicine WA, Nedlands, WA, Australia
- School of Pathology and Laboratory Medicine, University of Western Australia, Nedlands, WA, Australia
| | - Robert Flower
- Research and Development, Australian Red Cross Blood Service, Brisbane, QLD, Australia
- School of Biomedical Science, Queensland University of Technology, Brisbane, QLD, Australia
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Faddy HM, Prow NA, Fryk JJ, Hall RA, Keil SD, Goodrich RP, Marks DC. The effect of riboflavin and ultraviolet light on the infectivity of arboviruses. Transfusion 2014; 55:824-31. [PMID: 25370822 DOI: 10.1111/trf.12899] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Revised: 08/29/2014] [Accepted: 09/01/2014] [Indexed: 12/11/2022]
Abstract
BACKGROUND Arboviruses are an emerging threat to transfusion safety and rates of infection are likely to increase with the increased rainfall associated with climate change. Arboviral infections are common in Australia, where Ross River virus (RRV), Barmah Forest virus (BFV), and Murray Valley encephalitis virus (MVEV), among others, have the potential to cause disease in humans. The use of pathogen reduction technology (PRT) may be an alternative approach for blood services to manage the risk of arboviral transfusion transmission. In this study, the effectiveness of the Mirasol PRT (Terumo BCT) system at inactivating RRV, BFV, and MVEV in buffy coat (BC)-derived platelets (PLTs) was investigated. STUDY DESIGN AND METHODS BC-derived PLT concentrates in additive solution (SSP+) were spiked with RRV, BFV, or MVEV and then treated with the Mirasol PRT system. The level of infectious virus was determined before and after treatment, and the reduction in viral infectivity was calculated. RESULTS Treatment with PRT (Mirasol) reduced the amount of infectious virus of all three arboviruses. The greatest level of inactivation was observed for RRV (2.33 log; 99.25%), followed by BFV (1.97 log; 98.68%) and then MVEV (1.83 log; 98.42%). CONCLUSION Our study demonstrates that treatment of PLT concentrates with PRT (Mirasol) reduces the infectious levels of RRV, BFV, and MVEV. The relevance of the level of reduction required to prevent disease transmission by transfusion has not been fully defined and requires further investigation. In the face of a changing climate, with its associated threat to blood safety, PRT represents a proactive approach for maintaining blood safety.
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Affiliation(s)
- Helen M Faddy
- Research and Development, Australian Red Cross Blood Service, Brisbane, Queensland, Australia
| | - Natalie A Prow
- Australian Infectious Disease Research Centre, School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Jesse J Fryk
- Research and Development, Australian Red Cross Blood Service, Brisbane, Queensland, Australia
| | - Roy A Hall
- Australian Infectious Disease Research Centre, School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Queensland, Australia
| | | | | | - Denese C Marks
- Research and Development, Australian Red Cross Blood Service, Sydney, New South Wales, Australia
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Ng V, Dear K, Harley D, McMichael A. Analysis and prediction of Ross River virus transmission in New South Wales, Australia. Vector Borne Zoonotic Dis 2014; 14:422-38. [PMID: 24745350 DOI: 10.1089/vbz.2012.1284] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Ross River virus (RRV) disease is the most widespread mosquito-borne disease in Australia. The disease is maintained in enzootic cycles between mosquitoes and reservoir hosts. During outbreaks and in endemic regions, RRV transmission can be sustained between vectors and reservoir hosts in zoonotic cycles with spillover to humans. Symptoms include arthritis, rash, fever and fatigue and can persist for several months. The prevalence and associated morbidity make this disease a medically and economically important mosquito-borne disease in Australia. METHODS Climate, environment, and RRV vector and reservoir host information were used to develop predictive models in four regions in NSW over a 13-year period (1991-2004). Polynomial distributed lag (PDL) models were used to explore long-term influences of up to 2 years ago that could be related to RRV activity. RESULTS Each regional model consisted of a unique combination of predictors for RRV disease highlighting the differences in the disease ecology and epidemiology in New South Wales (NSW). Events up to 2 years before were found to influence RRV activity. The shorter-term associations may reflect conditions that promote virus amplification in RRV vectors whereas long-term associations may reflect RRV reservoir host breeding and herd immunity. The models indicate an association between host populations and RRV disease, lagged by 24 months, suggesting two or more generations of susceptible juveniles may be necessary for an outbreak. Model sensitivities ranged from 60.4% to 73.1%, and model specificities ranged from 57.9% to 90.7%. This was the first study to include reservoir host data into statistical RRV models; the inclusion of host parameters was found to improve model fit significantly. CONCLUSION The research presents the novel use of a combination of climate, environment, and RRV vector and reservoir host information in statistical predictive models. The models have potential for public health decision-making.
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Affiliation(s)
- Victoria Ng
- National Centre for Epidemiology and Population Health, The Australian National University , Canberra, Australia
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Naish S, Mengersen K, Hu W, Tong S. Forecasting the future risk of Barmah Forest virus disease under climate change scenarios in Queensland, Australia. PLoS One 2013; 8:e62843. [PMID: 23690959 PMCID: PMC3655130 DOI: 10.1371/journal.pone.0062843] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2012] [Accepted: 03/29/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Mosquito-borne diseases are climate sensitive and there has been increasing concern over the impact of climate change on future disease risk. This paper projected the potential future risk of Barmah Forest virus (BFV) disease under climate change scenarios in Queensland, Australia. METHODS/PRINCIPAL FINDINGS We obtained data on notified BFV cases, climate (maximum and minimum temperature and rainfall), socio-economic and tidal conditions for current period 2000-2008 for coastal regions in Queensland. Grid-data on future climate projections for 2025, 2050 and 2100 were also obtained. Logistic regression models were built to forecast the otential risk of BFV disease distribution under existing climatic, socio-economic and tidal conditions. The model was applied to estimate the potential geographic distribution of BFV outbreaks under climate change scenarios. The predictive model had good model accuracy, sensitivity and specificity. Maps on potential risk of future BFV disease indicated that disease would vary significantly across coastal regions in Queensland by 2100 due to marked differences in future rainfall and temperature projections. CONCLUSIONS/SIGNIFICANCE We conclude that the results of this study demonstrate that the future risk of BFV disease would vary across coastal regions in Queensland. These results may be helpful for public health decision making towards developing effective risk management strategies for BFV disease control and prevention programs in Queensland.
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Affiliation(s)
- Suchithra Naish
- School of Public Health, Queensland University of Technology, Queensland, Australia.
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Jacups S, Warchot A, Whelan P. Anthropogenic ecological change and impacts on mosquito breeding and control strategies in salt-marshes, Northern Territory, Australia. ECOHEALTH 2012; 9:183-194. [PMID: 22476689 DOI: 10.1007/s10393-012-0759-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2011] [Revised: 03/05/2012] [Accepted: 03/12/2012] [Indexed: 05/31/2023]
Abstract
Darwin, in the tropical north of Australia, is subject to high numbers of mosquitoes and several mosquito-borne diseases. Many of Darwin's residential areas were built in close proximity to tidally influenced swamps, where long-term storm-water run-off from nearby residences into these swamps has led to anthropogenic induced ecological change. When natural wet-dry cycles were disrupted, bare mud-flats and mangroves were transformed into perennial fresh to brackish-water reed swamps. Reed swamps provided year-round breeding habitat for many mosquito species, such that mosquito abundance was less predictable and seasonally dependent, but constant and often occurring in plague proportions. Drainage channels were constructed throughout the wetlands to reduce pooled water during dry-season months. This study assesses the impact of drainage interventions on vegetation and mosquito ecology in three salt-marshes in the Darwin area. Findings revealed a universal decline in dry-season mosquito abundance in each wetland system. However, some mosquito species increased in abundance during wet-season months. Due to the high expense and potentially detrimental environmental impacts of ecosystem and non-target species disturbance, large-scale modifications such as these are sparingly undertaken. However, our results indicate that some large scale environmental modification can assist the process of wetland restoration, as appears to be the case for these salt marsh systems. Drainage in all three systems has been restored to closer to their original salt-marsh ecosystems, while reducing mosquito abundances, thereby potentially lowering the risk of vector-borne disease transmission and mosquito pest biting problems.
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Affiliation(s)
- Susan Jacups
- School of Public Health and Tropical Medicine, James Cook University, Cairns, QLD, Australia.
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Abstract
Mosquito-transmitted alphaviruses causing human rheumatic disease are globally distributed and include chikungunya virus, Ross River virus, Barmah Forest virus, Sindbis virus, o'nyong-nyong virus and Mayaro virus. These viruses cause endemic disease and, occasionally, large epidemics; for instance, the 2004-2011 chikungunya epidemic resulted in 1.4-6.5 million cases, with imported cases reported in nearly 40 countries. The disease is usually self-limiting and characterized by acute and chronic symmetrical peripheral polyarthralgia-polyarthritis, with acute disease usually including fever, myalgia and/or rash. Arthropathy can be debilitating, usually lasts weeks to months and can be protracted; although adequate attention to differential diagnoses is recommended. The latest chikungunya virus epidemic was also associated with some severe disease manifestations and mortality, primarily in elderly patients with comorbidities and the young. Chronic alphaviral rheumatic disease probably arises from inflammatory responses stimulated by the virus persisting in joint tissues, despite robust antiviral immune responses. Serodiagnosis by ELISA is the standard; although international standardization is often lacking. Treatment usually involves simple analgesics and/or NSAIDs, which can provide relief, but better drug treatments are clearly needed. However, the small market size and/or the unpredictable and rapid nature of epidemics present major hurdles for development and deployment of new alphavirus-specific interventions.
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Affiliation(s)
- Andreas Suhrbier
- Immunovirology Laboratory, Queensland Institute of Medical Research, 300 Herston Road, Brisbane, Queensland 4006, Australia.
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