Comparative field evaluation of repellent formulations containing deet and IR3535 against mosquitoes in Queensland, Australia

The Emergence of Japanese Encephalitis Virus in Australia in 2022: Existing Knowledge of Mosquito Vectors

In early 2022, the Japanese encephalitis virus (JEV) was identified as the cause of stillborn and mummified piglets in pig farms in southeastern Australia. Human cases and additional pig farms with infected piglets were subsequently identified across a widespread area encompassing four states. To inform surveillance and control programs, we synthesized existing information on Australian vectors of JEV, much of which was generated in response to incursions of JEV into the northern state of Queensland between 1995 and 2005. Members of the Culex sitiens subgroup, particularly Culex annulirostris, should be considered the primary vectors of JEV in Australia, as they yielded >87% of field detections of JEV, were highly efficient laboratory vectors of the virus, readily fed on pigs and birds (the key amplifying hosts of the virus) when they were available, and are widespread and often occur in large populations. Three introduced species, Culex quinquefasciatus, Culex gelidus and Culex tritaeniorhynchus may also serve as vectors, but more information on their geographical distribution, abundance and bionomics in the Australian context is required. Mosquitoes from other genera, such as Aedes and Verrallina, whilst considered relatively poor vectors, could play a regional or supplemental role in transmission, especially facilitating vertical transmission as a virus overwintering mechanism. Additional factors that could impact JEV transmission, including mosquito survival, dispersal and genetics, are also discussed. Possible directions for investigation are provided, especially in the context of the virus emerging in a region with different mosquito fauna and environmental drivers than northern Australia.

Repellent Activity of TRIG (N-N Diethyl Benzamide) against Man-Biting Mosquitoes

A study was conducted to assess efficacy of a new repellent brand TRIG (15% N-N Diethyl Benzamide) when compared to DEET (20% N-N Methyl Toluamide). The repellents were tested in laboratory and field. In the laboratory, the repellence was tested on human volunteers, by exposing their repellent-treated arms on starved mosquitoes in cages for 3 minutes at hourly intervals, while counting the landing and probing attempts. Anopheles gambiae and Aedes aegypti mosquitoes were used. Field evaluation was conducted by Human Landing Catch technique. During the night, the repellents were applied on arms and legs and mosquitoes landing on these areas were collected. In laboratory tests, TRIG provided complete protection (100%) against Anopheles gambiae when applied at 1.25 g, while DEET provided this at 0.75 g. When tested on Aedes aegypti, TRIG provided complete protection when applied at 1 g, compared to 0.5 g for DEET. In the field, when applied at a recommended dose, both TRIG and DEET achieved above 90% protection against both An. arabiensis and Culex quinquefasciatus and a Complete Protection Time of about 6 hrs against both species of mosquitoes. The performances of the two products were found to be comparable and TRIG was recommended for use as repellent against mosquito bites.

Assessment of Local Mosquito Species Incriminates Aedes aegypti as the Potential Vector of Zika Virus in Australia

Background

Within the last 10 years Zika virus (ZIKV) has caused unprecedented epidemics of human disease in the nations and territories of the western Pacific and South America, and continues to escalate in both endemic and non-endemic regions. We evaluated the vector competence of Australian mosquitoes for ZIKV to assess their potential role in virus transmission.

Methodology/Principal Findings

Mosquitoes were exposed to infectious blood meals containing the prototype African ZIKV strain. After 14 days incubation at 28°C and high relative humidity, infection, dissemination and transmission rates were assessed. Infection in Culex annulirostris and Cx. sitiens could not be detected. 8% of Cx. quinquefasciatus were infected, but the virus did not disseminate in this species. Despite having infection rates > 50%, Aedes notoscriptus and Ae. vigilax did not transmit ZIKV. In contrast, Ae. aegypti had infection and transmission rates of 57% and 27%, respectively. In susceptibility trials, the virus dose required to infect 50% (ID₅₀) of Ae. aegypti was10^6.4 tissue culture infectious dose₅₀ (TCID₅₀)/mL. Additionally, a threshold viral load within the mosquito of at least 10^5.1 TCID₅₀ equivalents/mL had to be reached before virus transmission occurred.

Conclusions/Significance

We confirmed Ae. aegypti to be the most likely mosquito vector of ZIKV in Australia, although the restricted distribution of this species will limit the receptive zone to northern Queensland where this species occurs. Importantly, the role in ZIKV transmission of Culex and other Aedes spp. tested will be negligible. Despite being the implicated vector, the relatively high ID₅₀ and need for a high titer disseminated infection in Ae. aegypti suggest that high mosquito population densities will be required to facilitate epidemic ZIKV transmission among the currently immunologically naïve human population in Australia.

Zika virus was first isolated in Uganda in 1947 and exists in a transmission cycle between mosquitoes and non-human primates or humans. Whilst most clinical infections result in a self-limiting febrile illness, Zika virus has recently been linked to neurological syndromes, such as Guillain-Barré syndrome and congenital birth defects. Since 2007, Zika virus has undergone a dramatic range expansion, causing epidemics in nations and territories of the western Pacific and South America. To assess the emergence and transmission risk of Zika virus emerging in Australia, we evaluated the ability of local mosquitoes to become infected with and transmit the prototype African Zika virus strain. In agreement with its substantiated role in Zika virus transmission overseas, Australian Aedes aegypti were shown to be competent vectors. Coupled with its anthropophilic feeding behavior, this species should be considered the primary potential Zika virus vector in Australia. Although other common Australian species, such as Ae. notoscriptus and Ae. vigilax, were readily infected, they did not transmit the virus. The species of Culex tested were either refractory to infection or had a low infection rate. We also demonstrated that the Zika virus dose necessary to infect Ae. aegypti was higher than virus levels reported in infected humans. Finally, a high threshold level of virus circulating through the mosquito body was required before Ae. aegypti transmitted the virus. These results suggest that an outbreak of Zika virus in Australia would require high mosquito population densities and a susceptible human population.

Physicians, Primary Caregivers and Topical Repellent: All Under-Utilised Resources in Stopping Dengue Virus Transmission in Affected Households

BACKGROUND

Primary health care facilities frequently manage dengue cases on an ambulatory basis for the duration of the patient's illness. There is a great opportunity for specific messaging, aimed to reduce dengue virus (DENV) transmission in and around the home, to be directly targeted toward this high-risk ambulatory patient group, as part of an integrated approach to dengue management. The extent however, to which physicians understand, and can themselves effectively communicate strategies to stop focal DENV transmission around an ambulatory dengue case is unknown; the matter of patient comprehension and recollection then ensues. In addition, the effectiveness of N,N-diethyl-3-methylbenzamide (DEET)-based insect repellent in protecting dengue patients from Aedes aegypti mosquitoes' bites has not been investigated.

METHODOLOGY

A knowledge, attitude and practice (KAP) survey, focusing on the mechanisms of DENV transmission and prevention, was performed using semi-structured questionnaires. This survey was targeted towards the patients and family members providing supportive care, and physicians routinely involved in dengue patient management in Southern Vietnam. An additional clinical observational study was conducted to measure the efficacy of a widely-used 13% DEET-based insect repellent to repel Ae. aegypti mosquitoes from the forearms of dengue cases and matched healthy controls.

PRINCIPAL FINDINGS

Among both the physician (n = 50) and patient (n = 49) groups there were several respondents lacking a coherent understanding of DENV transmission, leading to some inappropriate attitudes and inadequate acute preventive practices in the household. The application of insect repellent to protect patients and their relatives from mosquito bites was frequently recommended by majority of physicians (78%) participating in the survey. Nevertheless, our tested topical application of 13% DEET conferred only ~1hr median protection time from Ae. aegypti landing. This is notably shorter than that advertised on the manufacturer's label. No differences in landing time between febrile dengue cases or matched healthy controls (n = 19 experiments) were observed.

CONCLUSION/SIGNIFICANCE

Our study identifies missed opportunities for primary care physicians to improve public health through communication of strategies that could prevent focal dengue transmission in and around a case household. We advocate better access to more efficient communication methods for physicians and auxilliary health workers, supporting to educate those at high risk of DENV transmission. Our empirical testing of a widely-available 13% DEET-based repellent was limited in its protective efficacy against Ae. aegypti mosquito bites, and therefore DENV transmission, suggesting more frequent application is necessary to be beneficial.

The Usual Suspects: Comparison of the Relative Roles of Potential Urban Chikungunya Virus Vectors in Australia

The global re-emergence of chikungunya virus (CHIKV) over the last decade presents a serious public health risk to Australia. An increasing number of imported cases further underline the potential for local transmission to occur if local mosquitoes bite an infected traveller. Laboratory experiments have identified a number of competent Australian mosquito species, including the primary vectors of CHIKV abroad, Aedes aegypti and Aedes albopictus, and local endemic species Aedes vigilax and Aedes notoscriptus. The implication of these additional endemic species as potential vectors has generated much uncertainty amongst public health professionals regarding their actual role in CHIKV transmission in the field. Using data estimated from or documented in the literature, we parameterise a simple vectorial capacity model to evaluate the relative roles of Australian mosquito species in potential CHIKV transmission. The model takes into account a number of key biological and ecological variables which influence the role of a species in field transmission, including population density, human feeding rates, mosquito survival rates and vector competence. We confirm the relative importance of Ae. aegypti and Ae. albopictus in sustaining potential CHIKV transmission in Australia. Even at maximum estimated densities and human feeding rates, Ae. vigilax and Ae. notoscriptus are likely to play a relatively minor role in CHIKV transmission, when compared with either Ae. aegypti or Ae. albopictus. This relatively straightforward analysis has application for any region where mosquito species have been incriminated in vector competence experiments, but where their actual role in CHIKV transmission has not been established.

Assessment of methods used to determine the safety of the topical insect repellent N,N-diethyl-m-toluamide (DEET)

N,N-diethyl-m-toluamide (DEET) has been registered for commercial use as an insect repellent for over five decades, and is used widely across the world. Concerns over the safety of DEET first emerged during the 1980s after reports of encephalopathy following DEET exposure, particularly in children. However, the role of DEET in either the illness or deaths was and remains purely speculative. In response to these cases a number of reviews and investigations of DEET safety were carried out. Here we examine the methods used and information available to determine the safety of DEET in humans. Animal testing, observational studies and intervention trials have found no evidence of severe adverse events associated with recommended DEET use. Minor adverse effects noted in animal trials were associated with very large doses and were not replicated between different test species. The safety surveillance from extensive humans use reveals no association with severe adverse events. This review compares the toxicity assessment using three different models to define the risk assessment and safety threshold for DEET use in humans and discusses the clinical consequences of the thresholds derived from the models.

The theoretical risks associated with wearing an insect repellent should be weighed against the reduction or prevention of the risk of fatal or debilitating diseases including malaria, dengue, yellow fever and filariasis. With over 48 million European residents travelling to regions where vector borne diseases are a threat in 2009, restricting the concentration of DEET containing repellents to 15% or less, as modelled in the 2010 EU directive, is likely to result in extensive sub-therapeutic activity where repellents are infrequently applied. Future European travellers, as a consequence of inadequate personal protection, could potentially be at increased risk of vector borne diseases. Risk assessments of repellents should take these factors into account when setting safe limits.

Field evaluation and user acceptability of repellent formulations containing DEET against mosquitoes in Australia

Field efficacy trials comparing 2 formulations of deet against mosquitoes in Redcliffe, Queensland, Australia were conducted in February 2009. A formulation containing 35% deet in a gel (Australian Defence Force deet) provided > 95% protection for 3 h, while a formulation containing 40% deet in ethanol (Bushman) in a spray applicator provided > 95% for 6 h. A user acceptability study showed that 82% of soldiers using the Bushman formulation during contingency operations for 14-28 days in Timor-Leste would recommend this formulation to others and believed that the formulation provided protection against mosquitoes.