Vector-borne disease intelligence: strategies to deal with disease burden and threats

Optimal environmental testing frequency for outbreak surveillance

Public health surveillance for pathogens presents an optimization problem: we require enough sampling to identify intervention-triggering shifts in pathogen epidemiology, such as new introductions or sudden increases in prevalence, but not so much that costs due to surveillance itself outweigh those from pathogen-associated illness. To determine this optimal sampling frequency, we developed a general mathematical model for the introduction of a new pathogen that, once introduced, increases in prevalence exponentially. Given the relative cost of infection vs. sampling, we derived equations for the expected combined cost per unit time of disease burden and surveillance for a specified sampling frequency, and thus the sampling frequency for which the expected total cost per unit time is lowest.

Role of invasive carnivores (Procyon lotor and Nyctereutes procyonoides) in epidemiology of vector-borne pathogens: molecular survey from the Czech Republic

BACKGROUND

Vector-borne pathogens (VBPs) are a major threat to humans, livestock and companion animals worldwide. The combined effect of climatic, socioeconomic and host composition changes favours the spread of the vectors, together with the expansion of invasive carnivores contributing to the spread of the pathogens. In Europe, the most widespread invasive species of carnivores are raccoons (Procyon lotor) and raccoon dogs (Nyctereutes procyonoides). This study focused on the detection of four major groups of VBPs namely Babesia, Hepatozoon, Anaplasma phagocytophilum and Bartonella in invasive and native carnivores in the Czech Republic, with the emphasis on the role of invasive carnivores in the eco-epidemiology of said VBPs.

METHODS

Spleen samples of 84 carnivores of eight species (Canis aureus, Canis lupus, Lynx lynx, P. lotor, Martes foina, Lutra lutra, Mustela erminea and N. procyonoides) were screened by combined nested PCR and sequencing for the above-mentioned VBPs targeting 18S rRNA and cytB in hemoprotozoa, groEL in A. phagocytophilum, and using multilocus genotyping in Bartonella spp. The species determination is supported by phylogenetic analysis inferred by the maximum likelihood method.

RESULTS

Out of 84 samples, 44% tested positive for at least one pathogen. Five different species of VBPs were detected in P. lotor, namely Bartonella canis, Hepatozoon canis, Hepatozoon martis, A. phagocytophilum and Bartonella sp. related to Bartonella washoensis. All C. lupus tested positive for H. canis and one for B. canis. Three VBPs (Hepatozoon silvestris, A. phagocytophilum and Bartonella taylorii) were detected in L. lynx for the first time. Babesia vulpes and yet undescribed species of Babesia, not previously detected in Europe, were found in N. procyonoides.

CONCLUSIONS

Wild carnivores in the Czech Republic are hosts of several VBPs with potential veterinary and public health risks. Among the studied carnivore species, the invasive raccoon is the most competent host. Raccoons are the only species in our study where all the major groups of studied pathogens were detected. None of the detected pathogen species were previously detected in these carnivores in North America, suggesting that raccoons adapted to local VBPs rather than introduced new ones. Babesia vulpes and one new, probably imported species of Babesia, were found in raccoon dogs.

Coordinated surveillance system under the One Health approach for cross-border pathogens that threaten the Union - options for sustainable surveillance strategies for priority pathogens

This report provides guidance for Member states who plan to submit applications under the work programme 'CP-g-22-04.01 Direct grants to Member States' authorities'. The priority pathogens on which the coordinated surveillance under the grant initiative shall focus have been identified in a prioritisation exercise with Member States and ECDC. These are Crimean Congo haemorrhagic fever, echinococcosis, hepatitis E, highly pathogenic avian influenza (HPAI), influenza in swine, Lyme disease, Q-fever, Rift Valley fever, tick-borne encephalitis, West Nile fever and Disease X (Disease Y of animals). Surveillance activities (surveillance cards) have been proposed for these agents in this report. Member States should select one or more diseases from the list of priority diseases and then choose surveillance activities from the surveillance cards and modify them where needed, to reflect their national needs and situation. Member States can also design alternative surveillance activities for the priority infectious agents that may better fit the epidemiological situation in their country. Further, this report provides a section on surveillance perspectives that links infectious agents to different hosts, allowing Member States to consider the testing for multiple infectious agents in samples from a single host population, as well as sections providing guidance on surveillance in vectors and wildlife and for Disease X (Disease Y in animals). Member States are encouraged to develop cross-sectoral collaborations and the report provides guidance on cross-sectoral collaboration to help them. Finally, there is a roadmap providing an overall description of the steps in the process of developing a surveillance system in order to apply for the grant.

Advanced approaches for the diagnosis and chemoprevention of canine vector-borne pathogens and parasites-Implications for the Asia-Pacific region and beyond

Vector-borne pathogens (VBPs) of canines are a diverse range of infectious agents, including viruses, bacteria, protozoa and multicellular parasites, that are pernicious and potentially lethal to their hosts. Dogs across the globe are afflicted by canine VBPs, but the range of different ectoparasites and the VBPs that they transmit predominate in tropical regions. Countries within the Asia-Pacific have had limited prior research dedicated to exploring the epidemiology of canine VBPs, whilst the few studies that have been conducted show VBP prevalence to be high, with significant impacts on dog health. Moreover, such impacts are not restricted to dogs, as some canine VBPs are zoonotic. We reviewed the status of canine VBPs in the Asia-Pacific, with particular focus on nations in the tropics, whilst also investigating the history of VBP diagnosis and examining recent progress in the field, including advanced molecular methods, such as next-generation sequencing (NGS). These tools are rapidly changing the way parasites are detected and discovered, demonstrating a sensitivity equal to, or exceeding that of, conventional molecular diagnostics. We also provide a background to the armoury of chemopreventive products available for protecting dogs from VBP. Here, field-based research within high VBP pressure environments has underscored the importance of ectoparasiticide mode of action on their overall efficacy. The future of canine VBP diagnosis and prevention at a global level is also explored, highlighting how evolving portable sequencing technologies may permit diagnosis at point-of-care, whilst further research into chemopreventives will be essential if VBP transmission is to be effectively controlled.

Proof of Concept of Biopolymer Based Hydrogels as Biomimetic Oviposition Substrate to Develop Tiger Mosquitoes (Aedes albopictus) Cost-Effective Lure and Kill Ovitraps

Pest management is looking for green and cost-effective innovative solutions to control tiger mosquitoes and other pests. By using biomimetic principles and biocompatible/biodegradable biopolymers, it could be possible to develop a new approach based on substrates that selectively attract insects by reproducing specific natural environmental conditions and then kill them by hosting and delivering a natural biopesticide or through mechanical action (biomimetic lure and kill approach, BL&K). Such an approach can be theoretically specialized against tiger mosquitoes (BL&K-TM) by designing hydrogels to imitate the natural oviposition site’s conditions to employ them inside a lure and kill ovitraps as a biomimetic oviposition substrate. In this work, the hydrogels have been prepared to prove the concept. The study compares lab/on-field oviposition between standard substrates (absorbing paper/masonite) and a physical and chemically crosslinked hydrogel composition panel. Then the best performing is characterized to evaluate a correlation between the hydrogel’s properties and oviposition. Tests identify a 2-Hydroxyethylcellulose (HEC)-based physical hydrogel preparation as five times more attractive than the control in a lab oviposition assay. When employed on the field in a low-cost cardboard trap, the same substrate is seven times more capturing than a standard masonite ovitrap, with a duration four times longer.

VectorNet: Putting Vectors on the Map

Public and animal health authorities face many challenges in surveillance and control of vector-borne diseases. Those challenges are principally due to the multitude of interactions between vertebrate hosts, pathogens, and vectors in continuously changing environments. VectorNet, a joint project of the European Food Safety Authority (EFSA) and the European Centre for Disease Prevention and Control (ECDC) facilitates risk assessments of VBD threats through the collection, mapping and sharing of distribution data for ticks, mosquitoes, sand flies, and biting midges that are vectors of pathogens of importance to animal and/or human health in Europe. We describe the development and maintenance of this One Health network that celebrated its 10th anniversary in 2020 and the value of its most tangible outputs, the vector distribution maps, that are freely available online and its raw data on request. VectorNet encourages usage of these maps by health professionals and participation, sharing and usage of the raw data by the network and other experts in the science community. For the latter, a more complete technical description of the mapping procedure will be submitted elsewhere.

Spatial Distribution, Seasonal Abundance and Physio-Chemical Assessment of Mosquito Larval Breeding Sites in Mardan District, Khyber Pakhtunkhwa, Pakistan

Background

Mosquitoes (Diptera: Culicidae) are haemotophagus insects and are vectors of many arthropod-borne diseases. Present study aimed to explore species composition, seasonal abundance, spatial distribution and physio-chemical properties of larval breeding sites of mosquitoes in District Mardan, Khyber Pakhtunkhwa, Pakistan.

Methods

Both adults and larvae of mosquitoes were collected through light traps, insecticide spray, mouth aspirator and larval standard dipping method in District Mardan from May to November 2017. Water samples from larval sites were physio-chemically analysed.

Results

5078 (3704 adults and 1374 larvae) mosquito specimens were collected in Mardan, Katlang and Takhtbhai tehsils. Six species in four genera were reported. Culex pipiens (89.80%) and Armigeres subalbatus (9.20%) were the most abundant species. Diversity was high in Takhtbhai (0.29) followed by Katlang (0.28) and Mardan (0.25). Greater number of specimens were recorded in peridomestic sites (93.97%) as compared to domestic habitats (6.03%). Culex pipiens larval abundance had negative correlation with pH whereas it correlated positively with electric conductivity, salinity, and TDS (total dissolved sulphur). Mosquito abundance peaked in August and July while the lowest was in May. Their monthly abundance had positive correlation with rainfall (r= 0.5069), relative humidity (r= 0.4439) and mean minimum temperature (r= 0.2866). Number of mosquitoes was highest at low elevation < 347m asl (above sea level) in agriculture land and near to water bodies (streams).

Conclusion

Culex pipiens being the most abundant species, was susceptible to high pH. Mosquitoes preferred habitats were at low elevation in agriculture land.

From tissue engineering to mosquitoes: biopolymers as tools for developing a novel biomimetic approach to pest management/vector control

Background

Pest management has been facing the spread of invasive species, insecticide resistance phenomena, and concern for the impact of chemical pesticides on human health and the environment. It has tried to deal with them by developing technically efficient and economically sustainable solutions to complement/replace/improve traditional control methods. The renewal has been mainly directed towards less toxic pesticides or enhancing the precision of their delivery to reduce the volume employed and side effects through lure-and-kill approaches based on semiochemicals attractants. However, one of the main pest management problems is that efficacy depends on the effectiveness of the attractant system, limiting its successful employment to semiochemical stimuli-responsive insects. Biomaterial-based and bioinspired/biomimetic solutions that already guide other disciplines (e.g., medical sciences) in developing precision approaches could be a helpful tool to create attractive new strategies to liberate precision pest management from the need for semiochemical stimuli, simplify their integration with bioinsecticides, and foster the use of still underemployed solutions.

Approach proposed

We propose an innovative approach, called “biomimetic lure-and-kill”. It exploits biomimetic principles and biocompatible/biodegradable biopolymers (e.g., natural hydrogels) to develop new substrates that selectively attract insects by reproducing specific natural environmental conditions (biomimetic lure) and kill them by hosting and delivering a natural biopesticide or through mechanical action. Biomimetic lure-and-kill-designed substrates point to provide a new attractive system to develop/improve and make more cost-competitive new and conventional devices (e.g. traps). A first example application is proposed using the tiger mosquito Aedes albopictus as a model.

Conclusions

Biomaterials, particularly in the hydrogel form, can be a useful tool for developing the biomimetic lure-and-kill approach because they can satisfy multiple needs simultaneously (e.g., biomimetic lure, mechanical lethality, biocompatibility, and bioinsecticide growth). Such an approach might be cost-competitive, and with the potential for applicability to several pest species. Moreover, it is already technically feasible, since all the technologies necessary to design and configure materials with specific characteristics are already available on the market.

Graphical Abstract

Use of Cervid Serosurveys to Monitor Eastern Equine Encephalitis Virus Activity in Northern New England, United States, 2009-2017

Vertebrate surveillance for eastern equine encephalitis virus (EEEV) activity usually focuses on three types of vertebrates: horses, passerine birds, and sentinel chicken flocks. However, there is a variety of wild vertebrates that are exposed to EEEV infections and can be used to track EEEV activity. In 2009, we initiated a pilot study in northern New England, United States, to evaluate the effectiveness of using wild cervids (free-ranging white-tailed deer and moose) as spatial sentinels for EEEV activity. In Maine, New Hampshire, and Vermont during 2009-2017, we collected blood samples from hunter-harvested cervids at tagging stations and obtained harvest location information from hunters. U.S. Centers for Disease Control and Prevention processed the samples for EEEV antibodies using plaque reduction neutralization tests (PRNTs). We detected EEEV antibodies in 6 to 17% of cervid samples in the different states and mapped cervid EEEV seropositivity in northern New England. EEEV antibody-positive cervids were the first detections of EEEV activity in the state of Vermont, in northern Maine, and northern New Hampshire. Our key result was the detection of the antibodies in areas far outside the extent of documented wild bird, mosquito, human case, or veterinary case reports of EEEV activity in Maine, New Hampshire, and Vermont. These findings showed that cervid (deer and moose) serosurveys can be used to characterize the geographic extent of EEEV activity, especially in areas with low EEEV activity or with little or no EEEV surveillance. Cervid EEEV serosurveys can be a useful tool for mapping EEEV activity in areas of North America in addition to northern New England.

Environment, vector, or host? Using machine learning to untangle the mechanisms driving arbovirus outbreaks

Climatic, landscape, and host features are critical components in shaping outbreaks of vector-borne diseases. However, the relationship between the outbreaks of vector-borne pathogens and their environmental drivers is typically complicated, nonlinear, and may vary by taxonomic units below the species level (e.g., strain or serotype). Here, we aim to untangle how these complex forces shape the risk of outbreaks of Bluetongue virus (BTV); a vector-borne pathogen that is continuously emerging and re-emerging across Europe, with severe economic implications. We tested if the ecological predictors of BTV outbreak risk were serotype-specific by examining the most prevalent serotypes recorded in Europe (1, 4, and 8). We used a robust machine learning (ML) pipeline and 23 relevant environmental features to fit predictive models to 24,245 outbreaks reported in 25 European countries between 2000 and 2019. Our ML models demonstrated high predictive performance for all BTV serotypes (accuracies > 0.87) and revealed strong nonlinear relationships between BTV outbreak risk and environmental and host features. Serotype-specific analysis suggests, however, that each of the major serotypes (1, 4, and 8) had a unique outbreak risk profile. For example, temperature and midge abundance were as the most important characteristics shaping serotype 1, whereas for serotype 4 goat density and temperature were more important. We were also able to identify strong interactive effects between environmental and host characteristics that were also serotype specific. Our ML pipeline was able to reveal more in-depth insights into the complex epidemiology of BTVs and can guide policymakers in intervention strategies to help reduce the economic implications and social cost of this important pathogen.

Atelerix algirus, the North African Hedgehog: Suitable Wild Host for Infected Ticks and Fleas and Reservoir of Vector-Borne Pathogens in Tunisia

Small wild mammals are an important element in the emergence and transmission of vector-borne pathogens (VBPs). Among these species, hedgehogs have been found to be a reservoir of VBPs and host of arthropod vectors. Surveillance of VBPs in wildlife and their arthropods are crucial in a one health context. We conducted an exploratory study to screen Atelerix algirus hedgehogs and their infesting ticks and fleas for VBPs using a high throughput microfluidic real-time PCR system. Tested biopsies from hedgehogs were found to be naturally infected by Theileria youngi, Hepatozoon sp., Ehrlichia ewingii, Coxiella burnetii, and Candidatus Ehrlichia shimanensis. Similarly, Haemaphysalis erinacei and Rhipicephalus sanguineus tick species were infected by Ehrlichia ewingii, Rickettsia spp., Rickettsia massiliae, Borrelia sp., Coxiella burnetii, Rickettsia lusitaniae and Anaplasma sp. Archaeopsylla erinacei fleas were infected by Rickettsia asembonensis, Coxiella burnetii, and Rickettsia massiliae. Co-infections by two and three pathogens were detected in hedgehogs and infesting ticks and fleas. The microfluidic real-time PCR system enabled us not only to detect new and unexpected pathogens, but also to identify co-infections in hedgehogs, ticks, and fleas. We suggest that hedgehogs may play a reservoir role for VBPs in Tunisia and contribute to maintaining enzootic pathogen cycles via arthropod vectors.

Shifting From Sectoral to Integrated Surveillance by Changing Collaborative Practices: Application to West Nile Virus Surveillance in a Small Island State of the Caribbean

After spreading in the Americas, West Nile virus was detected in Guadeloupe (French West Indies) for the first time in 2002. Ever since, several organizations have conducted research, serological surveys, and surveillance activities to detect the virus in horses, birds, mosquitoes, and humans. Organizations often carried them out independently, leading to knowledge gaps within the current virus' situation. Nearly 20 years after the first evidence of West Nile virus in the archipelago, it has not yet been isolated, its impact on human and animal populations is unknown, and its local epidemiological cycle is still poorly understood. Within the framework of a pilot project started in Guadeloupe in 2019, West Nile virus was chosen as a federative model to apply the "One Health" approach for zoonotic epidemiological surveillance and shift from a sectorial to an integrated surveillance system. Human, animal, and environmental health actors involved in both research and surveillance were considered. Semi-directed interviews and a Social Network Analysis were carried out to learn about the surveillance network structure and actors, analyze information flows, and identify communication challenges. An information system was developed to fill major gaps: users' needs and main functionalities were defined through a participatory process where actors also tested and validated the tool. Additionally, all actors shared their data, which were digitized, cataloged, and centralized, to be analyzed later. An R Shiny server was integrated into the information system, allowing an accessible and dynamic display of data showcasing all of the partners' information. Finally, a series of virtual workshops were organized among actors to discuss preliminary results and plan the next steps to improve West Nile Virus and vector-borne or emerging zoonosis surveillance. The actors are willing to build a more resilient and cooperative network in Guadeloupe with improved relevance, efficiency, and effectiveness of their work.

Wicked Solution for Wicked Problems: Citizen Science for Vector-Borne Disease Control in Africa

At the crossroads of interacting biological, socioeconomic, behavioral, and institutional factors, vector-borne diseases are complex 'wicked problems'. In this article, we argue that citizen science can help in vector control by boosting scientific data collection, tapping into local knowledge, and building durable partnerships between scientists and communities.

Dengue and Zika Viruses: Epidemiological History, Potential Therapies, and Promising Vaccines

Dengue virus (DENV), which can lead to fatal hemorrhagic fever, affects 390 million people worldwide. The closely related Zika virus (ZIKV) causes microcephaly in newborns and Guillain-Barré syndrome in adults. Both viruses are mostly transmitted by Aedes albopictus and Aedes aegypti mosquitoes, which, due to globalization of trade and travel alongside climate change, are spreading worldwide, paving the way to DENV and ZIKV transmission and the occurrence of new epidemics. Local outbreaks have already occurred in temperate climates, even in Europe. As there are no specific treatments, these viruses are an international public health concern. Here, we analyze and discuss DENV and ZIKV outbreaks history, clinical and pathogenesis features, and modes of transmission, supplementing with information on advances on potential therapies and restraining measures. Taking advantage of the knowledge of the structure and biological function of the capsid (C) protein, a relatively conserved protein among flaviviruses, within a genus that includes DENV and ZIKV, we designed and patented a new drug lead, pep14-23 (WO2008/028939A1). It was demonstrated that it inhibits the interaction of DENV C protein with the host lipid system, a process essential for viral replication. Such an approach can be used to develop new therapies for related viruses, such as ZIKV.

Making Vector-Borne Disease Surveillance Work: New Opportunities From the SDG Perspectives

Surveillance of vector-borne diseases (VBDs) exemplifies a One Health approach, which entails coordinated, collaborative, multidisciplinary, and cross-sectoral approaches to address potential or existing health risks originating at the animal-human-ecosystem interface. However, at the intervention stage of the surveillance system, it is sometimes difficult or even impossible to act. The human dimension of VBD control makes them wicked problems requiring an interdisciplinary systems approach beyond the One Health domain. Here, we make a case that the agenda of the UN Sustainable Development Goals (SDGs) can offer new opportunities to address these issues. The health of the population is a concern to us all and is more or less related to all 17 SDGs. The SDGs can provide a common language by which the interests of various stakeholders can be matched and the challenges that society faces identified, studied, and alleviated. To illustrate, the control and prevention of two VBDs, dengue and Lyme borreliosis, were selected and related to specific SDGs. Further, we use the framework proposed by the International Council of Science to: (1) show synergies and trade-offs between the various SDGs; and (2) present SDG 3 to identify policy that can be related to prevention. Engaging in an integrated approach will confront stakeholders with various viewpoints and through these oppositions, innovation can be nurtured. By adhering to the SDG agenda, we present policy advice including new opportunities for vector-borne disease control to reach its own health goals, while simultaneously supporting other sustainable development goals.

A framework for adaptive surveillance of emerging tick-borne zoonoses

Significant global ecological changes continue to drive emergence of tick-borne zoonoses around the world. This poses an important threat to both human and animal health, and highlights the need for surveillance systems that are capable of monitoring these complex diseases effectively across different stages of the emergence process. Our objective was to develop an evidence-based framework for surveillance of emerging tick-borne zoonoses. We conducted a realist review to understand the available approaches and major challenges associated with surveillance of emerging tick-borne zoonoses. Lyme disease, with a specific focus on emergence in Canada, was used as a case study to provide real-world context, since the process of disease emergence is ongoing in this country. We synthesize the results to propose a novel framework for adaptive surveillance of emerging tick-borne zoonoses. Goals for each phase of disease emergence are highlighted and approaches are suggested. The framework emphasizes the needs for surveillance systems to be inclusive, standardized, comprehensive and sustainable. We build upon a growing body of infectious disease literature that is advocating for reform to surveillance systems. Although our framework has been developed for tick-borne zoonoses, it is flexible and has the potential to be applied to a variety of other vector-borne and zoonotic diseases.

The composition, diversity, and distribution of mosquito fauna (Diptera: Culicidae) in Kosovo

The aim of this study is to identify the mosquito species that currently exist and their distributions in Kosovo in order to determine current potential endemic zones and areas at a higher risk for future epidemics. These scientific data will be shared with public health authorities for implementing mosquito control programs. During a two-year period of monitoring in 48 localities in 23 provinces in Kosovo, a total of 1,604 mosquitoes representing 13 species and six genera were collected and morphologically identified. Members of species complexes were also classified to species using DNA barcoding. In total, 13 species were identified with Culex pipiens s.l., the predominant species with an abundance rate of 39%. The remaining 12 species identified were grouped into five genera: Anopheles, Aedes, Coquillettidia, Culiseta, Uranotaenia, including species that are vectors of arboviruses in other parts of the world.

Detection of pathogens in Dermacentor reticulatus in northwestern Europe: evaluation of a high-throughput array

Background

The geographic distribution of Dermacentor reticulatus is expanding in Europe. Surveillance of this tick species and its pathogens is desirable, as it transmits pathogens of public and veterinary importance. A high-throughput real-time PCR-based array was used to screen 1.741 D. reticulatus ticks from Belgium, Germany, The Netherlands, and Great Britain for the presence of 28 tick-borne bacteria and twelve protozoan parasites. The presence of pathogen DNA was confirmed by conventional PCR followed by sequencing.

Results

The array detected the presence of DNA from Borrelia spp. (7%), B. afzelii (0.1%), B. garinii (0.1%), B. spielmanii (0.1%), B. miyamotoi (0.2%), Anaplasma marginale (0.1%), A. phagocytophilum (0.1%), Ehrlichia canis (2%), Rickettsia helvetica (0.2%), spotted fever group Rickettsia (9.6%), Francisella tularensis or Francisella-like endosymbionts (95%), Coxiella burnettii (0.1%), Babesia divergens (0.2%), B. canis (0.9%) B. vogeli (5.6%), and Theileria equi (0.1%). Only the presence of B. canis and spotted fever group Rickettsia could be confirmed by conventional PCR and sequencing. The spotted fever Rickettsia-positive samples were all identified as R. raoultii.

Conclusions

We successfully detected and determined the prevalence of B. canis and R. raoultii in D. reticulatus. An high-throughput array that allows fast and comprehensive testing of tick-borne pathogens is advantageous for surveillance and future epidemiological studies. The importance of thorough validation of real-time PCR-based assays and careful interpretation is evident.

Ticks and Tick-Borne Infections: Complex Ecology, Agents, and Host Interactions

Ticks transmit the most diverse array of infectious agents of any arthropod vector. Both ticks and the microbes they transmit are recognized as significant threats to human and veterinary public health. This article examines the potential impacts of climate change on the distribution of ticks and the infections they transmit; the emergence of novel tick-borne pathogens, increasing geographic range and incidence of tick-borne infections; and advances in the characterization of tick saliva mediated modulation of host defenses and the implications of those interactions for transmission, establishment, and control of tick infestation and tick-borne infectious agents.

Effects of conservation management of landscapes and vertebrate communities on Lyme borreliosis risk in the United Kingdom

Landscape change and altered host abundance are major drivers of zoonotic pathogen emergence. Conservation and biodiversity management of landscapes and vertebrate communities can have secondary effects on vector-borne pathogen transmission that are important to assess. Here we review the potential implications of these activities on the risk of Lyme borreliosis in the United Kingdom. Conservation management activities include woodland expansion, management and restoration, deer management, urban greening and the release and culling of non-native species. Available evidence suggests that increasing woodland extent, implementing biodiversity policies that encourage ecotonal habitat and urban greening can increase the risk of Lyme borreliosis by increasing suitable habitat for hosts and the tick vectors. However, this can depend on whether deer population management is carried out as part of these conservation activities. Exclusion fencing or culling deer to low densities can decrease tick abundance and Lyme borreliosis risk. As management actions often constitute large-scale perturbation experiments, these hold great potential to understand underlying drivers of tick and pathogen dynamics. We recommend integrating monitoring of ticks and the risk of tick-borne pathogens with conservation management activities. This would help fill knowledge gaps and the production of best practice guidelines to reduce risks.

This article is part of the themed issue ‘Conservation, biodiversity and infectious disease: scientific evidence and policy implications’.

Neglected vector-borne zoonoses in Europe: Into the wild

Wild vertebrates are involved in the transmission cycles of numerous pathogens. Additionally, they can affect the abundance of arthropod vectors. Urbanization, landscape and climate changes, and the adaptation of vectors and wildlife to human habitats represent complex and evolving scenarios, which affect the interface of vector, wildlife and human populations, frequently with a consequent increase in zoonotic risk. While considerable attention has focused on these interrelations with regard to certain major vector-borne pathogens such as Borrelia burgdorferi s.l. and tick-borne encephalitis virus, information regarding many other zoonotic pathogens is more dispersed. In this review, we discuss the possible role of wildlife in the maintenance and spread of some of these neglected zoonoses in Europe. We present case studies on the role of rodents in the cycles of Bartonella spp., of wild ungulates in the cycle of Babesia spp., and of various wildlife species in the life cycle of Leishmania infantum, Anaplasma phagocytophilum and Rickettsia spp. These examples highlight the usefulness of surveillance strategies focused on neglected zoonotic agents in wildlife as a source of valuable information for health professionals, nature managers and (local) decision-makers. These benefits could be further enhanced by increased collaboration between researchers and stakeholders across Europe and a more harmonised and coordinated approach for data collection.

Laboratory preparedness and response with a focus on arboviruses in Europe

BACKGROUND

The global health burden of arboviruses is continuously rising, which results in increasing pressure on local and (inter)national laboratory infrastructures. Timely and accurate diagnosis of cases is one of the main pillars for public health and clinical responses to an arbovirus emergence.

AIMS AND SOURCES

This narrative review aims to summarize recent advances and to identify needs in laboratory preparedness and response activities, with a focus on viruses transmitted by arthropods in Europe. The review is based on evidence extracted from PubMed searches, Public Health and clinical laboratory experiences from the authors and the authors' opinions substantiated by peer-reviewed scientific literature.

CONTENT

We illustrate the importance of inter-epidemic laboratory preparedness activities to ensure adequate Public Health and clinical responses. We describe the status of arbovirus endemicity and emergence in Europe thereby highlighting the need for preparedness for these viruses. We discuss the components and pitfalls of an adequate laboratory preparedness and response and the broader context of the current landscape of international research, clinical and laboratory preparedness networks. The complexity of arbovirus laboratory preparedness and response is described.

IMPLICATIONS

Outbreak preparedness plans need to look beyond national reference laboratories, to include first-line responding onsite hospital laboratories and plans for strengthening of such local capacity and capability as required depending on the nature of the outbreak. In particular, the diagnosis of arbovirus infections is complicated by the existence of geographic overlap of circulation of numerous arboviruses, the overlap in clinical manifestation between many arboviruses and other aetiologies and the existence of cross-reactivity between related arboviruses in serology testing. Inter-epidemic preparedness activities need strong national and international networks addressing these issues. However, the current mushrooming of European preparedness networks requires governance to bring the European preparedness and response to a next level.

Surveillance perspective on Lyme borreliosis across the European Union and European Economic Area

Lyme borreliosis (LB) is the most prevalent tick-borne disease in Europe. Erythema migrans (EM), an early, localised skin rash, is its most common presentation. Dissemination of the bacteria can lead to more severe manifestations including skin, neurological, cardiac, musculoskeletal and ocular manifestations. Comparison of LB incidence rates in the European Union (EU)/European Economic Area (EEA) and Balkan countries are difficult in the absence of standardised surveillance and reporting procedures. We explored six surveillance scenarios for LB surveillance in the EU/EEA, based on the following key indicators: (i) erythema migrans, (ii) neuroborreliosis, (iii) all human LB manifestations, (iv) seroprevalence, (v) tick bites, and (vi) infected ticks and reservoir hosts. In our opinion, neuroborreliosis seems most feasible and useful as the standard key indicator, being one of the most frequent severe LB manifestations, with the possibility of a specific case definition. Additional surveillance with erythema migrans as key indicator would add value to the surveillance of neuroborreliosis and lead to a more complete picture of LB epidemiology in the EU/EEA. The other scenarios have less value as a basis for EU-level surveillance, but can be considered periodically and locally, as they could supply complementary insights.

Evolutionary transition from blood feeding to obligate nonbiting in a mosquito

The evolutionary transformation from a blood-feeding to an obligate nonbiting lifestyle is occurring uniquely within the genetic background of a single species of mosquito, Wyeomyia smithii, as a product of selection in nature. Associated genetic changes in metabolic pathways indicate a high anticipatory metabolic investment prior to consuming blood, presumably balanced by the reproductive benefits from an imminent blood meal. This evolutionary transformation provides a starting point for determining pivotal upstream genetic changes between biters and nonbiters and for identifying universal nonbiting genes or pathways in mosquitoes. If there is no bite, there is no transmission of pathogens; hence W. smithii offers a different approach to investigate control of blood-feeding vectors of human diseases.

The spread of blood-borne pathogens by mosquitoes relies on their taking a blood meal; if there is no bite, there is no disease transmission. Although many species of mosquitoes never take a blood meal, identifying genes that distinguish blood feeding from obligate nonbiting is hampered by the fact that these different lifestyles occur in separate, genetically incompatible species. There is, however, one unique extant species with populations that share a common genetic background but blood feed in one region and are obligate nonbiters in the rest of their range: Wyeomyia smithii. Contemporary blood-feeding and obligate nonbiting populations represent end points of divergence between fully interfertile southern and northern populations. This divergence has undoubtedly resulted in genetic changes that are unrelated to blood feeding, and the challenge is to winnow out the unrelated genetic factors to identify those related specifically to the evolutionary transition from blood feeding to obligate nonbiting. Herein, we determine differential gene expression resulting from directional selection on blood feeding within a polymorphic population to isolate genetic differences between blood feeding and obligate nonbiting. We show that the evolution of nonbiting has resulted in a greatly reduced metabolic investment compared with biting populations, a greater reliance on opportunistic metabolic pathways, and greater reliance on visual rather than olfactory sensory input. W. smithii provides a unique starting point to determine if there are universal nonbiting genes in mosquitoes that could be manipulated as a means to control vector-borne disease.

Comparative analysis of storage conditions and homogenization methods for tick and flea species for identification by MALDI-TOF MS

Ticks and fleas are vectors for numerous human and animal pathogens. Controlling them, which is important in combating such diseases, requires accurate identification, to distinguish between vector and non-vector species. Recently, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS) was applied to the rapid identification of arthropods. The growth of this promising tool, however, requires guidelines to be established. To this end, standardization protocols were applied to species of Rhipicephalus sanguineus (Ixodida: Ixodidae) Latreille and Ctenocephalides felis felis (Siphonaptera: Pulicidae) Bouché, including the automation of sample homogenization using two homogenizer devices, and varied sample preservation modes for a period of 1-6 months. The MS spectra were then compared with those obtained from manual pestle grinding, the standard homogenization method. Both automated methods generated intense, reproducible MS spectra from fresh specimens. Frozen storage methods appeared to represent the best preservation mode, for up to 6 months, while storage in ethanol is also possible, with some caveats for tick specimens. Carnoy's buffer, however, was shown to be less compatible with MS analysis for the purpose of identifying ticks or fleas. These standard protocols for MALDI-TOF MS arthropod identification should be complemented by additional MS spectrum quality controls, to generalize their use in monitoring arthropods of medical interest.

Standardization of sample homogenization for mosquito identification using an innovative proteomic tool based on protein profiling

The rapid spread of vector-borne diseases demands the development of an innovative strategy for arthropod monitoring. The emergence of MALDI-TOF MS as a rapid, low-cost, and accurate tool for arthropod identification is revolutionizing medical entomology. However, as MS spectra from an arthropod can vary according to the body part selected, the sample homogenization method used and the mode and duration of sample storage, standardization of protocols is indispensable prior to the creation and sharing of an MS reference spectra database. In the present study, manual grinding of Anopheles gambiae Giles and Aedes albopictus mosquitoes at the adult and larval (L3) developmental stages was compared to automated homogenization. Settings for each homogenizer were optimized, and glass powder was found to be the best sample disruptor based on its ability to create reproducible and intense MS spectra. In addition, the suitability of common arthropod storage conditions for further MALDI-TOF MS analysis was kinetically evaluated. The conditions that best preserved samples for accurate species identification by MALDI-TOF MS were freezing at -20°C or in liquid nitrogen for up to 6 months. The optimized conditions were objectified based on the reproducibility and stability of species-specific MS profiles. The automation and standardization of mosquito sample preparation methods for MALDI-TOF MS analyses will popularize the use of this innovative tool for the rapid identification of arthropods with medical interest.

Stakeholder Narratives on Trypanosomiasis, Their Effect on Policy and the Scope for One Health

Background

This paper explores the framings of trypanosomiasis, a widespread and potentially fatal zoonotic disease transmitted by tsetse flies (Glossina species) affecting both humans and livestock. This is a country case study focusing on the political economy of knowledge in Zambia. It is a pertinent time to examine this issue as human population growth and other factors have led to migration into tsetse-inhabited areas with little historical influence from livestock. Disease transmission in new human-wildlife interfaces such as these is a greater risk, and opinions on the best way to manage this are deeply divided.

Methods

A qualitative case study method was used to examine the narratives on trypanosomiasis in the Zambian policy context through a series of key informant interviews. Interviewees included key actors from international organisations, research organisations and local activists from a variety of perspectives acknowledging the need to explore the relationships between the human, animal and environmental sectors.

Principal Findings

Diverse framings are held by key actors looking from, variously, the perspectives of wildlife and environmental protection, agricultural development, poverty alleviation, and veterinary and public health. From these viewpoints, four narratives about trypanosomiasis policy were identified, focused around four different beliefs: that trypanosomiasis is protecting the environment, is causing poverty, is not a major problem, and finally, that it is a Zambian rather than international issue to contend with. Within these narratives there are also conflicting views on the best control methods to use and different reasoning behind the pathways of response. These are based on apparently incompatible priorities of people, land, animals, the economy and the environment. The extent to which a One Health approach has been embraced and the potential usefulness of this as a way of reconciling the aims of these framings and narratives is considered throughout the paper.

Conclusions/Significance

While there has historically been a lack of One Health working in this context, the complex, interacting factors that impact the disease show the need for cross-sector, interdisciplinary decision making to stop rival narratives leading to competing actions. Additional recommendations include implementing: surveillance to assess under-reporting of disease and consequential under-estimation of disease risk; evidence-based decision making; increased and structurally managed funding across countries; and focus on interactions between disease drivers, disease incidence at the community level, and poverty and equity impacts.

This paper explores the differing opinions of various stakeholders in relation to trypanosomiasis, a widespread and potentially fatal disease spread by tsetse flies which affects both humans and animals. It is an important time to examine this issue as human population growth and other factors have led to migration into new areas which are populated by tsetse flies, and this may affect disease levels. This means that there is a greater risk to people and their livestock, and opinions on the best way to manage the disease are deeply divided. Cross sector working hasn’t been used historically, but breaking down the barriers between social scientists, natural scientists and the expertise of the community could lead to better disease management.

Lutzomyia longipalpis Presence and Abundance Distribution at Different Micro-spatial Scales in an Urban Scenario

The principal objective of this study was to assess a modeling approach to Lu. longipalpis distribution in an urban scenario, discriminating micro-scale landscape variables at microhabitat and macrohabitat scales and the presence from the abundance of the vector. For this objective, we studied vectors and domestic reservoirs and evaluated different environmental variables simultaneously, so we constructed a set of 13 models to account for micro-habitats, macro-habitats and mixed-habitats. We captured a total of 853 sandflies, of which 98.35% were Lu. longipalpis. We sampled a total of 197 dogs; 177 of which were associated with households where insects were sampled. Positive rK39 dogs represented 16.75% of the total, of which 47% were asymptomatic. Distance to the border of the city and high to medium density vegetation cover ended to be the explanatory variables, all positive, for the presence of sandflies in the city. All variables in the abundance model ended to be explanatory, trees around the trap, distance to the stream and its quadratic, being the last one the only one with negative coefficient indicating that the maximum abundance was associated with medium values of distance to the stream. The spatial distribution of dogs infected with L. infantum showed a heterogeneous pattern throughout the city; however, we could not confirm an association of the distribution with the variables assessed. In relation to Lu. longipalpis distribution, the strategy to discriminate the micro-spatial scales at which the environmental variables were recorded allowed us to associate presence with macrohabitat variables and abundance with microhabitat and macrohabitat variables. Based on the variables associated with Lu. longipalpis, the model will be validated in other cities and environmental surveillance, and control interventions will be proposed and evaluated in the microscale level and integrated with socio-cultural approaches and programmatic and village (mesoscale) strategies.

Visceral leishmaniasis in America is caused by an unicellular organism, Leishmania infantum (syn. chagasi) that is transmitted by insects belonging to Diptera:Phlebotominae, Lutzomyia longipalpis being the principal vector in urban areas. Therefore, the prevention and control of this vector is a sound objective, so as to reduce the probability of contact human-vector and reducing the probability of infection. Therefore, knowing the variables that have an impact and the spatial scale at which these act will allow us to approach an understanding of the dynamic population of the vector and allow us to develop more appropriate strategies of control. Thus, the aim of this study was to assess a modeling approach to Lu. longipalpis distribution in an urban scenario, discriminating micro-scale landscape variables at microhabitat and macrohabitat scales. For this, we worked in Santo Tomé, Corrientes, Argentina. We observed that the presence of Lu. longipalpis is defined only by the macrohabitat variables tested, but the abundance is defined by variables of both scales, microhabitat and macrohabitat.