Epidemiology of Dengue, Chikungunya, and Zika Virus Disease in U.S. States and Territories, 2017

Effects of climate change and human activities on vector-borne diseases

Vector-borne diseases are transmitted by haematophagous arthropods (for example, mosquitoes, ticks and sandflies) to humans and wild and domestic animals, with the largest burden on global public health disproportionately affecting people in tropical and subtropical areas. Because vectors are ectothermic, climate and weather alterations (for example, temperature, rainfall and humidity) can affect their reproduction, survival, geographic distribution and, consequently, ability to transmit pathogens. However, the effects of climate change on vector-borne diseases can be multifaceted and complex, sometimes with ambiguous consequences. In this Review, we discuss the potential effects of climate change, weather and other anthropogenic factors, including land use, human mobility and behaviour, as possible contributors to the redistribution of vectors and spread of vector-borne diseases worldwide.

Estimation of population age structure, daily survival rates, and potential to support dengue virus transmission for Florida Keys Aedes aegypti via transcriptional profiling

Aedes aegypti is an important vector of dengue virus and other arboviruses that affect human health. After being ingested in an infectious bloodmeal, but before being transmitted from mosquito to human, dengue virus must disseminate from the vector midgut into the hemocoel and then the salivary glands. This process, the extrinsic incubation period, typically takes 6-14 days. Since older mosquitoes are responsible for transmission, understanding the age structure of vector populations is important. Transcriptional profiling can facilitate predictions of the age structures of mosquito populations, critical for estimating their potential for pathogen transmission. In this study, we utilized a two-gene transcript model to assess the age structure and daily survival rates of three populations (Key West, Marathon, and Key Largo) of Ae. aegypti from the Florida Keys, United States, where repeated outbreaks of autochthonous dengue transmission have recently occurred. We found that Key Largo had the youngest Ae. aegypti population with the lowest daily survival rate, while Key West had the oldest population and highest survival rate. Across sites, 22.67% of Ae. aegypti females were likely old enough to transmit dengue virus (at least 15 days post emergence). Computed estimates of the daily survival rate (0.8364 using loglinear and 0.8660 using non-linear regression), indicate that dengue vectors in the region experienced relatively low daily mortality. Collectively, our data suggest that Ae. aegypti populations across the Florida Keys harbor large numbers of older individuals, which likely contributes to the high risk of dengue transmission in the area.

Re-Emerging, Under-Recognized Zoonotic, and Neglected Tropical Diseases in Hawai'i

Hawai'i, the United States' most western geographic state in the Pacific, lies between the North and South American continents and the Indo-Pacific regions, including Japan. The tropical environmental conditions of the Hawaiian Islands provide favorable ecosystems for various infectious pathogens, their vectors, and reservoirs. This creates an environment conducive to the transmission of zoonotic diseases affecting both humans and animals. Hawai'i has experienced an increase in dengue, leptospirosis, and murine typhus outbreaks. Furthermore, toxoplasmosis and neuroangiostrongyliasis cases remain prevalent throughout the state, and the putative presence of autochthonous Zika cases identified in a retrospective study may be of national public health concern. Understanding the factors that affect the transmission and distribution of zoonoses is necessary to identify at-risk locations and populations. The One Health approach seeks to understand, report, and interpret these factors and requires collaboration between private and governmental institutions. One Health should focus on neglected tropical diseases (NTD) and prioritize development of interventions to control and prevent the transmission of diseases that spread between animals and humans. This review focuses on the epidemiological and clinical characteristics of under-recognized zoonotic and NTD affecting Hawai'i, including leptospirosis, murine typhus, neuroangiostrongyliasis, toxoplasmosis, dengue, and Zika.

The evolutionary and molecular history of a chikungunya virus outbreak lineage

In 2018-2019, Thailand experienced a nationwide spread of chikungunya virus (CHIKV), with approximately 15,000 confirmed cases of disease reported. Here, we investigated the evolutionary and molecular history of the East/Central/South African (ECSA) genotype to determine the origins of the 2018-2019 CHIKV outbreak in Thailand. This was done using newly sequenced clinical samples from travellers returning to Sweden from Thailand in late 2018 and early 2019 and previously published genome sequences. Our phylogeographic analysis showed that before the outbreak in Thailand, the Indian Ocean lineage (IOL) found within the ESCA, had evolved and circulated in East Africa, South Asia, and Southeast Asia for about 15 years. In the first half of 2017, an introduction occurred into Thailand from another South Asian country, most likely Bangladesh, which subsequently developed into a large outbreak in Thailand with export to neighbouring countries. Based on comparative phylogenetic analyses of the complete CHIKV genome and protein modelling, we identified several mutations in the E1/E2 spike complex, such as E1 K211E and E2 V264A, which are highly relevant as they may lead to changes in vector competence, transmission efficiency and pathogenicity of the virus. A number of mutations (E2 G205S, Nsp3 D372E, Nsp2 V793A), that emerged shortly before the outbreak of the virus in Thailand in 2018 may have altered antibody binding and recognition due to their position. This study not only improves our understanding of the factors contributing to the epidemic in Southeast Asia, but also has implications for the development of effective response strategies and the potential development of new vaccines.

Fever and Rash

Infectious causes of fever and rash pose a diagnostic challenge for the emergency provider. It is often difficult to discern rashes associated with rapidly progressive and life-threatening infections from benign exanthems, which comprise the majority of rashes seen in the emergency department. Physicians must also consider serious noninfectious causes of fever and rash. A correct diagnosis depends on an exhaustive history and head-to-toe skin examination as most emergent causes of fever and rash remain clinical diagnoses. A provisional diagnosis and immediate treatment with antimicrobials and supportive care are usually required prior to the return of confirmatory laboratory testing.

Chikungunya: a decade of burden in the Americas

In the Americas, one decade following its emergence in 2013, chikungunya virus (CHIKV) continues to spread and cause epidemics across the region. To date, 3.7 million suspected and laboratory-confirmed chikungunya cases have been reported in 50 countries or territories in the Americas. Here, we outline the current status and epidemiological aspects of chikungunya in the Americas and discuss prospects for future research and public health strategies to combat CHIKV in the region.

Development of Vaccines against Emerging Mosquito-Vectored Arbovirus Infections

Among emergent climate-sensitive infectious diseases, some mosquito-vectored arbovirus infections have epidemiological, social, and economic effects. Dengue virus (DENV), West Nile virus (WNV), and Chikungunya virus (CHIKV) disease, previously common only in the tropics, currently pose a major risk to global health and are expected to expand dramatically in the near future if adequate containment measures are not implemented. The lack of safe and effective vaccines is critical as it seems likely that emerging mosquito-vectored arbovirus infections will be con-trolled only when effective and safe vaccines against each of these infections become available. This paper discusses the clinical characteristics of DENV, WNV, and CHIKV infections and the state of development of vaccines against these viruses. An ideal vaccine should be able to evoke with a single administration a prompt activation of B and T cells, adequate concentrations of protecting/neutralizing antibodies, and the creation of a strong immune memory capable of triggering an effective secondary antibody response after new infection with a wild-type and/or mutated infectious agent. Moreover, the vaccine should be well tolerated, safe, easily administrated, cost-effective, and widely available throughout the world. However, the development of vaccines against emerging mosquito-vectored arbovirus diseases is far from being satisfactory, and it seems likely that it will take many years before effective and safe vaccines for all these infections are made available worldwide.

Epidemiology and burden of dengue fever in the United States: a systematic review

BACKGROUND

Dengue is currently a global concern. The range of dengue vectors is expanding with climate change, yet United States of America (USA) studies on dengue epidemiology and burden are limited. This systematic review sought to characterize the epidemiology and disease burden of dengue within the USA.

METHODS

Studies evaluating travel-related and endemic dengue in US states and territories were identified and qualitatively summarized. Commentaries and studies on ex-US cases were excluded. MEDLINE, Embase, Cochrane Library, Latin American and Caribbean Center of Health Sciences Information, Centre for Reviews and Dissemination and Clinicaltrials.gov were searched through January 2022.

RESULTS

116 studies were included. In US states, dengue incidence was generally low, with spikes occurring in recent years in 2013-16 (0.17-0.31 cases/100,000) and peaking in 2019 (0.35 cases/100,000). Most cases (94%, n = 7895, 2010-21) were travel related. Dengue was more common in Puerto Rico (cumulative average: 200 cases/100,000, 1980-2015); in 2010-21, 99.9% of cases were locally acquired. There were <50 severe cases in US states (2010-17); fatal cases were even rarer. Severe cases in Puerto Rico peaked in 1998 (n = 173) and 2021 (n = 76). Besides lower income, risk factors in US states included having birds in residence, suggesting unspecified environmental characteristics favourable to dengue vectors. Commonly reported symptoms included fever, headache and rash; median disease duration was 3.5-11 days. Hospitalization rates increased following 2009 World Health Organization disease classification changes (pre-2009: 0-54%; post-2009: 14-75%); median length of stay was 2.7-8 days (Puerto Rico) and 2-3 days (US states). Hospitalization costs/case (2010 USD) were$14 350 (US states),$1764-$5497 (Puerto Rico) and$4207 (US Virgin Islands). In Puerto Rico, average days missed were 0.2-5.3 (work) and 2.5 (school).

CONCLUSIONS

Though dengue risk is ongoing, treatments are limited, and dengue's economic burden is high. There is an urgent need for additional preventive and therapeutic interventions.

El Niño Southern Oscillation (ENSO) effects on local weather, arboviral diseases, and dynamics of managed and unmanaged populations of Aedes aegypti (Diptera: Culicidae) in Puerto Rico

We investigated the effects of interannual El Niño Southern Oscillation (ENSO) events on local weather, Aedes aegypti populations, and combined cases of dengue (DENV), chikungunya (CHIKV), and Zika (ZIKV) viruses in 2 communities with mass mosquito trapping and 2 communities without mosquito control in southern Puerto Rico (2013-2019). Gravid adult Ae. aegypti populations were monitored weekly using Autocidal Gravid Ovitraps (AGO traps). Managing Ae. aegypti populations was done using 3 AGO traps per home in most homes. There were drought conditions in 2014-2015 concurrent with the emergence of a strong El Niño (2014-2016), wetter conditions during La Niña (2016-2018), a major hurricane (2017), and a weaker El Niño (2018-2019). The main factor explaining differences in Ae. aegypti abundance across sites was mass trapping. Populations of Ae. aegypti reached maximum seasonal values during the wetter and warmer months of the year when arbovirus epidemics occurred. El Niño was significantly associated with severe droughts that did not impact the populations of Ae. aegypti. Arbovirus cases at the municipality level were positively correlated with lagged values (5-12 mo.) of the Oceanic El Niño Index (ONI), droughts, and abundance of Ae. aegypti. The onset of strong El Niño conditions in Puerto Rico may be useful as an early warning signal for arboviral epidemics in areas where the abundance of Ae. aegypti exceeds the mosquito density threshold value.

Species Composition and Geographic Distribution of Culicinae Mosquitoes and Their Possible Infection with West Nile Virus in Hormozgan Province, Southern Iran

Background

West Nile virus (WNV) is a mosquito-borne virus that causes a febrile disease and may cause a fatal neurological illness in humans. We aimed to investigate the geographic distribution of Culicinae mosquitoes and their possible infection with WNV in Hormozgan Province, southern Iran.

Methods

Field studies were carried out from June 2017 to May 2019. Different mosquito sampling methods were used monthly to collect mosquitoes from 22 sites. The Real-Time PCR technique was used to detect the virus infection in the mosquitoes.

Results

Overall, 6165 mosquitoes were caught. The species were Culex theileri (33.25%), Cx. pipiens (20.45%), Cx. quinquefasciatus (10.51%), Aedes caspius (6.33%), Cx. tritaeniorhynchus (5.82%), Ae. vexans (4.10%), Cx. sinaiticus (3.62%), Cx. antennatus (3.29%), Culiseta longiareolata (2.81%), Cx. perexiguus (2.03%), Cs. subochrea (1.95%), Cx. mimeticus (1.49%), Cx. pusillus (1.38%), Cx. univittatus (1.27%), Cx. modestus (1.14%), and Cx. sitiens (0.57%). The molecular detection of virus infection in mosquitoes found to be negative for WNV.

Conclusion

The presence of many species of mosquito vectors and high population traffic increase the risk of disease transmission is very high. Therefore, the way to restrict WNV infection factors is increasing the knowledge for personal protection measures to prevent mosquito bites.

Effects of woody plant encroachment by eastern redcedar on mosquito communities in Oklahoma

Woody plant encroachment into grasslands is occurring worldwide, affecting ecosystems in ways that likely influence mosquito-borne disease transmission. In the U.S. Great Plains, encroachment by eastern redcedar (Juniperus virginiana) (ERC) may be expanding conducive habitat for mosquitoes and their hosts, but few studies have evaluated associations between ERC encroachment and West Nile virus (WNV). To test the hypotheses that mosquito abundance and WNV-infected mosquitoes increase with increasing ERC cover, we collected mosquitoes in 32 sites in Oklahoma reflecting various ERC encroachment stages. We found support for our first hypothesis, as mean abundance of Aedes albopictus increased significantly with ERC cover. However, Psorophora columbiae and Anopheles quadrimaculatus abundance decreased with increasing ERC. There was no significant association with ERC for other mosquito species. We could not test our second hypothesis due to low WNV prevalence, but the only detected WNV-infected pool of mosquitoes (Cx. tarsalis) was collected in ERC. Our results suggest ERC encroachment increases abundance of at least one medically important mosquito species, but further research is needed to clarify how encroachment affects ecology of the entire WNV disease system through changes to vector and host communities, vector-host interactions, and thus disease transmission and prevalence. Understanding relationships between woody plant encroachment and the nidus of infection for mosquito-borne diseases will be crucial for targeting public health efforts, including land management activities that limit and/or eradicate woody plant encroachment, particularly in areas with high levels of disease risk.

Arbovirus and its potential to lead the next global pandemic from sub-Saharan Africa: What lessons have we learned from COVID-19?

Risk and predisposing factors for viral zoonoses abound in the sub-Saharan Africa (SSA) region with significant public health implications. For several decades, there have been several reports on the emergence and re-emergence of arbovirus infections. The lifetime burden of arboviral diseases in developing countries is still poorly understood. Studies indicate significant healthcare disruptions and economic losses attributed to the viruses in resource-poor communities marked by impairment in the performance of daily activities. Arboviruses have reportedly evolved survival strategies to aid their proliferation in favorable niches, further magnifying their public health relevance. However, there is poor knowledge about the viruses in the region. Thus, this review presents a survey of zoonotic arboviruses in SSA, the burden associated with their diseases, management of diseases as well as their prevention and control, mobility and determinants of infections, their vectors, and co-infection with various microorganisms. Lessons learned from the ongoing coronavirus disease 2019 (COVID-19) pandemic coupled with routine surveillance of zoonotic hosts for these viruses will improve our understanding of their evolution, their potential to cause a pandemic, control and prevention measures, and vaccine development.

Chikungunya: An Emerging Public Health Concern

Purpose of Review

The worldwide spread of chikungunya over the past two decades calls for greater knowledge and awareness of the virus, its route of transmission, methods of diagnosis, and the use of available treatment and prevention measures.

Recent Findings

Chikungunya virus infection, an Aedes mosquito-borne febrile disease, has spread from Africa and Asia to Europe and the Americas and from the tropics and subtropics to temperate regions. International travel is a pivotal influence in the emergence of chikungunya as a global public health threat, as evidenced by a growing number of published reports on travel-related chikungunya infections. The striking features of chikungunya are arthralgia and arthritis, and the disease is often mistaken for dengue. Although mortality is low, morbidity can be profound and persistent. Current treatment for chikungunya is supportive; chikungunya vaccines and therapeutics are in development. Travelers planning to visit areas where the mosquito vectors are present should be advised on preventive measures.

Summary

Chikungunya is an emerging disease in the Americas. Frequent travel, the presence of at least two competent mosquito species, and a largely naïve human population in the Western Hemisphere create a setting conducive to future outbreaks. Awareness of the disease and its manifestations is critical to effectively and safely manage and limit its impact. Vaccines in late-stage clinical trials offer a new pathway to prevention.

Imaging and spectral analysis of autofluorescence patterns in larval head structures of mosquito vectors

Autofluorescence (AF) in mosquitoes is currently poorly explored, despite its great potential as a marker of body structures and biological functions. Here, for the first time AF in larval heads of two mosquitoes of key public health importance, Aedes albopictus and Culex pipiens, is studied using fluorescence imaging and spectrofluorometry, similarly to a label-free histochemical approach. In generally conserved distribution patterns, AF shows differences between mouth brushes and antennae of the two species. The blue AF ascribable to resilin at the antennal bases, more extended in Cx. pipiens, suggests a potential need to support different antennal movements. The AF spectra larger in Cx. pipiens indicate a variability in material composition and properties likely relatable to mosquito biology, including diverse feeding and locomotion behaviours with implications for vector control.

Severe Thrombocytopenia Associated with Dengue Fever: An Evidence-Based Approach to Management of Thrombocytopenia

Dengue is a mosquito-borne viral illness common in tropical and subtropical countries but very rare in the United States. Patients infected with dengue often present with thrombocytopenia. In the setting of dengue, platelet transfusions as a treatment for thrombocytopenia have no clear benefits in reduction of severe bleeding or improvement of the platelet count. Here, we present a case of a traveler infected with dengue virus and discuss the approach to treat thrombocytopenia.

Initial recognition and attachment of the Zika virus to host cells: A molecular dynamics and quantum interaction approach

The zika virus (ZIKV), transmitted to humans from the bites of Aedes Aegypti and Aedes Albopictus mosquitoes produces Zika fever and neurodegenerative disorders that despite affecting millions of people, most recently in Africa and the Americas, has been declared a neglected tropical disease by the World Health Organization. In this work, atomistic molecular dynamics simulations followed by rigorous analysis of the intermolecular interactions reveal crucial aspects of the initial virus···cell molecular recognition and attachment, events that trigger the infectious cycle. Previous experimental studies have shown that Dermatan Sulphate (DS) and Chondroitin Sulphate A (CSA), two glycosaminoglycans which are actually epimers to each other and that are structural constituents of receptors expressed in cell membranes, are the preferred anchorage sites, with a marked preference for DS. Our calculations rationalize this preference from a molecular perspective as follows: when free of the virus, DS has one sulfate group that does not participate in intramolecular strong hydrogen bonds, thus, it is readily available to interact with the envelope protein of the virus (Zika-E), then, after formation of the complexes, Zika-E···DS exhibits ten strong salt brides connecting the two fragments against only six salt bridges and two hydrogen bonds in Zika-E···CSA.

New tools for Aedes control: mass trapping

Aedes aegypti, the main vector of dengue, chikungunya, and Zika viruses uses artificial containers around homes to undergo immature development, making household-level detection and control extremely difficult in large urban areas. Mass trapping is an emerging methodology to control container-Aedes species such as Aedes aegypti and Aedes albopictus because effective traps for adult stages of these mosquitoes were developed recently. There are three main approaches to mass-trapping these mosquitoes: 1) Pull (attract/kill), 2) push (repel)-pull (attract/kill), and 3) pull (attract/contaminate/infect)-push (fly away). Effective mass-trapping depends on trap quality (capture efficiency, sturdiness, frequency of servicing), trap density and areal coverage, community involvement, and safety. Recent studies showed that Ae. aegypti populations can be sustainably controlled by mass trapping, although more area-wide studies showing effectiveness at preventing disease are needed for all trapping systems. Cost-effectiveness studies are needed for all emerging Aedes control approaches.

Landscape Composition Affects Elements of Metacommunity Structure for Culicidae Across South-Eastern Illinois

The interplay among invasive alien vectors and the species assemblage of native potential vectors in areas of range expansion may affect the dynamics of pathogen transmission. In this study we investigate how Aedes albopictus, an invasive mosquito of considerable public health concern fits within mosquito communities at the edge of its range of distribution. This was addressed using a 2-year field survey of mosquitoes in south-eastern Illinois. We found that Ae. albopictus was more broadly distributed in this region than previously realized, with new occurrence records for nine counties. Abundance of this species varied strongly and peaked in locations of low-intermediate overall mosquito species richness. This differed from overall mosquito abundance, as well as abundance of another important vector, Cx. pipiens, for which the abundance-richness relationships were best described with power functions. Metacommunity analyses revealed that mosquito communities showed a non-random distribution with a Clementsian gradient, which suggests a pattern whereby distinct species assemblages are associated with specific habitats or environmental conditions. Land use was a significant underlying factor shaping mosquito community structure and species assemblages. Multivariate analyses showed that while Ae. canadensis and Cx. pipiens complex mosquitoes were associated with high and low proportions of wetlands in the environment, respectively, Ae. albopictus was most strongly associated with urban settlements. This work sheds light on landscape-level processes, such as niche differentiation driven by urban and agricultural development, structuring mosquito communities. We suggest that mosquito community assessments across habitats be incorporated as part of a One Health vector surveillance approach to aid in the goal of prediction and prevention of new and (re-)emerging vector-borne diseases.

Capacity of a Multiplex IgM Antibody Capture ELISA to Differentiate Zika and Dengue Virus Infections in Areas of Concurrent Endemic Transmission

Serological cross-reactivity has proved to be a challenge to diagnose Zika virus (ZIKV) infections in dengue virus (DENV) endemic countries. Confirmatory testing of ZIKV IgM positive results by plaque reduction neutralization tests (PRNTs) provides clarification in only a minority of cases because most individuals infected with ZIKV were previously exposed to DENV. The goal of this study was to evaluate the performance of a ZIKV/DENV DUO IgM antibody capture ELISA (MAC-ELISA) for discriminating between DENV and ZIKV infections in endemic regions. Our performance evaluation included acute and convalescent specimens from patients with real-time reverse transcription polymerase chain reaction (RT-PCR)-confirmed DENV or ZIKV from the Sentinel Enhanced Dengue Surveillance System in Ponce, Puerto Rico. The ZIKV/DENV DUO MAC-ELISA specificity was 100% for DENV (N = 127) and 98.4% for ZIKV (N = 275) when specimens were tested during the optimal testing window (days post-onset of illness [DPO] 6-120). The ZIKV/DENV DUO MAC-ELISA sensitivity of RT-PCR confirmed specimens reached 100% for DENV by DPO 6 and for ZIKV by DPO 9. Our new ZIKV/DENV DUO MAC-ELISA was also able to distinguish ZIKV and DENV regardless of previous DENV exposure. We conclude this novel serologic diagnostic assay can accurately discriminate ZIKV and DENV infections. This can potentially be useful considering that the more labor-intensive and expensive PRNT assay may not be an option for confirmatory diagnosis in areas that lack PRNT capacity, but experience circulation of both DENV and ZIKV.

Does temperature matter for COVID-19 transmissibility? Evidence across Pakistani provinces

The outbreak of novel coronavirus (COVID-19) has become a global concern that is deteriorating environmental quality and damaging human health. Though some researchers have investigated the linkage between temperature and COVID-19 transmissibility across different geographical locations and over time, yet these studies are scarce. This study aims to bridge this gap using daily temperature and COVID-19 cases (transmissibility) by employing grey incidence analysis (GIA) models (i.e., Deng's grey incidence analysis (DGIA), the absolute degree GIA (ADGIA), the second synthetic degree GIA (SSDGIA), the conservative (maximin) model) and correlation analysis. Data on temperature are accessed from the NASA database, while the data on COVID-19 cases are collected from the official website of the government of Pakistan. Empirical results reveal the existence of linkages between temperature and COVID-19 in all Pakistani provinces. These linkages vary from a relatively stronger to a relatively weaker linkage. Based on calculated weights, the strength of linkages is ranked across provinces as follows: Gilgit Baltistan (0.715301) > Baluchistan (0.675091) > Khyber Pakhtunkhwa (0.619893) > Punjab (0.619286) > Sindh (0.601736). The disparity in the strength of linkage among provinces is explained by the discrepancy in the intensity of temperature. Besides, the diagrammatic correlation analysis shows that temperature is inversely linked to COVID-19 cases (per million persons) over time, implying that low temperatures are associated with high COVID-19 transmissibility and vice versa. This study is among the first of its kind to consider the linkages between temperature and COVID-19 transmissibility for a tropical climate country (Pakistan) using the advanced GIA models. Research findings provide an up-to-date glimpse of the outbreak and emphasize the need to raise public awareness about the devastating impacts of the COVID-19. The educational syllabus should provide information on the causes, signs, and precautions of the pandemic. Additionally, individuals should practice handwashing, social distancing, personal hygiene, mask-wearing, and the use of hand sanitizers to ensure a secure and supportive atmosphere for preventing and controlling the current pandemic.

Does temperature matter for COVID-19 transmissibility? Evidence across Pakistani provinces

The outbreak of novel coronavirus (COVID-19) has become a global concern that is deteriorating environmental quality and damaging human health. Though some researchers have investigated the linkage between temperature and COVID-19 transmissibility across different geographical locations and over time, yet these studies are scarce. This study aims to bridge this gap using daily temperature and COVID-19 cases (transmissibility) by employing grey incidence analysis (GIA) models (i.e., Deng's grey incidence analysis (DGIA), the absolute degree GIA (ADGIA), the second synthetic degree GIA (SSDGIA), the conservative (maximin) model) and correlation analysis. Data on temperature are accessed from the NASA database, while the data on COVID-19 cases are collected from the official website of the government of Pakistan. Empirical results reveal the existence of linkages between temperature and COVID-19 in all Pakistani provinces. These linkages vary from a relatively stronger to a relatively weaker linkage. Based on calculated weights, the strength of linkages is ranked across provinces as follows: Gilgit Baltistan (0.715301) > Baluchistan (0.675091) > Khyber Pakhtunkhwa (0.619893) > Punjab (0.619286) > Sindh (0.601736). The disparity in the strength of linkage among provinces is explained by the discrepancy in the intensity of temperature. Besides, the diagrammatic correlation analysis shows that temperature is inversely linked to COVID-19 cases (per million persons) over time, implying that low temperatures are associated with high COVID-19 transmissibility and vice versa. This study is among the first of its kind to consider the linkages between temperature and COVID-19 transmissibility for a tropical climate country (Pakistan) using the advanced GIA models. Research findings provide an up-to-date glimpse of the outbreak and emphasize the need to raise public awareness about the devastating impacts of the COVID-19. The educational syllabus should provide information on the causes, signs, and precautions of the pandemic. Additionally, individuals should practice handwashing, social distancing, personal hygiene, mask-wearing, and the use of hand sanitizers to ensure a secure and supportive atmosphere for preventing and controlling the current pandemic.

Blood Meals With Active and Heat-Inactivated Serum Modifies the Gene Expression and Microbiome of Aedes albopictus

The Asian "tiger mosquito" Aedes albopictus is currently the most widely distributed disease-transmitting mosquito in the world. Its geographical expansion has also allowed the expansion of multiple arboviruses like dengue, Zika, and chikungunya, to higher latitudes. Due to the enormous risk to global public health caused by mosquitoes species vectors of human disease, and the challenges in slowing their expansion, it is necessary to develop new and environmentally friendly vector control strategies. Among these, host-associated microbiome-based strategies have emerged as promising options. In this study, we performed an RNA-seq analysis on dissected abdomens of Ae. albopictus females from Manhattan, KS, United States fed with sugar and human blood containing either normal or heat-inactivated serum, to evaluate the effect of heat inactivation on gene expression, the bacteriome transcripts and the RNA virome of this mosquito species. Our results showed at least 600 genes with modified expression profile when mosquitoes were fed with normal vs. heat-inactivated-containing blood. These genes were mainly involved in immunity, oxidative stress, lipid metabolism, and oogenesis. Also, we observed bacteriome changes with an increase in transcripts of Actinobacteria, Rhodospirillaceae, and Anaplasmataceae at 6 h post-feeding. We also found that feeding with normal blood seems to particularly influence Wolbachia metabolism, demonstrated by a significant increase in transcripts of this bacteria in mosquitoes fed with blood containing normal serum. However, no differences were observed in the virome core of this mosquito population. These results suggest that heat and further inactivation of complement proteins in human serum may have profound effect on mosquito and microbiome metabolism, which could influence interpretation of the pathogen-host interaction findings when using this type of reagents specially when measuring the effect of Wolbachia in vector competence.

Zika Virus Non-Structural Protein 1 Antigen-Capture Immunoassay

Infection with Zika virus (ZIKV), a member of the Flavivirus genus of the Flaviviridae family, typically results in mild self-limited illness, but severe neurological disease occurs in a limited subset of patients. In contrast, serious outcomes commonly occur in pregnancy that affect the developing fetus, including microcephaly and other major birth defects. The genetic similarity of ZIKV to other widespread flaviviruses, such as dengue virus (DENV), presents a challenge to the development of specific ZIKV diagnostic assays. Nonstructural protein 1 (NS1) is established for use in immunodiagnostic assays for flaviviruses. To address the cross-reactivity of ZIKV NS1 with proteins from other flaviviruses we used site-directed mutagenesis to modify putative epitopes. Goat polyclonal antibodies to variant ZIKV NS1 were affinity-purified to remove antibodies binding to the closely related NS1 protein of DENV. An antigen-capture ELISA configured with the affinity-purified polyclonal antibody showed a linear dynamic range between approximately 500 and 30 ng/mL, with a limit of detection of between 1.95 and 7.8 ng/mL. NS1 proteins from DENV, yellow fever virus, St. Louis encephalitis virus and West Nile virus showed significantly reduced reactivity in the ZIKV antigen-capture ELISA. Refinement of approaches similar to those employed here could lead to development of ZIKV-specific immunoassays suitable for use in areas where infections with related flaviviruses are common.

Laboratory Evaluation of the Rapid Analyte Measurement Platform Assay to Detect Dengue Virus in Mosquito Pools

We report the results of a laboratory sensitivity and specificity evaluation of the Rapid Analyte Measurement Platform (RAMP®) Dengue Virus (DENV) antigen detection assay, which is designed to detect all serotypes of DENV in mosquito pools. The RAMP DENV assay was able to detect geographically distinct strains of all 4 DENV serotypes in virus-spiked mosquito pools that contained at least 4.3 log10 plaque forming units/ml, although discrete sensitivity limits varied slightly for each serotype. The RAMP DENV assay also detected DENV 1-4 in mosquito pools containing a single infected mosquito and 24 laboratory-reared uninfected mosquitoes. No false positives were detected in negative control mosquito pools or in samples containing high titers of nontarget arboviruses. We found that while the kit-supplied RAMP buffer reduced the infectious titer of DENV, it did not completely inactivate all serotypes. We recommend adding a detergent, Triton X-100, to the buffer to ensure complete inactivation of DENV if the assay is to be conducted at a lower biosafety level than required for DENV handling.

Evaluating the Safety of West Nile Virus Immunity During Congenital Zika Virus Infection in Mice

Antibody-dependent enhancement (ADE) is a phenomenon that occurs when cross-reactive antibodies generated from a previous flaviviral infection increase the pathogenesis of a related virus. Zika virus (ZIKV) is the most recent flavivirus introduced to the Western Hemisphere and has become a significant public health threat due to the unanticipated impact on the developing fetus. West Nile virus (WNV) is the primary flavivirus that circulates in North America, and we and others have shown that antibodies against WNV are cross-reactive to ZIKV. Thus, there is concern that WNV immunity could increase the risk of severe ZIKV infection, particularly during pregnancy. In this study, we examined the extent to which WNV antibodies could impact ZIKV pathogenesis in a murine pregnancy model. To test this, we passively transferred WNV antibodies into pregnant Stat2^-/- mice on E6.5 prior to infection with ZIKV. Evaluation of pregnant dams showed weight loss following ZIKV infection; however, no differences in maternal weights or viral loads in the maternal brain, spleen, or spinal cord were observed in the presence of WNV antibodies. Resorption rates, and other fetal parameters, including fetal and placental size, were similarly unaffected. Further, the presence of WNV antibodies did not significantly alter the viral load or the inflammatory response in the placenta or the fetus in response to ZIKV. Our data suggest that pre-existing WNV immunity may not significantly impact the pathogenesis of ZIKV infection during pregnancy. Our findings are promising for the safety of implementing WNV vaccines in the continental US.

Hippocampal and Prefrontal Cortical Brain Tissue Levels of Irisin and GDF15 Receptor Subunits in Children

Cold-stress hormones (CSHs) stimulate thermogenesis and have direct neuroprotective effects on the brain. The obligatory receptor components of two new CSHs (irisin and growth differentiation factor-15 [GDF15]) were recently discovered. Irisin binds integrin-αV/β5 heterodimers while GDF-15 binds to the orphan receptor glial cell-derived neurotrophic factor (GDNF) family receptor α-like (GFRAL). In addition, integrin-αV/β5 was just identified as the key receptor mediating Zika virus infection in the CNS. We measured integrin-αV, integrin-β5, and GFRAL protein levels across 78 high-quality human male/female brain tissues in infants, toddlers, preschoolers, adolescent, and adults-providing the most robust analysis to date on their levels in the human cortex and hippocampus. We report that integrin-αV was detected at all ages in the prefrontal cortex with levels greatest in adults. Integrin-αV was also detected in the hippocampus in all age groups. In contrast, integrin-β5 was detected in cortex and hippocampus largely restricted to infants. Co-expression of integrin-αV/β5 in the human infant hippocampus and cortex suggests the possibility that irisin has a more robust effect on the developing vs. the adult brain and may have implications for Zika virus infection in infants and young children.

ZanzaMapp: A Scalable Citizen Science Tool to Monitor Perception of Mosquito Abundance and Nuisance in Italy and Beyond

Mosquitoes represent a considerable nuisance and are actual/potential vectors of human diseases in Europe. Costly and labour-intensive entomological monitoring is needed to correct planning of interventions aimed at reducing nuisance and the risk of pathogen transmission. The widespread availability of mobile phones and of massive Internet connections opens the way to the contribution of citizen in complementing entomological monitoring. ZanzaMapp is the first mobile “mosquito” application for smartphones specifically designed to assess citizens’ perception of mosquito abundance and nuisance in Italy. Differently from other applications targeting mosquitoes, ZanzaMapp prioritizes the number of records over their scientific authentication by requesting users to answer four simple questions on perceived mosquito presence/abundance/nuisance and geo-localizing the records. The paper analyses 36,867 ZanzaMapp records sent by 13,669 devices from 2016 to 2018 and discusses the results with reference to either citizens’ exploitation and appreciation of the app and to the consistency of the results obtained with the known biology of main mosquito species in Italy. In addition, we provide a first small-scale validation of ZanzaMapp data as predictors of Aedes albopictus biting females and examples of spatial analyses and maps which could be exploited by public institutions and administrations involved in mosquito and mosquito-borne pathogen monitoring and control.

High Rate of Non-Human Feeding by Aedes aegypti Reduces Zika Virus Transmission in South Texas

Mosquito-borne viruses are emerging or re-emerging globally, afflicting millions of people around the world. Aedes aegypti, the yellow fever mosquito, is the principal vector of dengue, Zika, and chikungunya viruses, and has well-established populations across tropical and subtropical urban areas of the Americas, including the southern United States. While intense arboviral epidemics have occurred in Mexico and further south in the Americas, local transmission in the United States has been minimal. Here, we study Ae. aegypti and Culex quinquefasciatus host feeding patterns and vertebrate host communities in residential environments of South Texas to identify host-utilization relative to availability. Only 31% of Ae. aegypti blood meals were derived from humans, while 50% were from dogs and 19% from other wild and domestic animals. In Cx. quinquefasciatus, 67% of blood meals were derived from chicken, 22% came from dogs, 9% from various wild avian species, and 2% from other mammals including one human, one cat, and one pig. We developed a model for the reproductive number, R0, for Zika virus (ZIKV) in South Texas relative to northern Mexico using human disease data from Tamaulipas, Mexico. We show that ZIKV R0 in South Texas communities could be greater than one if the risk of human exposure to Ae. aegypti bites in these communities is at least 60% that of Northern Mexico communities. The high utilization of non-human vertebrates and low risk of human exposure in South Texas diminishes the outbreak potential for human-amplified urban arboviruses transmitted by Ae. aegypti.

Demographic, socioeconomic and disease knowledge factors, but not population mobility, associated with lymphatic filariasis infection in adult workers in American Samoa in 2014

Background

Prevalence of lymphatic filariasis (LF) antigen in American Samoa was 16.5% in 1999. Seven rounds of mass drug administration (MDA) programmes between 2000 and 2006 reduced antigen prevalence to 2.3%. The most efficient methods of surveillance after MDA are not clear, but testing specific at-risk groups such as adults may provide earlier warning of resurgence. The role of migration from LF endemic countries in maintaining transmission also needs investigation. Few studies have investigated knowledge about LF and how that relates to infection risk. This study aims to investigate associations between socio-demographics, population mobility, disease knowledge and LF infection risk.

Methods

In 2014, we surveyed 670 adults aged 16–68 years (62% female) at two worksites in American Samoa. Sera were tested for LF antigen and antibodies (Bm14 and Wb123) by rapid test and/or ELISA. Multivariate logistic regression was used to assess association between seromarkers and demographic factors, household socioeconomic status (SES), residence, travel history, and knowledge of LF.

Results

Overall, 1.8% of participants were positive for antigen, 11.8% for Bm14, 11.3% for Wb123 and 17.3% for at least one antibody. Recent travel outside American Samoa was not associated with positivity for any seromarker. Men had higher seroprevalence than women for all outcomes (any antibody: adjusted odds ratio (aOR) = 3.49 (95% CI: 2.21–5.49). Those aged over 35 years (compared to 15–24 years) had higher prevalence of Bm14 antibody (aOR = 3.75, 3.76 and 4.17 for ages 35–44, 45–54 and ≥ 55 years, respectively, P < 0.05). Lower SES was associated with seropositivity (antigen: aOR = 2.89, 95% CI: 1.09–7.69; either antibody: aOR = 1.51, 95% CI: 1.12–2.05). Those who knew that mosquitoes transmitted LF had lower Wb123 antibody prevalence (aOR = 0.55, 95% CI: 0.32–0.95).

Conclusions

Opportunistic sampling of adults at worksites provided an efficient and representative way to assess prevalence and risk factors for LF in American Samoa and in hindsight, foreshadowed the resurgence of transmission. Risk of LF infection, detected by one or more serological markers, was not related to recent travel history, but was strongly associated with male gender, older age, lower SES, and lack of knowledge about mosquito transmission. These results could guide future efforts to increase MDA participation.