La Crosse virus neuroinvasive disease: the kids are not alright

La Crosse virus (LACV) is the most common cause of neuroinvasive mosquito-borne disease in children within the United States. Despite more than 50 years of recognized endemicity in the United States, the true burden of LACV disease is grossly underappreciated, and there remain severe knowledge gaps that inhibit public health interventions to reduce morbidity and mortality. Long-standing deficiencies in disease surveillance, clinical diagnostics and therapeutics, actionable entomologic and environmental risk indices, case response capacity, public awareness, and availability of community support groups clearly frame LACV disease as neglected. Here we synthesize salient prior research and contextualize our findings as an assessment of current gaps and opportunities to develop a framework to prevent, detect, and respond to LACV disease. The persistent burdens of LACV disease clearly require renewed public health attention, policy, and action.

An ecological and epidemiological single-season survey of Anaplasma and Ehrlichia positive ticks in Victoria Falls National Park, Zimbabwe

There is an urgent need for continued research on the ecology of tick-borne diseases in Africa. Our objective was to provide a preliminary description of the ecology and epidemiology of tick species, tick-borne pathogens, and animal hosts in Zimbabwe, focusing efforts at Victoria Falls National Park, for a single season. We tested the hypothesis that tick surveillance and pathogen screening data can be used to model associations among ticks, hosts, and pathogens. We collected ticks from domesticated animals and wildlife in Zimbabwe and screened the ticks for the presence of Anaplasma and Ehrlichia bacteria. Nearly 30% of the screened ticks were PCR-positive; 89% of tick species were PCR-positive, and 88% of animal species carried at least one PCR-positive tick. We sequenced a subset of amplicons that were similar to three Anaplasma species and three Ehrlichia species. The odds of a tick being PCR-positive increased when many ticks were collected from the host or the tick was collected from a cow (domesticated animal). Tick species shared host species more often than expected. We demonstrate that ticks in northwestern Zimbabwe present a One Health problem for nearby wildlife and humans.

A Cross-Sectional Household Survey in the US Virgin Islands (2019) Reveals Cisterns as Challenging Peridomestic Aedes aegypti Habitats

Most residences in the United States Virgin Islands (USVI) rely on household rainwater-catchment systems and subterranean cisterns for long-term water storage that may provide suitable habitats for mosquitoes of public health relevance. We conducted a household cistern survey (n = 164) on the islands of St. Croix, St. John, and St. Thomas in 2019. The survey revealed that 45.7% (95% CI: 38.3-53.4%) of cisterns contained mosquitoes (adult and/or immature mosquitoes). Aedes aegypti, a vector of chikungunya, dengue, and Zika viruses in the USVI, was found in 27.4% (95% CI: 21.2-34.7%) of cisterns and accounted for 83.3% of the total mosquitoes identified in the study. The odds of detecting mosquitoes in a cistern were 5.45 times higher at locations where the residents reported that they had observed adult mosquitoes coming out of their cisterns (95% CI: 2.25-14.21), suggesting that vector control personnel should consider resident complaints about mosquitoes in their cistern as valid and likely reliable self-assessments. Resident mosquito management practices in cisterns did not correspond with decreased odds of mosquito detection. We conclude that cisterns in the USVI commonly provide habitat for immature and adult Ae. aegypti, which may decrease the effectiveness of area-wide mosquito control strategies. Additional studies are necessary to evaluate the importance of these cisterns as they relate to mosquito production and arbovirus transmission risk, and to assess physical and chemical control methods.

Development of a Community-Driven Mosquito Surveillance Program for Vectors of La Crosse Virus to Educate, Inform, and Empower a Community

Simple Summary

A pilot program was designed using innovative STEM education programming to create a community-driven surveillance network for mosquitoes that transmit La Crosse virus (LACV). This East Tennessee program is called MEGA:BITESS (Medical Entomology and Geospatial Analyses: Bringing Innovation to Teacher Education and Surveillance Studies). MEGA:BITESS uses student-driven inquiries and classroom learning to engage 6th–12th graders directly with the science of mosquito biology and behaviors and public health science surrounding infectious diseases. As part of the program, the students test hypotheses by collecting surveillance data on mosquitoes carrying LACV, which causes La Crosse encephalitis (LACE), and analyzing their data with an open online platform. Program participants enhance awareness of LACE and help to identify mosquito populations for management, with our long-term goal of reducing LACE cases in children and other vulnerable populations in the region.

Abstract

The fields of entomology, geospatial science, and science communication are understaffed in many areas, resulting in poor community awareness and heightened risks of vector-borne diseases. This is especially true in East Tennessee, where La Crosse encephalitis (LACE) causes pediatric illness each year. In response to these problems, we created a community engagement program that includes a yearlong academy for secondary STEM educators in the 6–12 grade classroom. The objectives of this program were to support inquiry-driven classroom learning to foster student interest in STEM fields, produce community-driven mosquito surveillance, and enhance community awareness of LACE. We trained educators in medical entomology, geospatial science, and science communication, and they incorporated those skills into lesson plans for a mosquito oviposition experiment that tested hypotheses developed in the classroom. Here, we share results from the first two years of the MEGA:BITESS academy, tailored for our community by having students ask questions directly related to Aedes mosquito oviposition biology and La Crosse encephalitis. In year one, we recruited 17 educators to participate in the project, and 15 of those educators returned in year two. All participating educators completed the academy, conducted the oviposition experiment, and informed over 400 students about a variety of careers and disciplines for their students. Here, we present a community-based program that helps to address the problems associated with long-term mosquito surveillance, health and science education and communication, career opportunities, and the community needs of Appalachia, as well as the initial data on the effectiveness of two years of an educator-targeted professional-development program.

Population Growth Rates of Aedes atropalpus (Diptera: Culicidae) Are Depressed at Lower Temperatures Where Aedes japonicus japonicus (Diptera: Culicidae) Are Naturally Abundant in Rock Pools

Recent studies report extensive reductions in the abundance of the North American rock pool mosquito, Aedes atropalpus (Diptera: Culicidae), following the invasion of Ae. japonicus japonicus in the United States. Although developmental temperature is recognized as an important component of the invasion biology of Ae. j. japonicus, its impacts on the population growth and fitness of Ae. atropalpus remain largely undefined. In this study we reared Ae. atropalpus larvae at three temperature ranges reflecting ecologically important temperatures in natural rock pools: a low temperature range (mean: 19°C) where Ae. j. japonicus is common and Ae. atropalpus is often rare, a middle temperature range (mean: 25°C) where both species are naturally found in similar relative abundances, and a higher temperature range (mean: 31°C) where Ae. atropalpus is the dominant species. We measured survival, development time, wing length, and fecundity to calculate a finite population growth rate at each temperature. Our results indicate that Ae. atropalpus population growth suffers in colder rock pools, which informs the perceived displacement of the species in temperate habitats. The population growth rate was highest in the middle temperature range, but not significantly higher than in the highest temperature range used in this study. The developmental success of Ae. atropalpus at the intermediate temperature range suggests that competition with Ae. j. japonicus in rock pools within that range may significantly impact natural Ae. atropalpus populations.

Field Observations of Invasive Species Aedes japonicus and Larval Contemporaries in Escambia County, Florida

The Asian bush mosquito, Aedes japonicus, is an invasive species that is well established in North America and Europe. Though it is considered a temperate species, we have observed an established population of Ae. japonicus in the subtropical climate of northwestern Florida. To evaluate the temporal patterns of Ae. japonicus abundance, mosquito larvae were collected from 15 artificial containers in Escambia County, FL, from August 2019 to July 2020, with the prediction that Ae. japonicus abundance would peak in the winter months and decline with increasing ambient temperatures. Aedes japonicus larvae were collected in low abundances during each month except for February (n = 51), with no clear temporal patterns of abundance. Larval contemporaries belonging to other species were considered in sampling of containers and were also cataloged. We demonstrate monthly observance of this temperate species at a single site in the Florida panhandle, exemplifying the persistence of Ae. japonicus through all seasons in a subtropical climate.

Diapause influenced oviposition behavior and physical egg hatch cues of Aedes atropalpus (Diptera: Culicidae): traits that may influence successful colonization of riverine rock pools

Mosquitoes have developed specialized oviposition strategies that allow them to develop in a wide variety of aquatic habitats. Environmentally cued hatching traits may also play an important role in the successful colonization of some larval habitats, but this subject has remained largely unexplored in Culicidae. Aedes atropalpus (Coquillett) is an autogenous rock pool specialist that may maintain unique adaptations for oviposition and egg hatching. We investigated the egg-laying strategies of Ae. atropalpus exposed to standard (non-diapausing) rearing conditions and diapause-inducing conditions and tested the impact of physical agitation on egg hatch rates by exposing floating and submerged eggs to physical agitation treatments. The results of the oviposition experiment indicate that Ae. atropalpus females primarily lay non-diapausing eggs directly onto the water surface and lay diapausing eggs directly on solid surfaces. The egg-hatching experiment demonstrated that physical agitation significantly increases Ae. atropalpus hatch rates. Floating and submerged eggs responded similarly to the agitation treatment. These data suggest that oviposition behaviors based on both egg diapause status and environmentally-cued hatching strategies may be important adaptations for Ae. atropalpus in riverine rock pools.

Phenology of Rock Pool Mosquitoes in the Southern Appalachian Mountains: Surveys Reveal Apparent Winter Hatching of Aedes japonicus and the Potential For Asymmetrical Stage-Specific Interactions

The North American rock pool mosquito, Aedes atropalpus, has reportedly decreased in abundance following the introduction of Ae. japonicus japonicus to the USA, but the specific mechanisms responsible for the reduction remain unclear. Thus, there is a need for field studies to improve our knowledge of natural rock pool systems where both species co-occur. We sampled rock pool invertebrates over a 12-month period along the Chattooga River at a high-elevation site (728 m) near Cashiers, NC, and at a lower-elevation site (361 m) near Clayton, GA. We identified 12 orders of macroinvertebrates representing at least 19 families and 5 mosquito species. Aedes j. japonicus was present year-round at both sites. We observed overwintering Ae. j. japonicus larvae in pools with water temperatures as cold as 3°C and detected apparent winter egg hatching in water below 10°C. Aedes atropalpus was rarely encountered at the high-elevation site but was highly abundant in the summer months at the low-elevation site. Late-stage Ae. j. japonicus larvae inhabited pools in March 2019 when Ae. atropalpus first appeared in the same pools, creating the potential for asymmetrical stage-specific interactions. Our observations provide evidence of overwintering and early hatching of Ae. j. japonicus in the southeastern climate. Further study of the importance of stage-dependent competition and winter egg hatching of diapausing Ae. j. japonicus eggs is warranted.

Context-Dependent Accuracy of the BG-Counter Remote Mosquito Surveillance Device in North Carolina

There is a clear need for improved vector surveillance approaches that are affordable, labor efficient, and safer than traditional methods. The BG-Counter (Biogents USA, Moorefield, WV) is a device for remotely monitoring mosquito activity in combination with the BG-Sentinel (Biogents USA), a widely used trap for the collection of host-seeking mosquitoes. The BG-Counter uses a wireless connection to provide real-time counts of mosquitoes captured by the BG-Sentinel, allowing users to remotely monitor mosquito populations. This study tested the effectiveness of the BG-Counter in 5 North Carolina counties. A total of 96 trap-days resulted in the collection of >45,000 individual mosquitoes representing 35 species. Aedes albopictus was the most common species collected in all counties, except for New Hanover County where Culex nigripalpus was the most common. The mean daily accuracy ranged from 80.1% (New Hanover County) to 9.4% (Jackson County). There was a significant linear relationship between the actual number of mosquitoes collected and the device counts at all sites except Jackson County, the site with the lowest relative mosquito abundance compared with nontarget organisms. A linear regression of daily BG-Counter accuracy and the daily proportion of mosquitoes to the total number of arthropods collected revealed a significant positive linear relationship, supporting the premise that the BG-Counter is less effective when the relative abundance of mosquitoes is low. Mosquito surveillance programs using the BG-Counter should recognize its context-dependent accuracy and routinely evaluate the accuracy of the device based on local conditions.

First Record of Mansonia dyari From Saint Croix, United States Virgin Islands

The first report of Mansonia dyari on Saint Croix, United States Virgin Islands (USVI), is confirmed. Adult and larval specimens were collected in 2018 and 2019 through adult surveillance and larval collections. Specimens were identified by microscopic methods, and a representative specimen was confirmed by DNA sequencing (mitochondrial cytochrome c oxidase subunit I). Morphological features are reviewed and compared with Mansonia flaveola, a species previously reported in the USVI. Notes are provided on the locations, collection methods, and mosquito associates found with Ma. dyari in the USVI.

Effect of treatment willingness on specialist assessment and treatment uptake for hepatitis C virus infection among people who use drugs: the ETHOS study

Among people who inject drugs (PWID) with chronic HCV, the association between HCV treatment willingness and intent, and HCV specialist assessment and treatment were evaluated. The Enhancing Treatment for Hepatitis C in Opioid Substitution Settings (ETHOS) is a prospective observational cohort. Recruitment was through six opioid substitution treatment clinics, two community health centres and one Aboriginal community controlled health organisation in Australia. Analyses were performed using logistic regression. Among 415 participants (mean age 41 years, 71% male), 67% were 'definitely willing' to receive HCV treatment and 70% reported plans to initiate therapy 12 months postenrolment. Those definitely willing to receive HCV treatment were more likely to undergo specialist assessment (64% vs 32%, P < 0.001) and initiate therapy (36% vs 9%, P < 0.001), compared to those with lower treatment willingness. Those with early HCV treatment plans were more likely to undergo specialist assessment (65% vs 27%, P < 0.001) and initiate therapy (36% vs 5%, P < 0.001), compared to those without early plans. In adjusted analyses, HCV treatment willingness independently predicted specialist assessment (aOR 3.06, 95% CI 1.90, 4.94) and treatment uptake (aOR 4.33, 95% CI 2.14, 8.76). In adjusted analysis, having early HCV treatment plans independently predicted specialist assessment (aOR 4.38, 95% CI 2.63, 7.29) and treatment uptake (aOR 9.79, 95% CI 3.70, 25.93). HCV treatment willingness was high and predicted specialist assessment and treatment. Strategies for enhanced HCV care should be developed with an initial focus on people willing to receive treatment and to increase treatment willingness among those less willing.

Leaders and elites: portrayals of smoking in popular films

OBJECTIVE

To study frequency and traits of characters that smoke in films and to document on-screen consequences of tobacco use.

DESIGN

This study conducted a content analysis of the top 100 grossing films in 2002, with a total global gross of 12.4 billion US dollars.

OUTCOME MEASURES

Three outcome measures were frequency of smoking incidents, traits of characters who smoke, and consequences of tobacco use.

RESULTS

6% of characters smoked in 453 incidents, including 3% of children. In 92% of incidences, smoking had no consequences. The most frequent consequence was a verbal reprimand. Although tobacco is a leading cause of preventable deaths globally, only 0.4% of tobacco incidences resulted in death. No deaths were caused by disease. Characters who smoked tended to be major characters playing leadership roles. They tended to be from privileged elites: male, white, and mature.

CONCLUSIONS

Films portray characters that smoke as leaders from privileged elites, making smoking more attractive to audience members. Because 99.6% of characters suffer no life threatening consequences from smoking on screen, smokers seem invincible, belying tobacco's role as a leading cause of preventable deaths.

Prognostic value of c-erbB-2 and epidermal growth factor receptor in stage A1 (T1a) prostatic adenocarcinoma

OBJECTIVE

To determine whether the presence or absence of the oncoproteins epidermal growth factor receptor (EGFR) and c-erbB-2 could predict tumour behaviour.

PATIENTS AND METHODS

Tissue from 45 stage A1 (T1a) prostatic adenocarcinomas from patients with a mean age of 65 years were immunostained for EGFR (12E) and c-erbB-2 (NCL-CB11). Their expression in the tumour and surrounding benign hyperplastic epithelium was correlated with each other and with survival.

RESULTS

Forty percent (18 of 45) and 36% (16 of 45) of patients respectively were EGFR and c-erbB-2 positive in the tumour. Expression of these tyrosine kinase oncogenes was not confined to the tumour and the surrounding hyperplastic prostate was also positive for EGFR in 76% (34/45) of patients and for c-erbB-2 in 16% (11 of 45). EGFR and c-erbB-2 expression was weakly associated in both benign and malignant epithelium. Statistical analysis of survival showed that tumour c-erbB-2 expression was associated with a significantly worse prognosis (exact two tailed P = 0.0316), whereas no significant association was observed between EGFR expression and survival (P = 0.737).

CONCLUSION

As c-erbB-2 expression increases the rate of dying by 4.2 times, recording its expression by these tumours may be useful in selecting patients who would benefit from treatment in stage A1 (T1a) disease.

Increased susceptibility of Pseudomonas aeruginosa to ciprofloxacin in the presence of vancomycin

Vancomycin in combination with ciprofloxacin exhibited synergy against 7 of 10 strains of Pseudomonas aeruginosa. MICs for the microbial strains used in this study ranged from 0.0325 to 3.0 micrograms/ml for ciprofloxacin and from 23.5 to > 188 micrograms/ml for vancomycin. Combinations of these antibiotics, tested in a checkerboard pattern, gave fractional inhibitory concentrations of 0.5 or less for 7 of the 10 strains tested.

Expression of cathepsin D and estrogen receptor in male breast carcinoma

Male breast cancer is probably hormone dependent, but studies are few due to the rarity of this tumor. We have studied 21 cases of male breast cancer immunohistologically for estrogen receptor (ER) and cathepsin D (CD) expression. In carcinoma of the female breast ER expression is associated with longer patient survival and responsiveness to hormonal manipulation. Cathepsin D is an estrogen-regulated lysosomal protease with proteolytic and mitogenic properties whose presence denotes a functioning ER. In our series of male breast carcinomas 86% were ER positive and 62% were CD positive; this compares with typical figures of 50% and 66%, respectively, for female breast cancer. We observed no trends between expression of ER and CD and patient survival; immunostaining for ER and CD is unlikely to be clinically useful in carcinoma of the male breast. The high rate of ER positivity in males suggests that male and female breast carcinomas are biologically different tumors.

Oestrogen receptor and epidermal growth factor receptor expression in male breast carcinoma

Male breast carcinomas are probably hormone-dependent, but receptor studies are few because this is a relatively rare tumour. We have studied 21 cases of male breast carcinoma immunohistochemically for oestrogen receptor (ER) and epidermal growth factor receptor (EGFR) expression employing the antibodies ER-ICA and 12E on formalin-fixed, paraffin-embedded material. In our series, 86 per cent of male breast cancers were ER-positive and 76 per cent were EGFR-positive. Male breast carcinomas do not exhibit the inverse correlation between ER and EGFR expression that characterizes female breast carcinomas. Owing to the limitations of a small series, we were unable to comment on the relationship between ER and EGFR expression and patient survival. However, the relatively high incidence of ER expression may provide a growth advantage for this tumour in a male environment characterized by low levels of oestrogen. In addition, high EGFR expression may also contribute to a poor prognosis independent of ER status.

Lack of c-erbB-2 oncoprotein expression in male breast carcinoma

A series of 21 male breast carcinomas were immunostained using NCL-CB11, an antibody directed against the internal domain of the c-erbB-2 transmembrane oncoprotein. In contrast to female breast cancer, where up to 35% of cases show positivity, all of these cases were negative. This suggests that no prognostic information regarding patient survival can be made in these patients and that male breast carcinomas may be under different growth control mechanisms from female breast carcinomas.

DNA in meningioma tissues and explant cell cultures. A flow cytometric study with clinicopathological correlates

Flow cytometry was performed on stored frozen tissues and explant cell cultures from 39 meningiomas using ethidium bromide and mithramycin in a selective staining technique for deoxyribonucleic acid (DNA). The ploidy index and percentage of cells in the G0/G1, S, and G2/M phases were calculated for each specimen. The results were compared with the age and sex of the patients; the site, the histological subtype, and mitotic rate of the neoplasms; and the estrogen- and progesterone-receptor levels assayed in cytosol-enriched supernatants from cryostat-cut sections. Sixteen neoplasms (41%) were aneuploid. These included two recurrent neoplasms, seven of the eight neoplasms from patients with multiple meningiomas, and three clinically aggressive neoplasms (one hemangiopericytic and two anaplastic meningiomas). Significant correlations were found between values for the ploidy index (r = 0.75, p less than 0.01), the percentage of S-phase cells (r = 0.82, p less than 0.01), and the percentage of G2/M-phase cells (r = 0.69, p less than 0.05) in vivo and in vitro. The results support the suggestion that flow cytometry for DNA in meningiomas may be of value in predicting the behavior of these neoplasms, and indicate that under controlled conditions explant cell cultures may provide a useful model for the proliferative characteristics of meningiomas in vivo.

Examination of the relationship between pathological changes, immunological response and serum protein concentrations in pregnant sheep inoculated with Aspergillus fumigatus

Pregnant sheep inoculated with Aspergillus fumigatus conidia developed precipitating and latex agglutinating antibodies to mycelial antigens. The titres of these tended to be higher in those animals developing placental or fetal infection than in those which did not. The concentrations of total serum proteins and of albumin, alpha, beta and gamma globulins did not show any consistent changes which could be related to abortion or placental infection. Lymphocyte transformation tests on whole blood showed significant responses to phytohaemagglutinin but not to A. fumigatus antigens.

Examination of the immunoglobulin classes involved in the serological response of pregnant sheep to Aspergillus fumigatus

Pregnant sheep inoculated with Aspergillus fumigatus conidia developed agglutinating and precipitating antibodies for mycelial antigens. The agglutinins were initially exclusively of the IgM class, but were later supplemented by IgG antibodies, although IgM production was usually sustained throughout the serological response. Precipitins active in the immunodiffusion test were of the IgG class. They developed later in the immune response than agglutinins and declined more rapidly. The precipitins and IgG agglutinins were more closely associated with recent active infection than IgM agglutinins.

Haematological changes associated with Aspergillus fumigatus infection in experimental mycotic abortion of sheep

The haematological changes specifically associated with Aspergillus fumigatus infection were studied in experimentally inoculated pregnant sheep.

No significant changes in relation to infection were observed in the haemoglobin concentration, erythrocyte sedimentation rate, packed cell volume, mean corpuscular haemoglobin concentration or erythrocyte morphology of inoculated sheep. There was little evidence of changes in total leucocyte count in most sheep in the first few weeks following inoculation, although those animals receiving larger inocula showed signs of an increasing leucocytosis at the terminal phase of gestation. This increase was even more pronounced at the time of lambing or abortion. Compared with uninoculated pregnant controls, the mean relative neutrophil counts of the inoculated sheep tended to increase during the later stages of gestation and showed highly significant increases at the time of lambing or abortion. Both total leucocyte and relative neutrophil counts were significantly higher in those sheep showing signs of placental infection than in those inoculated animals with no evidence of placentitis. There was some evidence of a relationship between the dose of A. fumigatus conidia inoculated and the severity of infection as indicated by the number of animals aborting, extent of placental involvement and reduction in mean gestation period. Irrespective of inoculum size, only a proportion of inoculated animals developed detectable placentitis.