Chikungunya: a risk for Mediterranean countries?

The Italian outbreak of the 2007 summer and the active spreading of the Asian tiger mosquito Aedes albopictus in southern Europe, raise the possibility of local transmission of chikungunya (CHIK) in Mediterranean countries. Established in at least 12 countries in southern Europe since the end of the 1970s and in southern France since 2004, Ae. albopictus, is invading the French Mediterranean coast from East to West. To determine the possibility of an outbreak of CHIK in southern France, we provide an assessment of vector competence towards CHIK virus of different mosquito species, including Ae. albopictus, collected in 2006 in Camargue and the "C?te d'Azur" (Alpes Maritimes). In the laboratory, Ae. albopictus showed a high susceptibility to CHIK infection (77.1%) comparable to that observed for specimens collected in March 2006 in La Reunion Island. Hence, Ae. albopictus from southern France has the potential to serve as a vector based on its susceptibility to CHIK infection. Its presence in a tourist area such as the "C?te d'Azur" should be considered as a potential threat for the introduction of CHIK virus as in Italy where the initial case was probably a traveller coming back from an endemic zone.     

Variation among goegraphic strains of Aedes albopictus in susceptibility to infection with chikungunya virus.

Two types of variation were observed when the susceptibility of 16 different geographic strains of Aedes albopictus to oral infection with chikungunya (CHIK) virus was studied. One was differential susceptibility to infection with the virus. The other was variation in the quantity of virus present in infected mosquitoes after a standard incubation period. Mean virus titers of infected mosquitoes of different geographic strains varied almost 1,000-fold. Attempts to develop increasingly resistant or susceptible mosquito lines through genetic selection were unsuccessful. Infection rates did not change significantly despite 3 to 6 generations of selective inbreeding. In contrast, crosses between strains of high and low CHIK susceptibility yielded hybrid mosquitoes with infection rates and mean virus titers intermediate between those of the parent colonies. These data suggest that at least one factor controlling the susceptibility of A. albopictus to CHIK infection is genetic. Two lines of A. albopictus with a marked difference in susceptibility to oral infection with dengue viruses were equally susceptible to oral infection with chikungunya virus.     

云南省西双版纳州蚊虫分布特点及与虫媒病毒的关系

１９８１、１９８２、１９８３、１９８６、１９８７和１９８８年在西双版纳州景洪、勐海和勐腊县（市）捕获成年雌性蚊虫８属３４种３４５０８只。夜晚在农村畜圈及其周围采获蚊虫２１种,优势蚊种为棕头库蚊和三带喙库蚊;白天在野外竹林采获蚊虫２５种,优势蚊种为贺斑伊蚊和白蚊伊蚊。从三带喙库蚊（８株）、霜背库蚊（４株）、伪杂鳞库蚊（３株）、环带库蚊（１株）、棕头库蚊（１株）、中华按蚊（３株）、刺扰伊蚊（２株）、白     

Growth characteristics of ChimeriVax-DEN2 vaccine virus in Aedes aegypti and Aedes albopictus mosquitoes

The chimeric yellow fever (YF) 17D-dengue type 2 (ChimeriVax-DEN2) vaccine virus developed by Acambis, Inc. (Cambridge, MA) contains the prM and E genes of wild-type (wt) dengue 2 (DEN-2) (strain PUO-218) virus in the YF vaccine virus (strain 17D) backbone. The potential of ChimeriVax-DEN2 virus to infect and be transmitted by Aedes aegypti, the principal DEN and YF virus mosquito vector, and Aedes albopictus, a species that occurs in areas of active transmission of YF and DEN viruses, was evaluated. Mosquitoes were intrathoracically (IT) inoculated with virus or were fed a virus-laden blood meal, and the replication kinetics of ChimeriVax-DEN2 were compared with the wt DEN-2 and YF 17D vaccine viruses. Replication of YF 17D virus is attenuated in cultured Ae. albopictus C6/36 mosquito cells and in Ae. aegypti and Ae. albopictus mosquitoes. Growth of ChimeriVax-DEN2 virus similarly was restricted in C6/36 cells and in mosquitoes. ChimeriVax-DEN2 replicated in 56% of IT inoculated Ae. aegypti, and virus disseminated to head tissue in 36%, with a mean viral titer of 1.8 log10 PFU/mosquito. Of mosquitoes, 16% of Ae. aegypti and 24% of Ae. albopictus were infected 14 days after a blood meal containing ChimeriVax-DEN2, but virus did not disseminate to head tissue. In contrast, DEN-2 replicated in all IT inoculated and orally infected Ae. aegypti (mean titer 5.5 log10 PFU/mosquito), and virus disseminated to head tissue in 95%. Of Ae. albopictus, 84% were infected after a blood meal containing DEN-2 virus; dissemination occurred in 36%. Replication of ChimeriVax-DEN2 virus in mosquitoes corresponded to that of YF 17D vaccine virus, which is restricted in its ability to infect and replicate in mosquitoes. Therefore, transmission of ChimeriVax-DEN2 virus by vector mosquitoes is unlikely.     

南昌市登革热传播媒介白纹伊蚊密度、抗药性及病原体携带监测研究

目的 掌握南昌地区白纹伊蚊密度、季节消长规律、登革热病毒携带以及对常用杀虫剂的抗药性程度,为合理选择和使用杀虫剂,科学防控登革热提供科学依据。方法 采用WHO推荐的幼虫浸渍法和成蚊接触筒法分别测定白纹伊蚊幼虫和成蚊的抗药性;密度监测:成蚊采用双层叠帐法,幼虫分别采用布雷图指数法(BI)、勺舀法和路径指数法;白纹伊蚊登革热病毒携带检测采用RT-PCR核酸检测。结果 2018年南昌地区白纹伊蚊成蚊呈单峰活动趋势,活动最高峰为6月份,全年平均帐诱指数为2.76只/(顶·h),平均布雷图指数(BI)为6.18,平均路径指数为4.67处/km,居民区帐诱指数、BI和路径指数远高于工地和公园生境。白纹伊蚊成蚊对溴氰菊酯和高效氯氰菊酯产生抗性,对马拉硫磷、氯菊酯、杀螟硫磷和残杀威表现敏感;白纹伊蚊幼虫除对溴氰菊酯表现为敏感外,对DDVP等其他6种杀虫剂分别表现出不同的抗性,抗性倍数处于9.09~76.19之间。南昌地区野外品系白纹伊蚊未检测到登革热病毒。结论 一旦有登革热病例的输入,南昌地区存在登革热传播风险, 应停用已产生高度抗药性的氯氰菊酯、残杀威等杀虫剂,重点清除居民区生境内白纹伊蚊孳生地,及时根据监测结果评估登革热发生或流行的风险,可为南昌地区登革热疫情的预测预警提供科学依据。     

Dengue vector prevalence and virus infection in a rural area in south India

We conducted a 2-year (1997-1999) longitudinal, entomological and virological study in three dengue endemic villages in Vellore district, Tamil Nadu, to understand the dynamics of dengue transmission. Aedes aegypti (Linn.), Ae. albopictus (Skuse) and Ae. vittatus (Bigot) were the prevalent vector species. Aedes aegypti was breeding throughout the year with a Breteau index ranging from 9.05 to 45.49. Aedes albopictus and Ae. vittatus were prevalent mainly in the rainy season. Small water holding containers (cemented tanks/cisterns) were the perennial breeding source of Ae. aegypti, and its abundance was significantly higher in semi-urbanized central areas than the peripheral areas of the villages. From 271 pools (4016 specimens) of adult females, eight dengue virus (DENV) isolates were obtained of which seven were from Ae. aegypti and one from Ae. albopictus. This is the first report of DENV isolation from Ae. albopictus in rural India. Infection rates in the two species were comparable. However, due to higher and perennial prevalence, Ae. aegypti is considered as primary vector with Ae. albopictus playing a secondary role. Despite circulation of all four serotypes (DENV 1-4) detected mainly during the transmission season, the high anthropophilic index of the vectors and their abundance, no human dengue case was reported, suggesting silent dengue transmission.     

A survey of dengue viral infection in Aedes aegypti and Aedes albopictus from re-epidemic areas in the north of Thailand using nucleic acid sequence based amplification assay

Immature stages of Aedes aegypti and Ae. albopictus were collected from 17 dengue re-epidemic areas in Chiang Mai and Lampang Provinces, in the north of Thailand. They were reared to adults and tested for dengue viral RNA by a nucleic acid sequence based amplification assay (NASBA). Of a total of 9,825 Ae. aegypti and 150 Ae. albopictus examined, none of them were found positive for the virus, suggesting that transovarial transmission may be very low in the vector populations and may not play a significant role in the epidemiology of dengue infection in Thailand.     

Climatic factors associated with epidemic dengue in Palembang, Indonesia: implications of short-term meteorological events on virus transmission

An extensive outbreak of dengue fever and dengue hemorhagic fever occurred in the city of Palembang, South Sumatra, Indonesia from late 1997 through March/April 1998. All surveyed administrative areas (kelurahan) in Palembang were found to be 'permissive' for dengue virus transmission; and all areas that had Aedes (subgenus Stegomyia) larval mosquitoes in abundance experienced increased cases of DHF during the epidemic. The Aedes House Index (HI) for combined Aedes aegypti and Aedes albopictus was recorded every 3 months before, during, and after the epidemic. Ten surveyed sentinel sites (October-December 1997) immediately preceding the epidemic peak had a combined HI of 25% (range 10-50.8%). Entomological surveys during the peak epidemic period (January-April) showed a combined HI of 23.7% (range: 7.6-43.8%). Kelurahans with the highest numbers of reported dengue cases had an HI exceeding 25%; however, there was no discernable relationship between elevated HI and increased risk of DHF incidence. Despite the unusual climatic conditions during late 1997 created throughout the region by the El Ni?o Southern Oscillation (ENSO), the house indices during both wet and dry months remained above 23% for the 4 quarterly (3-month) periods surveyed in the second half of 1997 and first half of 1998. Rainfall returned to near normal monthly levels shortly before the reported increase in human cases. However, mean ambient air temperatures continued above normal (+0.6 to 1.2 degrees C) and were sustained over the months leading up to and during the epidemic. Evidence suggests that an ENSO-driven increase in ambient temperature had a marked influence on increased virus transmission by the vector population. We explore the apparent associations of entomological and climatic effects that precipitated the epidemic before the influx of reported human cases.     

Use of a geographic information system for defining spatial risk for dengue transmission in Bangladesh: role for Aedes albopictus in an urban outbreak

We used conventional and spatial analytical tools to characterize patterns of transmission during a community-wide outbreak of dengue fever and dengue hemorrhagic fever in Dhaka, Bangladesh in 2000. A comprehensive household-level mosquito vector survey and interview was conducted to obtain data on mosquito species and breeding as well as illness consistent with dengue. Clusters of dengue illnesses and high-density vector populations were observed in a distinct sector of the city. Dengue clusters are less identifiable in areas further away from major hospitals, suggesting that proximity to hospitals determines whether cases of dengue are diagnosed. Focusing on those areas relatively close to hospitals, we found a spatial association between dengue clusters and vector populations. Households reporting a recent dengue illness were more likely to have Aedes albopictus larvae present in the home when compared with households not reporting cases. Households reporting a recent dengue illness were also more likely to have a neighbor with Ae. albopictus present in the home. In contrast, the presence of Aedes aegypti within the premises as well as the homes of neighbors (within 50 meters) was not associated with dengue illness. Given that the breeding habitats for Ae. albopictus are somewhat distinct from those of Ae. aegypti, the findings of this study have implications for control of dengue transmission in this urban setting where much of the focus has been on indoor mosquito breeding and transmission. Public health officials may find the disease-environment map useful for planning targeted interventions because it displays areas where transmission is most intense.     

Natural vertical transmission of dengue virus in Aedes albopictus (Diptera: Culicidae) in Kerala, a southern Indian state

The natural occurrence of vertical transmission of dengue viruses in Aedes albopictus (Skuse) mosquitoes was examined in the state of Kerala in southern India. Adults and larvae of Ae. albopictus collected from Kerala were screened for dengue viruses by using enzyme-linked immunosorbent assay with dengue-specific monoclonal antibodies. The possibility of the vertical transmission of dengue virus in Ae. albopictus was further evidenced by the detection of the virus in field-collected adult males as well as females emerged from field-collected larvae. Two pools, one pool from the adult males and one pool from the emerged females derived from field-collected larvae, were collected in the relatively hot months of June and March, respectively, and found to be positive for dengue virus antigen. Dengue serotype 2 virus was isolated from field-collected male adults in Kerala. These findings suggest that dengue virus is maintained in Ae. albopictus mosquitoes during the dry season by vertical transmission in nature.     

福建省莆田市2007年登革热暴发的流行病学调查分析

目的调查分析2007年福建省莆田市登革热暴发的流行病学特征、影响因素,并对病原体的可能来源进行追踪。方法利用流行病学调查和疫情报告数据以及病毒分离株的序列信息,分析、阐明暴发的流行学特点及影响因素;从感染者体内分离病毒并进行病毒序列测定,分析本次暴发可能的病毒来源。结果本次暴发为登革II型病毒引起的登革热暴发流行。共报告确诊病例103例,波及5个乡镇,发病主要集中在9月8日-10月8日,多数病例发生在1-2个村(街道),发病具有时间和空间的聚集性特征,病例临床表现均为典型登革热特征,无临床严重或死亡病例。从病毒分离株的序列分析表明,导致暴发的病毒来源可能为东南亚。外界病毒传入、高白纹伊蚊密度和临床漏诊可能是导致该起登革热暴发流行的主要原因。结论本次暴发流行为一起由输入性病例引起,在当地扩散造成的登革II型病毒暴发,病毒的来源可能是东南亚一带。     

Distribution and seasonality of vertically transmitted dengue viruses in Aedes mosquitoes in arid and semi-arid areas of Rajasthan, India

BACKGROUND & OBJECTIVES: Transovarial transmission of dengue virus is a crucial etiological phenomenon responsible for persistence of virus during inter-epidemic period of the disease. Distribution and seasonality of this phenomenon in disease endemic areas may contribute to explain emergence of dengue and its subsequent prevention. The study on seasonal and area distribution of transovarial transmission of dengue virus in Aedes aegypti, Ae. albopictus and Ae. vittatus has been made in desert and non-desert districts of Rajasthan, India from 2006 to 2007. The observations revealed role of different Aedes species in transmission and retention of dengue virus. METHODS: The larvae of Ae. aegypti, Ae. albopictus and Ae. vittatus were collected during each of the study seasons from rural and urban areas of three districts-Jodhpur, Jaipur and Kota. The larvae were collected from domestic and peri-domestic containers and from tree holes of peri-urban foci such as gardens and parks and were reared into adults in the laboratory at room temperature. The laboratory reared adults were subjected to Indirect fluorescence antibody test (IFAT). The laboratory-reared adult mosquitoes showing positive IFA were treated as the sample showing vertically transmitted dengue virus. RESULTS: Pooled data for all the four seasons revealed maximum (15.7%) mosquito infectivity in Ae. albopictus followed by Ae. aegypti (12.6%) in Jodhpur district. In Jaipur district, Ae. vittatus showed highest infection (20%) of vertically transmitted virus followed by Ae. albopictus (18.7%) and least in Ae. aegypti (13.3%). In Kota district, pooled data for all the four seasons showed maximum vertical infection of mosquitoes in Ae. albopictus (14.2%). INTERPRETATION & CONCLUSION: Transovarial transmission of dengue virus by available vector species in a dengue endemic setting could be the key etiological phenomenon responsible for re-emergence of the disease from inter-epidemic to epidemic phase of disease onset. The observations in the present study suggest that during winter season which is not the active transmission season of dengue in Rajasthan, Ae. albopictus has shown maximum percentage of vertically transmitted virus. Our observation substantiates with the earlier studies that how Ae. albopictus is horbouring virus during inter-epidemic period of dengue. Another important lead emerging through present study is the high mosquito infectivity of Ae. aegypti during summer and rainy seasons especially from desert districts, Jodhpur and semi district. This observation suggests that in Rajasthan, owing to tendency of overstorage of domestic water by the inhabitants, mosquito and vertically transmitted virus get pronounced during summer season which could precedes the active transmission season of dengue during following rainy season.     

Outbreak of dengue fever in Palau,Western Pacific: risk factors for infection

Between January and June 1995, an outbreak of dengue fever occurred in Palau, an island nation of 32,000 inhabitants in the Western Pacific. To determine the magnitude of this outbreak and to determine modifiable risk factors to guide control strategies, we established active surveillance at the national hospital and private clinics, reviewed available clinical records, and conducted serologic and entomologic surveys. Between January 1 and July 1, 1995, 817 case-patients with acute febrile illness with body or joint aches and one of the following: headache, rash, nausea, vomiting, or hemorrhagic manifestations presented to health facilities in Palau. The epidemic peaked in the second week of April 1995. Of 338 case-patients tested, 254 (75%) had positive serologic results by an IgM capture enzyme-linked immunosorbent assay. Dengue 4 virus was isolated from 78 (51%) of 154 serum samples tested. Blood samples collected during a cross-sectional survey were tested for IgM antibody and yielded an attack ratio of 27% (95% confidence interval = 23-31%). Potential vectors included the introduced species Aedes aegypti and Ae. albopictus, and the native species Ae. hensilli. Significant risk factors (P < or = 0.05) for infection included age < 20 years, the presence of food or water pans for animals on the property, taro farming, the presence of Ae. aegypti on the property, and presence of Ae. scutellaris group mosquitoes (Ae. Hensilli, Ae. albopictus, and a native species). This was the first outbreak of dengue 4 virus in the Western Pacific, and the first documented epidemic of dengue in Palau since 1988.     

An outbreak of dengue virus serotype 1 infection in Cixi, Ningbo, People's Republic of China, 2004, associated with a traveler from Thailand and high density of Aedes albopictus

Autochthonous dengue infections have not been reported in Ningbo, People's Republic of China since 1929. In August-October 2004, an outbreak of dengue fever was confirmed in Xiaolin, Cixi, Ningbo. Of 83 cases reported, 68 were laboratory confirmed. Fifty-three percent (34 of 64) of the cases had IgM antibodies to dengue virus. Dengue virus serotype-1 was isolated from two cases. The outbreak was linked to a traveler who returned from Thailand. Phylogenetic analysis showed that the Ningbo isolate was closely associated to strains from Thailand. Prevalence of dengue-specific IgG in asymptomatic residents was significantly higher in the epidemic-stricken area than in a control area. High density of Aedes albopictus, which resulted from waterlogging caused by Typhoon Rananim and lifestyle of local residents, was responsible for rapid spread of the virus. Eradication of mosquito infestation might interrupt transmission. This outbreak underscores the importance of maintaining surveillance and control of potential vectors for the control of emerging infectious diseases.     

Population genetic structure and competence as a vector for dengue type 2 virus of Aedes aegypti and Aedes albopictus from Madagascar.

Starch gel electrophoresis was used to assess the polymorphism of 7 isoenzymes in single mosquitoes (field-collected F0 or F1 generation) for Aedes albopictus (8 strains) from northern Madagascar. Mosquitoes of the F2 generation (3 strains of Aedes aegypti and 10 strains of Ae. albopictus) were tested for oral susceptibility to dengue type 2 virus. Aedes aegypti was less susceptible to viral infection than Ae. albopictus. The genetic differentiation was less high between Ae. albopictus populations collected in agglomerations connected by highly frequented roads, indicating that human ground transportation favors mosquito dispersal. These results have implications for the ecology, pattern of migration, and relative importance in epidemic transmission of dengue viruses between the 2 Aedes species.     

Limited potential for mosquito transmission of a live, attenuated chikungunya virus vaccine.

Studies were conducted to determine the potential for transmission of a live, attenuated chikungunya (CHIK) virus vaccine by orally exposed or virus-inoculated mosquitoes. The vaccine (CHIK 181/clone 25) replicated in and was transmitted by female Aedes albopictus and Ae. aegypti after intrathoracic inoculation. Mosquitoes also became infected with the vaccine after ingesting virus from either a blood-soaked cotton pledget or a viremic monkey. However, because of the low viremias produced in inoculated humans, it is unlikely that mosquitoes would become infected by feeding on a person inoculated with the live, attenuated CHIK vaccine. Although the vaccine was transmitted by mosquitoes after intrathoracic inoculation, there was no evidence of reversion to a virulent phenotype.     

Introduction of Aedes albopictus in Gabon: what consequences for dengue and chikungunya transmission?

The 2007 outbreak of chikungunya in Gabon has indicated the potential of this disease to spread beyond its usual range ensuing from the expansion of the mosquito Aedes albopictus . A few cases of dengue (DEN) infection were also detected. Because little is known about the potential for Gabonese mosquito species to transmit both chikungunya and DEN viruses (DENV), we conducted studies to determine the susceptibility of Ae. albopictus and Aedes aegypti collected in Libreville to both viruses by experimental infections. Disseminated infection rates were high for Ae. albopictus infected with chikungunya virus (CHIKV) (66.7–86%) and low with DENV (13–21.4%). Moreover, Ae. aegypti sp. formosus was a less efficient vector of CHIKV than Ae. albopictus . The recent introduction and dissemination of chikungunya associated with the invasion of Ae. albopictus in Africa illustrates the potential for CHIKV to spread to other parts of the world.     

Silent transmission of virus during a Dengue epidemic, Nakhon Pathom Province, Thailand 2001

In the year 2001 a large dengue fever (DF)/dengue hemorrhagic fever (DHF) outbreak occurred in Nakhon Pathom Province, Thailand. Three thousand one hundred twelve cases of DHF were reported, an attack rate of 393 per 100,000 population. The Nakhon Pathom Provincial Health Office immediately carried out a control action according to WHO recommendations. Active serological surveys and viral RNA isolation were carried out to detect silent transmission of dengue virus in 329 healthy volunteers in Nakhon Pathom Province subdistricts where the dengue epidemic had the highest rate of infection of 2.5 per 1000. Eight point eight percent of these volunteers had a serum sample positive for DF/DHF virus IgM antibody. The highest prevalence occurred in the 15 to 40 year old group. In two instances viral RNA was detected by PCR and dengue serotype 3 was subsequently identified. The data support the hypothesis of subclinical infection with dengue virus. This high frequency of virus circulation combined with a high population density, urbanization and increasing breeding sites for mosquitoes, needs to be taken into account in the evaluation of viral transmission during and after epidemics. This underlines the importance of community-based control in informing people of their involvement in virus transmission and the importance of personal protection.     

Dengue virus infection in renal allograft recipients: a case series during 2010 outbreak

Dengue virus infection is an emerging global threat caused by Arbovirus, a virus from Flaviridiae family, which is transmitted by mosquitoes, Aedes aegypti and Aedes albopictus. Renal transplant recipients who live in the endemic zones of dengue infection or who travel to an endemic zone could be at risk of this infection. Despite multiple epidemics and a high case fatality rate in the Southeast Asian region, only a few cases of dengue infection in renal transplant recipients have been reported. Here, we report a case series of 8 dengue viral infection in renal transplant recipients. Of the 8 patients, 3 developed dengue hemorrhagic shock syndrome and died.     

Costs of dengue prevention and incremental cost of dengue outbreak control in Guantanamo, Cuba

Objective To assess the economic cost of routine Aedes aegypti control in an at‐risk environment without dengue endemicity and the incremental costs incurred during a sporadic outbreak. Methods The study was conducted in 2006 in the city of Guantanamo, Cuba. We took a societal perspective to calculate costs in months without dengue transmission (January–July) and during an outbreak (August–December). Data sources were bookkeeping records, direct observations and interviews. Results The total economic cost per inhabitant (p.i.) per month. (p.m.) increased from 2.76 USD in months without dengue transmission to 6.05 USD during an outbreak. In months without transmission, the routine Aedes control programme cost 1.67 USD p.i. p.m. Incremental costs during the outbreak were mainly incurred by the population and the primary/secondary level of the healthcare system, hardly by the vector control programme (1.64, 1.44 and 0.21 UDS increment p.i. p.m., respectively). The total cost for managing a hospitalized suspected dengue case was 296.60 USD (62.0% direct medical, 9.0% direct non‐medical and 29.0% indirect costs). In both periods, the main cost drivers for the Aedes control programme, the healthcare system and the community were the value of personnel and volunteer time or productivity losses. Conclusions Intensive efforts to keep A. aegypti infestation low entail important economic costs for society. When a dengue outbreak does occur eventually, costs increase sharply. In‐depth studies should assess which mix of activities and actors could maximize the effectiveness and cost‐effectiveness of routine Aedes control and dengue prevention.