Autochthonous dengue outbreak in Italy 2020: clinical, virological and entomological findings

Serum levels of neurofilament light chain and glial fibrillary acidic protein correlate with disease severity in patients with West Nile virus infection

West Nile virus (WNV) is a neurotropic mosquito-borne orthoflavivirus, representing a relevant public health threat. Identification of biomarkers that would predict the course of WNV infection is of interest for the early identification of patients at risk and for supporting decisions on therapeutic interventions. In this study, serum levels of glial fibrillary acidic protein (sGFAP) and neurofilament light chain (sNfL), which are markers of brain tissue damage and inflammation, were analysed in 103 subjects with laboratory-confirmed WNV infection, comprising 13 asymptomatic blood donors, 23 with WN fever (WNF), 50 with encephalitis/meningoencephalitis (E/ME) and 17 with acute flaccid paralysis (AFP). In addition, 55 WNV-negative subjects with fever, encephalitis or healthy asymptomatic were included as controls. Age-adjusted levels of both sNfL and sGFAP were significantly higher in patients with neuroinvasive disease than in those with fever or asymptomatic (both WNV-positive and WNV-negative), suggesting a broad association of these biomarkers with systemic inflammation and brain injury resulting from infection. In WNV patients, the combined analysis of sNfL and sGFAP early after symptom onset allowed discrimination between neuroinvasive disease and fever with 67.2% sensitivity and 91.3% specificity, but not between E/ME and AFP. Furthermore, high levels of sNfL and sGFAP were significantly associated with prolonged hospital stay, intensive care unit admission and the occurrence of death or severe sequelae. Detection of WNV RNA in CSF was associated with increased sGFAP. In conclusion, our study indicates the potential utility of sNfL and sGFAP as biomarkers of WNV disease severity and adverse outcome.

Rapid molecular method for early detection of the invasive mosquito Aedes aegypti (Linnaeus, 1762) at Points of Entry

In recent years, globalization and climate change have led to a rise in the number of imported cases of Aedes-diseases in Europe, resulting in increased frequency and magnitude of local transmissions due to the presence of competent vectors. Recently, Italy has experienced the establishment of three exotic Aedes mosquitoes relevant to human health, Aedes albopictus, Aedes koreicus and Aedes japonicus. Aedes aegypti, the primary vector of dengue and yellow fever, distributed in tropical and subtropical regions, has recently reappeared in Europe and the risk for its re-introduction in Italy is high given the climatic conditions suitable for the species. To address the risk of introduction and spread of Aedes-diseases, the Health Authorities recommend the strengthening of entomological surveillance at regional level, particularly in strategic areas and Points of Entry, such as ports and airports. In 2021, a Korean research team developed a multiplex-PCR assay for the identification of six Aedini species, not including Ae. aegypti. In the present study, the previous diagnostic test was improved by designing reverse primers for the identification of Ae. aegypti and Aedes geniculatus. This latter native mosquito lays eggs morphologically similar to those of invasive species with which it can sometimes be found in sympatry. Furthermore, a ten-minute DNA extraction method was implemented. The results obtained demonstrate a perfect diagnostic capacity and sensitivity of the method in discriminating the five species tested. Here, findings of a sensitive, rapid and cost-effective molecular assay developed for the early identification of invasive species at high-risk sites are shown.

First clinical experiences with the tetravalent live vaccine against dengue (Qdenga®) in travellers: a multicentric TravVacNet study in Germany

BACKGROUND

A study was conducted to assess the safety and tolerability of the tetravalent live-attenuated dengue vaccine Qdenga®, which received marketing approval in Germany in 2022. The study evaluated vaccine-related reactions in a predominantly dengue-naïve population, highlighting the importance of post-marketing surveillance as an essential component of safety evaluation for newly licensed vaccines.

METHODS

Following dengue vaccination, participants were recruited for an anonymous online questionnaire through the national 'Trav VacNet' network in Germany. The questionnaire focused on post-vaccination reactions up to 18 days after the first and second vaccination, as well as previous travel history and coadministration.

RESULTS

The study included 1176 participants, with a median age of 39 years (IQR 28-56), 53.2% female (n = 625), 46.5% male (n = 547), and 0.3% non-binary participants (n = 4). After the first dose, 51% of the participants reported systemic reactions such as headache [40% (190/474)], weakness [40% (189/474)], and malaise [32% (154/474)], which were most pronounced between days 7 and 11 post vaccination. After the second dose, localized signs and symptoms such as pain at the injection site [22% (n = 55/250)] were more common. Fever was more common after the first dose [20% (96/474)] vs. 2% (6/250) after the second. Females reported significantly more reactions than males after both vaccinations (1st dose P = 0.0002; 2nd dose P = 0.0003). A total of 334 (28%) co-administrations were reported whereby assessing adverse events were reported in 47% (157/333) of participants, with the highest prevalence observed when combined with the Japanese encephalitis vaccine [56.8%, (42/74)]. Differences in age groups were observed, with a decrease in reactions in the elderly (≥65 years).

CONCLUSIONS

Vaccine-related reactions were frequently reported, predominantly after the first dose in dengue-naïve participants. Coadministration was a common strategy without significantly increasing side effects. The study provides important insights into reactogenicity and may help improve vaccination strategies in dengue-naïve populations.

Assessing dengue seroprevalence among people living with HIV (PLWH) in rome, Italy: Insights from the 2023 Italian autochthonous outbreak

BACKGROUND

Global warming has facilitated the spread of mosquito-borne diseases, including dengue, to non-endemic areas like Italy. People living with HIV (PLWH) are at increased risk of severe dengue, especially during secondary infections, but current vaccination options are constrained by safety considerations. This study assesses the seroprevalence of IgG anti-DENV among PLWH in Italy, after the 2023 Italian autochthonous outbreak.

METHODS

This cross-sectional study enrolled PLWH from July to November 2023 in Rome during the abovementioned outbreak. Blood samples were collected and analyzed for IgG anti-DENV using ELISA. Participants were stratified by country of birth and those with immune profiles suitable for live attenuated virus vaccination were identified. Cryopreserved serum samples from 2021 to 2022 were tested to trace the timing of infections.

RESULTS

We included 475 PLWH of whom 37 tested positive for IgG anti-DENV, resulting in an overall seroprevalence of 7.79 % (95 % CI 5.54-10.6). The seroprevalence was significantly higher among PLWH born in DENV-endemic countries (37.14 %) compared to Italian (2.86 %). Notably, among the Italian participants, three individuals who had not traveled outside Italy in the past 12 months showed seroconversion during the 2023 outbreak, providing further evidence of autochthonous dengue transmission in the country. This finding underscores the growing relevance of dengue as an emerging public health concern in Italy. Of the 37 seropositive individuals, 34 (91.9 %) had a CD4 count ≥200 cells/μl, indicating that a significant portion of the at-risk population could safely be vaccinated.

CONCLUSIONS

Many PLWH have been exposed to DENV, with some experiencing seroconversion during the 2023 outbreak. Most of these individuals could feasibly receive live attenuated virus vaccination without significant risks, but further studies are needed to confirm vaccine safety for PLWH.

The 2023 dengue outbreak in Lombardy, Italy: A one-health perspective

INTRODUCTION

Here we reported the virological, entomological and epidemiological characteristics of the large autochthonous outbreak of dengue (DENV) occurred in a small village of the Lombardy region (Northern Italy) during summer 2023.

METHODS

After the diagnosis of the first autochthonous case on August 18, 2023, public health measures, including epidemiological investigation and vector control measures, were carried out. A serological screening for DENV antibodies detection was offered to the population. In the case of positive DENV IgM, a second sample was collected to detect DENV RNA and verify seroconversion. Entomological and epidemiological investigations were also performed. A modeling analysis was conducted to estimate the dengue generation time, transmission potential, distance of transmission, and assess diagnostic delays.

RESULTS

Overall, 416 subjects participated to the screening program and 20 were identified as DENV-1 cases (15 confirmed and 5 probable). In addition, DENV-1 infection was diagnosed in 24 symptomatic subjects referred to the local Emergency Room Department for suggestive symptoms and 1 case was identified through blood donation screening. The average generation time was estimated to be 18.3 days (95 % CI: 13.1-23.5 days). R0 was estimated at 1.31 (95 % CI: 0.76-1.98); 90 % of transmission occurred within 500m. Entomological investigations performed in 46 pools of mosquitoes revealed the presence of only one positive pool for DENV-1.

DISCUSSION

This report highlights the importance of synergic surveillance, including virological, entomological and public health measures to control the spread of arboviral infections.

Outbreak of autochthonous dengue in Fano, Pesaro-Urbino Province - Marche region, Italy, September 2024

Dengue is the most common arboviral disease globally. It is caused by four distinct but closely related Dengue viruses (DENV-1, -2, -3, and - 4) transmitted through bites of infected Aedes species mosquito vectors. In the last 50 years, incidence has increased 30-fold with increasing geographic expansion to new countries. Here we report the most important autochthonous Dengue epidemic in Italy ever recorded with a total of 86 confirmed cases occurring in September 2024 in Fano. They were caused by DENV-2. They were 61 Dengue fever, 21 Dengue with warning signs and no cases of severe Dengue. Our data underline the importance of considering Dengue not only as imported disease and rapidly testing all those patients with suggestive clinical pictures even if they have no travel history.

Modelling the seasonal dynamics of Aedes albopictus populations using a spatio-temporal stacked machine learning model

Various modelling techniques are available to understand the temporal and spatial variations of the phenology of species. Scientists often rely on correlative models, which establish a statistical relationship between a response variable (such as species abundance or presence-absence) and a set of predominantly abiotic covariates. The choice of the modeling approach, i.e., the algorithm, is itself a significant source of variability, as different algorithms applied to the same dataset can yield disparate outcomes. This inter-model variability has led to the adoption of ensemble modelling techniques, among which stacked generalisation, which has recently demonstrated its capacity to produce robust results. Stacked ensemble modelling incorporates predictions from multiple base learners or models as inputs for a meta-learner. The meta-learner, in turn, assimilates these predictions and generates a final prediction by combining the information from all the base learners. In our study, we utilized a recently published dataset documenting egg abundance observations of Aedes albopictus collected using ovitraps. and a set of environmental predictors to forecast the weekly median number of mosquito eggs using a stacked machine learning model. This approach enabled us to (i) unearth the seasonal egg-laying dynamics of Ae. albopictus for 12 years; (ii) generate spatio-temporal explicit forecasts of mosquito egg abundance in regions not covered by conventional monitoring initiatives. Our work establishes a robust methodological foundation for forecasting the spatio-temporal abundance of Ae. albopictus, offering a flexible framework that can be tailored to meet specific public health needs related to this species.

Can Wastewater Surveillance Enhance Genomic Tracking of Climate-Driven Pathogens?

Climate change heightens the threat of infectious diseases in Europe, necessitating innovative surveillance methods. Based on 390 scientific papers, for the first time, this review associates climate-related pathogens, data related to their presence in wastewater, and associated available genomic detection methods. This deep analysis reveals a wide range of pathogens that can be tracked through methods such as quantitative and digital PCR, as well as genomic pathogen enrichment in combination with sequencing and metagenomics. Nevertheless, significant gaps remain in the development of methods, particularly for vector-borne pathogens, and in their general harmonization relating to performance criteria. By offering an overview of recent advancements while identifying critical gaps, we advocate for collaborative research and validation to integrate detection techniques into surveillance frameworks. This will enhance public health resilience against emerging infectious diseases driven by climate change.

iNaturalist community observations provide valuable data on human-mosquito encounters

Mosquitoes (Diptera: Culicidae) and the pathogens they transmit represent a threat to human and animal health. Low-cost and effective surveillance methods are necessary to enable sustainable monitoring of mosquito distributions, diversity, and human interactions. This study examined the use of iNaturalist, an online, community-populated biodiversity recording database, for passive mosquito surveillance in the United Kingdom (UK) and Ireland, countries under threat from the introduction of invasive mosquitoes and emerging mosquito-borne diseases. The Mozzie Monitors UK & Ireland iNaturalist project was established to collate mosquito observations in these countries. Data were compared with existing long-term mosquito UK datasets to assess representativeness of seasonal and distribution trends in citizen scientist-recorded observations. The project collected 738 observations with the majority recorded 2020-2022. Records were primarily associated with urban areas, with the most common species Culex pipiens and Culiseta annulata significantly more likely to be observed in urban areas than other species. Analysis of images uploaded to the iNaturalist project also provided insights into human-biting behavior. Our analyses indicate that iNaturalist provides species composition, seasonal occurrence, and distribution figures consistent with existing datasets and is therefore a useful surveillance tool for recording information on human interactions with mosquitoes and monitoring species of concern.

Genetic and structural characterization of dengue virus involved in the 2023 autochthonous outbreaks in central Italy

Dengue virus (DENV) has been expanding its range to temperate areas that are not usually affected, where the spread of vectors has been facilitated by global trade and climate change. In Europe, there have been many cases of DENV imported from other regions in the past few years, leading to local outbreaks of DENV among people without travel history. Here we describe the epidemiological and molecular investigations of three transmission events locally acquired DENV infections caused by serotypes 1, 2 and 3, respectively, in the Latium Region from August to November 2023. Next-generation or Sanger sequencing was used to obtain the whole genomes, or the complete E-gene of the viruses, respectively. The structure of the DENV-1 and DENV-3 sequences was analysed to identify amino acid changes that were not found in the closest related sequences. The major cluster was supported by DENV-1 (originated in South America), with 42 autochthonous infections almost occurring in the eastern area of Rome, probably due to a single introduction followed by local sustained transmission. Seven DENV-1 subclusters have been identified by mutational and phylogenetic analysis. Structural analysis indicated changes whose meaning can be explained by the adaptation of the virus to human hosts and vectors and their interactions with antibodies and cell receptors.

Autochthonous dengue outbreak in Rome, Italy, in 2023

Dengue, traditionally confined to endemic regions, is now emerging in non-endemic areas, including Italy. This manuscript describes the 2023 Italian autochthonous dengue outbreak, reporting the clinical and demographic characteristics of 19 patients followed by the Fondazione Policlinico Universitario Gemelli IRCCS in Rome, Italy.

Will the Olympic flame spark dengue outbreaks during the Paris 2024 summer Olympic and Paralympic games?

The risk of dengue emergence in France this summer is likely and must be considered in preparedness planning. The risk could arise from international visitors but also French travellers returning from epidemic areas. The French preparedness and response plan and the importance of international surveillance after the Olympics are highlighted.

An easier life to come for mosquito researchers: field-testing across Italy supports VECTRACK system for automatic counting, identification and absolute density estimation of Aedes albopictus and Culex pipiens adults

BACKGROUND

Disease-vector mosquito monitoring is an essential prerequisite to optimize control interventions and evidence-based risk predictions. However, conventional entomological monitoring methods are labor- and time-consuming and do not allow high temporal/spatial resolution. In 2022, a novel system coupling an optical sensor with machine learning technologies (VECTRACK) proved effective in counting and identifying Aedes albopictus and Culex pipiens adult females and males. Here, we carried out the first extensive field evaluation of the VECTRACK system to assess: (i) whether the catching capacity of a commercial BG-Mosquitaire trap (BGM) for adult mosquito equipped with VECTRACK (BGM + VECT) was affected by the sensor; (ii) the accuracy of the VECTRACK algorithm in correctly classifying the target mosquito species genus and sex; (iii) Ae. albopictus capture rate of BGM with or without VECTRACK.

METHODS

The same experimental design was implemented in four areas in northern (Bergamo and Padua districts), central (Rome) and southern (Procida Island, Naples) Italy. In each area, three types of traps-one BGM, one BGM + VECT and the combination of four sticky traps (STs)-were rotated each 48 h in three different sites. Each sampling scheme was replicated three times/area. Collected mosquitoes were counted and identified by both the VECTRACK algorithm and operator-mediated morphological examination. The performance of the VECTRACK system was assessed by generalized linear mixed and linear regression models. Aedes albopictus capture rates of BGMs were calculated based on the known capture rate of ST.

RESULTS

A total of 3829 mosquitoes (90.2% Ae. albopictus) were captured in 18 collection-days/trap/site. BGM and BGM + VECT showed a similar performance in collecting target mosquitoes. Results show high correlation between visual and automatic identification methods (Spearman Ae. albopictus: females = 0.97; males = 0.89; P < 0.0001) and low count errors. Moreover, the results allowed quantifying the heterogeneous effectiveness associated with different trap types in collecting Ae. albopictus and predicting estimates of its absolute density.

CONCLUSIONS

Obtained results strongly support the VECTRACK system as a powerful tool for mosquito monitoring and research, and its applicability over a range of ecological conditions, accounting for its high potential for continuous monitoring with minimal human effort.

Primary Dengue and Long-Term Health Status in Madeira Island, Portugal: A Retrospective Questionnaire-Based Study

Dengue is among the most important mosquito-borne viral diseases worldwide. Although its acute manifestations are well known, little is known about the long-term impact of dengue on the population's health status. Madeira Island experienced a single outbreak of autochthonous dengue from September 2012 to March 2013. To extend our knowledge about the clinical impact of the outbreak on this naive population, we applied an online questionnaire to 168 adults diagnosed with dengue at the time to characterize retrospectively their symptoms during the infection and to identify long-term manifestations, possibly triggered by dengue. The most frequent symptoms during the clinical period, reported by more than three-quarters of our participants, were fever, myalgia, extreme tiredness, and headaches, whereas vomiting, pruritus, nausea, retro-orbital pain, and arthralgia occurred in 35% to 50% of participants. In the 8 years after dengue, 61.5% of participants reported at least one recurrent previously nonexistent symptom, the most frequent being headaches, abundant hair loss, extreme tiredness, arthralgia, and myalgia, experienced by 25% to 35% of participants. Nearly 20% of the participants with persistent symptoms reported the onset of chronic illness in the 4 years after dengue, most frequently ophthalmological and autoimmune diseases (5.6% each), versus only 2.2% of chronic disease onset in participants without persistent symptoms. Our results suggest that the occurrence of persistent symptoms after primary dengue might be more frequent than anticipated and may persist for several years, having an impact on the health status and well-being of a considerable proportion of the infected population.

An Update on the Entomology, Virology, Pathogenesis, and Epidemiology Status of West Nile and Dengue Viruses in Europe (2018-2023)

In recent decades, increases in temperature and tropical rainfall have facilitated the spread of mosquito species into temperate zones. Mosquitoes are vectors for many viruses, including West Nile virus (WNV) and dengue virus (DENV), and pose a serious threat to public health. This review covers most of the current knowledge on the mosquito species associated with the transmission of WNV and DENV and their geographical distribution and discusses the main vertebrate hosts involved in the cycles of WNV or DENV. It also describes virological and pathogenic aspects of WNV or DENV infection, including emerging concepts linking WNV and DENV to the reproductive system. Furthermore, it provides an epidemiological analysis of the human cases of WNV and DENV reported in Europe, from 1 January 2018 to 31 December 2023, with a particular focus on Italy. The first autochthonous cases of DENV infection, with the most likely vector being Aedes albopictus, have been observed in several European countries in recent years, with a high incidence in Italy in 2023. The lack of treatments and effective vaccines is a serious challenge. Currently, the primary strategy to prevent the spread of WNV and DENV infections in humans remains to limit the spread of mosquitoes.

Arthropod-Borne Viruses of Human and Animal Importance: Overwintering in Temperate Regions of Europe during an Era of Climate Change

The past three decades have seen an increasing number of emerging arthropod-borne viruses in temperate regions This process is ongoing, driven by human activities such as inter-continental travel, combined with the parallel emergence of invasive arthropods and an underlying change in climate that can increase the risk of virus transmission and persistence. In addition, natural events such as bird migration can introduce viruses to new regions. Despite the apparent regularity of virus emergence, arthropod-borne viruses circulating in temperate regions face the challenge of the late autumn and winter months where the arthropod vector is inactive. Viruses therefore need mechanisms to overwinter or they will fail to establish in temperate zones. Prolonged survival of arthropod-borne viruses within the environment, outside of both vertebrate host and arthropod vector, is not thought to occur and therefore is unlikely to contribute to overwintering in temperate zones. One potential mechanism is continued infection of a vertebrate host. However, infection is generally acute, with the host either dying or producing an effective immune response that rapidly clears the virus. There are few exceptions to this, although prolonged infection associated with orbiviruses such as bluetongue virus occurs in certain mammals, and viraemic vertebrate hosts therefore can, in certain circumstances, provide a route for long-term viral persistence in the absence of active vectors. Alternatively, a virus can persist in the arthropod vector as a mechanism for overwintering. However, this is entirely dependent on the ecology of the vector itself and can be influenced by changes in the climate during the winter months. This review considers the mechanisms for virus overwintering in several key arthropod vectors in temperate areas. We also consider how this will be influenced in a warming climate.

VectAbundance: a spatio-temporal database of Aedes mosquitoes observations

Modelling approaches play a crucial role in supporting local public health agencies by estimating and forecasting vector abundance and seasonality. However, the reliability of these models is contingent on the availability of standardized, high-quality data. Addressing this need, our study focuses on collecting and harmonizing egg count observations of the mosquito Aedes albopictus, obtained through ovitraps in monitoring and surveillance efforts across Albania, France, Italy, and Switzerland from 2010 to 2022. We processed the raw observations to obtain a continuous time series of ovitraps observations allowing for an extensive geographical and temporal coverage of Ae. albopictus population dynamics. The resulting post-processed observations are stored in the open-access database VectAbundance.This initiative addresses the critical need for accessible, high-quality data, enhancing the reliability of modelling efforts and bolstering public health preparedness.

Persistence and Variation of the Indirect Effects of COVID-19 Restrictions on the Spectrum of Notifiable Infectious Diseases in China: Analysis of National Surveillance Among Children and Adolescents From 2018 to 2021

BACKGROUND

Beyond the direct effect of COVID-19 infection on young people, the wider impact of the pandemic on other infectious diseases remains unknown.

OBJECTIVE

This study aims to assess changes in the incidence and mortality of 42 notifiable infectious diseases during the pandemic among children and adolescents in China, compared with prepandemic levels.

METHODS

The Notifiable Infectious Disease Surveillance System of China was used to detect new cases and fatalities among individuals aged 5-22 years across 42 notifiable infectious diseases spanning from 2018 to 2021. These infectious diseases were categorized into 5 groups: respiratory, gastrointestinal and enterovirus, sexually transmitted and blood-borne, zoonotic, and vector-borne diseases. Each year (2018-2021) was segmented into 4 phases: phase 1 (January 1-22), phase 2 (January 23-April 7), phase 3 (April 8-August 31), and phase 4 (September 1-December 31) according to the varying intensities of pandemic restrictive measures in 2020. Generalized linear models were applied to assess the change in the incidence and mortality within each disease category, using 2018 and 2019 as the reference.

RESULTS

A total of 4,898,260 incident cases and 3701 deaths were included. The overall incidence of notifiable infectious diseases decreased sharply during the first year of the COVID-19 pandemic (2020) compared with prepandemic levels (2018 and 2019), and then rebounded in 2021, particularly in South China. Across the past 4 years, the number of deaths steadily decreased. The incidence of diseases rebounded differentially by the pandemic phase. For instance, although seasonal influenza dominated respiratory diseases in 2019, it showed a substantial decline during the pandemic (percent change in phase 2 2020: 0.21, 95% CI 0.09-0.50), which persisted until 2021 (percent change in phase 4 2021: 1.02, 95% CI 0.74-1.41). The incidence of gastrointestinal and enterovirus diseases decreased by 33.6% during 2020 but rebounded by 56.9% in 2021, mainly driven by hand, foot, and mouth disease (percent change in phase 3 2021: 1.28, 95% CI 1.17-1.41) and infectious diarrhea (percent change in phase 3 2020: 1.22, 95% CI 1.17-1.28). Sexually transmitted and blood-borne diseases were restrained during the first year of 2021 but rebounded quickly in 2021, mainly driven by syphilis (percent change in phase 3 2020: 1.31, 95% CI 1.23-1.40) and gonorrhea (percent change in phase 3 2020: 1.10, 95% CI 1.05-1.16). Zoonotic diseases were not dampened by the pandemic but continued to increase across the study period, mainly due to brucellosis (percent change in phase 2 2020: 0.94, 95% CI 0.75-1.16). Vector-borne diseases showed a continuous decline during 2020, dominated by hemorrhagic fever (percent change in phase 2 2020: 0.68, 95% CI 0.53-0.87), but rebounded in 2021.

CONCLUSIONS

The COVID-19 pandemic was associated with a marked decline in notifiable infectious diseases in Chinese children and adolescents. These effects were not sustained, with evidence of a rebound to prepandemic levels by late 2021. To effectively address the postpandemic resurgence of infectious diseases in children and adolescents, it will be essential to maintain disease surveillance and strengthen the implementation of various initiatives. These include extending immunization programs, prioritizing the management of sexually transmitted infections, continuing feasible nonpharmaceutical intervention projects, and effectively managing imported infections.

Transcription factor B-H2 regulates CYP9J34 expression conveying deltamethrin resistance in Culex pipiens pallens

BACKGROUND

Mosquitoes are vectors of various diseases, posing significant health threats worldwide. Chemical pesticides, particularly pyrethroids like deltamethrin, are commonly used for mosquito control, but the emergence of resistant mosquito populations has become a concern. In the deltamethrin-resistant (DR) strain of Culex pipiens pallens, the highly expressed cytochrome P450 9 J34 (CYP9J34) gene is believed to play a role in resistance, yet the underlying mechanism remains unclear.

RESULTS

Quantitative polymerase chain reaction with reverse transcription (qRT-PCR) analysis revealed that the expression of CYP9J34 was 14.6-fold higher in DR strains than in deltamethrin-susceptible (DS) strains. The recombinant production of CYP9J34 protein of Cx. pipiens pallens showed that the protein could directly metabolize deltamethrin, yielding the major metabolite 4'-OH deltamethrin. Through dual luciferase reporter assays and RNA interference, the transcription factor homeobox protein B-H2-like (B-H2) was identified to modulate the expression of the CYP9J34 gene, contributing to mosquito resistance to deltamethrin.

CONCLUSIONS

Our findings demonstrate that the CYP9J34 protein could directly degrade deltamethrin, and the transcription factor B-H2 could regulate CYP9J34 expression, influencing the resistance of mosquitoes to deltamethrin. © 2023 Society of Chemical Industry.

The epidemiology of imported and locally acquired dengue in Australia, 2012-2022

BACKGROUND

Dengue is the most important arboviral disease globally and poses ongoing challenges for control including in non-endemic countries with competent mosquito vectors at risk of local transmission through imported cases. We examined recent epidemiological trends in imported and locally acquired dengue in Australia, where the Wolbachia mosquito population replacement method was implemented throughout dengue-prone areas of northern Queensland between 2011 and 2019.

METHODS

We analysed dengue cases reported to the Australian National Notifiable Disease Surveillance System between January 2012 and December 2022, and Australian traveller movement data.

RESULTS

Between 2012 and 2022, 13 343 dengue cases were reported in Australia (median 1466 annual cases); 12 568 cases (94.2%) were imported, 584 (4.4%) were locally acquired and 191 (1.4%) had no origin recorded. Locally acquired cases decreased from a peak in 2013 (n = 236) to zero in 2021-22. Annual incidence of imported dengue ranged from 8.29/100 000 (n = 917 cases) to 22.10/100 000 (n = 2203) annual traveller movements between 2012 and 2019, decreased in 2020 (6.74/100 000 traveller movements; n = 191) and 2021 (3.32/100 000 traveller movements; n = 10) during COVID-19-related border closures, then rose to 34.79/100 000 traveller movements (n = 504) in 2022. Imported cases were primarily acquired in Southeast Asia (n = 9323; 74%), Southern and Central Asia (n = 1555; 12%) and Oceania (n = 1341; 11%). Indonesia (n = 5778; 46%) and Thailand (n = 1483; 12%) were top acquisition countries. DENV-2 (n = 2147; 42%) and DENV-1 (n = 1526; 30%) were predominant serotypes.

CONCLUSION

Our analysis highlights Australia's successful control of locally acquired dengue with Wolbachia. Imported dengue trends reflect both Australian travel destinations and patterns and local epidemiology in endemic countries.

[Clinical Update on Diagnosis, Treatment and Prevention of Dengue]

Dengue is a vector-borne disease that has a significant impact on global public health. The vector mosquito belongs to the genus Aedes. Two species play a key role in human transmission: Ae. aegypti, which has adapted to the urban environment of highly populated areas in tropical and subtropical countries, leading to a dramatic increase in dengue cases over the years, and Ae. albopictus, which poses a potential threat to temperate climate countries due to its ability to adapt to colder climates. The disease is widespread across the world, posing a risk to nearly half of the world's population. Although most cases are asymptomatic, dengue causes a burden on healthcare systems and mainly affects the younger population. The disease is also spreading to temperate climate countries, thus becoming a global threat. Vector control measures and vaccine development have been the main prevention strategies, as there is still no effective treatment for the disease.

TV005 dengue vaccine protects against dengue serotypes 2 and 3 in two controlled human infection studies

BACKGROUNDDisease due to dengue viruses is a growing global health threat, causing 100-400 million cases annually. An ideal dengue vaccine should demonstrate durable protection against all 4 serotypes in phase III efficacy trials, however the lack of circulating serotypes may lead to incomplete efficacy data. Controlled human infection models help downselect vaccine candidates and supply critical data to supplement efficacy trials. We evaluated the efficacy of a leading live-attenuated tetravalent dengue vaccine candidate, TV005, against infection with a newly established dengue serotype 3 or an established serotype 2 challenge virus.METHODSTwo randomized, controlled clinical trials were performed. In study 1, a total of 42 participants received TV005 or placebo (n = 21 each), and 6 months later, all were challenged with dengue 2 virus (rDEN2Δ30) at a dose of 103 PFU. In study 2, a total of 23 participants received TV005 and 20 received placebo, and 6 months later, all were challenged with 104 PFU dengue 3 virus (rDEN3Δ30). The study participants were closely monitored for safety, viremia, and immunologic responses. Infection, measured by post-challenge viremia, and the occurrence of rash and neutropenia were the primary endpoints. Secondary endpoints included safety, immunologic, and virologic profiles following vaccination with TV005 and subsequent challenge with the rDEN2Δ30 or rDEN3Δ30 strain.RESULTSTV005 was well tolerated and protected all vaccinated volunteers from viremia with DENV2 or DENV3 (none infected in either group). Placebo recipients had post-challenge viremia (100% in study 1, 85% in study 2), and all experienced rash following challenge with either serotype.CONCLUSIONSTV005 is a leading tetravalent dengue vaccine candidate that fully protected against infection with DENV2 and DENV3 in an established controlled human infection model.TRIAL REGISTRATIONClinicalTrials.gov NCT02317900 and NCT02873260.FUNDINGIntramural Research Program, NIH (contract HHSN272200900010C).

A new dengue vaccine (TAK-003) now WHO recommended in endemic areas; what about travellers?

Qdenga (Takeda) is now WHO recommended for residents of highly endemic areas. Travellers from dengue non-endemic countries with previous travel-related dengue (any serotype) will benefit from TAK-003 vaccination to prevent a secondary dengue infection during future dengue risk travel. Dengue-naïve travellers have less potential benefit and use will remain discretionary for now.

Impact, healthcare utilization and costs of travel-associated mosquito-borne diseases in international travellers: a prospective study

BACKGROUND

International travellers frequently acquire infectious diseases whilst travelling, yet relatively little is known about the impact and economic burden of these illnesses on travellers. We conducted a prospective exploratory costing study on adult returning travellers with falciparum malaria, dengue, chikungunya or Zika virus.

METHODS

Patients were recruited in eight Travel and Tropical Medicine clinics between June 2016 and March 2020 upon travellers' first contact with the health system in their country of residence. The patients were presented with a structured 52-question self-administered questionnaire after full recovery to collect information on patients' healthcare utilization and out-of-pocket costs both in the destination and home country, and about income and other financial losses due to the illness.

RESULTS

A total of 134 patients participated in the study (malaria, 66; dengue, 51; chikungunya, 8; Zika virus, 9; all fully recovered; median age 40; range 18-72 years). Prior to travelling, 42% of patients reported procuring medical evacuation insurance. Across the four illnesses, only 7% of patients were hospitalized abroad compared with 61% at home. Similarly, 15% sought ambulatory services whilst abroad compared with 61% at home. The average direct out-of-pocket hospitalization cost in the destination country (USD $2236; range: $108-$5160) was higher than the direct out-of-pocket ambulatory cost in the destination country (USD $327; range: $0-$1560), the direct out-of-pocket hospitalization cost at home (USD $35; range: $0-$120) and the direct out-of-pocket ambulatory costs at home (US$45; range: $0-$192). Respondents with dengue or malaria lost a median of USD $570 (Interquartile range [IQR] 240-1140) and USD $240 (IQR 0-600), respectively, due to their illness, whilst those with chikungunya and Zika virus lost a median of USD $2400 (IQR 1200-3600) and USD $1500 (IQR 510-2625), respectively.

CONCLUSION

Travellers often incur significant costs due to travel-acquired diseases. Further research into the economic impact of these diseases on travellers should be conducted.

Travel vaccines-priorities determined by incidence and impact

BACKGROUND

Infectious disease epidemiology is continuously shifting. While travel has been disrupted by the COVID-19 pandemic and travel-related epidemiological research experienced a pause, further shifts in vaccine-preventable diseases (VPDs) relevant for travellers have occurred.

METHODS

We conducted a literature search on the epidemiology of travel-related VPD and synthesized data for each disease with a focus on symptomatic cases and on the impact of the respective infection among travellers, considering the hospitalization rate, disease sequela and case fatality rate. We present new data and revised best estimates on the burden of VPD relevant for decisions on priorities in travel vaccines.

RESULTS

COVID-19 has emerged to be a top travel-related risk and influenza remains high in the ranking with an estimated incidence at 1% per month of travel. Dengue is another commonly encountered infection among international travellers with estimated monthly incidence of 0.5-0.8% among non-immune exposed travellers; the hospitalized proportion was 10 and 22%, respectively, according to two recent publications. With recent yellow fever outbreaks particularly in Brazil, its estimated monthly incidence has risen to >0.1%. Meanwhile, improvements in hygiene and sanitation have led to some decrease in foodborne illnesses; however, hepatitis A monthly incidence remains substantial in most developing regions (0.001-0.01%) and typhoid remains particularly high in South Asia (>0.01%). Mpox, a newly emerged disease that demonstrated worldwide spread through mass gathering and travel, cannot be quantified regarding its travel-related risk.

CONCLUSION

The data summarized may provide a tool for travel health professionals to prioritize preventive strategies for their clients against VPD. Updated assessments on incidence and impact are ever more important since new vaccines with travel indications (e.g. dengue) have been licensed or are undergoing regulatory review.

Outbreaks of autochthonous Dengue in Lazio region, Italy, August to September 2023: preliminary investigation

Between August and September 2023, three distinct autochthonous dengue virus transmission events occurred in Lazio, Italy, with the main event in Rome. The events involved three different dengue serotypes. No link with previous imported cases was identified. Here we describe the epidemiological and phylogenetic analysis of the first autochthonous cases and the implemented control actions. The multiple transmission events call for a strengthening of the vector control strategies and future research to better characterise the risk in countries like Italy.

Antiviral Activity of Flavonoids from Geopropolis of the Brazilian Jandaira Bee against Zika and Dengue Viruses

Arthropod-borne viruses within the Flaviviridae family such as Zika (ZIKV) and dengue (DENV) are responsible for major outbreaks in tropical countries, and there are no specific treatments against them. Naringenin and 7-O-methyl naringenin are flavonoids that can be extracted from geopropolis, a natural material that the Brazilian Jandaira stingless bee (Melipona subnitida Ducke) produces to protect its nest. Here, these flavonoids were tested against ZIKV and DENV using Vero cells as a cellular model to perform a cytotoxicity assay and to define the effective concentrations of TCID50 as the readout method. The results demonstrated the antiviral activity of the compounds against both viruses upon the treatment of infected cells. The tested flavonoids had antiviral activity comparable with 6-methylmercaptopurine riboside (6-MMPr), used here as a positive control. In addition, to identify the possible action mechanism of the antiviral candidates, we carried out a docking analysis followed by a molecular dynamics simulation to elucidate naringenin and 7-O-methyl naringenin binding sites to each virus. Altogether, these results demonstrate that both flavonoids have potent antiviral effects against both viruses and warrant further in vivo trials.

Preliminary results on an autochthonous dengue outbreak in Lombardy Region, Italy, August 2023

In August 2023, six locally acquired dengue virus 1 infections were detected in Lodi province, Lombardy Region, in northern Italy, where the vector Aedes albopictus is present. Four cases were hospitalised, none died. The viruses clustered with Peruvian and Brazilian strains collected between 2021 and 2023. This preliminary report highlights the importance of continued integrated surveillance of imported vector-borne virus infections and the potential for tropical disease outbreaks in highly populated regions of northern Italy where competent vectors are present.

A modified BG-Sentinel trap equipped with FTA card as a novel tool for mosquito-borne disease surveillance: a field test for flavivirus detection

Early detection of pathogens in vectors is important in preventing the spread of arboviral diseases, providing a timely indicator of pathogen circulation before outbreaks occur. However, entomological surveillance may face logistical constraints, such as maintaining the cold chain, and resource limitations, such as the field and laboratory workload of mosquito processing. We propose an FTA card-based trapping system that aims to simplify both field and laboratory phases of arbovirus surveillance. We modified a BG-Sentinel trap to include a mosquito collection chamber and a sugar feeding source through an FTA card soaked in a long-lasting viscous solution of honey and hydroxy-cellulose hydrogel. The FTA card ensures environmental preservation of nucleic acids, allowing continuous collection and feeding activity of specimens for several days and reducing the effort required for viral detection. We tested the trap prototype during two field seasons (2019 and 2021) in North-eastern Italy and compared it to CDC-CO2 trapping applied in West Nile and Usutu virus regional surveillance. Collections by the BG-FTA approach detected high species diversity, including Culex pipiens, Aedes albopictus, Culex modestus, Anopheles maculipennis sensu lato and Ochlerotatus caspius. When used for two-days sampling, the BG-FTA trap performed equally to CDC also for the WNV-major vector Cx. pipiens. The FTA cards detected both WNV and USUV, confirming the reliability of this novel approach to detect viral circulation in infectious mosquitoes. We recommend this surveillance approach as a particularly useful alternative in multi-target surveillance, for sampling in remote areas and in contexts characterized by high mosquito densities and diversity.

VectorNet: collaborative mapping of arthropod disease vectors in Europe and surrounding areas since 2010

BackgroundArthropod vectors such as ticks, mosquitoes, sandflies and biting midges are of public and veterinary health significance because of the pathogens they can transmit. Understanding their distributions is a key means of assessing risk. VectorNet maps their distribution in the EU and surrounding areas.AimWe aim to describe the methodology underlying VectorNet maps, encourage standardisation and evaluate output.Methods: Vector distribution and surveillance activity data have been collected since 2010 from a combination of literature searches, field-survey data by entomologist volunteers via a network facilitated for each participating country and expert validation. Data were collated by VectorNet members and extensively validated during data entry and mapping processes.ResultsAs of 2021, the VectorNet archive consisted of ca 475,000 records relating to > 330 species. Maps for 42 species are routinely produced online at subnational administrative unit resolution. On VectorNet maps, there are relatively few areas where surveillance has been recorded but there are no distribution data. Comparison with other continental databases, namely the Global Biodiversity Information Facility and VectorBase show that VectorNet has 5-10 times as many records overall, although three species are better represented in the other databases. In addition, VectorNet maps show where species are absent. VectorNet's impact as assessed by citations (ca 60 per year) and web statistics (58,000 views) is substantial and its maps are widely used as reference material by professionals and the public.ConclusionVectorNet maps are the pre-eminent source of rigorously validated arthropod vector maps for Europe and its surrounding areas.

[Wolbachia pipientis infections in populations of Aedes albopictus in the city of València (Spain): implications for mosquito control.]

OBJECTIVE

The presence of Aedes albopictus, of high sanitary and social impact, was first reported in Valencia (Eastern Spain) in 2015. Innovative tools for its control include the use of the endosymbiotic bacterium Wolbachia pipientis. The release of mosquito males infected with the wPip strain, has proven very promising for large-scale Incompatible Insect Technique (IIT) applications. Before this strategy can be implemented in Valencia, it is important to know whether the natural local mosquito populations are Wolbachia-infected and, if so, identifying the infecting strains/supergroups, these being the objectives of the present work.

METHODS

Eggs were collected from the 19 districts of the València city between May and October 2019. A total of 50 lab-reared adult Ae. albopictus individuals were processed and analyzed for Wolbachia detection and molecular characterization. These actions took place within the framework of a collaboration established with the Department of Health and Consumer Affairs of the city council of Valencia. Fisher's exact test was used to detect the statistical significance of the differences between groups.

RESULTS

Our study revealed that 94% of the analyzed samples were naturally infected with Wolbachia. Both wAlbA and wAlbB supergroups were identified, with most samples (72% of the infected ones) carrying co-infections.

CONCLUSIONS

These data provide the first characterization of the Wolbachia presence in natural populations of Ae. albopictus in the Mediterranean area of Spain. This information is relevant to evaluate the potential use of Wolbachia strains in order to achieve the suppression of the Asian tiger mosquito populations through massive release of artificially-infected males.

Invasive mosquito vectors in Europe: From bioecology to surveillance and management

Invasive mosquitoes (Diptera: Culicidae) play a key role in the spread of a number of mosquito-borne diseases worldwide. Anthropogenic changes play a significant role in affecting their distribution. Invasive mosquitoes usually take advantage from biotic homogenization and biodiversity reduction, therefore expanding in their distribution range and abundance. In Europe, climate warming and increasing urbanization are boosting the spread of several mosquito species of high public health importance. The present article contains a literature review focused on the biology and ecology of Aedes albopictus, Ae. aegypti, Ae. japonicus japonicus, Ae. koreicus, Ae. atropalpus and Ae. triseriatus, outlining their distribution and public health relevance in Europe. Bioecology insights were tightly connected with vector surveillance and control programs targeting these species. In the final section, a research agenda aiming for the effective and sustainable monitoring and control of invasive mosquitoes in the framework of Integrated Vector Management and One Health is presented. The WHO Vector Control Advisory Group recommends priority should be given to vector control tools with proven epidemiological impact.

Human Arboviral Infections in Italy: Past, Current, and Future Challenges

Arboviruses represent a public health concern in many European countries, including Italy, mostly because they can infect humans, causing potentially severe emergent or re-emergent diseases, with epidemic outbreaks and the introduction of endemic circulation of new species previously confined to tropical and sub-tropical regions. In this review, we summarize the Italian epidemiology of arboviral infection over the past 10 years, describing both endemic and imported arboviral infections, vector distribution, and the influence of climate change on vector ecology. Strengthening surveillance systems at a national and international level is highly recommended to be prepared to face potential threats due to arbovirus diffusion.

dynamAedes: a unified modelling framework for invasive Aedes mosquitoes

Mosquito species belonging to the genus Aedes have attracted the interest of scientists and public health officers because of their capacity to transmit viruses that affect humans. Some of these species were brought outside their native range by means of trade and tourism and then colonised new regions thanks to a unique combination of eco-physiological traits. Considering mosquito physiological and behavioural traits to understand and predict their population dynamics is thus a crucial step in developing strategies to mitigate the local densities of invasive Aedes populations. Here, we synthesised the life cycle of four invasive Aedes species (Ae. aegypti, Ae. albopictus, Ae. japonicus and Ae. koreicus) in a single multi-scale stochastic modelling framework which we coded in the R package dynamAedes. We designed a stage-based and time-discrete stochastic model driven by temperature, photo-period and inter-specific larval competition that can be applied to three different spatial scales: punctual, local and regional. These spatial scales consider different degrees of spatial complexity and data availability by accounting for both active and passive dispersal of mosquito species as well as for the heterogeneity of the input temperature data. Our overarching aim was to provide a flexible, open-source and user-friendly tool rooted in the most updated knowledge on the species' biology which could be applied to the management of invasive Aedes populations as well as to more theoretical ecological inquiries.

Rapid spread of a new West Nile virus lineage 1 associated with increased risk of neuroinvasive disease during a large outbreak in northern Italy, 2022: One Health analysis

BACKGROUND

A new strain of WNV lineage 1 (WNV - 1) emerged in the Veneto Region, northern Italy, in 2021, eight years after the last outbreak of WNV - 1 in Italy. The virus, which co-circulates with WNV-2, has become endemic in the Region, where, in 2022, most human cases of neuroinvasive disease (WNND) reported in Europe have occurred.

METHODS

Comparative analysis of the epidemiology and clinical presentation of WNV-1 and WNV-2 infection in humans, as well as the temporal and geographic distribution of WNV-1 and WNV-2 among wild birds and Culex pipiens mosquitoes in Veneto, from May 16th to August 21st, 2022, to determine if the high number of WNND cases was associated with WNV-1.

RESULTS

As of August 21st, 2022, 222 human cases of WNV infection were confirmed by molecular testing, including 103 with fever (WNF) and 119 with WNND. WNV lineage was determined in 201 (90.5%) cases, comprising 138 WNV-1 and 63 WNV-2 infections. During the same period, 35 blood donors tested positive, including 30 in whom WNV lineage was determined (13 WNV-1 and 17 WNV-2). Comparative analysis of the distribution of WNV-1 and WNV-2 infections among WNND cases, WNF cases and WNV-positive blood donors showed that patients with WNND were more likely to have WNV-1 infection than blood donors (odds ratio 3.44; 95% CI 95% 1.54 to 8.24; p = 0.0043). As observed in humans, in wild birds WNV-1 had higher infectious rate (IR) and showed a more rapid expansion than WNV-2. At variance, the distribution of the two lineages was more even in mosquitoes, but with a trend of rapid increase of WNV-1 IR over WNV-2.

CONCLUSIONS

Comparative analysis of WNV-1 vs WNV-2 infection in humans, wild birds, and mosquitos showed a rapid expansion of WNV-1 and suggested that WNV-1 infected patients might have an increased risk to develop severe disease.

Efficacy Evaluation of Oregano Essential Oil Mixed with Bacillus thuringiensis israelensis and Diflubenzuron against Culex pipiens and Aedes albopictus in Road Drains of Italy

Mosquito management programs in the urban environment of Italian cities mainly rely on larval control with conventional insecticides, primarily targeting the road drains that constitute the principal mosquito breeding sites encountered in public. The repeated utilization of synthetic insecticides may have adverse effects on non-targets and lead to resistance development issues, while the performance of biopesticides encounters limitations in field use. Botanical insecticides as single larval control agents or in binary mixtures with conventional insecticides have been extensively studied in the laboratory as an effective and eco-friendly alternative mosquito control method with promising results. The study herein concerns the investigation, for the first time under realistic conditions in the field, of the joint action of a carvacrol-rich oregano Essential Oil (EO) with two conventional insecticides, namely, the insect growth regulator diflubenzuron and the bio-insecticide Bacillus thuringiensis israelensis (B.t.i.), in road drains in Crevalcore city, Italy, against Culex pipiens and Aedes albopictus. According to the obtained results, the application of both plain EO and its mixtures with diflubenzuron and B.t.i. exerted very high efficacy in terms of immature mosquito population reduction over a two-week period. Three weeks after treatment, the performance of the oil and its mixtures diminished but remained high, while the addition of diflubenzuron potentiated the persistent action of the oil against Cx. pipiens. These findings are indicative of the potential of mixing carvacrol-rich EO with diflubenzuron and B.t.i. as an efficient eco-friendly alternative to mono-insecticide applications in road drains against Cx. pipiens and Ae. albopictus larvae.

Dengue vaccine development: challenges and prospects

PURPOSE OF REVIEW

Dengue vaccine development is a high public health priority. To date, no dengue vaccine is in widespread use. Here we review the challenges in dengue development and the latest results for the second-generation dengue vaccines.

RECENT FINDINGS

The biggest hurdle is the immunological interaction between the four antigenically distinct dengue serotypes. The advantages of second-generation dengue vaccines are the inclusion of nonstructural proteins of the dengue backbone and a more convenient dosing with reduced numbers of doses needed.

SUMMARY

Although dengue-primed individuals can already benefit from vaccination with the first licensed dengue vaccine CYD-TDV, the public health need for the dengue-naive population has not yet been met. The urgent need remains to identify correlates of both protection and enhancement; until such correlates have been identified, all second-generation dengue vaccines still need to go through full phase 3 trials. The 5-year efficacy and safety data for both second-generation dengue vaccines are imminent.

First report of the blood-feeding pattern in Aedes koreicus, a new invasive species in Europe

Aedes koreicus is an invasive mosquito species which has been introduced into several European countries. Compared to other invasive Aedes mosquitoes, little is known of its biology and ecology. To determine Ae. koreicus’ vectorial capacity, it is essential to establish its feeding patterns and level of anthropophagy. We report on the blood-feeding patterns of Ae. koreicus, examining the blood meal origin of engorged females and evaluating the influence of different biotic and abiotic factors on feeding behavior. Mosquitoes were collected in 23 sites in northern Italy by manual aspiration and BG-sentinel traps; host availability was estimated by survey. The source of blood meals was identified using a nested PCR and by targeting and sequencing the cytochrome c oxidase subunit I gene. In total, 352 Ae. koreicus engorged females were collected between 2013 and 2020 and host blood meals were determined from 299 blood-fed mosquitoes (84.9%). Eleven host species were identified, with the highest prevalences being observed among roe deer (Capreolus capreolus) (N = 189, 63.2%) and humans (N = 46, 15.4%). Blood meals were mostly taken from roe deer in forested sites and from humans in urban areas, suggesting that this species can feed on different hosts according to local abundance. Two blood meals were identified from avian hosts and one from lizard. Ae. koreicus’ mammalophilic feeding pattern suggests that it may be a potential vector of pathogens establishing transmission cycles among mammals, whereas its role as a bridge vector between mammals and birds could be negligible.

Spatial and Temporal Distribution of Aedes aegypti and Aedes albopictus Oviposition on the Coast of Paraná, Brazil, a Recent Area of Dengue Virus Transmission

Aedes aegypti and Aedes albopictus are considered the most important vectors of arboviruses in the world. Aedes aegypti is the primary vector of dengue, urban yellow fever, chikungunya and zika in Brazil, and Ae. albopictus is considered a potential vector. Distribution patterns and the influence of climatic variables on the oviposition of Ae. aegypti and Ae. albopictus were evaluated in Morretes, a tourist city in the coastal area of Paraná State, Brazil, which has recently been experiencing cases of dengue fever. Eggs were collected using ovitraps over a period of one year (September 2017 to September 2018) and reared from hatching until the emergence of the adults. Both Aedes species were found in anthropized areas with a high human density index. Findings suggest that the monthly average temperature (LRT = 16.65, p = 0.001) had significant positive influences on the oviposition of the Aedes species. Considering the wide distribution of DENV around the Paraná coast and the presence of Ae. albopictus alongside Ae. aegypti, studies on natural arbovirus infection patterns and seasonality are recommended in the region.

New Zealand travellers to high-risk destinations for arbovirus infection make little effort to avoid mosquito bites

There has been no local transmission of arbovirus disease recorded in New Zealand to date. However, in the past two decades, there have been increasing numbers of overseas-acquired cases of arbovirus infections in New Zealand, mainly dengue, Zika, chikungunya and Ross River viruses. The repeated introduction of these viruses to the immunologically naïve New Zealand population through viraemic travellers represents a potential risk for local transmission by resident or new mosquito vectors. This study assessed the extent to which these imported arbovirus disease cases used the bite-avoidance measures recommended by the New Zealand Ministry of Health between 2001-2017. The majority of notified cases reported making little effort to avoid mosquito bites even during high-risk periods and outbreaks. This suggests that the infection of New Zealand travellers might be due to underestimation or unawareness of the risk of travel-related mosquito-borne diseases. New Zealand travellers to endemic or epidemic areas, mainly in the Asia-Pacific region, should be informed about ongoing risks according to season and epidemic activity at the destination and updated on the latest disease situation and new trends. This would reduce the likelihood of pathogen introduction and, therefore, local transmission of arbovirus infection in New Zealand.

Wolbachia in Aedes koreicus: Rare Detections and Possible Implications

The emerging distribution of new alien mosquito species was recently described in Europe. In addition to the invasion of Aedes albopictus, several studies have focused on monitoring and controlling other invasive Aedes species, as Aedes koreicus and Aedes japonicus. Considering the increasing development of insecticide resistance in Aedes mosquitoes, new control strategies, including the use of bacterial host symbionts, are proposed. However, little is known about the bacterial communities associated with these species, thus the identification of possible candidates for Symbiotic Control is currently limited. The characterization of the natural microbiota of field-collected Ae. koreicus mosquitoes from North-East Italy through PCR screening, identified native infections of Wolbachia in this species that is also largely colonized by Asaia bacteria. Since Asaia and Wolbachia are proposed as novel tools for Symbiotic Control, our study supports their use for innovative control strategies against new invasive species. Although the presence of Asaia was previously characterized in Ae. koreicus, our study characterized this Wolbachia strain, also inferring its phylogenetic position. The co-presence of Wolbachia and Asaia may provide additional information about microbial competition in mosquito, and to select suitable phenotypes for the suppression of pathogen transmission and for the manipulation of host reproduction in Ae. koreicus.

Dengue during the COVID-19 pandemic

Despite COVID-19-related disruptions in controlling dengue, efforts need to be maintained to prevent vector-borne diseases during this pandemic. Although travel restrictions brought a global halt to mobility and therefore also a substantial decline of imported and travel-associated dengue, dengue will become dominant again in travel medicine as soon as international travel resumes.