Arboviruses and Their Vectors

Significance of vertical transmission of arboviruses in mosquito-borne disease epidemiology

Mosquito-borne diseases (MBDs) are increasingly prevalent due to the resultant impact of global change with significant health and economic impacts worldwide. Dengue virus (DENV), chikungunya virus (CHIKV), Zika virus (ZIKV), yellow fever virus (YFV), Japanese encephalitis (JEV), and West Nile virus (WNV) transmitted by Aedes and Culex species have been identified as arboviruses of public health interest. The vertical transmission (VT) refers to the process where infected mosquitoes transmit viruses to their offspring; this has been often overlooked in MBD epidemiology. We conducted a systematic review to evaluate the role of VT in the occurrence, prevalence, and spread of MBDs, focusing on study types, mosquito species, and virus genera. In total, 73 studies from 2005 to 2024 relating to VT in the mosquito population were reviewed. Findings revealed the occurrence of VT across multiple mosquito species in natural and experimental settings, with significant variation in VT rates depending on vector species, virus genus, and study location. Aedes aegypti, Aedes albopictus, Aedes vexans, Culex pipiens, Culex tarsalis, and Culex quinquefasciatus were identified as mosquito species that support VT, while pathogens identified to be transmitted vertically were DENV, ZIKV, WNV, CHIKV, YFV, Sindbis virus (SINV), Ross River virus (RRV), and Mayaro virus (MAYV). VT rates were reported as minimum, and infection rate (MIR) varied across species, study type and location. Also, a high VT rate may precede a mosquito-borne disease outbreak. These findings indicate that VT, though often overlooked, contributes to the dynamics of MBD transmission and could influence disease outbreaks and endemism, especially under changing climatic conditions, highlighting the need for incorporating VT in mathematical models, experimental studies, and control strategies to understand dynamics of MBDs, given its potential role in sustaining arbovirus transmission and influencing outbreak dynamics.

Dermatological manifestations during Dengue, Chikungunya, and Zika infections

PURPOSE OF REVIEW

Arboviral infections caused by Dengue, Zika, and Chikungunya viruses continue to pose a significant global health threat, particularly in endemic regions. This review is timely because of the increasing prevalence of these infections, driven by factors such as urbanization and climate change. Dermatological manifestations of these viruses are crucial for early diagnosis, especially given the overlap in symptoms, which can complicate differential diagnosis.

RECENT FINDINGS

Recent studies emphasize the importance of mucocutaneous symptoms in diagnosing arboviral infections. In Dengue, distinctive rashes like the 'islands of white in a sea of red' and hemorrhagic skin manifestations have been key diagnostic features. Zika is marked by a pruritic maculopapular rash and nonpurulent conjunctivitis, whereas Chikungunya often results in persistent rashes, desquamation, and hyperpigmentation, particularly on the face. Emerging research highlights the skin's role as both a primary infection site and an immune mediator in these viral diseases, offering new insights into their pathophysiology and potential therapeutic targets.

SUMMARY

The unique dermatological profiles of Dengue, Zika, and Chikungunya are critical for guiding clinical diagnosis and treatment, especially in resource-limited settings. Understanding these cutaneous manifestations can improve early recognition, particularly in differentiating between these viruses in co-endemic areas. Future research may uncover novel therapeutic strategies by focusing on the interaction between these viruses and the skin's immune responses.

Characterization of the Temporal Dynamics of the Endothelial-Mesenchymal-like Transition Induced by Soluble Factors from Dengue Virus Infection in Microvascular Endothelial Cells

Dengue virus (DV) infection poses a severe life-threatening risk in certain cases. This is mainly due to endothelial dysregulation, which causes plasma leakage and hemorrhage. However, the etiology of DV-induced endothelial dysregulation remains incompletely understood. To identify the potential mechanisms of endothelial dysregulation caused by DV, the effects of conditioned media from Dengue virus (CMDV) on the mechanics and transcriptional profile of the endothelial cells were examined using permeability assays, atomic force microscopy, In-Cell Western blot and in silico transcriptomics. Exposure of HMEC-1 cells to the CMDV increased endothelial permeability and cellular stiffness. It also induced the expression of the key proteins associated with endothelial-to-mesenchymal transition (EndMT). These data support the notion that the DV promotes endothelial dysfunction by triggering transcriptional programs that compromise the endothelial barrier function. Understanding the molecular mechanisms underlying DV-induced endothelial dysregulation is crucial for developing targeted therapeutic strategies to mitigate the severe outcomes associated with dengue infection.

Larvicidal Efficacy of Chloris virgata Extracts Against Aedes aegypti, Anopheles stephensi, and Culex quinquefasciatus with Insights into Mode of Action via Molecular Docking

The indiscriminate use of synthetic insecticides for mosquito control has resulted in significant challenges, such as environmental pollution and growing insecticide resistance. In response, there is increasing interest in eco-friendly alternatives like plant-based larvicides. This study assesses the larvicidal efficacy of Chloris virgate (Poales: Poaceae) extracts against Aedes aegypti (Diptera: Culicidae), Culex quinquefasciatus (Diptera: Culicidae), and Anopheles stephensi (Diptera: Culicidae), and investigates the bioactive chemical compounds responsible for this activity. Soxhlet individual extraction was performed using n-hexane, chloroform, and ethanol, and methanol solvents are used separately to extract bioactive compounds from C. virgata. This approach allows for the selective extraction of specific compounds based on their solubility in each solvent. The extracts were tested on fourth instar larvae, and lethal concentrations (LC50 and LC90) were calculated via probit analysis. The methanol extract exhibited the lowest LC50 and LC90 values against Culex quinquefasciatus, with LC50 at 80.11 ppm and LC90 at 176.22 ppm, suggesting higher toxicity and effectiveness in larvicidal activity. Methanol extracts significantly affected mosquito larvae midguts, causing cytoplasmic thinning, muscle fiber disorganization, and brush border disruption. Gas chromatography-mass spectrometry (GC-MS) analysis identified major compounds such as stigmasterol, campesterol, and γ-sitosterol. Campesterol, 4.alpha.,14-Dimethyl-5.alpha, and Lanosterol showed strong binding affinities with acetylcholine esterase (5X61), exhibiting multiple hydrophobic interactions with key residues, including TRP 441, TYR 282, and CYS 447. Campesterol also displayed significant binding to Sterol Carrier Protein-2 (1PZ4) and Odorant-Binding Protein (3OGN) with several hydrophobic interactions, achieving binding affinities of - 10.1 kcal/mol and - 9.7 kcal/mol, respectively. This study highlights the potential of C. virgata methanol extracts as a promising eco-friendly larvicide for mosquito population management.

Machine learning for predicting severe dengue in Puerto Rico

BACKGROUND

Distinguishing between non-severe and severe dengue is crucial for timely intervention and reducing morbidity and mortality. World Health Organization (WHO)-recommended warning signs offer a practical approach for clinicians but have limited sensitivity and specificity. This study aims to evaluate machine learning (ML) model performance compared to WHO-recommended warning signs in predicting severe dengue among laboratory-confirmed cases in Puerto Rico.

METHODS

We analyzed data from Puerto Rico's Sentinel Enhanced Dengue Surveillance System (May 2012-August 2024), using 40 clinical, demographic, and laboratory variables. Nine ML models, including Decision Trees, K-Nearest Neighbors, Naïve Bayes, Support Vector Machines, Artificial Neural Networks, AdaBoost, CatBoost, LightGBM, and XGBoost, were trained using fivefold cross-validation and evaluated with area under the receiver operating characteristic curve (AUC-ROC), sensitivity, and specificity. A subanalysis excluded hemoconcentration and leukopenia to assess performance in resource-limited settings. An AUC-ROC value of 0.5 indicates no discriminative power, while values closer to 1.0 reflect better performance.

RESULTS

Among the 1708 laboratory-confirmed dengue cases, 24.3% were classified as severe. Gradient boosting algorithms achieved the highest predictive performance, with an AUC-ROC of 97.1% (95% CI: 96.0-98.3%) for CatBoost using the full 40-variable feature set. Feature importance analysis identified hemoconcentration (≥ 20% increase during illness or ≥ 20% above baseline for age and sex), leukopenia (white blood cell count < 4000/mm3), and timing of presentation at 4-6 days post-symptom onset as key predictors. When excluding hemoconcentration and leukopenia, the CatBoost AUC-ROC was 96.7% (95% CI: 95.5-98.0%), demonstrating minimal reduction in performance. Individual warning signs like abdominal pain and restlessness had sensitivities of 79.0% and 64.6%, but lower specificities of 48.4% and 59.1%, respectively. Combining ≥ 3 warning signs improved specificity (80.9%) while maintaining moderate sensitivity (78.6%), resulting in an AUC-ROC of 74.0%.

CONCLUSIONS

ML models, especially gradient boosting algorithms, outperformed traditional warning signs in predicting severe dengue. Integrating these models into clinical decision-support tools could help clinicians better identify high-risk patients, guiding timely interventions like hospitalization, closer monitoring, or the administration of intravenous fluids. The subanalysis excluding hemoconcentration confirmed the models' applicability in resource-limited settings, where access to laboratory data may be limited.

Low-density Lipoprotein Receptor is an important host factor in flaviviral entry and replication in neurons

Flaviviruses, which are transmitted by mosquitoes, are arthropod-borne infections that are pathogenic to both humans and animals, posing a significant global threat to public health. So far, various endocytic pathways have been reported for flaviviral entry; however, the role of cellular factors in viral replication and entry remains uncertain. Here in this study, we identified the role of Low-density lipoprotein receptor, which has long been established as a cholesterol carrier for neurons but remained unexplored as an essential host factor for JEV/WNV replication. To explore this, we utilized 10-day old BALB/c pups and two neuronal cell lines, NSC34 and HT22, both of different origin, as experimental models. Transient knockdown of LDLR gene in vitro using siRNA-mediated gene silencing drastically reduced viral specific transcripts and proteins upon viral incubation. Moreover, flaviviral binding and internalization were significantly compromised upon infection in LDLR-transfected cells when compared with non-specific eGFP-transfected cells. Antibody neutralization experiments using LDLR-specific polyclonal antibody significantly reduced viral entry in vitro, suggesting the role of LDLR as an important cell attachment factor for JEV and WNV uptake. Furthermore, ectopic expression of LDLR via plasmid transfection led to significant increase in virus replication in cells, indicating significant role of LDLR in flavivirus replication beside acting as an active attachment factor for JEV and WNV. Overall, our results indicate that LDLR act as novel host factor involved in both flaviviral entry and replication, thus serving as a suitable candidate for antiviral research.

Auto-Abs neutralizing type I IFNs in patients with severe Powassan, Usutu, or Ross River virus disease

Arboviral diseases are a growing global health concern. Pre-existing autoantibodies (auto-Abs) neutralizing type I interferons (IFNs) can underlie encephalitis due to West Nile virus (WNV) (∼40% of patients) and tick-borne encephalitis (TBE, due to TBE virus [TBEV]) (∼10%). We report here that these auto-Abs can also underlie severe forms of rarer arboviral infections. Auto-Abs neutralizing high concentrations of IFN-α2, IFN-β, and/or IFN-ω are present in the single case of severe Powassan virus (POWV) encephalitis studied, two of three cases of severe Usutu virus (USUV) infection studied, and the most severe of 24 cases of Ross River virus (RRV) disease studied. These auto-Abs are not found in any of the 137 individuals with silent or mild infections with these three viruses. Thus, auto-Abs neutralizing type I IFNs underlie an increasing list of severe arboviral diseases due to Flaviviridae (WNV, TBEV, POWV, USUV) or Togaviridae (RRV) viruses transmitted to humans by mosquitos (WNV, USUV, RRV) or ticks (TBEV, POWV).

A comprehensive seroepidemiology of dengue and chikungunya arboviruses in Iran, 2020-2023

AIM

Dengue virus (DENV) and Chikungunya virus (CHIKV) are the most common arthropod-borne viruses (Arboviruses) globally. So far, no autochthonous cases of DENV and CHIKV infections have been reported in Iran. Nevertheless, due to the recent identification of Aedes aegypti in the south and Aedes albopictus in the north of Iran, the country is at a serious risk of local outbreaks of these infections.

METHODS

Between 2020 and 2023, a comprehensive cross-sectional study was conducted to explore the anti-DENV and CHIKV IgG antibodies in the general populations of both southern and northern regions of Iran using ELISA.

RESULTS

A total of 11,192 participants were included, of whom 2.3% (256 individuals) and 0.1% (11 cases) were DENV seropositive and CHIK seropositive, respectively. Across the eight examined provinces, Sistan and Baluchestan province displayed the highest prevalence of dengue seropositive cases (6.80%) (P < 0.001). Samples collected in 2022 demonstrated a notably higher seropositive rate of 5.5% (P < 0.001). Interestingly, all 11 CHIKV seropositive cases were from Sistan and Baluchestan province.

CONCLUSION

The seroprevalence of DENV was notably higher in southern regions, particularly in Sistan and Baluchestan province and CHIKV seropositive cases were exclusively found in Sistan and Baluchestan province. This study furnishes crucial insights into the seroepidemiology of DENV and CHIKV in Iran, which in conjunction with the presence of Ae. aegypti in the south and Ae. albopictus in the north of Iran, emphasizes the requirement of improving integrated surveillance and control systems in the whole of the country, especially in the south of Iran.

Prevalence of dengue, Zika, and chikungunya virus infections among mosquitoes in Asia: A systematic review and meta-analysis

BACKGROUND

Dengue virus (DENV), Zika virus (ZIKV), and chikungunya virus (CHIKV) continue to pose significant public health risks. This study aims to assess the prevalence of these arbovirus infections in field-caught mosquitoes across Asia.

METHODS

Studies published after the year 2000 on DENV, ZIKV, and/or CHIKV infections in Asian mosquitoes were identified from Embase, Scopus, PubMed, and Ovid. A random-effects model estimated the pooled prevalence, defined as the overall prevalence from included studies, adjusted for variability among the studies. Meta-regression models were used to evaluate the association between predictors and their prevalence.

RESULTS

A total of 2529 articles were retrieved; 57 met the inclusion criteria. Pooled prevalence of DENV, ZIKV, and CHIKV infections in Asian mosquitoes were 5.85%, 2.15%, and 1.26%, respectively. Subgroup analysis revealed varying DENV prevalence across regions: East Asia (3.32%), South Asia (5.26%), and Southeast Asia (6.92%). Univariate regression analysis demonstrated significant associations between mosquito capture site and DENV prevalence (P < 0.001), and between study region and ZIKV prevalence (P = 0.005). However, no significant predictors were identified for CHIKV prevalence.

CONCLUSION

Our findings provide reference pooled summary estimates of arbovirus infections in mosquitoes, offering crucial insight into the regional disease burden and - guidance in the development and implementation of arbovirus surveillance in mosquitoes.

High-Sensitivity RT-LAMP for Molecular Detection of O'nyong-nyong (Alphavirus onyong)

Mosquitoes serve as vectors for many arthropod-borne viruses (arboviruses) that are responsible for millions of human infections and thousands of deaths each year. Among these arboviruses, O'nyong-nyong virus (ONNV) is an African alphavirus mainly transmitted by Anopheles mosquitoes. ONNV can be detected through serological or molecular tests, the first showing cross-reactivity to co-circulating alphaviruses and requiring technically demanding confirmation, while the latter, usually based on real-time PCR, are costly and demand specific equipment. Isothermal amplification approaches, such as Loop-Mediated Isothermal Amplification (LAMP), should therefore provide a cost-effective, sensitive, and specific alternative for virus detection, suitable for the resource-limited regions where ONNV circulates up to the present time. Here, we describe the development and optimization of a rapid and highly sensitive (10 pfu/reaction) RT-LAMP assay for ONNV detection. Additionally, we demonstrate that it is possible to bypass the RNA extraction step, reducing sample handling time and costs. The final RT-LAMPONNV is a promising field detection tool for ONNV, enabling a better understanding of its impact and serving as a point-of-care diagnostic method.

Invasive brown algae (Sargassum spp.) as a potential source of biocontrol against Aedes aegypti

Influxes of sargassos are responsible for economic and environmental disasters in areas where they bloom, especially in regions whose main income relies on tourism and with limited capacity for sanitation and public health response. A promising way of valorization would be to convert this incredible biomass into tools to fight the deadly vector mosquito Aedes aegypti. In the present study, we generated hydrolates and aqueous extracts from three main Sargassum morphotypes identified in Guadeloupe (French West Indies): Sargassum natans VIII, Sargassum natans I and Sargassum fluitans. We conducted a chemical characterization and a holistic evaluation of their potential to induce toxic and behavioral effects in Ae. aegypti. Despite the low insecticidal potential observed for all the extracts, we found that S. natans VIII and S. fluitans hydrolates deterred oviposition, induced contact irritancy and stimulated blood feeding behavior in host seeking Ae. aegypti females, while aqueous extracts from S. natans I and S. fluitans deterred both blood feeding behavior and oviposition. Chemical characterization evidenced the presence of phenylpropanoid, polyphenols, amino acids and esters. Thus, Sargassum spp. aqueous extracts and hydrolates could be used to manipulate Ae. aegypti behavior and be valorized as control tools against this mosquito.

Antibodies against medically relevant arthropod-borne viruses in the ubiquitous African rodent Mastomys natalensis

Over the past decades, the number of arthropod-borne virus (arbovirus) outbreaks has increased worldwide. Knowledge regarding the sylvatic cycle (i.e., non-human hosts/environment) of arboviruses is limited, particularly in Africa, and the main hosts for virus maintenance are unknown. Previous studies have shown the presence of antibodies against certain arboviruses (i.e., chikungunya-, dengue-, and Zika virus) in African non-human primates and bats. We hypothesize that small mammals, specifically rodents, may function as amplifying hosts in anthropogenic environments. The detection of RNA of most arboviruses is complicated by the viruses' short viremic period within their hosts. An alternative to determine arbovirus hosts is by detecting antibodies, which can persist several months. Therefore, we developed a high-throughput multiplex immunoassay to detect antibodies against 15 medically relevant arboviruses. We used this assay to assess approximately 1,300 blood samples of the multimammate mouse, Mastomys natalensis from Tanzania. In 24% of the samples, we detected antibodies against at least one of the tested arboviruses, with high seroprevalences of antibodies reacting against dengue virus serotype one (7.6%) and two (8.4%), and chikungunya virus (6%). Seroprevalence was higher in females and increased with age, which could be explained by inherent immunity and behavioral differences between sexes, and the increased chance of exposure to an arbovirus with age. We evaluated whether antibodies against multiple arboviruses co-occur more often than randomly and found that this may be true for some members of the Flaviviridae and Togaviridae. In conclusion, the development of an assay against a wide diversity of medically relevant arboviruses enabled the analysis of a large sample collection of one of the most abundant African small mammals. Our findings highlight that Mastomys natalensis is involved in the transmission cycle of multiple arboviruses and provide a solid foundation to better understand the role of this ubiquitous rodent in arbovirus outbreaks.

Inhibitors of the Structural and Nonstructural Proteins of Alphaviruses

The Alphavirus genus includes viruses that cause encephalitis due to neuroinvasion and viruses that cause arthritis due to acute and chronic inflammation. There is no approved therapeutic for alphavirus infections, but significant efforts are ongoing, more so in recent years, to develop vaccines and therapeutics for alphavirus infections. This review article highlights some of the major advances made so far to identify small molecules that can selectively target the structural and the nonstructural proteins in alphaviruses with the expectation that persistent investigation of an increasingly expanding chemical space through a variety of structure-based design and high-throughput screening strategies will yield candidate drugs for clinical studies. While most of the works discussed are still in the early discovery to lead optimization stages, promising avenues remain for drug development against this family of viruses.

Characterization of the fragmentation mechanisms in electrospray ionization tandem mass spectrometry of chloroquinoline derivatives with larvicidal activity against Aedes aegypti

RATIONALE

4,7-Dichloroquinoline (DCQ) represents a group of synthetic molecules inspired by natural products with important roles in biological and biomedical areas. This work aimed to characterize DCQ and its derivatives by high-resolution electrospray ionization (ESI) mass spectrometry and tandem mass spectrometry (ESI-MS/MS), supported by theoretical calculations. Biological assays were carried out with DCQ and its derivatives to determine LC50 values against Aedes aegypti larvae.

METHODS

Five DCQ derivatives were synthesized by using previously described protocols. ESI-MS/MS analyses were carried out with a quadrupole/time-of-flight and ion-trap instrument. The proposed gas-phase protonation sites and fragmentation were supported by density functional theory calculations. The larvicidal tests were performed with the Ae. aegypti Rockefeller strain, and the LC50 values were determined by employing five test concentrations. Larval mortality was determined after treatment for 48 h.

RESULTS

DCQ bromides or aldehydes (C-3 or C-8 positions), as well as the trimethylsilyl derivative (C-3 position), were prepared. Detailed ESI-MS/MS data revealed heteroatom elimination through an exception to the even-electron rule, to originate open-shell species. Computational studies were used to define the protonation sites and fragmentation pathways. High activity of DCQ and its derivatives against Ae. aegypti larvae was demonstrated.

CONCLUSION

Our results provided a well-founded characterization of the fragmentation reactions of DCQ and its derivatives, which can be useful for complementary studies of the development of a larvicidal product against Ae. aegypti.

Ingrained: Rice farming and the risk of zoonotic spillover, examples from Cambodia

Rice cultivation in Southeast Asia is a One Health interface intersecting human, animal, and environmental health. This complexity creates a potential for zoonotic transmission between diverse reservoirs. Bats harbor viruses like Nipah; mosquitoes transmit arboviruses; rodents spread hantaviruses. Domestic animals- including pigs with influenza and dogs with rabies and aquatic animals can also transmit pathogens. Climate change and urbanization may further disrupt rice agro-ecologies. This paper explores animal viral reservoirs, vectors, and historical practices associated with risk in rice farming. Climate and land use changes could enhance spillover. Solutions are proposed, including surveillance of animals, vectors, water, and air to detect threats before major outbreaks, such as improved biosecurity, hygiene, and livestock vaccinations. Ecological viral surveillance and agricultural interventions together can reduce zoonotic transmission from rice farming.

Sentinel Enhanced Dengue Surveillance System - Puerto Rico, 2012-2022

Problem/Condition

Dengue is the most prevalent mosquitoborne viral illness worldwide and is endemic in Puerto Rico. Dengue's clinical spectrum can range from mild, undifferentiated febrile illness to hemorrhagic manifestations, shock, multiorgan failure, and death in severe cases. The disease presentation is nonspecific; therefore, various other illnesses (e.g., arboviral and respiratory pathogens) can cause similar clinical symptoms. Enhanced surveillance is necessary to determine disease prevalence, to characterize the epidemiology of severe disease, and to evaluate diagnostic and treatment practices to improve patient outcomes. The Sentinel Enhanced Dengue Surveillance System (SEDSS) was established to monitor trends of dengue and dengue-like acute febrile illnesses (AFIs), characterize the clinical course of disease, and serve as an early warning system for viral infections with epidemic potential.

Reporting Period

May 2012-December 2022.

Description of System

SEDSS conducts enhanced surveillance for dengue and other relevant AFIs in Puerto Rico. This report includes aggregated data collected from May 2012 through December 2022. SEDSS was launched in May 2012 with patients with AFIs from five health care facilities enrolled. The facilities included two emergency departments in tertiary acute care hospitals in the San Juan-Caguas-Guaynabo metropolitan area and Ponce, two secondary acute care hospitals in Carolina and Guayama, and one outpatient acute care clinic in Ponce. Patients arriving at any SEDSS site were eligible for enrollment if they reported having fever within the past 7 days. During the Zika epidemic (June 2016-June 2018), patients were eligible for enrollment if they had either rash and conjunctivitis, rash and arthralgia, or fever. Eligibility was expanded in April 2020 to include reported cough or shortness of breath within the past 14 days. Blood, urine, nasopharyngeal, and oropharyngeal specimens were collected at enrollment from all participants who consented. Diagnostic testing for dengue virus (DENV) serotypes 1-4, chikungunya virus, Zika virus, influenza A and B viruses, SARS-CoV-2, and five other respiratory viruses was performed by the CDC laboratory in San Juan.

Results

During May 2012-December 2022, a total of 43,608 participants with diagnosed AFI were enrolled in SEDSS; a majority of participants (45.0%) were from Ponce. During the surveillance period, there were 1,432 confirmed or probable cases of dengue, 2,293 confirmed or probable cases of chikungunya, and 1,918 confirmed or probable cases of Zika. The epidemic curves of the three arboviruses indicate dengue is endemic; outbreaks of chikungunya and Zika were sporadic, with case counts peaking in late 2014 and 2016, respectively. The majority of commonly identified respiratory pathogens were influenza A virus (3,756), SARS-CoV-2 (1,586), human adenovirus (1,550), respiratory syncytial virus (1,489), influenza B virus (1,430), and human parainfluenza virus type 1 or 3 (1,401). A total of 5,502 participants had confirmed or probable arbovirus infection, 11,922 had confirmed respiratory virus infection, and 26,503 had AFI without any of the arboviruses or respiratory viruses examined.

Interpretation

Dengue is endemic in Puerto Rico; however, incidence rates varied widely during the reporting period, with the last notable outbreak occurring during 2012-2013. DENV-1 was the predominant virus during the surveillance period; sporadic cases of DENV-4 also were reported. Puerto Rico experienced large outbreaks of chikungunya that peaked in 2014 and of Zika that peaked in 2016; few cases of both viruses have been reported since. Influenza A and respiratory syncytial virus seasonality patterns are distinct, with respiratory syncytial virus incidence typically reaching its annual peak a few weeks before influenza A. The emergence of SARS-CoV-2 led to a reduction in the circulation of other acute respiratory viruses.

Public Health Action

SEDSS is the only site-based enhanced surveillance system designed to gather information on AFI cases in Puerto Rico. This report illustrates that SEDSS can be adapted to detect dengue, Zika, chikungunya, COVID-19, and influenza outbreaks, along with other seasonal acute respiratory viruses, underscoring the importance of recognizing signs and symptoms of relevant diseases and understanding transmission dynamics among these viruses. This report also describes fluctuations in disease incidence, highlighting the value of active surveillance, testing for a panel of acute respiratory viruses, and the importance of flexible and responsive surveillance systems in addressing evolving public health challenges. Various vector control strategies and vaccines are being considered or implemented in Puerto Rico, and data from ongoing trials and SEDSS might be integrated to better understand epidemiologic factors underlying transmission and risk mitigation approaches. Data from SEDSS might guide sampling strategies and implementation of future trials to prevent arbovirus transmission, particularly during the expansion of SEDSS throughout the island to improve geographic representation.

Exploiting bacterial effector proteins to uncover evolutionarily conserved antiviral host machinery

Arboviruses are a diverse group of insect-transmitted pathogens that pose global public health challenges. Identifying evolutionarily conserved host factors that combat arbovirus replication in disparate eukaryotic hosts is important as they may tip the balance between productive and abortive viral replication, and thus determine virus host range. Here, we exploit naturally abortive arbovirus infections that we identified in lepidopteran cells and use bacterial effector proteins to uncover host factors restricting arbovirus replication. Bacterial effectors are proteins secreted by pathogenic bacteria into eukaryotic hosts cells that can inhibit antimicrobial defenses. Since bacteria and viruses can encounter common host defenses, we hypothesized that some bacterial effectors may inhibit host factors that restrict arbovirus replication in lepidopteran cells. Thus, we used bacterial effectors as molecular tools to identify host factors that restrict four distinct arboviruses in lepidopteran cells. By screening 210 effectors encoded by seven different bacterial pathogens, we identify several effectors that individually rescue the replication of all four arboviruses. We show that these effectors encode diverse enzymatic activities that are required to break arbovirus restriction. We further characterize Shigella flexneri-encoded IpaH4 as an E3 ubiquitin ligase that directly ubiquitinates two evolutionarily conserved proteins, SHOC2 and PSMC1, promoting their degradation in insect and human cells. We show that depletion of either SHOC2 or PSMC1 in insect or human cells promotes arbovirus replication, indicating that these are ancient virus restriction factors conserved across invertebrate and vertebrate hosts. Collectively, our study reveals a novel pathogen-guided approach to identify conserved antimicrobial machinery, new effector functions, and conserved roles for SHOC2 and PSMC1 in virus restriction.

An optical system to detect, surveil, and kill flying insect vectors of human and crop pathogens

Sustainable and effective means to control flying insect vectors are critically needed, especially with widespread insecticide resistance and global climate change. Understanding and controlling vectors requires accurate information about their movement and activity, which is often lacking. The Photonic Fence (PF) is an optical system that uses machine vision, infrared light, and lasers to identify, track, and interdict vectors in flight. The PF examines an insect's outline, flight speed, and other flight parameters and if these match those of a targeted vector species, then a low-power, retina-safe laser kills it. We report on proof-of-concept tests of a large, field-sized PF (30 mL × 3 mH) conducted with Aedes aegypti, a mosquito that transmits dangerous arboviruses, and Diaphorina citri, a psyllid which transmits the fatal huanglongbing disease of citrus. In tests with the laser engaged, < 1% and 3% of A. aegypti and D. citri, respectfully, were recovered versus a 38% and 19% recovery when the lacer was silenced. The PF tracked, but did not intercept the orchid bee, Euglossa dilemma. The system effectively intercepted flying vectors, but not bees, at a distance of 30 m, heralding the use of photonic energy, rather than chemicals, to control flying vectors.

Beyond schistosomiasis: unraveling co-infections and altered immunity

Schistosomiasis is a neglected tropical disease caused by the helminth Schistosoma spp. and has the second highest global impact of all parasites. Schistosoma are transmitted through contact with contaminated fresh water predominantly in Africa, Asia, the Middle East, and South America. Due to the widespread prevalence of Schistosoma, co-infection with other infectious agents is common but often poorly described. Herein, we review recent literature describing the impact of Schistosoma co-infection between species and Schistosoma co-infection with blood-borne protozoa, soil-transmitted helminths, various intestinal protozoa, Mycobacterium, Salmonella, various urinary tract infection-causing agents, and viral pathogens. In each case, disease severity and, of particular interest, the immune landscape, are altered as a consequence of co-infection. Understanding the impact of schistosomiasis co-infections will be important when considering treatment strategies and vaccine development moving forward.

Clinical manifestations of dengue, Zika and chikungunya in the Pacific Islands: A systematic review and meta-analysis

Dengue, Zika and chikungunya outbreaks pose a significant public health risk to Pacific Island communities. Differential diagnosis is challenging due to overlapping clinical features and limited availability of laboratory diagnostic facilities. There is also insufficient information regarding the complications of these arboviruses, particularly for Zika and chikungunya. We conducted a systematic review and meta-analysis to calculate pooled prevalence estimates with 95% confidence intervals (CI) for the clinical manifestations of dengue, Zika and chikungunya in the Pacific Islands. Based on pooled prevalence estimates, clinical features that may help to differentiate between the arboviruses include headache, haemorrhage and hepatomegaly in dengue; rash, conjunctivitis and peripheral oedema in Zika; and the combination of fever and arthralgia in chikungunya infections. We estimated that the hospitalisation and mortality rates in dengue were 9.90% (95% CI 7.67-12.37) and 0.23% (95% CI 0.16-0.31), respectively. Severe forms of dengue occurred in 1.92% (95% CI 0.72-3.63) of reported cases and 23.23% (95% CI 13.58-34.53) of hospitalised patients. Complications associated with Zika virus included Guillain-Barré syndrome (GBS), estimated to occur in 14.08 (95% CI 11.71-16.66) per 10,000 reported cases, and congenital brain malformations such as microcephaly, particularly with first trimester maternal infection. For chikungunya, the hospitalisation rate was 2.57% (95% CI 1.30-4.25) and the risk of GBS was estimated at 1.70 (95% CI 1.06-2.48) per 10,000 reported cases. Whilst ongoing research is required, this systematic review enhances existing knowledge on the clinical manifestations of dengue, Zika and chikungunya infections and will assist Pacific Island clinicians during future arbovirus outbreaks.

Exploiting Bacterial Effector Proteins to Uncover Evolutionarily Conserved Antiviral Host Machinery

Arboviruses are a diverse group of insect-transmitted pathogens that pose global public health challenges. Identifying evolutionarily conserved host factors that combat arbovirus replication in disparate eukaryotic hosts is important as they may tip the balance between productive and abortive viral replication, and thus determine virus host range. Here, we exploit naturally abortive arbovirus infections that we identified in lepidopteran cells and use bacterial effector proteins to uncover host factors restricting arbovirus replication. Bacterial effectors are proteins secreted by pathogenic bacteria into eukaryotic hosts cells that can inhibit antimicrobial defenses. Since bacteria and viruses can encounter common host defenses, we hypothesized that some bacterial effectors may inhibit host factors that restrict arbovirus replication in lepidopteran cells. Thus, we used bacterial effectors as molecular tools to identify host factors that restrict four distinct arboviruses in lepidopteran cells. By screening 210 effectors encoded by seven different bacterial pathogens, we identify six effectors that individually rescue the replication of all four arboviruses. We show that these effectors encode diverse enzymatic activities that are required to break arbovirus restriction. We further characterize Shigella flexneri-encoded IpaH4 as an E3 ubiquitin ligase that directly ubiquitinates two evolutionarily conserved proteins, SHOC2 and PSMC1, promoting their degradation in insect and human cells. We show that depletion of either SHOC2 or PSMC1 in insect or human cells promotes arbovirus replication, indicating that these are ancient virus restriction factors conserved across invertebrate and vertebrate hosts. Collectively, our study reveals a novel pathogen-guided approach to identify conserved antimicrobial machinery, new effector functions, and conserved roles for SHOC2 and PSMC1 in virus restriction.

Mosquito-Borne Arboviruses Occurrence and Distribution in the Last Three Decades in Central Africa: A Systematic Literature Review

Arboviruses represent a real public health problem globally and in the Central African subregion in particular, which represents a high-risk zone for the emergence and re-emergence of arbovirus outbreaks. Furthermore, an updated review on the current arbovirus burden and associated mosquito vectors is lacking for this region. To contribute to filling this knowledge gap, the current study was designed with the following objectives: (i) to systematically review data on the occurrence and distribution of arboviruses and mosquito fauna; and (ii) to identify potential spillover mosquito species in the Central African region in the last 30 years. A web search enabled the documentation of 2454 articles from different online databases. The preferred reporting items for systematic reviews and meta-analyses (PRISMA) and the quality of reporting of meta-analyses (QUORUM) steps for a systematic review enabled the selection of 164 articles that fulfilled our selection criteria. Of the six arboviruses (dengue virus (DENV), chikungunya virus (CHIKV), yellow fever virus (YFV), Zika virus (ZIKV), Rift Valley fever virus (RVFV), and West Nile virus (WNV)) of public health concern studied, the most frequently reported were chikungunya and dengue. The entomological records showed >248 species of mosquitoes regrouped under 15 genera, with Anopheles (n = 100 species), Culex (n = 56 species), and Aedes (n = 52 species) having high species diversity. Three genera were rarely represented, with only one species included, namely, Orthopodomyia, Lutzia, and Verrallina, but individuals of the genera Toxorhinchites and Finlayas were not identified at the species level. We found that two Aedes species (Ae. aegypti and Ae. albopictus) colonised the same microhabitat and were involved in major epidemics of the six medically important arboviruses, and other less-frequently identified mosquito genera consisted of competent species and were associated with outbreaks of medical and zoonotic arboviruses. The present study reveals a high species richness of competent mosquito vectors that could lead to the spillover of medically important arboviruses in the region. Although epidemiological studies were found, they were not regularly documented, and this also applies to vector competence and transmission studies. Future studies will consider unpublished information in dissertations and technical reports from different countries to allow their information to be more consistent. A regional project, entitled "Ecology of Arboviruses" (EcoVir), is underway in three countries (Gabon, Benin, and Cote d'Ivoire) to generate a more comprehensive epidemiological and entomological data on this topic.

Genome sequences of Phasi Charoen-like phasivirus and Fako virus from Aedes aegypti mosquitoes collected in coastal Kenya

We report the sequencing of two viruses, Phasi Charoen-like phasivirus (PCLV) and Fako virus (FAKV), which were detected in a pool of Aedes aegypti from Kenya. Analysis showed a high similarity of PCLV to publicly available PCLV genomes from Kenya. FAKV showed a high genetic divergence from publicly available FAKV genomes.

Health professionals' knowledge on dengue and health facility preparedness for case detection: A cross-sectional study in Dar es Salaam, Tanzania

Dengue presents a growing public health concern in the Dar es Salaam region of Tanzania, marked by the recurring incidence of outbreaks. Unfortunately, there is little information available on the region's preparedness in terms of health care workers' knowledge on dengue as well as the availability of reagents and equipment essential for diagnosing and monitoring of dengue infections. To elucidate this, 78 health facilities were visited in Temeke district and structured questionnaires were distributed to 324 health care workers. The aim was to evaluate health care workers' knowledge on dengue and to assess the availability of reagents and equipment essential for diagnosing and monitoring of dengue infections. Content validity of the questionnaire was achieved through extensive literature review and it exhibited high reliability (Cronbach Alpha coefficient = 0.813). Cumulative scores for responses on knowledge questions by health care workers were computed. Characteristics such as level of education, place of work and gender were tested for association with these scores using chi-square tests and logistics regression. Almost all health care workers (99.7%) were aware of dengue disease. However, less than half (46.9%) had knowledge scores of or over 40%. Clinicians had approximately four times higher knowledge scores than other cadres (AOR, 3.637; p-value≤ 0.0001), and those who worked in private facilities had twice the knowledge score than those working in government institutions (AOR, 2.071; p-value = 0.007). Only 8.6%, 35.6% and 14.7% of respondents reported the availability of dengue rapid tests, medical guidelines and refresher training respectively, showing a lack of health facilities readiness for the detection of dengue infections. Based on findings from this study, we recommend government authorities to build capacity of health care workers, to improve their understanding of dengue. We also urge the government and stakeholders to work together to ensure availability of diagnostic tests and other tools needed for diagnosis and surveillance of dengue.

Latest Advances in Arbovirus Diagnostics

Arboviruses are a diverse family of vector-borne pathogens that include members of the Flaviviridae, Togaviridae, Phenuviridae, Peribunyaviridae, Reoviridae, Asfarviridae, Rhabdoviridae, Orthomyxoviridae and Poxviridae families. It is thought that new world arboviruses such as yellow fever virus emerged in the 16th century due to the slave trade from Africa to America. Severe disease-causing viruses in humans include Japanese encephalitis virus (JEV), yellow fever virus (YFV), dengue virus (DENV), West Nile virus (WNV), Zika virus (ZIKV), Crimean-Congo hemorrhagic fever virus (CCHFV), severe fever with thrombocytopenia syndrome virus (SFTSV) and Rift Valley fever virus (RVFV). Numerous methods have been developed to detect the presence of these pathogens in clinical samples, including enzyme-linked immunosorbent assays (ELISAs), lateral flow assays (LFAs) and reverse transcriptase-polymerase chain reaction (RT-PCR). Most of these assays are performed in centralized laboratories due to the need for specialized equipment, such as PCR thermal cyclers and dedicated infrastructure. More recently, molecular methods have been developed which can be performed at a constant temperature, termed isothermal amplification, negating the need for expensive thermal cycling equipment. In most cases, isothermal amplification can now be carried out in as little as 5-20 min. These methods can potentially be used as inexpensive point of care (POC) tests and in-field deployable applications, thus decentralizing the molecular diagnosis of arboviral disease. This review focuses on the latest developments in isothermal amplification technology and detection techniques that have been applied to arboviral diagnostics and highlights future applications of these new technologies.

Role of the Microbiome in Aedes spp. Vector Competence: What Do We Know?

Aedes aegypti and Aedes albopictus are the vectors of important arboviruses: dengue fever, chikungunya, Zika, and yellow fever. Female mosquitoes acquire arboviruses by feeding on the infected host blood, thus being able to transmit it to their offspring. The intrinsic ability of a vector to infect itself and transmit a pathogen is known as vector competence. Several factors influence the susceptibility of these females to be infected by these arboviruses, such as the activation of the innate immune system through the Toll, immunodeficiency (Imd), JAK-STAT pathways, and the interference of specific antiviral response pathways of RNAi. It is also believed that the presence of non-pathogenic microorganisms in the microbiota of these arthropods could influence this immune response, as it provides a baseline activation of the innate immune system, which may generate resistance against arboviruses. In addition, this microbiome has direct action against arboviruses, mainly due to the ability of Wolbachia spp. to block viral genome replication, added to the competition for resources within the mosquito organism. Despite major advances in the area, studies are still needed to evaluate the microbiota profiles of Aedes spp. and their vector competence, as well as further exploration of the individual roles of microbiome components in activating the innate immune system.

Evaluation of Larvicidal Activity of Kaempferia galanga Extracts Against Aedes aegypti Larvae

&lt;b&gt;Background and Objective:&lt;/b&gt; The resistance of &lt;i&gt;Aedes aegypti&lt;/i&gt; larvae against temephos become an obstacle in controlling the arboviral vector. This condition triggered researchers to investigate the larvicidal activity of phytochemical compounds that are effective, safe, biodegradable and eco-friendly from various medicinal plants. This study evaluated the larvicidal activity of &lt;i&gt;Kaempferia galanga&lt;/i&gt; extracts against &lt;i&gt;Ae. aegypti&lt;/i&gt; larvae. &lt;b&gt;Materials and Methods:&lt;/b&gt; Four solvents with different polarities, namely ethanol, ethyl acetate, n-hexane and water were used in the sequential extraction. The final larvicidal bioassay test of the four extract types was designed in five replicates of five concentration ranges, namely 1.0, 8.75, 17.5, 35.0 and 70.0 ppm. A total of 20 3rd instar larvae of &lt;i&gt;Ae. aegypti&lt;/i&gt; were contacted with each replicate in a plastic cup. Larval mortality and effective concentration of larvicide were calculated and determined after 24 and 48 hrs of exposure. &lt;b&gt;Results:&lt;/b&gt; The average range of larval mortality according to the concentration of larvicide extracts of ethanol, ethyl acetate, n-hexane and water was 40-91, 2-36, 7-83 and 44-86% after 24 hrs and 88-100, 11-84, 12-99 and 77-100% after 48 hrs of exposure. The data yielded LC&lt;sub&gt;50&lt;/sub&gt; for 24 and 48 hrs of exposure at 1,563 and 0.061 ppm, 206,739 and 7,623 ppm, 47,579 and 38,063 ppm and 1.33 and 0.300 ppm, respectively. &lt;b&gt;Conclusion:&lt;/b&gt; The polar extract of &lt;i&gt;K. galanga&lt;/i&gt; showed high effectiveness so it is necessary to design the right formulation for field application, potency stability and active period of this larvicide residue.

A Review: Aedes-Borne Arboviral Infections, Controls and Wolbachia-Based Strategies

Arthropod-borne viruses (Arboviruses) continue to generate significant health and economic burdens for people living in endemic regions. Of these viruses, some of the most important (e.g., dengue, Zika, chikungunya, and yellow fever virus), are transmitted mainly by Aedes mosquitoes. Over the years, viral infection control has targeted vector population reduction and inhibition of arboviral replication and transmission. This control includes the vector control methods which are classified into chemical, environmental, and biological methods. Some of these control methods may be largely experimental (both field and laboratory investigations) or widely practised. Perceptively, one of the biological methods of vector control, in particular, Wolbachia-based control, shows a promising control strategy for eradicating Aedes-borne arboviruses. This can either be through the artificial introduction of Wolbachia, a naturally present bacterium that impedes viral growth in mosquitoes into heterologous Aedes aegypti mosquito vectors (vectors that are not natural hosts of Wolbachia) thereby limiting arboviral transmission or via Aedes albopictus mosquitoes, which naturally harbour Wolbachia infection. These strategies are potentially undermined by the tendency of mosquitoes to lose Wolbachia infection in unfavourable weather conditions (e.g., high temperature) and the inhibitory competitive dynamics among co-circulating Wolbachia strains. The main objective of this review was to critically appraise published articles on vector control strategies and specifically highlight the use of Wolbachia-based control to suppress vector population growth or disrupt viral transmission. We retrieved studies on the control strategies for arboviral transmissions via arthropod vectors and discussed the use of Wolbachia control strategies for eradicating arboviral diseases to identify literature gaps that will be instrumental in developing models to estimate the impact of these control strategies and, in essence, the use of different Wolbachia strains and features.