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Sahimin N, Low ZX, Hassandarvish P, Mohd Hanapi IR, Mohd Zain SN, Yahaya H, Abu Bakar S. Seroprevalence of dengue and chikungunya viruses among urban refugees in Klang Valley, Malaysia. Trans R Soc Trop Med Hyg 2024:trad097. [PMID: 38226501 DOI: 10.1093/trstmh/trad097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 02/26/2023] [Accepted: 12/24/2023] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND Mosquito-borne diseases pose a significant global public health threat, with Malaysia's Klang Valley experiencing numerous outbreaks in densely populated urban areas. METHODS This study aimed to estimate the seroprevalence of anti-dengue and anti-chikungunya antibodies among urban refugees in the Klang Valley, Malaysia, and identify associated risk factors. RESULTS High seroprevalence of anti-dengue immunoglobulin G (IgG) and IgM (60.0% [confidence interval {CI} 55.39 to 64.48] and 9.2% [CI 6.77 to 12.25], respectively) were observed among refugees >18 years of age (χ22=11.720, p=0.003), Kachin ethnicity (χ28=72.253, p<0.001), without formal education (χ21=3.856, p=0.050), homes near waste disposal sites (χ21=10.378, p=0.001) and refugees who have experienced flooding (χ21=5.460, p=0.019). Meanwhile, the overall seroprevalence of anti-chikungunya IgG and IgM was 9.7% (CI 7.15 to 12.73) and 10.8% (CI 8.09 to 13.93), respectively, with ages 12-18 years (χ22=6.075, p=0.048), Rohingya ethnicity (χ28=31.631, p<0.001) and homes close to waste disposal sites (χ21=3.912, p=0.048) being significant risk factors. Results showed a link to poor environmental living conditions, with an increase in the vector population with higher availability of breeding sites and thus exposure to dengue and chikungunya virus. CONCLUSIONS Health education among the community is the key to disease prevention, as there are no specific antiviral drugs for treatment and limited vaccine availability.
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Affiliation(s)
- Norhidayu Sahimin
- Tropical Infectious Diseases Research and Education Centre (TIDREC), Universiti Malaya, 50603 Kuala Lumpur, Malaysia
| | - Zhao Xuan Low
- Tropical Infectious Diseases Research and Education Centre (TIDREC), Universiti Malaya, 50603 Kuala Lumpur, Malaysia
| | - Pouya Hassandarvish
- Tropical Infectious Diseases Research and Education Centre (TIDREC), Universiti Malaya, 50603 Kuala Lumpur, Malaysia
| | - Izzah Ruzana Mohd Hanapi
- Institute of Biological Sciences, Faculty of Science, Universiti Malaya, 50603 Kuala Lumpur, Malaysia
| | - Siti Nursheena Mohd Zain
- Institute of Biological Sciences, Faculty of Science, Universiti Malaya, 50603 Kuala Lumpur, Malaysia
| | - Hasmawati Yahaya
- Tropical Infectious Diseases Research and Education Centre (TIDREC), Universiti Malaya, 50603 Kuala Lumpur, Malaysia
| | - Sazaly Abu Bakar
- Tropical Infectious Diseases Research and Education Centre (TIDREC), Universiti Malaya, 50603 Kuala Lumpur, Malaysia
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Graham VA, Easterbrook L, Kennedy E, Rayner E, Findlay-Wilson S, Flett L, Wise EL, Treagus S, Fotheringham S, Kempster S, Almond N, Dowall S. Pathogenesis of Rift Valley Fever Virus in a BALB/c Mouse Model Is Affected by Virus Culture Conditions and Sex of the Animals. Viruses 2023; 15:2369. [PMID: 38140610 PMCID: PMC10747589 DOI: 10.3390/v15122369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 11/27/2023] [Accepted: 11/29/2023] [Indexed: 12/24/2023] Open
Abstract
Rift Valley fever virus (RVFV) is a mosquito-borne zoonotic pathogen causing disease in livestock and humans. Whilst initially restricted to the African continent, recent spread to the Arabian Peninsula has highlighted the likelihood of entry into new regions. Due to the absence of a regulatory-approved human vaccine, work is ongoing to develop and assess countermeasures. As such, small animal models play a pivotal role in providing information on disease pathogenesis and elucidating which intervention strategies confer protection. To develop and establish the BALB/c mouse model, we challenged mice with RVFV grown from two separate cell lines: one derived from mosquitoes (C6/36) and the other mammalian derived (Vero E6). Following infection, we assessed the clinical course of disease progression at days 1 and 3 post-challenge and evaluated viral tropism and immune analytes. The results demonstrated that RVFV infection was affected by the cell line used to propagate the challenge virus, with those grown in insect cells resulting in a more rapid disease progression. The lowest dose that caused uniform severe disease remained the same across both virus preparations. In addition, to demonstrate reproducibility, the lowest dose was used for a subsequent infection study using male and female animals. The results further demonstrated that male mice succumbed to infection more rapidly than their female counterparts. Our results establish an RVFV mouse model and key parameters that affect the course of disease progression in BALB/c mice.
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Affiliation(s)
- Victoria A. Graham
- UK Health Security Agency (UKHSA), Porton Down, Salisbury SP4 0JG, UK; (V.A.G.); (L.E.); (E.K.); (E.R.); (S.F.-W.); (L.F.); (E.L.W.); (S.T.); (S.F.)
| | - Linda Easterbrook
- UK Health Security Agency (UKHSA), Porton Down, Salisbury SP4 0JG, UK; (V.A.G.); (L.E.); (E.K.); (E.R.); (S.F.-W.); (L.F.); (E.L.W.); (S.T.); (S.F.)
| | - Emma Kennedy
- UK Health Security Agency (UKHSA), Porton Down, Salisbury SP4 0JG, UK; (V.A.G.); (L.E.); (E.K.); (E.R.); (S.F.-W.); (L.F.); (E.L.W.); (S.T.); (S.F.)
| | - Emma Rayner
- UK Health Security Agency (UKHSA), Porton Down, Salisbury SP4 0JG, UK; (V.A.G.); (L.E.); (E.K.); (E.R.); (S.F.-W.); (L.F.); (E.L.W.); (S.T.); (S.F.)
| | - Stephen Findlay-Wilson
- UK Health Security Agency (UKHSA), Porton Down, Salisbury SP4 0JG, UK; (V.A.G.); (L.E.); (E.K.); (E.R.); (S.F.-W.); (L.F.); (E.L.W.); (S.T.); (S.F.)
| | - Lucy Flett
- UK Health Security Agency (UKHSA), Porton Down, Salisbury SP4 0JG, UK; (V.A.G.); (L.E.); (E.K.); (E.R.); (S.F.-W.); (L.F.); (E.L.W.); (S.T.); (S.F.)
| | - Emma Louise Wise
- UK Health Security Agency (UKHSA), Porton Down, Salisbury SP4 0JG, UK; (V.A.G.); (L.E.); (E.K.); (E.R.); (S.F.-W.); (L.F.); (E.L.W.); (S.T.); (S.F.)
| | - Samantha Treagus
- UK Health Security Agency (UKHSA), Porton Down, Salisbury SP4 0JG, UK; (V.A.G.); (L.E.); (E.K.); (E.R.); (S.F.-W.); (L.F.); (E.L.W.); (S.T.); (S.F.)
| | - Susan Fotheringham
- UK Health Security Agency (UKHSA), Porton Down, Salisbury SP4 0JG, UK; (V.A.G.); (L.E.); (E.K.); (E.R.); (S.F.-W.); (L.F.); (E.L.W.); (S.T.); (S.F.)
| | - Sarah Kempster
- Medicines and Healthcare Products Regulatory Agency (MHRA), Blanche Ln, South Mimms, Potters Bar EN6 3QG, UK; (S.K.); (N.A.)
| | - Neil Almond
- Medicines and Healthcare Products Regulatory Agency (MHRA), Blanche Ln, South Mimms, Potters Bar EN6 3QG, UK; (S.K.); (N.A.)
| | - Stuart Dowall
- UK Health Security Agency (UKHSA), Porton Down, Salisbury SP4 0JG, UK; (V.A.G.); (L.E.); (E.K.); (E.R.); (S.F.-W.); (L.F.); (E.L.W.); (S.T.); (S.F.)
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MacIntyre C, Lourens C, Mendes A, de Villiers M, Avenant T, du Plessis NM, Leendertz FH, Venter M. West Nile Virus, an Underdiagnosed Cause of Acute Fever of Unknown Origin and Neurological Disease among Hospitalized Patients in South Africa. Viruses 2023; 15:2207. [PMID: 38005884 PMCID: PMC10674603 DOI: 10.3390/v15112207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 10/31/2023] [Accepted: 11/01/2023] [Indexed: 11/26/2023] Open
Abstract
West Nile virus (WNV), a mosquito-borne flavivirus, is endemic to South Africa. However, its contribution to acute febrile and neurological disease in hospitalized patients in South Africa is unknown. This study examined two patient cohorts for WNV using molecular testing and IgM serology with confirmation of serological results by viral neutralization tests (VNT) to address this knowledge gap. Univariate analysis was performed using collected demographic and clinical information to identify risk factors. In the first cohort, 219 cerebrospinal fluid (CSF) specimens from patients with acute neurological disease in Gauteng hospitals collected in January to June 2017 were tested for WNV. The study identified WNV in 8/219 (3.65%, 95.00% CI (1.59-7.07)) patients with unsolved neurological infections. The second cohort, from 2019 to 2021, included 441 patients enrolled between January and June with acute febrile or neurological disease from urban and rural sites in Gauteng and Mpumalanga provinces. West Nile virus was diagnosed in 40/441 (9.07%, 95.00% CI (6.73-12.12)) of patients, of which 29/40 (72.50%, 95.00% CI (56.11-85.40)) had neurological signs, including headaches, encephalitis, meningitis, and acute flaccid paralysis (AFP). Notably, most of the cases were identified in children although adolescents and senior adults had a significantly higher risk of testing WNV positive. This suggests a previously underestimated disease burden and that WNV might be underrecognized as a cause of febrile and neurological diseases in hospitalized patients in South Africa, especially in children. This emphasizes the importance of further research and awareness regarding arboviruses of public health concern.
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Affiliation(s)
- Caitlin MacIntyre
- Zoonotic Arbo- and Respiratory Virus Program, Department of Medical Virology, Faculty of Health Sciences, University of Pretoria, Pretoria 0031, South Africa; (C.M.); (C.L.); (A.M.)
| | - Carla Lourens
- Zoonotic Arbo- and Respiratory Virus Program, Department of Medical Virology, Faculty of Health Sciences, University of Pretoria, Pretoria 0031, South Africa; (C.M.); (C.L.); (A.M.)
| | - Adriano Mendes
- Zoonotic Arbo- and Respiratory Virus Program, Department of Medical Virology, Faculty of Health Sciences, University of Pretoria, Pretoria 0031, South Africa; (C.M.); (C.L.); (A.M.)
| | - Maryke de Villiers
- Department of Internal Medicine, Kalafong Provincial Tertiary Hospital, Faculty of Health Sciences, University of Pretoria, Pretoria 0031, South Africa;
| | - Theunis Avenant
- Department of Pediatrics, Kalafong Provincial Tertiary Hospital, Faculty of Health Sciences, University of Pretoria, Pretoria 0031, South Africa; (T.A.); (N.M.d.P.)
| | - Nicolette M. du Plessis
- Department of Pediatrics, Kalafong Provincial Tertiary Hospital, Faculty of Health Sciences, University of Pretoria, Pretoria 0031, South Africa; (T.A.); (N.M.d.P.)
| | - Fabian H. Leendertz
- Helmholtz Institute for One Health and University of Greifswald, 17489 Greifswald, Germany;
| | - Marietjie Venter
- Zoonotic Arbo- and Respiratory Virus Program, Department of Medical Virology, Faculty of Health Sciences, University of Pretoria, Pretoria 0031, South Africa; (C.M.); (C.L.); (A.M.)
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Snyman J, Snyman LP, Buhler KJ, Villeneuve CA, Leighton PA, Jenkins EJ, Kumar A. California Serogroup Viruses in a Changing Canadian Arctic: A Review. Viruses 2023; 15:1242. [PMID: 37376542 DOI: 10.3390/v15061242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 04/24/2023] [Accepted: 05/18/2023] [Indexed: 06/29/2023] Open
Abstract
The Arctic is warming at four times the global rate, changing the diversity, activity and distribution of vectors and associated pathogens. While the Arctic is not often considered a hotbed of vector-borne diseases, Jamestown Canyon virus (JCV) and Snowshoe Hare virus (SSHV) are mosquito-borne zoonotic viruses of the California serogroup endemic to the Canadian North. The viruses are maintained by transovarial transmission in vectors and circulate among vertebrate hosts, both of which are not well characterized in Arctic regions. While most human infections are subclinical or mild, serious cases occur, and both JCV and SSHV have recently been identified as leading causes of arbovirus-associated neurological diseases in North America. Consequently, both viruses are currently recognised as neglected and emerging viruses of public health concern. This review aims to summarise previous findings in the region regarding the enzootic transmission cycle of both viruses. We identify key gaps and approaches needed to critically evaluate, detect, and model the effects of climate change on these uniquely northern viruses. Based on limited data, we predict that (1) these northern adapted viruses will increase their range northwards, but not lose range at their southern limits, (2) undergo more rapid amplification and amplified transmission in endemic regions for longer vector-biting seasons, (3) take advantage of northward shifts of hosts and vectors, and (4) increase bite rates following an increase in the availability of breeding sites, along with phenological synchrony between the reproduction cycle of theorized reservoirs (such as caribou calving) and mosquito emergence.
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Affiliation(s)
- Jumari Snyman
- Department of Biochemistry, Microbiology and Immunology, College of Medicine, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada
| | - Louwrens P Snyman
- Department of Veterinary Microbiology, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK S7N 5B4, Canada
| | - Kayla J Buhler
- Department of Veterinary Microbiology, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK S7N 5B4, Canada
| | - Carol-Anne Villeneuve
- Research Group on Epidemiology of Zoonoses and Public Health (GREZOSP), Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC J2S 2M2, Canada
| | - Patrick A Leighton
- Research Group on Epidemiology of Zoonoses and Public Health (GREZOSP), Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC J2S 2M2, Canada
| | - Emily J Jenkins
- Department of Veterinary Microbiology, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK S7N 5B4, Canada
| | - Anil Kumar
- Department of Biochemistry, Microbiology and Immunology, College of Medicine, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada
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Thilakarathne SS, Yuen NKY, Hassan MM, Yahathugoda TC, Abdullah S. Animal and Human Dirofilariasis in India and Sri Lanka: A Systematic Review and Meta-Analysis. Animals (Basel) 2023; 13:ani13091551. [PMID: 37174588 PMCID: PMC10177550 DOI: 10.3390/ani13091551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 05/02/2023] [Accepted: 05/03/2023] [Indexed: 05/15/2023] Open
Abstract
Dirofilariasis is an emerging vector-borne tropical disease of public health importance that mainly affects humans and dogs. Dirofilaria immitis and D. repens are the two well-documented dirofilariasis-causing filarioid helminths of both medical and veterinary concerns in India and Sri Lanka. This systematic review and meta-analysis aimed to describe and summarize the current evidence of dirofilariasis prevalence and distribution in India and Sri Lanka. Interestingly, D. repens is reported to circulate in both dogs (prevalence of 35.8% (95% CI: 11.23-60.69)) and humans (97% of published case reports) in India and Sri Lanka, but D. immitis is reported to be present in the dog populations in India (prevalence of 9.7% (95% CI: 8.5-11.0%)), and so far, it has not been reported in Sri Lanka. This peculiar distribution of D. immitis and D. repens in the two neighbouring countries could be due to the interaction between the two parasite species, which could affect the pattern of infection of the two worm species in dogs and thus influence the geographical distribution of these two filarial worms. In medical and veterinary practice, histopathology was the most commonly used diagnostic technique (31.3%; 95% CI 2.5-60.2%). The low specificity of histopathology to speciate the various Dirofilaria spp. may lead to misdiagnosis. It was identified in this study that several regions of India and Sri Lanka have not yet been surveyed for dirofilariasis. This limits our understanding of the geographical distribution and interspecies interactions of the two parasites within these countries. Parasite distribution, disease prevalence, and interspecies interactions between the vectors and the host should be targeted for future research.
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Affiliation(s)
- Sandani S Thilakarathne
- Department of Parasitology, Faculty of Medicine, University of Ruhuna, Galle P.O. Box 70, Sri Lanka
| | - Nicholas K Y Yuen
- School of Veterinary Science, The University of Queensland, Gatton, QLD 4343, Australia
| | - Mohammad Mahmudul Hassan
- School of Veterinary Science, The University of Queensland, Gatton, QLD 4343, Australia
- Faculty of Veterinary Medicine, Chattogram Veterinary and Animal Sciences University, Chattogram 4225, Bangladesh
| | - Thishan C Yahathugoda
- Department of Parasitology, Faculty of Medicine, University of Ruhuna, Galle P.O. Box 70, Sri Lanka
| | - Swaid Abdullah
- School of Veterinary Science, The University of Queensland, Gatton, QLD 4343, Australia
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Wu B, Qi Z, Qian X. Recent Advancements in Mosquito-Borne Flavivirus Vaccine Development. Viruses 2023; 15:813. [PMID: 37112794 PMCID: PMC10143207 DOI: 10.3390/v15040813] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/21/2023] [Accepted: 03/21/2023] [Indexed: 04/29/2023] Open
Abstract
Lately, the global incidence of flavivirus infection has been increasing dramatically and presents formidable challenges for public health systems around the world. Most clinically significant flaviviruses are mosquito-borne, such as the four serotypes of dengue virus, Zika virus, West Nile virus, Japanese encephalitis virus and yellow fever virus. Until now, no effective antiflaviviral drugs are available to fight flaviviral infection; thus, a highly immunogenic vaccine would be the most effective weapon to control the diseases. In recent years, flavivirus vaccine research has made major breakthroughs with several vaccine candidates showing encouraging results in preclinical and clinical trials. This review summarizes the current advancement, safety, efficacy, advantages and disadvantages of vaccines against mosquito-borne flaviviruses posing significant threats to human health.
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Affiliation(s)
| | - Zhongtian Qi
- Department of Microbiology, Faculty of Naval Medicine, Naval Medical University, Shanghai 200433, China;
| | - Xijing Qian
- Department of Microbiology, Faculty of Naval Medicine, Naval Medical University, Shanghai 200433, China;
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Wang J, Zhu Z. Novel paradigm of mosquito-borne disease control based on self-powered strategy. Front Public Health 2023; 11:1115000. [PMID: 36741958 PMCID: PMC9895093 DOI: 10.3389/fpubh.2023.1115000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 01/03/2023] [Indexed: 01/22/2023] Open
Affiliation(s)
- Junhao Wang
- School of Electronic Information Engineering, Southwest University, Chongqing, China,State Key Laboratory of Bioelectronics, Southeast University, Nanjing, China
| | - Zhiyuan Zhu
- School of Electronic Information Engineering, Southwest University, Chongqing, China,*Correspondence: Zhiyuan Zhu ✉
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CRIVEI LA, MOUTAILLER S, GONZALEZ G, LOWENSKI S, CRIVEI IC, POREA D, ANITA DC, RATOI IA, ZIENTARA S, OSLOBANU LE, TOMAZATOS A, SAVUTA G, LECOLLINET S. Detection of West Nile Virus Lineage 2 in Eastern Romania and First Identification of Sindbis Virus RNA in Mosquitoes Analyzed using High-Throughput Microfluidic Real-Time PCR. Viruses 2023; 15:186. [PMID: 36680227 PMCID: PMC9860827 DOI: 10.3390/v15010186] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/03/2023] [Accepted: 01/04/2023] [Indexed: 01/11/2023] Open
Abstract
The impact of mosquito-borne diseases on human and veterinary health is being exacerbated by rapid environmental changes caused mainly by changing climatic patterns and globalization. To gain insight into mosquito-borne virus circulation from two counties in eastern and southeastern Romania, we have used a combination of sampling methods in natural, urban and peri-urban sites. The presence of 37 mosquito-borne viruses in 16,827 pooled mosquitoes was analyzed using a high-throughput microfluidic real-time PCR assay. West Nile virus (WNV) was detected in 10/365 pools of Culex pipiens (n = 8), Culex modestus (n = 1) and Aedes vexans (n = 1) from both studied counties. We also report the first molecular detection of Sindbis virus (SINV) RNA in the country in one pool of Culex modestus. WNV infection was confirmed by real-time RT-PCR (10/10) and virus isolation on Vero or C6/36 cells (four samples). For the SINV-positive pool, no cytopathic effectwas observed after infection of Vero or C6/36 cells, but no amplification was obtained in conventional SINV RT-PCR. Phylogenetic analysis of WNV partial NS5 sequences revealed that WNV lineage 2 of theCentral-Southeast European clade, has a wider circulation in Romania than previously known.
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Affiliation(s)
- Luciana Alexandra CRIVEI
- Regional Center of Advanced Research for Emerging Diseases, Zoonoses and Food Safety, Iași University of Life Sciences, 700490 Iași, Romania
| | - Sara MOUTAILLER
- ANSES, INRAE, Ecole Nationale Vétérinaire d’Alfort, UMR BIPAR, Laboratoire de Santé Animale, 94700 Maisons-Alfort, France
| | - Gaëlle GONZALEZ
- ANSES, INRAE, Ecole Nationale Vétérinaire d’Alfort, UMR VIROLOGIE, Laboratoire de Santé Animale, 94700 Maisons-Alfort, France
| | - Steeve LOWENSKI
- ANSES, INRAE, Ecole Nationale Vétérinaire d’Alfort, UMR VIROLOGIE, Laboratoire de Santé Animale, 94700 Maisons-Alfort, France
| | - Ioana Cristina CRIVEI
- Regional Center of Advanced Research for Emerging Diseases, Zoonoses and Food Safety, Iași University of Life Sciences, 700490 Iași, Romania
| | - Daniela POREA
- Regional Center of Advanced Research for Emerging Diseases, Zoonoses and Food Safety, Iași University of Life Sciences, 700490 Iași, Romania
| | - Dragoș Constantin ANITA
- Regional Center of Advanced Research for Emerging Diseases, Zoonoses and Food Safety, Iași University of Life Sciences, 700490 Iași, Romania
| | - Ioana Alexandra RATOI
- Regional Center of Advanced Research for Emerging Diseases, Zoonoses and Food Safety, Iași University of Life Sciences, 700490 Iași, Romania
| | - Stéphan ZIENTARA
- ANSES, INRAE, Ecole Nationale Vétérinaire d’Alfort, UMR VIROLOGIE, Laboratoire de Santé Animale, 94700 Maisons-Alfort, France
| | - Luanda Elena OSLOBANU
- Regional Center of Advanced Research for Emerging Diseases, Zoonoses and Food Safety, Iași University of Life Sciences, 700490 Iași, Romania
| | - Alexandru TOMAZATOS
- Department of Arbovirology, Bernhard Nocht Institute for Tropical Medicine, 20359 Hamburg, Germany
| | - Gheorghe SAVUTA
- Regional Center of Advanced Research for Emerging Diseases, Zoonoses and Food Safety, Iași University of Life Sciences, 700490 Iași, Romania
| | - Sylvie LECOLLINET
- ANSES, INRAE, Ecole Nationale Vétérinaire d’Alfort, UMR VIROLOGIE, Laboratoire de Santé Animale, 94700 Maisons-Alfort, France
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Dickinson KL, Banacos N, Carbajal E, Dacko N, Fredregill C, Hinojosa S, Juarez JG, Weldon C, Hamer GL. Public Acceptance of and Willingness to Pay for Mosquito Control, Texas, USA. Emerg Infect Dis 2022; 28:425-428. [PMID: 35076377 PMCID: PMC8798704 DOI: 10.3201/eid2802.210501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Mosquito control is essential to reduce vectorborne disease risk. We surveyed residents in Harris, Tarrant, and Hidalgo Counties, Texas, USA, to estimate willingness-to-pay for mosquito control and acceptance of control methods. Results show an unmet demand for expanded mosquito control that could be funded through local taxes or fees.
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Velu RM, Kwenda G, Libonda L, Chisenga CC, Flavien BN, Chilyabanyama ON, Simunyandi M, Bosomprah S, Sande NC, Changula K, Muleya W, Mburu MM, Mubemba B, Chitanga S, Tembo J, Bates M, Kapata N, Orba Y, Kajihara M, Takada A, Sawa H, Chilengi R, Simulundu E. Mosquito-Borne Viral Pathogens Detected in Zambia: A Systematic Review. Pathogens 2021; 10:pathogens10081007. [PMID: 34451471 PMCID: PMC8401848 DOI: 10.3390/pathogens10081007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/27/2021] [Accepted: 08/05/2021] [Indexed: 11/16/2022] Open
Abstract
Emerging and re-emerging mosquito-borne viral diseases are a threat to global health. This systematic review aimed to investigate the available evidence of mosquito-borne viral pathogens reported in Zambia. A search of literature was conducted in PubMed and Google Scholar for articles published from 1 January 1930 to 30 June 2020 using a combination of keywords. Eight mosquito-borne viruses belonging to three families, Togaviridae, Flaviviridae and Phenuiviridae were reported. Three viruses (Chikungunya virus, Mayaro virus, Mwinilunga virus) were reported among the togaviruses whilst four (dengue virus, West Nile virus, yellow fever virus, Zika virus) were among the flavivirus and only one virus, Rift Valley fever virus, was reported in the Phenuiviridae family. The majority of these mosquito-borne viruses were reported in Western and North-Western provinces. Aedes and Culex species were the main mosquito-borne viral vectors reported. Farming, fishing, movement of people and rain patterns were among factors associated with mosquito-borne viral infection in Zambia. Better diagnostic methods, such as the use of molecular tools, to detect the viruses in potential vectors, humans, and animals, including the recognition of arboviral risk zones and how the viruses circulate, are important for improved surveillance and design of effective prevention and control measures.
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Affiliation(s)
- Rachel Milomba Velu
- Centre for Infectious Disease Research in Zambia, Lusaka P.O. Box 34681, Zambia; (C.C.C.); (O.N.C.); (M.S.); (S.B.); (R.C.)
- Department of Disease Control, School of Veterinary Medicine, University of Zambia, Lusaka P.O. Box 32379, Zambia; (N.C.S.); (A.T.); (E.S.)
- Correspondence: (R.M.V.); (H.S.)
| | - Geoffrey Kwenda
- Department of Biomedical Sciences, School of Health Sciences, University of Zambia, Lusaka P.O. Box 50110, Zambia; (G.K.); (S.C.)
- Africa Center of Excellence for Infectious Diseases of Humans and Animals, University of Zambia, Lusaka P.O. Box 32379, Zambia
| | - Liyali Libonda
- Department of Disease Control and Prevention, School of Medicine and Health Sciences, Eden University, Lusaka P.O. Box 37727, Zambia; (L.L.); (B.N.F.)
| | - Caroline Cleopatra Chisenga
- Centre for Infectious Disease Research in Zambia, Lusaka P.O. Box 34681, Zambia; (C.C.C.); (O.N.C.); (M.S.); (S.B.); (R.C.)
| | - Bumbangi Nsoni Flavien
- Department of Disease Control and Prevention, School of Medicine and Health Sciences, Eden University, Lusaka P.O. Box 37727, Zambia; (L.L.); (B.N.F.)
| | | | - Michelo Simunyandi
- Centre for Infectious Disease Research in Zambia, Lusaka P.O. Box 34681, Zambia; (C.C.C.); (O.N.C.); (M.S.); (S.B.); (R.C.)
| | - Samuel Bosomprah
- Centre for Infectious Disease Research in Zambia, Lusaka P.O. Box 34681, Zambia; (C.C.C.); (O.N.C.); (M.S.); (S.B.); (R.C.)
- Department of Biostatistics, School of Public Health, University of Ghana, Accra P.O. Box LG13, Ghana
| | - Nicholus Chintu Sande
- Department of Disease Control, School of Veterinary Medicine, University of Zambia, Lusaka P.O. Box 32379, Zambia; (N.C.S.); (A.T.); (E.S.)
| | - Katendi Changula
- Department of Paraclinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka P.O. Box 32379, Zambia;
| | - Walter Muleya
- Department of Biomedical Sciences, School of Veterinary Medicine, University of Zambia, Lusaka P.O. Box 32379, Zambia;
| | | | - Benjamin Mubemba
- Department of Zoology and Aquatic Sciences, School of Natural Resources, Copperbelt University, Kitwe P.O. Box 21692, Zambia;
| | - Simbarashe Chitanga
- Department of Biomedical Sciences, School of Health Sciences, University of Zambia, Lusaka P.O. Box 50110, Zambia; (G.K.); (S.C.)
- School of Veterinary Medicine, University of Namibia, Windhoek Private Bag 13301, Namibia
- School of Life Sciences, University of KwaZulu-Natal, Private Bag X54001, Durban 4000, South Africa
| | - John Tembo
- HerpeZ Infection Research and Training, University Teaching Hospital, Lusaka Private Bag RW1X Ridgeway, Lusaka P.O. Box 10101, Zambia; (J.T.); (M.B.)
| | - Matthew Bates
- HerpeZ Infection Research and Training, University Teaching Hospital, Lusaka Private Bag RW1X Ridgeway, Lusaka P.O. Box 10101, Zambia; (J.T.); (M.B.)
- School of Life Sciences, University of Lincoln, Brayford Pool, Lincoln LN6 7TS, UK
| | - Nathan Kapata
- Zambia National Public Health Institute, Ministry of Health, Lusaka P.O. Box 30205, Zambia;
| | - Yasuko Orba
- Division of Molecular Pathobiology, International Institute for Zoonosis Control, Hokkaido University, N 20 W10, Kita-ku, Sapporo 001-0020, Japan;
| | - Masahiro Kajihara
- Division of Global Epidemiology, International Institute for Zoonosis Control, Hokkaido University, N 20 W10, Kita-ku, Sapporo 001-0020, Japan;
| | - Ayato Takada
- Department of Disease Control, School of Veterinary Medicine, University of Zambia, Lusaka P.O. Box 32379, Zambia; (N.C.S.); (A.T.); (E.S.)
- Africa Center of Excellence for Infectious Diseases of Humans and Animals, University of Zambia, Lusaka P.O. Box 32379, Zambia
- Division of Global Epidemiology, International Institute for Zoonosis Control, Hokkaido University, N 20 W10, Kita-ku, Sapporo 001-0020, Japan;
| | - Hirofumi Sawa
- Department of Disease Control, School of Veterinary Medicine, University of Zambia, Lusaka P.O. Box 32379, Zambia; (N.C.S.); (A.T.); (E.S.)
- Africa Center of Excellence for Infectious Diseases of Humans and Animals, University of Zambia, Lusaka P.O. Box 32379, Zambia
- Division of Molecular Pathobiology, International Institute for Zoonosis Control, Hokkaido University, N 20 W10, Kita-ku, Sapporo 001-0020, Japan;
- Global Virus Network, 725 W Lombard St., Baltimore, MD 21201, USA
- Correspondence: (R.M.V.); (H.S.)
| | - Roma Chilengi
- Centre for Infectious Disease Research in Zambia, Lusaka P.O. Box 34681, Zambia; (C.C.C.); (O.N.C.); (M.S.); (S.B.); (R.C.)
| | - Edgar Simulundu
- Department of Disease Control, School of Veterinary Medicine, University of Zambia, Lusaka P.O. Box 32379, Zambia; (N.C.S.); (A.T.); (E.S.)
- Macha Research Trust, Choma P.O. Box 630166, Zambia;
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11
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Abstract
Flaviviruses are a group of positive-sense RNA viruses that are primarily transmitted through arthropod vectors and are capable of causing a broad spectrum of diseases. Many of the flaviviruses that are pathogenic in humans are transmitted specifically through mosquito vectors. Over the past century, many mosquito-borne flavivirus infections have emerged and re-emerged, and are of global importance with hundreds of millions of infections occurring yearly. There is a need for novel, effective, and accessible vaccines and antivirals capable of inhibiting flavivirus infection and ameliorating disease. The development of therapeutics targeting viral entry has long been a goal of antiviral research, but most efforts are hindered by the lack of broad-spectrum potency or toxicities associated with on-target effects, since many host proteins necessary for viral entry are also essential for host cell biology. Mosquito-borne flaviviruses generally enter cells by clathrin-mediated endocytosis (CME), and recent studies suggest that a subset of these viruses can be internalized through a specialized form of CME that has additional dependencies distinct from canonical CME pathways, and antivirals targeting this pathway have been discovered. In this review, we discuss the role and contribution of endocytosis to mosquito-borne flavivirus entry as well as consider past and future efforts to target endocytosis for therapeutic interventions.
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Affiliation(s)
| | - Sara Cherry
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA;
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12
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Parekh FK, Yeh KB, Olinger G, Ribeiro FA. Infectious Disease Risks and Vulnerabilities in the Aftermath of an Environmental Disaster in Minas Gerais, Brazil. Vector Borne Zoonotic Dis 2020; 20:387-389. [PMID: 31944914 DOI: 10.1089/vbz.2019.2501] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
In January 2019, the state of Minas Gerais experienced another environmental disaster with the collapse of a mining dam near the city of Brumadinho. This disaster has resulted in 256 deaths and 14 people still missing. Toxic mud has contaminated the Paraopeba River resulting in significant fish and wildlife deaths in the river and surrounding areas. The effect of environmental disasters such as this is felt across multiple sectors damaging ecosystems in agriculture, wildlife and human communities. Environmental disasters cause significant disruption of ecosystems, flooding, contamination of water supplies, and displacement of human populations, which can result in increases in transmission and outbreaks of mosquito-borne and zoonotic diseases that can become a serious and long-term public health problem for the region.
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Affiliation(s)
| | | | | | - Flavia Andrade Ribeiro
- Clinical Research Center of the Hospital das Clinicas/Federal University of Minas Gerais (CPC-HC/UFMG), Belo Horizonte, Brazil
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13
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Tomashek KM, Challberg M, Nayak SU, Schiltz HF. Disease Resurgence, Production Capability Issues and Safety Concerns in the Context of an Aging Population: Is There a Need for a New Yellow Fever Vaccine? Vaccines (Basel) 2019; 7:E179. [PMID: 31717289 DOI: 10.3390/vaccines7040179] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 10/28/2019] [Accepted: 11/05/2019] [Indexed: 12/19/2022] Open
Abstract
Yellow fever is a potentially fatal, mosquito-borne viral disease that appears to be experiencing a resurgence in endemic areas in Africa and South America and spreading to non-endemic areas despite an effective vaccine. This trend has increased the level of concern about the disease and the potential for importation to areas in Asia with ecological conditions that can sustain yellow fever virus transmission. In this article, we provide a broad overview of yellow fever burden of disease, natural history, treatment, vaccine, prevention and control initiatives, and vaccine and therapeutic agent development efforts.
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14
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Pujhari S, Brustolin M, Macias VM, Nissly RH, Nomura M, Kuchipudi SV, Rasgon JL. Heat shock protein 70 (Hsp70) mediates Zika virus entry, replication, and egress from host cells. Emerg Microbes Infect 2019; 8:8-16. [PMID: 30866755 PMCID: PMC6455116 DOI: 10.1080/22221751.2018.1557988] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Zika virus (ZIKV) is a historically neglected mosquito-borne flavivirus that has caused recent epidemics in the western hemisphere. ZIKV has been associated with severe symptoms including infant microcephaly and Guillain-Barré syndrome, stimulating interest in understanding factors governing ZIKV infection. Heat shock protein 70 (Hsp70) has been shown to be an infection factor for multiple viruses, leading us to investigate the role of Hsp70 in the ZIKV infection process. ZIKV infection induced Hsp70 expression in host cells 48-h post-infection. Inducing Hsp70 expression in mammalian cells increased ZIKV production, whereas inhibiting Hsp70 activity reduced ZIKV viral RNA production and virion release from the cell. Hsp70 was localized both on the cell surface where it could interact with ZIKV during the initial stages of the infection process, and intracellularly where it localized with viral RNA. Blocking cell surface-localized Hsp70 using antibodies decreased ZIKV cell infection rates and production of infectious virus particles, as did competition with recombinant Hsp70 protein. Overall, Hsp70 was found to play a functional role in both the pre- and post-ZIKV infection processes affecting viral entry, replication, and egress. Understanding the interactions between Hsp70 and ZIKV may lead to novel therapeutics for ZIKV infection.
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Affiliation(s)
- Sujit Pujhari
- a Department of Entomology , Center for Infectious Disease Dynamics and the Huck Institutes of the Life Sciences, The Pennsylvania State University , University Park , PA , USA
| | - Marco Brustolin
- a Department of Entomology , Center for Infectious Disease Dynamics and the Huck Institutes of the Life Sciences, The Pennsylvania State University , University Park , PA , USA
| | - Vanessa M Macias
- a Department of Entomology , Center for Infectious Disease Dynamics and the Huck Institutes of the Life Sciences, The Pennsylvania State University , University Park , PA , USA
| | - Ruth H Nissly
- b Animal Diagnostic Laboratory, Department of Veterinary and Biomedical Sciences , The Pennsylvania State University , University Park , PA , USA
| | - Masashi Nomura
- a Department of Entomology , Center for Infectious Disease Dynamics and the Huck Institutes of the Life Sciences, The Pennsylvania State University , University Park , PA , USA.,c Graduate School of Horticulture , Chiba University , Japan
| | - Suresh V Kuchipudi
- b Animal Diagnostic Laboratory, Department of Veterinary and Biomedical Sciences , The Pennsylvania State University , University Park , PA , USA
| | - Jason L Rasgon
- a Department of Entomology , Center for Infectious Disease Dynamics and the Huck Institutes of the Life Sciences, The Pennsylvania State University , University Park , PA , USA
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15
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Hastings AK, Uraki R, Gaitsch H, Dhaliwal K, Stanley S, Sproch H, Williamson E, MacNeil T, Marin-Lopez A, Hwang J, Wang Y, Grover JR, Fikrig E. Aedes aegypti NeSt1 Protein Enhances Zika Virus Pathogenesis by Activating Neutrophils. J Virol 2019; 93:e00395-19. [PMID: 30971475 PMCID: PMC6580965 DOI: 10.1128/jvi.00395-19] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 04/07/2019] [Indexed: 12/17/2022] Open
Abstract
Saliva from the mosquito vector of flaviviruses is capable of changing the local immune environment, leading to an increase in flavivirus-susceptible cells at the infected bite site. In addition, an antibody response to specific salivary gland (SG) components changes the pathogenesis of flaviviruses in human populations. To investigate whether antigenic SG proteins are capable of enhancing infection with Zika virus (ZIKV), a reemerging flavivirus primarily transmitted by the Aedes aegypti mosquito, we screened for antigenic SG proteins using a yeast display library and demonstrate that a previously undescribed SG protein we term neutrophil stimulating factor 1 (NeSt1) activates primary mouse neutrophils ex vivo Passive immunization against NeSt1 decreases pro-interleukin-1β and CXCL2 expression, prevents macrophages from infiltrating the bite site, protects susceptible IFNAR-/- IFNGR-/- (AG129) mice from early ZIKV replication, and ameliorates virus-induced pathogenesis. These findings indicate that NeSt1 stimulates neutrophils at the mosquito bite site to change the immune microenvironment, allowing a higher level of early viral replication and enhancing ZIKV pathogenesis.IMPORTANCE When a Zika virus-infected mosquito bites a person, mosquito saliva is injected into the skin along with the virus. Molecules in this saliva can make virus infection more severe by changing the immune system to make the skin a better place for the virus to replicate. We identified a molecule that activates immune cells, called neutrophils, to recruit other immune cells, called macrophages, that the virus can infect. We named this molecule neutrophil-stimulating factor 1 (NeSt1). When we used antibodies to block NeSt1 in mice and then allowed Zika virus-infected mosquitoes to feed on these mice, they survived much better than mice that do not have antibodies against NeSt1. These findings give us more information about how mosquito saliva enhances virus infection, and it is possible that a vaccine against NeSt1 might protect people against severe Zika virus infection.
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Affiliation(s)
- Andrew K Hastings
- Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Ryuta Uraki
- Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Hallie Gaitsch
- Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Khushwant Dhaliwal
- Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Sydney Stanley
- Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Hannah Sproch
- Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Eric Williamson
- Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Tyler MacNeil
- Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Alejandro Marin-Lopez
- Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Jesse Hwang
- Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Yuchen Wang
- Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Jonathan R Grover
- Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Erol Fikrig
- Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
- Howard Hughes Medical Institute, Chevy Chase, Maryland, USA
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16
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Liu YF, Sun GW, Wang L, Guo ZM. Establishing Wolbachia in the wild mosquito population: The effects of wind and critical patch size. Math Biosci Eng 2019; 16:4399-4414. [PMID: 31499668 DOI: 10.3934/mbe.2019219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Releasing mosquitoes with Wolbachia into the wild mosquito population is becoming the very promising strategy to control mosquito-borne infections. To investigate the effects of wind and critical patch size on the Wolbachia establishment in the wild mosquito population, in this paper, we propose a diffusion-reaction-advection system in a heterogeneous environment. By studying the related eigenvalue problems, we derive various conditions under which Wolbachia can fully establish in the entire wild mosquito population. Our findings may provide some useful insights on designing practical releasing strategies to control the mosquito population.
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Affiliation(s)
- Yun Feng Liu
- School of Mathematics and Information Sciences, Guangzhou University, Guangzhou, 510006, China
| | - Guo Wei Sun
- School of Mathematics and Information Technology, Yuncheng University, Yuncheng, Shanxi, 044000, China
| | - Lin Wang
- Department of Mathematics and Statistics, University of New Brunswick, Fredericton, NB, E3B 5A3, Canada
| | - Zhi Ming Guo
- School of Mathematics and Information Sciences, Guangzhou University, Guangzhou, 510006, China
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17
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Mostafavi H, Abeyratne E, Zaid A, Taylor A. Arthritogenic Alphavirus-Induced Immunopathology and Targeting Host Inflammation as A Therapeutic Strategy for Alphaviral Disease. Viruses 2019; 11:v11030290. [PMID: 30909385 PMCID: PMC6466158 DOI: 10.3390/v11030290] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 03/19/2019] [Accepted: 03/19/2019] [Indexed: 12/25/2022] Open
Abstract
Arthritogenic alphaviruses are a group of medically important arboviruses that cause inflammatory musculoskeletal disease in humans with debilitating symptoms, such as arthralgia, arthritis, and myalgia. The arthritogenic, or Old World, alphaviruses are capable of causing explosive outbreaks, with some viruses of major global concern. At present, there are no specific therapeutics or commercially available vaccines available to prevent alphaviral disease. Infected patients are typically treated with analgesics and non-steroidal anti-inflammatory drugs to provide often inadequate symptomatic relief. Studies to determine the mechanisms of arthritogenic alphaviral disease have highlighted the role of the host immune system in disease pathogenesis. This review discusses the current knowledge of the innate immune response to acute alphavirus infection and alphavirus-induced immunopathology. Therapeutic strategies to treat arthritogenic alphavirus disease by targeting the host immune response are also examined.
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Affiliation(s)
- Helen Mostafavi
- Emerging Viruses and Inflammation Research Group, Institute for Glycomics, Griffith University, Gold Coast, QLD 4222, Australia.
| | - Eranga Abeyratne
- Emerging Viruses and Inflammation Research Group, Institute for Glycomics, Griffith University, Gold Coast, QLD 4222, Australia.
| | - Ali Zaid
- Emerging Viruses and Inflammation Research Group, Institute for Glycomics, Griffith University, Gold Coast, QLD 4222, Australia.
| | - Adam Taylor
- Emerging Viruses and Inflammation Research Group, Institute for Glycomics, Griffith University, Gold Coast, QLD 4222, Australia.
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18
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Kinimi E, Shayo MJ, Patrick BN, Angwenyi SO, Kasanga CJ, Weyer J, Jansen van Vuren P, Paweska JT, Mboera LEG, Misinzo G. Evidence of chikungunya virus infection among febrile patients seeking healthcare in selected districts of Tanzania. Infect Ecol Epidemiol 2018; 8:1553460. [PMID: 30834070 PMCID: PMC6394322 DOI: 10.1080/20008686.2018.1553460] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Accepted: 11/19/2018] [Indexed: 01/10/2023] Open
Abstract
Introduction: Chikungunya virus (CHIKV) infection is an emerging mosquito-borne disease that has been associated with frequent epidemics in the world. However, there is a dearth of information on its magnitude and associated risk factors in Tanzania. Objective: A study was conducted to determine seroprevalence of CHIKV among febrile patients seeking medical care at health facilities in Karagwe, Sengerema, Kilombero and Kyela districts. Methods: Structured questionnaires were administered and 728 serum samples were collected between May and June, 2015 and tested for the presence of CHIKV-IgM and IgG-specific antibodies using Enzyme-linked immunosorbent assay. Results and discussion: The common clinical characteristics exhibited by outpatients were fever, headache and joint pains (100%, 70%, and 68.3% respectively). Out of 728 outpatients screened for CHIKV, 105 (14%) tested CHIKV IgG positive whilst 11 (1.5%) tested CHIKV IgM positive. Chikungunya seropositivity was significantly higher than previously reported in Tanzania. The most affected age group was 20–29 years. Our results indicate that CHIKV infection is prevalent and contributes to the burden of febrile illnesses in Tanzania. The seroprevalence varies between districts, reflecting variation in mosquito vector transmission dynamics in different parts of the country. Abbreviations: CHIKV: Chikungunya virus; EDTA: Ethylenediaminetetraacetic acid; ELISA: Enzyme-linked immunosorbent assay; IgG: Immunoglobulin G; IgM: Immunoglobulin M; NIMR: National Institute for Medical Research; RU: Relative Units; SACIDS: Southern African Centre for Infectious Disease Surveillance; USA: United States of America
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Affiliation(s)
- Edson Kinimi
- Department of Veterinary Microbiology, Parasitology and Biotechnology, College of Veterinary Medicine and Biomedical Sciences, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Mariana J Shayo
- Department of Veterinary Microbiology, Parasitology and Biotechnology, College of Veterinary Medicine and Biomedical Sciences, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Bisimwa N Patrick
- Department of Veterinary Microbiology, Parasitology and Biotechnology, College of Veterinary Medicine and Biomedical Sciences, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Samuel O Angwenyi
- Department of Veterinary Microbiology, Parasitology and Biotechnology, College of Veterinary Medicine and Biomedical Sciences, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Christopher J Kasanga
- Department of Veterinary Microbiology, Parasitology and Biotechnology, College of Veterinary Medicine and Biomedical Sciences, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Jacqueline Weyer
- Center for Emerging, Zoonotic and Parasitic Diseases, National Institute for Communicable Diseases of the National Health Laboratory Services, Sandringham, Republic of South Africa
| | - Petrus Jansen van Vuren
- Center for Emerging, Zoonotic and Parasitic Diseases, National Institute for Communicable Diseases of the National Health Laboratory Services, Sandringham, Republic of South Africa
| | - Janusz T Paweska
- Center for Emerging, Zoonotic and Parasitic Diseases, National Institute for Communicable Diseases of the National Health Laboratory Services, Sandringham, Republic of South Africa.,Southern African Centre for Infectious Disease Surveillance (SACIDS) - Africa Centre of Excellence for Infectious Disease of Human and Animals, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Leonard E G Mboera
- Southern African Centre for Infectious Disease Surveillance (SACIDS) - Africa Centre of Excellence for Infectious Disease of Human and Animals, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Gerald Misinzo
- Department of Veterinary Microbiology, Parasitology and Biotechnology, College of Veterinary Medicine and Biomedical Sciences, Sokoine University of Agriculture, Morogoro, Tanzania.,Southern African Centre for Infectious Disease Surveillance (SACIDS) - Africa Centre of Excellence for Infectious Disease of Human and Animals, Sokoine University of Agriculture, Morogoro, Tanzania
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19
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Prow NA, Mah MG, Deerain JM, Warrilow D, Colmant AMG, O'Brien CA, Harrison JJ, McLean BJ, Hewlett EK, Piyasena TBH, Hall-Mendelin S, van den Hurk AF, Watterson D, Huang B, Schulz BL, Webb CE, Johansen CA, Chow WK, Hobson-Peters J, Cazier C, Coffey LL, Faddy HM, Suhrbier A, Bielefeldt-Ohmann H, Hall RA. New genotypes of Liao ning virus (LNV) in Australia exhibit an insect-specific phenotype. J Gen Virol 2018. [PMID: 29533743 DOI: 10.1099/jgv.0.001038] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Liao ning virus (LNV) was first isolated in 1996 from mosquitoes in China, and has been shown to replicate in selected mammalian cell lines and to cause lethal haemorrhagic disease in experimentally infected mice. The first detection of LNV in Australia was by deep sequencing of mosquito homogenates. We subsequently isolated LNV from mosquitoes of four genera (Culex, Anopheles, Mansonia and Aedes) in New South Wales, Northern Territory, Queensland and Western Australia; the earliest of these Australian isolates were obtained from mosquitoes collected in 1988, predating the first Chinese isolates. Genetic analysis revealed that the Australian LNV isolates formed two new genotypes: one including isolates from eastern and northern Australia, and the second comprising isolates from the south-western corner of the continent. In contrast to findings reported for the Chinese LNV isolates, the Australian LNV isolates did not replicate in vertebrate cells in vitro or in vivo, or produce signs of disease in wild-type or immunodeficient mice. A panel of human and animal sera collected from regions where the virus was found in high prevalence also showed no evidence of LNV-specific antibodies. Furthermore, high rates of virus detection in progeny reared from infected adult female mosquitoes, coupled with visualization of the virus within the ovarian follicles by immunohistochemistry, suggest that LNV is transmitted transovarially. Thus, despite relatively minor genomic differences between Chinese and Australian LNV strains, the latter display a characteristic insect-specific phenotype.
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Affiliation(s)
- Natalie A Prow
- Australian Infectious Diseases Research Centre, The University of Queensland, Queensland, Australia.,QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia.,School of Chemistry and Molecular Biosciences, The University of Queensland, Queensland, Australia
| | - Marcus G Mah
- QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia.,School of Chemistry and Molecular Biosciences, The University of Queensland, Queensland, Australia.,Present address: Duke-NUS Medical School, Programme in Emerging Infectious Diseases, 8 College Rd, 169857, Singapore
| | - Joshua M Deerain
- Present address: Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, 792 Elizabeth Street, Melbourne, VIC 3000, Australia.,School of Chemistry and Molecular Biosciences, The University of Queensland, Queensland, Australia.,Australian Infectious Diseases Research Centre, The University of Queensland, Queensland, Australia
| | - David Warrilow
- Public Health Virology, Queensland Health Forensic and Scientific Services (QHFSS), Queensland, Australia
| | - Agathe M G Colmant
- School of Chemistry and Molecular Biosciences, The University of Queensland, Queensland, Australia.,Australian Infectious Diseases Research Centre, The University of Queensland, Queensland, Australia
| | - Caitlin A O'Brien
- School of Chemistry and Molecular Biosciences, The University of Queensland, Queensland, Australia.,Australian Infectious Diseases Research Centre, The University of Queensland, Queensland, Australia
| | - Jessica J Harrison
- School of Chemistry and Molecular Biosciences, The University of Queensland, Queensland, Australia.,Australian Infectious Diseases Research Centre, The University of Queensland, Queensland, Australia
| | - Breeanna J McLean
- School of Chemistry and Molecular Biosciences, The University of Queensland, Queensland, Australia.,Australian Infectious Diseases Research Centre, The University of Queensland, Queensland, Australia.,Present address: Monash University, Institute of Vector-Borne Disease, 12 Innovation Walk, Clayton, VIC 3800, Australia
| | - Elise K Hewlett
- School of Chemistry and Molecular Biosciences, The University of Queensland, Queensland, Australia.,Research and Development, Australian Red Cross Blood Service, Brisbane, Queensland, Australia
| | - Thisun B H Piyasena
- School of Chemistry and Molecular Biosciences, The University of Queensland, Queensland, Australia.,Australian Infectious Diseases Research Centre, The University of Queensland, Queensland, Australia
| | - Sonja Hall-Mendelin
- Public Health Virology, Queensland Health Forensic and Scientific Services (QHFSS), Queensland, Australia
| | - Andrew F van den Hurk
- Public Health Virology, Queensland Health Forensic and Scientific Services (QHFSS), Queensland, Australia
| | - Daniel Watterson
- School of Chemistry and Molecular Biosciences, The University of Queensland, Queensland, Australia.,Australian Infectious Diseases Research Centre, The University of Queensland, Queensland, Australia
| | - Bixing Huang
- Public Health Virology, Queensland Health Forensic and Scientific Services (QHFSS), Queensland, Australia
| | - Benjamin L Schulz
- School of Chemistry and Molecular Biosciences, The University of Queensland, Queensland, Australia.,Australian Infectious Diseases Research Centre, The University of Queensland, Queensland, Australia
| | - Cameron E Webb
- Medical Entomology Marie Bashir Institute of Infectious Diseases and Biosecurity, The University of Sydney, Sydney, NSW, Australia
| | - Cheryl A Johansen
- PathWest Laboratory Medicine WA, Nedlands, Western Australia, Australia.,School of Biomedical Sciences, The University of Western Australia, Nedlands, Western Australia, Australia
| | - Weng K Chow
- Australian Defence Force Malaria Infectious and Disease Institute, Gallipoli Barracks, Enoggera Queensland 4051, Australia
| | - Jody Hobson-Peters
- School of Chemistry and Molecular Biosciences, The University of Queensland, Queensland, Australia.,Australian Infectious Diseases Research Centre, The University of Queensland, Queensland, Australia
| | - Chris Cazier
- Queensland University of Technology, Brisbane, Queensland, Australia
| | - Lark L Coffey
- Department of Pathology, Microbiology and Immunology, School of Veterinary Medicine, University of California, Davis, CA, USA
| | - Helen M Faddy
- Research and Development, Australian Red Cross Blood Service, Brisbane, Queensland, Australia
| | - Andreas Suhrbier
- QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia.,Australian Infectious Diseases Research Centre, The University of Queensland, Queensland, Australia
| | - Helle Bielefeldt-Ohmann
- School of Veterinary Science, The University of Queensland, Gatton, Queensland, Australia.,Australian Infectious Diseases Research Centre, The University of Queensland, Queensland, Australia
| | - Roy A Hall
- Australian Infectious Diseases Research Centre, The University of Queensland, Queensland, Australia.,School of Chemistry and Molecular Biosciences, The University of Queensland, Queensland, Australia
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20
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Abstract
The emergence of outbreaks of Zika virus (ZIKV) in Brazil in 2015 was associated with devastating effects on fetal development and prompted a world health emergency and multiple efforts to generate an effective vaccine against infection. There are now more than 40 vaccine candidates in preclinical development and six in clinical trials. Despite similarities with other flaviviruses to which successful vaccines have been developed, such as yellow fever virus and Japanese Encephalitis virus, there are unique challenges to the development and clinical trials of a vaccine for ZIKV.
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Affiliation(s)
| | | | | | - Stephen J Thomas
- 2 Infectious Disease Division, Upstate Medical University, State University of New York , Syracuse, New York
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21
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Webster D, Dimitrova K, Holloway K, Makowski K, Safronetz D, Drebot MA. California Serogroup Virus Infection Associated with Encephalitis and Cognitive Decline, Canada, 2015. Emerg Infect Dis 2017; 23:1423-1424. [PMID: 28726628 PMCID: PMC5547809 DOI: 10.3201/eid2308.170239] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
California serogroup (CSG) viruses, such as Jamestown Canyon and snowshoe hare viruses, are mosquitoborne pathogens that cause febrile illness and neurologic disease. Human exposures have been described across Canada, but infections are likely underdiagnosed. We describe a case of neuroinvasive illness in a New Brunswick, Canada, patient infected with a CSG virus.
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22
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Shihada S, Emmerich P, Thomé-Bolduan C, Jansen S, Günther S, Frank C, Schmidt-Chanasit J, Cadar D. Genetic Diversity and New Lineages of Dengue Virus Serotypes 3 and 4 in Returning Travelers, Germany, 2006-2015. Emerg Infect Dis 2017; 23:272-275. [PMID: 28098525 PMCID: PMC5324807 DOI: 10.3201/eid2302.160751] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
During 2006-2015, we analyzed 70 dengue virus (DENV) strains isolated from febrile travelers returning to Germany. High genetic diversity, including multiple co-circulating DENV lineages and emerging new lineages of DENV-3 and DENV-4, was demonstrated. Our passive surveillance system based on returning travelers yielded substantial information on DENV diversity.
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23
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Vanlandingham DL, Higgs S, Huang YJS. Aedes albopictus (Diptera: Culicidae) and Mosquito-Borne Viruses in the United States. J Med Entomol 2016; 53:1024-1028. [PMID: 27113107 DOI: 10.1093/jme/tjw025] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Accepted: 02/24/2016] [Indexed: 06/05/2023]
Abstract
The Asian tiger mosquito Aedes albopictus (Skuse), is a highly invasive species that continues to expand its geographic distribution both in the United States and in countries on other continents. Studies have demonstrated its susceptibility to infection with at least 32 viruses, including 13 that are present in the United States. Despite this susceptibility, its role as a significant competent vector in natural transmission cycles of arboviruses, has been limited. However, with the recent introductions of chikungunya and Zika viruses into the Americas, for which Ae. albopictus is a recognized vector, it is possible that the species may contribute to the transmission of these viruses to humans and perhaps other susceptible vertebrates.
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Affiliation(s)
- Dana L Vanlandingham
- Diagnostic Medicine and Pathobiology, Kansas State University, Manhattan, KS (; ; )
| | - Stephen Higgs
- Diagnostic Medicine and Pathobiology, Kansas State University, Manhattan, KS (; ; ) Biosecurity Research Institute, Kansas State University, Manhattan, KS
| | - Yan-Jang S Huang
- Diagnostic Medicine and Pathobiology, Kansas State University, Manhattan, KS (; ; ) Biosecurity Research Institute, Kansas State University, Manhattan, KS
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24
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Korhonen EM, Huhtamo E, Smura T, Kallio-Kokko H, Raassina M, Vapalahti O. Zika virus infection in a traveller returning from the Maldives, June 2015. ACTA ACUST UNITED AC 2016; 21:30107. [PMID: 26794427 DOI: 10.2807/1560-7917.es.2016.21.2.30107] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 01/14/2016] [Indexed: 11/20/2022]
Abstract
We report a Zika virus (ZIKV) infection in a patient with fever and rash after returning to Finland from Maldives, June 2015. The patient had dengue virus (DENV) IgG and IgM antibodies but pan-flavivirus RT-PCR and subsequent sequencing showed presence of ZIKV RNA in urine. Recent association of ZIKV with microcephaly highlights the need for laboratory differentiation of ZIKV from DENV infection and the circulation of ZIKV in areas outside its currently known distribution range.
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Affiliation(s)
- Essi Marjana Korhonen
- Department of Virology, Medicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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25
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Rezza G, El-Sawaf G, Faggioni G, Vescio F, Al Ameri R, De Santis R, Helaly G, Pomponi A, Metwally D, Fantini M, Qadi H, Ciccozzi M, Lista F. Co-circulation of Dengue and Chikungunya Viruses, Al Hudaydah, Yemen, 2012. Emerg Infect Dis 2016; 20:1351-4. [PMID: 25061762 PMCID: PMC4111199 DOI: 10.3201/eid2008.131615] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We investigated 400 cases of dengue-like illness in persons hospitalized during an outbreak in Al Hudaydah, Yemen, in 2012. Overall, 116 dengue and 49 chikungunya cases were diagnosed. Dengue virus type 2 was the predominant serotype. The co-circulation of these viruses indicates that mosquitoborne infections represent a public health threat in Yemen.
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26
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Diaz JH. Chemical and Plant-Based Insect Repellents: Efficacy, Safety, and Toxicity. Wilderness Environ Med 2016; 27:153-63. [PMID: 26827259 DOI: 10.1016/j.wem.2015.11.007] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 11/17/2015] [Accepted: 11/18/2015] [Indexed: 12/22/2022]
Abstract
Most emerging infectious diseases today are arthropod-borne and cannot be prevented by vaccinations. Because insect repellents offer important topical barriers of personal protection from arthropod-borne infectious diseases, the main objectives of this article were to describe the growing threats to public health from emerging arthropod-borne infectious diseases, to define the differences between insect repellents and insecticides, and to compare the efficacies and toxicities of chemical and plant-derived insect repellents. Internet search engines were queried with key words to identify scientific articles on the efficacy, safety, and toxicity of chemical and plant-derived topical insect repellants and insecticides to meet these objectives. Data sources reviewed included case reports; case series; observational, longitudinal, and surveillance studies; and entomological and toxicological studies. Descriptive analysis of the data sources identified the most effective application of insect repellents as a combination of topical chemical repellents, either N-diethyl-3-methylbenzamide (formerly N, N-diethyl-m-toluamide, or DEET) or picaridin, and permethrin-impregnated or other pyrethroid-impregnated clothing over topically treated skin. The insecticide-treated clothing would provide contact-level insecticidal effects and provide better, longer lasting protection against malaria-transmitting mosquitoes and ticks than topical DEET or picaridin alone. In special cases, where environmental exposures to disease-transmitting ticks, biting midges, sandflies, or blackflies are anticipated, topical insect repellents containing IR3535, picaridin, or oil of lemon eucalyptus (p-menthane-3, 8-diol or PMD) would offer better topical protection than topical DEET alone.
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Affiliation(s)
- James H Diaz
- Schools of Public Health and Medicine, Louisiana State University, Health Sciences Center, New Orleans, LA.
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27
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Jones SG, Coulter S, Conner W. Using administrative medical claims data to supplement state disease registry systems for reporting zoonotic infections. J Am Med Inform Assoc 2013; 20:193-8. [PMID: 22811492 PMCID: PMC3555318 DOI: 10.1136/amiajnl-2012-000948] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Accepted: 06/20/2012] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To determine what, if any, opportunity exists in using administrative medical claims data for supplemental reporting to the state infectious disease registry system. MATERIALS AND METHODS Cases of five tick-borne (Lyme disease (LD), babesiosis, ehrlichiosis, Rocky Mountain spotted fever (RMSF), tularemia) and two mosquito-borne diseases (West Nile virus, La Crosse viral encephalitis) reported to the Tennessee Department of Health during 2000-2009 were selected for study. Similarly, medically diagnosed cases from a Tennessee-based managed care organization (MCO) claims data warehouse were extracted for the same time period. MCO and Tennessee Department of Health incidence rates were compared using a complete randomized block design within a general linear mixed model to measure potential supplemental reporting opportunity. RESULTS MCO LD incidence was 7.7 times higher (p<0.001) than that reported to the state, possibly indicating significant under-reporting (∼196 unreported cases per year). MCO data also suggest about 33 cases of RMSF go unreported each year in Tennessee (p<0.001). Three cases of babesiosis were discovered using claims data, a significant finding as this disease was only recently confirmed in Tennessee. DISCUSSION Data sharing between MCOs and health departments for vaccine information already exists (eg, the Vaccine Safety Datalink Rapid Cycle Analysis project). There may be a significant opportunity in Tennessee to supplement the current passive infectious disease reporting system with administrative claims data, particularly for LD and RMSF. CONCLUSIONS There are limitations with administrative claims data, but health plans may help bridge data gaps and support the federal administration's vision of combining public and private data into one source.
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Affiliation(s)
- Stephen G Jones
- BlueCross and BlueShield of Tennessee, Chattanooga, TN 37402, USA.
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