Emerging infectious encephalitides.

PURPOSE OF REVIEW: The COVID-19 pandemic has cast increased attention on emerging infections. Clinicians and public health experts should be aware of emerging infectious causes of encephalitis, mechanisms by which they are transmitted, and clinical manifestations of disease. RECENT FINDINGS: A number of arthropod-borne viral infections -- transmitted chiefly by mosquitoes and ticks -- have emerged in recent years to cause outbreaks of encephalitis. Examples include Powassan virus in North America, Chikungunya virus in Central and South America, and tick-borne encephalitis virus in Europe. Many of these viruses exhibit complex life cycles and can infect multiple host animals in addition to humans. Factors thought to influence emergence of these diseases, including changes in climate and land use, are also believed to underlie the emergence of the rickettsial bacterium Orientia tsutsugamushi, now recognized as a major causative agent of acute encephalitis syndrome in South Asia. In addition, the COVID-19 pandemic has highlighted the role of bats as carriers of viruses. Recent studies have begun to uncover mechanisms by which the immune systems of bats are poised to allow for viral tolerance. Several bat-borne infections, including Nipah virus and Ebola virus, have resulted in recent outbreaks of encephalitis. SUMMARY: Infectious causes of encephalitis continue to emerge worldwide, in part because of climate change and human impacts on the environment. Expansion of surveillance measures will be critical in rapid diagnosis and limiting of outbreaks in the future.

The ecology and epidemiology of Ross River and Murray Valley encephalitis viruses in Western Australia: examples of One Health in Action.

Arboviruses are maintained and transmitted through an alternating biological cycle in arthropods and vertebrates, with largely incidental disease in humans and animals. As such, they provide excellent examples of One Health, as their health impact is inextricably linked to their vertebrate hosts, their arthropod vectors and the environment. Prevention and control requires a comprehensive understanding of these interactions, and how they may be effectively and safely modified. This review concentrates on human disease due to Ross River and Murray Valley encephalitis viruses, the two major arboviral pathogens in Australia. It describes how their pattern of infection and disease is influenced by natural climatic and weather patterns, and by anthropogenic activities. The latter includes human-mediated environmental manipulations, such as water impoundment infrastructures, human movements and migration, and community and social changes, such as urban spread into mosquito larval habitats. Effective interventions need to be directed at the environmental precursors of risk. This can best be achieved using One Health approaches to improve collaboration and coordination between different disciplines and cross-sectoral jurisdictions in order to develop more holistic mitigation and control procedures, and to address poorly understood ecological issues through multidisciplinary research.

A review of West Nile and Usutu virus co-circulation in Europe: how much do transmission cycles overlap?

Due to the increasing global spread of arboviruses, the geographic extent of virus co-circulation is expanding. This complicates the diagnosis of febrile conditions and can have direct effects on the epidemiology. As previously demonstrated, subsequent infections by two closely related viruses, such as those belonging to the Japanese encephalitis virus (JEV) serocomplex, can lead to partial or complete cross-immunity, altering the risk of infections or the outcome of disease. Two flaviviruses that may interact at population level are West Nile virus (WNV) and Usutu virus (USUV). These pathogens have antigenic cross-reactivity and affect human and animal populations throughout Europe. This systematic review investigates the overlap of WNV and USUV transmission cycles, not only geographically but also in terms of host and vector ranges. Co-circulation of WNV and USUV was reported in 10 countries and the viruses were found to infect 34 common bird species belonging to 11 orders. Moreover, four mosquito species are potential vectors for both viruses. Taken together, these data suggest that WNV and USUV transmission overlaps substantially in Europe and highlight the importance of further studies investigating the interactions between the two viruses within host and vector populations.

Habitat modification for mosquito control in the Ilparpa Swamp, Northern Territory, Australia.

Habitat modification is an established method of effective long-term mosquito management, particularly in salt-marsh environments. It is especially pertinent when mosquitoes are known vectors of life-threatening disease and their larval breeding habitat is in close proximity to residential areas. The Ilparpa Swamp is located less than 10 km from Alice Springs, Northern Territory. Wet season rainfall, often followed by effluent discharges to the swamp from the adjacent sewage treatment plant, create ideal sites for the immature stages of the common banded mosquito Culex annulirostris (Skuse), a major vector of Murray Valley encephalitis (MVEV) and Kunjin (KUNV) viruses. Subsequent to increases in notifications of MVEV disease cases in 2000 and 2001, a drainage system was established in the Ilparpa Swamp in early 2002. This paper evaluates the drainage intervention effects. Results indicate a significant reduction in mosquito numbers following habitat modification, which remain low. There have been no seroconversions in sentinel chickens to MVEV or KUNV and no human infections from these viruses in the Alice Springs urban region since the drains were completed. Habitat modification has successfully reduced mosquito numbers and minimized the risk for mosquito-borne disease to residents in Alice Springs urban and surrounding areas, which has never before been documented in Australia.

Usutu virus in Africa.

Usutu virus (USUV) was discovered in South Africa in 1959. Since then, it has been reported in several African countries including Senegal, Central African Republic, Nigeria, Uganda, Burkina Faso, Cote d'Ivoire, and Morocco. In 2001, USUV has been identified for the first time outside of Africa, namely in Europe, where it caused a significant mortality among blackbirds in Vienna, Austria. In 2009, the first two human cases of USUV infection in Europe have been reported in Italy, causing encephalitis in immunocompromised patients. The host range in Africa includes mainly Culex mosquitoes, birds, and also humans with one benign and one severe case. Given its role as a potential human pathogen and the similar appearance compared with other emerging arboviruses, it is essential to investigate the natural history and ecology of USUV in Africa. In this regard, we review the emergence of USUV in Africa, summarizing data about isolations, host range, and potential vectors, which should help to improve our understanding of the factors underlying the circulation of USUV in Europe and Africa.

Vertical and horizontal transmission of tilapia larvae encephalitis virus: the bad and the ugly.

Impairment of innate immunity in tilapia larvae after vertical and horizontal infection with the newly characterized tilapia larvae encephalitis virus (TLEV) was accessed by evaluation of cell-mediated reactive oxygen species (ROS) production in affected fish with the use of horseradish peroxidase-amplified luminol-dependent chemiluminescence assay. The priming in-vivo infection with TLEV resulted in downregulation of ROS response in both vertically- and horizontally-infected fish; this suppression was further exacerbated by specific in-vitro booster infection with the same virus. Application of Ca ionophore and phorbol myristate acetate as alternative nonspecific boosters enabled restoration of ROS release in vertically-infected but not in horizontally-infected larvae. The results indicate severe TLEV-imposed phagocyte dysfunction in affected larvae. The difference in restoration potential of ROS production after vertical and horizontal virus transmission is interpreted in the frame of principal distinctions between the two modes.

[New records and epidemiological potential of certain species of mosquito (Diptera, Culicidae) in the State of Rio Grande do Sul, Brazil]. / Novos registros e potencial epidemiológico de algumas espécies de mosquitos (Diptera, Culicidae), no Estado do Rio Grande do Sul.

INTRODUCTION: Entomological surveillance has proven to be an important strategy for monitoring culicidae fauna, aimed at predicting the risk of exposure to pathogen vector species. The present work reports species identified for the first time in the State Rio Grande do Sul and discusses the epidemiological potential displayed by mosquito species occurring in Maquiné municipality and in other regions of the State. METHODS: Mosquitoes were collected with Nasci vacuum and CDC light traps between December 2006 and December 2008, in the wild, rural and urban areas of Maquiné. RESULTS: Fifty-five species were verified, of which 22 were registered for the first time in the state and 10 are potential vector species for the Saint Louis, Oropouche, Aura, Trocara, Ilhéus, Rocio, Una, West Nile, and eastern equine encephalitis viruses. CONCLUSIONS: These data demonstrate the importance of entomological surveillance as a tool for gathering information and promoting Health Surveillance actions.

Novos registros e potencial epidemiológico de algumas espécies de mosquitos (Diptera, Culicidae), no Estado do Rio Grande do Sul / New records and epidemiological potential of certain species of mosquito (Diptera, Culicidae) in the State of Rio Grande do Sul, Brazil

INTRODUÇÃO: A vigilância entomológica tem se mostrado uma importante estratégia de monitoramento da fauna de culicídeos com vistas a predizer o risco de exposição a espécies vetoras de patógenos. Esse trabalho apresenta uma lista de mosquitos identificados pela primeira vez no Rio Grande do Sul e discute o potencial epidemiológico de algumas espécies ocorrentes no Município de Maquiné com registros em outras regiões do Estado. MÉTODOS: Os mosquitos foram coletados com aspirador de Nasci e armadilhas CDC, entre dezembro de 2006 e dezembro de 2008, em área silvestre, rural e urbana do Município de Maquiné. RESULTADOS: Foram verificadas 55 espécies, das quais 22 são registradas pela primeira vez no estado e 10 são potencialmente vetoras do vírus Saint Louis, Oropouche, Aura, Trocara, Ilhéus, Rocio, Una, West Nile e encefalite equina do leste. CONCLUSÕES: Esses dados demonstram a importância da Vigilância Entomológica como ferramenta de informação e ação para a Vigilância em Saúde.

INTRODUCTION: Entomological surveillance has proven to be an important strategy for monitoring culicidae fauna, aimed at predicting the risk of exposure to pathogen vector species. The present work reports species identified for the first time in the State Rio Grande do Sul and discusses the epidemiological potential displayed by mosquito species occurring in Maquiné municipality and in other regions of the State. METHODS: Mosquitoes were collected with Nasci vacuum and CDC light traps between December 2006 and December 2008, in the wild, rural and urban areas of Maquiné. RESULTS: Fifty-five species were verified, of which 22 were registered for the first time in the state and 10 are potential vector species for the Saint Louis, Oropouche, Aura, Trocara, Ilhéus, Rocio, Una, West Nile, and eastern equine encephalitis viruses. CONCLUSIONS: These data demonstrate the importance of entomological surveillance as a tool for gathering information and promoting Health Surveillance actions.

Arboviral encephalitides: transmission, emergence, and pathogenesis.

Arthropod-borne viruses (arboviruses) are of paramount concern as a group of pathogens at the forefront of emerging and re-emerging diseases. Although some arboviral infections are asymptomatic or present with a mild influenza-like illness, many are important human and veterinary pathogens causing serious illness ranging from rash and arthritis to encephalitis and hemorrhagic fever. Here, we discuss arboviruses from diverse families (Flaviviruses, Alphaviruses, and the Bunyaviridae) that are causative agents of encephalitis in humans. An understanding of the natural history of these infections as well as shared mechanisms of neuroinvasion and neurovirulence is critical to control the spread of these viruses and for the development of effective vaccines and treatment modalities.

[Study on the characteristics of major mosquito-borne infectious diseases in Three Gorges Reservoir Area from 1997 to 2008].

OBJECTIVE: Characteristics and tendency of mosquito and major mosquito-borne diseases (including epidemic encephalitis B and malaria) were analyzed in the Three Gorges Reservoir Area from 1997 to 2008. METHODS: Information on surveillance data related to mosquito-borne infectious diseases and on mosquito density and category, from 1997 to 2008 was collected from Health Surveillance System in Three Gorges Reservoir Area. Data regarding meteorological factors and construction of Three Gorges Reservoir was also collected. Pearson and Poisson models were used. RESULTS: From 1997 to 2008, in the Three Gorges Reservoir Area, the incidence rates of epidemic encephalitis B and malaria were decreasing. Positive correlations were shown between indoor and outdoor mosquito density as well with temperature with coefficient as 0.281 and 0.355 respectively. Correlations of mosquito-borne diseases with indoor and outdoor mosquito density were positive, with correlation coefficient as 0.340 and 0.328 respectively. CONCLUSION: There seemed lack of evidence to prove that negative influences had occurred on the incidence of mosquito-borne infectious diseases or the mosquito density after the Three Gorges Reservoir water storage came into being in 2003, however, long-time surveillance program needs to be carried out to gather information on this issue.

Influence of hosts on the ecology of arboviral transmission: potential mechanisms influencing dengue, Murray Valley encephalitis, and Ross River virus in Australia.

Ecological interactions are fundamental to the transmission of infectious disease. Arboviruses are particularly elegant examples, where rich arrays of mechanisms influence transmission between vectors and hosts. Research on host contributions to the ecology of arboviral diseases has been undertaken within multiple subdisciplines, but significant gaps in knowledge remain and multidisciplinary approaches are needed. Through our multidisciplinary review of the literature we have identified five broad areas where hosts may influence the ecology of arboviral transmission: host immunity; cross-protective immunity and antibody-dependent enhancement; host abundance; host diversity; and pathogen spillover and dispersal. Herein we discuss the known and theoretical roles of hosts within these topics and then apply this knowledge to three epidemiologically important mosquito-borne arboviruses that occur in Australia: dengue virus (DENV), Murray Valley encephalitis virus (MVEV), and Ross River virus (RRV). We argue that the underlying mechanisms by which hosts influence arboviral activity are numerous and attempts to delineate these mechanisms further are needed. Investigations that focus on hosts of vector-borne diseases are likely to be rewarding, particularly where the ecology of vectors is relatively well understood. From an applied perspective, enhanced knowledge of host influences upon vector-borne disease transmission is likely to enable better management of disease burden. Finally, we suggest a framework that may be useful to identify and determine host contributions to the ecology of arboviruses.

Climate change and mosquito-borne disease: knowing the horse before hitching the cart.

Speculations on the potential impacts of climate change on human health often focus on the mosquito-borne diseases but ignore the complex interplay of the multitude of factors that are generally dominant in the dynamics of their transmission. A holistic view of this complexity - particularly the ecology and behaviour of the host and the ecology and behaviour of the vector - is the only valid starting point for assessing the significance of climate in the prevalence and incidence of these diseases.

Vaccination against mosquito borne viral infections: current status.

Mosquito borne infectious diseases are among important group of diseases worldwide. Vaccination is available for some tropical mosquito-borne diseases, especially for Japanese encephalitis virus infection and yellow fever. There are also several attempts to develop new vaccines for the other mosquito-borne diseases such as malaria, dengue infection and West Nile virus infection. In this article, the author reviews the issues on vaccination of some important tropical mosquito borne infectious diseases.

Comparison of immune responses of brown-headed cowbird and related blackbirds to west Nile and other mosquito-borne encephalitis viruses.

The rapid geographic spread of West Nile virus (family Flaviviridae, genus Flavivirus, WNV) across the United States has stimulated interest in comparative host infection studies to delineate competent avian hosts critical for viral amplification. We compared the host competence of four taxonomically related blackbird species (Icteridae) after experimental infection with WNV and with two endemic, mosquito-borne encephalitis viruses, western equine encephalomyelitis virus (family Togaviridae, genus Alphavirus, WEEV), and St. Louis encephalitis virus (family Flaviviridae, genus Flavivirus, SLEV). We predicted differences in disease resistance among the blackbird species based on differences in life history, because they differ in geographic range and life history traits that include mating and breeding systems. Differences were observed among the response of these hosts to all three viruses. Red-winged Blackbirds were more susceptible to SLEV than Brewer's Blackbirds, whereas Brewer's Blackbirds were more susceptible to WEEV than Red-winged Blackbirds. In response to WNV infection, cowbirds showed the lowest mean viremias, cleared their infections faster, and showed lower antibody levels than concurrently infected species. Brown-headed Cowbirds also exhibited significantly lower viremia responses after infection with SLEV and WEEV as well as coinfection with WEEV and WNV than concurrently infected icterids. We concluded that cowbirds may be more resistant to infection to both native and introduced viruses because they experience heightened exposure to a variety of pathogens of parenting birds during the course of their parasitic life style.

Emergence and virulence of encephalitogenic arboviruses.

Each arbovirus that causes encephalitis is geographically restricted by the availability of appropriate vectors and reservoir hosts. These viruses evolve regionally by recombination, reassortment and point mutation and can "emerge" as causes of human encephalitis through extension to new geographic regions or by selection of more virulent or more efficiently transmitted virus variants. The properties of arboviruses that result in encephalitis involve efficient replication in peripheral tissues after initiation of infection, production of a viremia, entry into the central nervous system and efficient replication in neurons with spread to additional populations of neurons. Many of these steps are determined by properties of the envelope glycoproteins responsible for cellular attachment, but changes in noncoding regions of the genome, as well as in other structural and nonstructural proteins, also contribute to neurovirulence.

Epizootic activity of Murray Valley encephalitis and Kunjin viruses in an aboriginal community in the southeast Kimberley region of Western Australia: results of mosquito fauna and virus isolation studies.

We undertook annual surveys of flavivirus activity in the community of Billiluna in the southeast Kimberley region of Western Australia between 1989 and 2001 [corrected]. Culex annulirostris was the dominant mosquito species, particularly in years of above average rains and flooding. Murray Valley encephalitis (MVE) virus was isolated in 8 of the 13 years of the study from seven mosquito species, but more than 90% of the isolates were from Cx. annulirostris. The results suggest that MVE virus is epizootic in the region, w ith activity only apparent in years with average or above average rainfall and increased numbers of Cx. annulirostris. High levels of MVE virus activity and associated human cases were detected only once (in 1993) during the survey period. Activity of MVE virus could only be partially correlated with wet season rainfall and flooding, suggesting that a number of other factors must also be considered to accurately predict MVE virus activity at such communities.