Rocky Mountain Spotted Fever Mimicking Multisystem Inflammatory Syndrome in Hospitalized Children, Sonora, Mexico.

We describe 5 children who had Rocky Mountain spotted fever (RMSF) and manifested clinical symptoms similar to multisystem inflammatory syndrome in Sonora, Mexico, where RMSF is hyperendemic. Physicians should consider RMSF in differential diagnoses of hospitalized patients with multisystem inflammatory syndrome to prevent illness and death caused by rickettsial disease.

Insecticide susceptibility status of Anopheles albimanus populations in historical malaria foci in Quintana Roo, Mexico.

BACKGROUND: Mexico has experienced a significant reduction in malaria cases over the past two decades. Certification of localities as malaria-free areas (MFAs) has been proposed as a steppingstone before elimination is achieved throughout the country. The Mexican state of Quintana Roo is a candidate for MFA certification. Monitoring the status of insecticide susceptibility of major vectors is crucial for MFA certification. This study describes the susceptibility status of Anopheles albimanus, main malaria vector, from historically important malaria foci in Quintana Roo, using both phenotypic and genotypic approaches. METHODS: Adult mosquito collections were carried out at three localities: Palmar (Municipality of Othon P. Blanco), Buenavista (Bacalar) and Puerto Morelos (Puerto Morelos). Outdoor human-landing catches were performed by pairs of trained staff from 18:00 to 22:00 during 3-night periods at each locality during the rainy season of 2022. Wild-caught female mosquitoes were exposed to diagnostic doses of deltamethrin, permethrin, malathion, pirimiphos-methyl or bendiocarb using CDC bottle bioassays. Mortality was registered at the diagnostic time and recovery was assessed 24 h after exposure. Molecular analyses targeting the Voltage-Gated Sodium Channel (vgsc) gene and acetylcholinesterase (ace-1) gene were used to screen for target site polymorphisms. An SNP analysis was carried out to identify mutations at position 995 in the vgsc gene and at position 280 in the ace-1 gene. RESULTS: A total of 2828 anophelines were collected. The main species identified were Anopheles albimanus (82%) and Anopheles vestitipennis (16%). Mortalities in the CDC bottle bioassay ranged from 99% to 100% for all the insecticides and mosquito species. Sequence analysis was performed on 35 An. albimanus across the three localities; of those, 25 were analysed for vgsc and 10 for ace-1 mutations. All individuals showed wild type alleles. CONCLUSION: The results demonstrated that An. albimanus populations from historical malaria foci in Quintana Roo are susceptible to the main insecticides used by the Ministry of Health.

Arbovirus surveillance on the Mexico-USA border: West Nile virus identification in various species of field mosquitoes.

West Nile virus (WNV) has been documented in human and/or mosquito samples near the border with Mexico in El Paso, Texas, and Doña Ana County, New Mexico. However, on the Mexican side of the border, particularly in the State of Chihuahua, no such cases of WNV-infected mosquitoes have been documented. We tested 367 mosquitoes of four species (Culex quinquefasciatus, Cx. tarsalis, Aedes aegypti, and Aedes (Ochlerotatus) epactius) and found a high rate of WNV-positivity, including the first record of Ae. (Ochlerotatus) epactius infection with WNV. These results call for intensifying WNV surveillance efforts on the border between the United States and Mexico, with particular emphasis on vector control and monitoring of the species included in this study.

Species diversity and detection of pathogens in phlebotomine sand flies collected from forest management areas of Quintana Roo, Mexico.

Sand flies have expanded their areas of distribution, thereby increasing the risk of pathogen transmission in non-endemic areas. To establish efficient prevention and control strategies for the transmission of vector-borne pathogens, it is important to understand seasonal dynamics of their vectors. In Mexico, there are several areas where the contact between sand flies, hosts and reservoirs favours the transmission of the pathogen. We compared sand fly communities in a forest management area and a conserved area in Noh-Bec, Quintana Roo, Mexico. The analysis included species diversity, activity peaks and molecular detection of pathogens. Sand flies were collected from November to December 2021 and April to May 2022, during 84 night-traps. The conserved area showed higher numbers and greater species heterogeneity of sand flies as compared with the other sites. The ß-diversity analysis revealed that sites disturbed by logging (S1, S2, S3) had greater similarity (90%) in their sand fly species composition than a conserved area (S4) (similarity = 36%). Although none of the specimens were infected with Leishmania, we detected Wolbachia (19.4%) in all four sites, as well as Bartonella (3.25%) only in the disturbed sites. Further studies on the dynamics of sand fly populations and their association with pathogens are necessary.

Detection of Wolbachia and Leishmania DNA in sand flies (Diptera: Psychodidae, Phlebotominae) from a focus of cutaneous leishmaniasis in Tabasco, Mexico.

Phlebotomine sand flies are the main vectors of Leishmania genus species worldwide; therefore, the detection of some reproductive parasites, such as Wolbachia, has been considered a possible strategy for biological control. In Mexico, leishmaniasis cases have been recorded in 25 states, yet only two sand fly species have been related to Wolbachia spp. Although the state of Tabasco has a high number of leishmaniasis cases, only few studies have been done on sand fly species. The aim of this study was to analyze the diversity of sand fly species and to detect Wolbachia spp. and/or Leishmania spp. in the captured specimens. Sand flies were collected at the locality of Huimango, Tabasco, Mexico, during October 2019, using nine light traps (CDC) and two Shannon traps per night. The specimens were identified and females were analyzed by PCR for the DNA detection for pathogens. A total of 193 sand fly specimens belonging to five species were morphologically identified. Pintomyia ovallesi was the most abundant species (76.84%), followed by Micropygomyia cayennensis (6.40%). Furthermore, first records of four sand fly species were established for the state of Tabasco, thereby increasing the species richness in the state from four to eight. We observed a natural infection rate of 9.7% (10/103) for Leishmania and 0.91% (1/103) for Wolbachia. The importance of conducting entomological surveys in endemic areas of leishmaniasis in Mexico is highlighted, to determine whether other sand fly species may be potential vectors of Leishmania spp., and if some Wolbachia strains could be relevant for the control of leishmaniasis.

First national record of Aedes melanimon (Diptera: Culicidae) in Mexico.

Aedes (Ochlerotatus) melanimon Dyar 1924 has been considered an important pest in agricultural and rural communities. Aedes melanimon is a vector of WEEV and CEV and is a competent laboratory vector of WNV. The known range of Ae. melanimon extends throughout Southwest Canada, part of Central and most of Western USA. Here we report the first record of Ae. melanimon in Mexico, at Ciudad Juárez, Chihuahua. The collect represents the southernmost distributional record for this species. Its indigenous presence in a highly urbanized and dry area was not expected. A permanent surveillance program to detect and determine the species in border-crossing cities is encouraged.

New records of Triatoma huehuetenanguensis in an urban area of Southwest Mexico.

The recently described Triatoma huehuetenanguensis, has been reported in Mexico, Guatemala, Belize and Honduras. In Mexico, the species has been collected primarily in rural areas; it has the potential to colonize human dwellings, however, its contribution to Chagas outbreaks remains unclear. In 2021, T. huehuetenanguensis was first observed at Tuxtla Gutierrez city, Chiapas; then a collection for the species was performed. A total of 308 houses were inspected in the intra and peridomestic structures. Only 3 houses (0.97%) were infested. Triatoma huehuetenangensis was the only triatomine specie recorded and four males were collected. None of the bugs tested positive for Trypanosoma infection. We do not have evidence to suggest that urban human-vector contact still limited, and a possible domestication process is possible. The presence of reservoirs, the vector species and the parasite demonstrate that Tuxtla Gutierrez could be at risk of a Chagas disease outbreak.

Experimental infection and vector competence of Zika virus in Aedes aegypti mosquitoes from Acapulco, Guerrero, Mexico.

OBJECTIVE: To gain a better understanding of the Zika virus (ZIKV) vector transmission in Mexico, we determined the vector competence of a local population of Ae. aegypti (Acapulco, Guerrero) for a strain of ZIKV isolated from a Mexican febrile patient. MATERIALS AND METHODS: Eggs were hatched and larvae were reared under controlled conditions. After five days post-emergence, female mosquitoes were fed an infectious blood-meal containing ZIKV. Mosquitoes were analyzed at 4, 7 and 14-day post-infection (dpi). Infection (gut), dissemination (wings, legs and heads) and potential transmission (salivary glands) were assessed by RT-qPCR. The Rockefeller Ae. aegypti strain was used as ZIKV infection control. RESULTS: ZIKV infection, dissemination, and potential transmission rates were 96.2, 96.1 and 93.2%, respectively. CONCLUSIONS: Ae. aegypti (F1) from Acapulco were very susceptible to ZIKV infection, and showed similar vector competence to that of the susceptible Rockefeller strain. To our knowledge, this is the first report of vector competence for ZIKV performed in a Mexican laboratory.

OBJETIVO: Determinar la competencia vectorial de una población local de Ae. aegypti para transmitir el virus Zika (ZIKV) aislado de un paciente febril mexicano. MATERIAL Y MÉTODOS: Se desarrolló la primera generación (F1) de mosquitos Ae. aegypti en el insectario a partir de huevos colectados mediante ovitrampas en la Colonia Renacimiento, Acapulco, Guerrero. Después de cinco días de la emergencia, los mosquitos hembras fueron alimentados con sangre infecciosa con ZIKV. La infección (intestino), la diseminación (alas, piernas y cabezas) y la transmisión potencial (glándulas salivales) se evaluaron mediante RT-qPCR, a los 4, 7 y 14 días después de la alimentación. RESULTADOS: La infección por ZIKV, la diseminación y las tasas potenciales de transmisión fueron de 96.2, 96.1 y 93.2%, respectivamente. CONCLUSIONES: Los mosquitos Ae. aegypti (F1) de Acapulco presentan una alta competencia vectorial (93.2%). Según los autores de este estudio, este es el primer informe de competencia vectorial para ZIKV realizado en un laboratorio mexicano.

Aedes aegypti, the dengue fever mosquito in Mexico City. Early invasion and its potential risks.

INTRODUCTION: Mexico City has no endemic presence of Aedes aegypti, and it is therefore free of vector-borne diseases, such as dengue fever, Zika and chikungunya. However, evidence has shown the presence of Aedes aegypti eggs in the city since 2015. OBJECTIVE: To report the constant and increasing presence of Aedes aegypti eggs in Mexico City from 2015 to 2018. METHODS: Surveillance was carried out using ovitraps. Eggs were counted and hatched in order to determine the species. RESULTS: From 2015 to 2018, 378 organisms were identified as Ae. aegypti. In total, 76 Aedes aegypti-positive ovitraps were collected at 50 different places in 11 boroughs of the city. Northeastern Mexico City was the area with the highest number of positive traps. CONCLUSIONS: The results may be indicating a period of early colonization and the probable existence of cryptic colonies of the mosquito; Mexico City could be at risk of experiencing vector-borne epidemics.

INTRODUCCIÓN: La Ciudad de México no tiene presencia endémica de Aedes aegypti, por lo que está libre de enfermedades transmitidas por vector como dengue, Zika y chikunguña. Sin embargo, existe evidencia de la presencia de huevecillos en la urbe desde 2015. OBJETIVO: Reportar la presencia constante y en aumento de huevecillos de Aedes aegypti en la Ciudad de México de 2015 a 2018. MÉTODO: Se realizó vigilancia a través de ovitrampas; se contabilizaron y eclosionaron huevecillos para determinar la especie. RESULTADOS: De 2015 a 2018 fueron identificados 378 organismos como Aedes aegypti. En total fueron colectadas 76 ovitrampas positivas a Aedes aegypti en 50 sitios distintos de 11 alcaldías. El noreste de la Ciudad de México fue el área con mayor positividad. CONCLUSIONES: Los resultados pueden estar indicando un periodo de colonización incipiente y la probable la existencia de colonias crípticas del mosquito, por lo que la Ciudad de México podría estar en riesgo de presentar epidemias de enfermedades transmitidas por vector.

Natural Vertical Transmission of Zika Virus in Larval Aedes aegypti Populations, Morelos, Mexico.

We characterized natural vertical transmission of Zika virus in pools of Aedes aegypti larvae hatched from eggs collected in Jojutla, Morelos, Mexico. Of the 151 pools analyzed, 17 tested positive for Zika virus RNA; infectious Zika virus was successfully isolated from 1 of the larvae pools (31N) in C6/36 cells. Real-time quantitative PCR and indirect immunofluorescence assays confirmed the identity of the isolate, named Zika virus isolate 31N; plaque assays in Vero cells demonstrated the isolate's infectivity in a mammalian cell line. We obtained the complete genome of Zika virus isolate 31N by next-generation sequencing and identified 3 single-nucleotide variants specific to Zika virus isolate 31N using the meta-CATS tool. These results demonstrate the occurrence of natural vertical transmission of Zika virus in wild Ae. aegypti mosquitoes and suggest that this transmission mode could aid in the spread and maintenance of Zika virus in nature.

West Nile virus in Mexico: Why vectors matter for explaining the current absence of epidemics.

Since 2002, West Nile Virus (WNV) has been reported in 18 states in Mexico, either by PCR or serological testing. However, it is believed that the virus is present in more states. Only four states (out of 32) have reported confirmed human cases, and one state has serological evidence. In the country, WNV is present in mainly horses and birds, but its presence extends to crocodiles, felines, canines, swines, donkeys, caprines, antilopes, cattle, bats, and camelids. Positive mosquito species include Aedes and Culex spp. Different hypotheses have been proposed to explain the absence of WNV epidemics in Latin America. Since some regions of Mexico and the United States share ecological and climatic conditions, these hypotheses may not be sufficient to account for the absence of WNV outbreaks or epidemics. This paper discusses the proposed ideas and attempts to contextualize them for Mexico, particularly for the U.S.-Mexico border, where WNV infections have been reported in humans, horses, and mosquitoes. We propose that integration of urban ecology and entomology knowledge is needed to better understand the absence of WN cases in Mexico.

NEW RECORDS OF CULICOIDES (HAEMATOMYIDIUM) PARAENSIS AND A KEY TO ADULT CULICOIDES FROM YUCATAN PENINSULA, MEXICO.

We provide new records of Culicoides paraensis from the Yucatan Peninsula. The anthropophilic biting midge C. paraensis is the main vector of Oropouche fever virus in South and Central America. We also report Culicoides poikilonotus for the 1st time in the Yucatan Peninsula and a key to identify the species in this region of Mexico.

Surveillance of sand flies (Psychodidae, Phlebotominae) from Mexico: Altitudinal and climatic patterns after historical and new geographic records in endemic areas of leishmaniasis.

This study updates knowledge on historical geographic distribution of sand fly species through identifying altitudinal and bioclimatic patterns in leishmaniasis endemic areas in Mexico. We analyze and identify sand fly specimens obtained through national efforts by the Instituto de Diagnóstico y Referencia Epidemiológicos (InDRE, Mexico), collected between 1995 and 2001, 2008-2012, and 2017-2023, and add bibliographic information (427 additional records). After a principal components analysis of WorldClim variables and altitudinal ranges, variables that better explain the distribution of sand fly species were chosen (BIO6, BIO12, and BIO16, explaining 72 % of variation). A total of 1,187 specimens of 22 species were retrieved from eight states, providing 29 new municipalities and 48 new localities, being Lutzomyia cruciata, Micropygomyia chiapanensis, and Psathyromyia shannoni the most common species. We presented new historical records of distribution for sand fly species from Morelos (3), Oaxaca (7) and Tabasco (1). The 82.7 % of sand fly species analyzed were distributed in areas with altitudinal ranges below 420 m. The anthropophilic species Psathyromyia shannoni, and Lutzomyia cruciata showed the greatest variability regarding altitudinal range, and climatic preferences, while several wild species showed abiotic preferences. It is likely that the effect of urbanization and climate change generate new beneficial biotopes for the proliferation of the vector sand fly species. Complementary studies that consider seasonality, vegetation types, and change in land use could provide new information to better understand the spread of vector-borne diseases.

Seroprevalence of Trypanosoma cruzi among children from Veracruz, Mexico: Epidemiological baseline for a control model based on Chagas disease active transmission / Seroprevalencia de Trypanosoma cruzi en niños de Veracruz, México: línea epidemiológica de base para un modelo de control fundamentado de la transmisión activa de la enfermedad de Chagas.

Introduction. In 2021, the Secretaría de Salud de México and the Pan American Health Organization launched an initiative to interrupt intra-domiciliary vector transmission of Trypanosoma cruzi based on the prevalence of Chagas disease in children. The Mexican State of Veracruz was leading this initiative. Objective. To estimate the seroprevalence of T. cruzi infection among children under 15 years of age from rural areas of Veracruz, México. Materials and methods. We identified eight localities of high priority from the Municipality of Tempoal, Veracruz, for baseline serology. Blood samples were collected on filter paper from 817 individuals between June and August 2017, for screening with a third-generation enzyme immunoassay. Reactive cases were confirmed by indirect hemagglutination, enzyme-linked immunosorbent assay, and indirect immunofluorescence tests on peripheral blood serum samples. We calculated seroprevalence and 95% confidence intervals (CI). Results. We confirmed Chagas disease cases in children under 15 years of age with a seroprevalence of 1,9% (95 % CI = 1,12-3,16) in the localities of Citlaltepetl, Cornizuelo, Cruz de Palma and Rancho Nuevo. Conclusions. These results indicate recent transmission of T. cruzi in these communities and allow to establish an epidemiological baseline for the design and implementation of a model focused on geographical areas with active transmission to advance toward the elimination of intra-domiciliary vector transmission of this parasite in Mexico.

Introducción. En el 2021, la Secretaría de Salud de México y la Organización Panamericana de la Salud lanzaron una iniciativa para interrumpir la transmisión vectorial intradomiciliaria de Trypanosoma cruzi, fundamentada en la prevalencia de la enfermedad de Chagas en la población infantil. El estado mexicano de Veracruz fue el pionero de esta iniciativa. Objetivo. Estimar la seroprevalencia de infección por T. cruzi en menores de 15 años de localidades rurales de Veracruz, México. Materiales y métodos. Se identificaron ocho localidades prioritarias para la serología basal del municipio de Tempoal, Veracruz. Entre junio y agosto de 2017, se recolectaron muestras de sangre en papel filtro de 817 individuos para su tamizaje mediante un inmunoensayo enzimático de tercera generación. Los casos reactivos del tamizaje se confirmaron mediante pruebas de hemaglutinación indirecta, ensayo de inmunoabsorción ligado a enzimas e inmunofluorescencia indirecta en muestras de suero. Se calculó la seroprevalencia y su intervalo de confianza (IC) del 95 %. Resultados. En las localidades de Citlaltépetl, Cornizuelo, Cruz de Palma y Rancho Nuevo se confirmaron casos de la enfermedad de Chagas en menores de 15 años con una seroprevalencia de 1,9 % (IC 95 % = 1,12-3,16). Conclusiones. Los resultados indican que estas comunidades presentan transmisión reciente de T. cruzi y permiten establecer una línea epidemiológica de base para el diseño e implementación de un modelo dirigido a aquellas áreas geográficas con transmisión activa. Se espera que dicho modelo contribuya a la eliminación de la transmisión vectorial intradomiciliaria del tripanosomátido en México.

Human movement and environmental barriers shape the emergence of dengue.

Understanding how emerging infectious diseases spread within and between countries is essential to contain future pandemics. Spread to new areas requires connectivity between one or more sources and a suitable local environment, but how these two factors interact at different stages of disease emergence remains largely unknown. Further, no analytical framework exists to examine their roles. Here we develop a dynamic modelling approach for infectious diseases that explicitly models both connectivity via human movement and environmental suitability interactions. We apply it to better understand recently observed (1995-2019) patterns as well as predict past unobserved (1983-2000) and future (2020-2039) spread of dengue in Mexico and Brazil. We find that these models can accurately reconstruct long-term spread pathways, determine historical origins, and identify specific routes of invasion. We find early dengue invasion is more heavily influenced by environmental factors, resulting in patchy non-contiguous spread, while short and long-distance connectivity becomes more important in later stages. Our results have immediate practical applications for forecasting and containing the spread of dengue and emergence of new serotypes. Given current and future trends in human mobility, climate, and zoonotic spillover, understanding the interplay between connectivity and environmental suitability will be increasingly necessary to contain emerging and re-emerging pathogens.

Evidence of Ongoing Transmission of Zika Virus in Mérida, Mexico.

Since the Zika virus (ZIKV) pandemic in 2015-2017, there has been a near absence of reported cases in the Americas outside of Brazil. However, the conditions for Aedes-borne transmission persist in Latin America, and the threat of ZIKV transmission is increasing as population immunity wanes. Mexico has reported only 70 cases of laboratory-confirmed ZIKV infection since 2020, with no cases recorded in the Yucatán peninsula. Here, we provide evidence of active ZIKV transmission, despite the absence of official case reports, in the city of Mérida, Mexico, the capital of the state of Yucatán. Capitalizing on an existing cohort, we detected cases in participants with symptoms consistent with flavivirus infection from 2021 to 2022. Serum samples from suspected cases were tested for ZIKV RNA by polymerase chain reaction or ZIKV-reactive IgM by ELISA. To provide more specific evidence of exposure, focus reduction neutralization tests were performed on ELISA-positive samples. Overall, we observed 25 suspected ZIKV infections for an estimated incidence of 2.8 symptomatic cases per 1,000 persons per year. Our findings emphasize the continuing threat of ZIKV transmission in the setting of decreased surveillance and reporting.

The TIRS trial: Enrollment procedures and baseline characterization of a pediatric cohort to quantify the epidemiologic impact of targeted indoor residual spraying on Aedes-borne viruses in Merida, Mexico.

Aedes mosquito-borne viruses (ABVs) place a substantial strain on public health resources in the Americas. Vector control of Aedes mosquitoes is an important public health strategy to decrease or prevent spread of ABVs. The ongoing Targeted Indoor Residual Spraying (TIRS) trial is an NIH-sponsored clinical trial to study the efficacy of a novel, proactive vector control technique to prevent dengue virus (DENV), Zika virus (ZIKV), and chikungunya virus (CHIKV) infections in the endemic city of Merida, Yucatan, Mexico. The primary outcome of the trial is laboratory-confirmed ABV infections in neighborhood clusters. Despite the difficulties caused by the COVID-19 pandemic, by early 2021 the TIRS trial completed enrollment of 4,792 children aged 2-15 years in 50 neighborhood clusters which were allocated to control or intervention arms via a covariate-constrained randomization algorithm. Here, we describe the makeup and ABV seroprevalence of participants and mosquito population characteristics in both arms before TIRS administration. Baseline surveys showed similar distribution of age, sex, and socio-economic factors between the arms. Serum samples from 1,399 children were tested by commercially available ELISAs for presence of anti-ABV antibodies. We found that 45.1% of children were seropositive for one or more flaviviruses and 24.0% were seropositive for CHIKV. Of the flavivirus-positive participants, most were positive for ZIKV-neutralizing antibodies by focus reduction neutralization testing which indicated a higher proportion of participants with previous ZIKV than DENV infections within the cohort. Both study arms had statistically similar seroprevalence for all viruses tested, similar socio-demographic compositions, similar levels of Ae. aegypti infestation, and similar observed mosquito susceptibility to insecticides. These findings describe a population with a high rate of previous exposure to ZIKV and lower titers of neutralizing antibodies against DENV serotypes, suggesting susceptibility to future outbreaks of flaviviruses is possible, but proactive vector control may mitigate these risks.

Rocky Mountain Spotted Fever in Mexico: A Call to Action.

Rocky Mountain spotted fever (RMSF) is an ongoing public health crisis in Mexico, particularly in states bordering the United States. The national highest incidence and mortality of RMSF occur in this region, resulting in a case-fatality rate that ranges annually between 10% and 50%, primarily affecting vulnerable groups such as children, elderly adults, and persons living in poverty. Multiple biological, environmental, and social determinants can explain its growing presence throughout the country and how it challenges the health system and society. It is necessary to integrate resources and capacities from health authorities, research centers, and society to succeed in dealing with this problem. Through a scientific symposium, a group of academicians, U.S. health officials, and Mexican health authorities met on November 8-10, 2023, in Hermosillo, Mexico, to discuss the current situation of RMSF across the country and the challenges associated with its occurrence. An urgent call for action to improve national capacity against RMSF in the aspects of epidemiological and acarological surveillance, diagnosis, medical care, case and outbreak prevention, health promotion, and research was urged by the experts. The One Health approach is a proven multidisciplinary strategy to integrate policies and interventions to mitigate and prevent the burden of cases, deaths, and suffering caused by RMSF in Mexico.

Web Geographic Information System: A Support Tool for the Study, Evaluation, and Monitoring of Foci of Malaria Transmission in Mexico.

Malaria is currently an endemic disease in Mexico. The country joined the WHO's E-25 initiative for the elimination of Plasmodium vivax to achieve elimination and certification within the established period. Having a Web-based information system was, therefore, deemed necessary to assist in the detection, investigation, and elimination of transmission in the foci, as well as for the timely treatment of malaria-positive cases. The "Information System for the Elimination of Malaria in Mexico" was designed, developed, and implemented with a geographic vision, which includes a Web tool to georeference homes and aquatic systems, a dashboard and an indicator evaluation card for monitoring activities, notification of probable cases, and vector control among other indicators. The implementation of the system was gradual in the seven states that are currently in the malaria elimination phase; subsequently, the system was implemented in non-transmission states. In 2020, the system implementation stage began; first, the basic data of more than 96,000 homes throughout the country were georeferenced, and then the primary data capture tools of 17 formats, 32 reports, and 2 geographic viewers were enabled for information queries. A total of 56 active foci have been identified in 406 localities as well as 71 residual foci in 320 localities. Recently, the Foci Manager was developed, which is a specific tool for the study, evaluation, and monitoring of active foci through a GIS, a dashboard, and a systematized evaluation certificate. Georeferencing tools decreased the cost of spatial data collection.

Targeted indoor residual insecticide applications shift Aedes aegypti age structure and arbovirus transmission potential.

While residual insecticide applications have the potential to decrease pathogen transmission by reducing the density of vectors and shifting the age structure of the adult mosquito population towards younger stages of development, this double entomological impact has not been documented for Aedes aegypti. Aedes collected from households enrolled in a cluster-randomized trial evaluating the epidemiological impact of targeted indoor residual spraying (TIRS) in Merida, Mexico, were dissected and their age structure characterized by the Polovodova combined with Christopher's ovariole growth methods. In total, 813 females were dissected to characterize age structure at 1, 3, 6, and 9 months post-TIRS. Significant differences in the proportion of nulliparous Ae. aegypti females between the treatment groups was found at one-month post-TIRS (control: 35% vs. intervention: 59%), three months (20% vs. 49%) but not at six or nine months post-TIRS. TIRS significantly shiftted Ae. aegypti age structure towards younger stages and led to a non-linear reduction in survivorship compared to the control arm. Reduced survivorship also reduced the number of arbovirus transmitting females (those who survived the extrinsic incubation period). Our findings provide strong evidence of the full entomological impact of TIRS, with important implications for quantifying the epidemiological impact of vector control methods.