Assessment of Prickly Sida as a Potential Inoculum Source for Sida Golden Mosaic Virus in Commercial Snap Bean Farms in Georgia, United States.

Sida golden mosaic virus (SiGMV), an obligate pathogen that infects snap beans (Phaseolus vulgaris), is known to infect prickly sida (Sida spinosa L.), which is a common weed in agricultural farms in Georgia. Prickly sida has also been reported as a suitable host of sweetpotato whitefly (Bemisia tabaci), the vector of SiGMV. Despite being a host for both SiGMV and its vector, the role of prickly sida as a reservoir and inoculum source for SiGMV in snap bean farms has not been evaluated. This study was conducted to document the occurrence of SiGMV-infected prickly sida plants and to assess its potential role as a source of SiGMV inoculum in snap bean farms. A survey of 17 commercial snap bean farms conducted in spring 2021 confirmed the presence of SiGMV-infected prickly sida in southern Georgia. In fall 2021 and 2022, on-farm field trials were conducted in four commercial farms where SiGMV-infected prickly sida plants were documented earlier as a part of survey in spring 2021. The spatial distribution and temporal patterns of adult whiteflies and SiGMV on snap bean were compared between macroplots (13.7 × 30.5 m) "with prickly sida" or "without prickly sida" that were at least 232 m apart from each other. We did not observe any consistent differences in counts of adult whiteflies between macroplots with or without prickly sida in the four commercial farms. SiGMV infection was detected earlier and with higher incidences in snap bean macroplots "with prickly sida" compared with macroplots "without prickly sida." An apparent disease gradient was observed in two of the four farms assessed. Higher SiGMV incidences were observed on the edges of macroplots "with prickly sida." These findings indicate prickly sida as a potential natural reservoir and a source for SiGMV spread in snap bean farms in southern Georgia.

Spatial analysis of the incidence of Dengue, Zika and Chikungunya and socioeconomic determinants in the city of Rio de Janeiro, Brazil.

In 2015-2016, simultaneous circulation of dengue, Zika and chikungunya in the municipality of Rio de Janeiro (Brazil) was reported. We conducted an ecological study to analyse the spatial distribution of dengue, Zika and chikungunya cases and to investigate socioeconomic factors associated with individual and combined disease incidence in 2015-2016. We then constructed thematic maps and analysed the bivariate global Moran indices. Classical and spatial models were used. A distinct spatial distribution pattern for dengue, Zika and chikungunya was identified in the municipality of Rio de Janeiro. The bivariate global Moran indices (P < 0.05) revealed negative spatial correlations between rates of dengue, Zika, chikungunya and combined arboviruses incidence and social development index and mean income. The regression models (P < 0.05) identified a negative relationship between mean income and each of these rates and between sewage and Zika incidence rates, as well as a positive relationship between urban areas and chikungunya incidence rates. In our study, spatial analysis techniques helped to identify high-risk and social determinants at the local level for the three arboviruses. Our findings may aid in backing effective interventions for the prevention and control of epidemics of these diseases.

An expert opinion assessment of blood-feeding arthropods based on their capacity to transmit African swine fever virus in Metropolitan France.

To deal with the limited literature data on the vectorial capacity of blood-feeding arthropods (BFAs) and their role in the transmission of African swine fever virus (ASFV) in Metropolitan France, a dedicated working group of the French Agency for Food, Environmental and Occupational Health & Safety performed an expert knowledge elicitation. In total, 15 different BFAs were selected as potential vectors by the ad hoc working group involved. Ten criteria were considered to define the vectorial capacity: vectorial competence, current abundance, expected temporal abundance, spatial distribution, longevity, biting rate, active dispersal capacity, trophic preferences for Suidae, probability of contact with domestic pigs and probability of contact with wild boar. Fourteen experts participated to the elicitation. For each BFA, experts proposed a score (between 0 and 3) for each of the above criteria with an index of uncertainty (between 1 and 4). Overall, all experts gave a weight for all criteria (by distributing 100 marbles). A global weighted sum of score per BFA was calculated permitting to rank the different BFAs in decreasing order. Finally, a regression tree analysis was used to group those BFAs with comparable likelihood to play a role in ASF transmission. Out of the ten considered criteria, the experts indicated vectorial competence, abundance and biting rate as the most important criteria. In the context of Metropolitan France, the stable fly (Stomoxys calcitrans) was ranked as the most probable BFA to be a vector of ASFV, followed by lice (Haematopinus suis), mosquitoes (Aedes, Culex and Anopheles), Culicoides and Tabanidea. Since scientific knowledge on their vectorial competence for ASF is scarce and associated uncertainty on expert elicitation moderate to high, more studies are however requested to investigate the potential vector role of these BFAs could have in ASFV spread, starting with Stomoxys calcitrans.

A model for the assessment of bluetongue virus serotype 1 persistence in Spain.

Bluetongue virus (BTV) is an arbovirus of ruminants that has been circulating in Europe continuously for more than two decades and has become endemic in some countries such as Spain. Spain is ideal for BTV epidemiological studies since BTV outbreaks from different sources and serotypes have occurred continuously there since 2000; BTV-1 has been reported there from 2007 to 2017. Here we develop a model for BTV-1 endemic scenario to estimate the risk of an area becoming endemic, as well as to identify the most influential factors for BTV-1 persistence. We created abundance maps at 1-km2 spatial resolution for the main vectors in Spain, Culicoides imicola and Obsoletus and Pulicaris complexes, by combining environmental satellite data with occurrence models and a random forest machine learning algorithm. The endemic model included vector abundance and host-related variables (farm density). The three most relevant variables in the endemic model were the abundance of C. imicola and Obsoletus complex and density of goat farms (AUC 0.86); this model suggests that BTV-1 is more likely to become endemic in central and southwestern regions of Spain. It only requires host- and vector-related variables to identify areas at greater risk of becoming endemic for bluetongue. Our results highlight the importance of suitable Culicoides spp. prediction maps for bluetongue epidemiological studies and decision-making about control and eradication measures.

Assessment of climate change impact on the malaria vector Anopheles hyrcanus, West Nile disease, and incidence of melanoma in the Vojvodina Province (Serbia) using data from a regional climate model.

Motivated by the One Health paradigm, we found the expected changes in temperature and UV radiation (UVR) to be a common trigger for enhancing the risk that viruses, vectors, and diseases pose to human and animal health. We compared data from the mosquito field collections and medical studies with regional climate model projections to examine the impact of climate change on the spreading of one malaria vector, the circulation of West Nile virus (WNV), and the incidence of melanoma. We analysed data obtained from ten selected years of standardised mosquito vector sampling with 219 unique location-year combinations, and 10 years of melanoma incidence. Trends in the observed data were compared to the climatic variables obtained by the coupled regional Eta Belgrade University and Princeton Ocean Model for the period 1961-2015 using the A1B scenario, and the expected changes up to 2030 were presented. Spreading and relative abundance of Anopheles hyrcanus was positively correlated with the trend of the mean annual temperature. We anticipated a nearly twofold increase in the number of invaded sites up to 2030. The frequency of WNV detections in Culex pipiens was significantly correlated to overwintering temperature averages and seasonal relative humidity at the sampling sites. Regression model projects a twofold increase in the incidence of WNV positive Cx. pipiens for a rise of 0.5°C in overwintering TOctober-April temperatures. The projected increase of 56% in the number of days with Tmax ≥ 30°C (Hot Days-HD) and UVR doses (up to 1.2%) corresponds to an increasing trend in melanoma incidence. Simulations of the Pannonian countries climate anticipate warmer and drier conditions with possible dominance of temperature and number of HD over other ecological factors. These signal the importance of monitoring the changes to the preparedness of mitigating the risk of vector-borne diseases and melanoma.

Combatting the Increasing Threat of Vector-Borne Disease in the United States with a National Vector-Borne Disease Prevention and Control System.

Reported cases of vector-borne diseases in the United States have more than tripled since 2004, characterized by steadily increasing incidence of tick-borne diseases and sporadic outbreaks of domestic and invasive mosquito-borne diseases. An effective public health response to these trends relies on public health surveillance and laboratory systems, proven prevention and mitigation measures, scalable capacity to implement these measures, sensitive and specific diagnostics, and effective therapeutics. However, significant obstacles hinder successful implementation of these public health strategies. The recent emergence of Haemaphysalis longicornis, the first invasive tick to emerge in the United States in approximately 80 years, serves as the most recent example of the need for a coordinated public health response. Addressing the dual needs for innovation and discovery and for building state and local capacities may overcome current challenges in vector-borne disease prevention and control, but will require coordination across a national network of collaborators operating under a national strategy. Such an effort should reduce the impact of emerging vectors and could reverse the increasing trend of vector-borne disease incidence and associated morbidity and mortality.

Assessment of the Public Health Threats Posed by Vector-Borne Disease in the United Kingdom (UK).

In recent years, the known distribution of vector-borne diseases in Europe has changed, with much new information also available now on the status of vectors in the United Kingdom (UK). For example, in 2016, the UK reported their first detection of the non-native mosquito Aedes albopictus, which is a known vector for dengue and chikungunya virus. In 2010, Culex modestus, a principal mosquito vector for West Nile virus was detected in large numbers in the Thames estuary. For tick-borne diseases, data on the changing distribution of the Lyme borreliosis tick vector, Ixodes ricinus, has recently been published, at a time when there has been an increase in the numbers of reported human cases of Lyme disease. This paper brings together the latest surveillance data and pertinent research on vector-borne disease in the UK, and its relevance to public health. It highlights the need for continued vector surveillance systems to monitor our native mosquito and tick fauna, as well as the need to expand surveillance for invasive species. It illustrates the importance of maintaining surveillance capacity that is sufficient to ensure accurate and timely disease risk assessment to help mitigate the UK's changing emerging infectious disease risks, especially in a time of climatic and environmental change and increasing global connectivity.

Dengue burden in India: recent trends and importance of climatic parameters.

For the past ten years, the number of dengue cases has gradually increased in India. Dengue is driven by complex interactions among host, vector and virus that are influenced by climatic factors. In the present study, we focused on the extrinsic incubation period (EIP) and its variability in different climatic zones of India. The EIP was calculated by using daily and monthly mean temperatures for the states of Punjab, Haryana, Gujarat, Rajasthan and Kerala. Among the studied states, a faster/low EIP in Kerala (8-15 days at 30.8 and 23.4 °C) and a generally slower/high EIP in Punjab (5.6-96.5 days at 35 and 0 °C) were simulated with daily temperatures. EIPs were calculated for different seasons, and Kerala showed the lowest EIP during the monsoon period. In addition, a significant association between dengue cases and precipitation was also observed. The results suggest that temperature is important in virus development in different climatic regions and may be useful in understanding spatio-temporal variations in dengue risk. Climate-based disease forecasting models in India should be refined and tailored for different climatic zones, instead of use of a standard model.

Scaling Up of an Innovative Intervention to Reduce Risk of Dengue, Chikungunya, and Zika Transmission in Uruguay in the Framework of an Intersectoral Approach with and without Community Participation.

To contribute to the prevention of dengue, chikungunya, and Zika, a process of scaling up an innovative intervention to reduce Aedes aegypti habitats, was carried out in the city of Salto (Uruguay) based on a transdisciplinary analysis of the eco-bio-social determinants. The intervention in one-third of the city included the distributions of plastic bags for all households to collect all discarded water containers that were recollected by the Ministry of Health and the Municipality vector control services. The results were evaluated in 20 randomly assigned clusters of 100 households each, in the intervention and control arm. The intervention resulted in a significantly larger decrease in the number of pupae per person index (as a proxy for adult vector abundance) than the corresponding decrease in the control areas (both areas decreased by winter effects). The reduction of intervention costs ("incremental costs") in relation to routine vector control activities was 46%. Community participation increased the collaboration with the intervention program considerably (from 48% of bags handed back out of the total of bags delivered to 59% of bags handed back). Although the costs increased by 26% compared with intervention without community participation, the acceptability of actions by residents increased from 66% to 78%.

Assessment of the Probability of Autochthonous Transmission of Chikungunya Virus in Canada under Recent and Projected Climate Change.

BACKGROUND: Chikungunya virus (CHIKV) is a reemerging pathogen transmitted by Aedes aegypti and Aedes albopictus mosquitoes. The ongoing Caribbean outbreak is of concern due to the potential for infected travelers to spread the virus to countries where vectors are present and the population is susceptible. Although there has been no autochthonous transmission of CHIKV in Canada, there is concern that both Ae. albopictus and CHIKV will become established, particularly under projected climate change. We developed risk maps for autochthonous CHIKV transmission in Canada under recent (1981­2010) and projected climate (2011­2040 and 2041­2070). METHODS: The risk for CHIKV transmission was the combination of the climatic suitability for CHIKV transmission potential and the climatic suitability for the presence of Ae. albopictus; the former was assessed using a stochastic model to calculate R0 and the latter was assessed by deriving a suitability indicator (SIG) that captures a set of climatic conditions known to influence the ecology of Ae. albopictus. R0 and SIG were calculated for each grid cell in Canada south of 60°N, for each time period and for two emission scenarios, and combined to produce overall risk categories that were mapped to identify areas suitable for transmission and the duration of transmissibility. FINDINGS: The risk for autochthonous CHIKV transmission under recent climate is very low with all of Canada classified as unsuitable or rather unsuitable for transmission. Small parts of southern coastal British Columbia become progressively suitable with short-term and long-term projected climate; the duration of potential transmission is limited to 1­2 months of the year. INTERPRETATION: Although the current risk for autochthonous CHIKV transmission in Canada is very low, our study could be further supported by the routine surveillance of Ae. albopictus in areas identified as potentially suitable for transmission given our uncertainty on the current distribution of this species in Canada. https://doi.org/10.1289/EHP669

Community phytosanitation to manage cassava brown streak disease.

Cassava viruses are the major biotic constraint to cassava production in Africa. Community-wide action to manage them has not been attempted since a successful cassava mosaic disease control programme in the 1930s/40s in Uganda. A pilot initiative to investigate the effectiveness of community phytosanitation for managing cassava brown streak disease (CBSD) was implemented from 2013 to 2016 in two communities in coastal (Mkuranga) and north-western (Chato) Tanzania. CBSD incidence in local varieties at the outset was >90%, which was typical of severely affected regions of Tanzania. Following sensitization and monitoring by locally-recruited taskforces, there was effective community-wide compliance with the initial requirement to replace local CBSD-infected material with newly-introduced disease-free planting material of improved varieties. The transition was also supported by the free provision of additional seed sources, including maize, sweet potato, beans and cowpeas. Progress of the initiative was followed in randomly-selected monitoring fields in each of the two locations. Community phytosanitation in both target areas produced an area-wide reduction in CBSD incidence, which was sustained over the duration of the programme. In Chato, maximum CBSD incidence was 39.1% in the third season, in comparison with an incidence of >60% after a single season in a control community where disease-free planting material was introduced in the absence of community phytosanitation. Kriging and geospatial analysis demonstrated that inoculum pressure, which was a function of vector abundance and the number of CBSD-infected plants surrounding monitored fields, was a strong determinant of the pattern of CBSD development in monitored fields. In the first year, farmers achieved yield increases with the new varieties relative to the local variety baseline of 94% in Chato (north-west) and 124% in Mkuranga (coast). Yield benefits of the new material were retained up to the final season in each location. The new variety (Mkombozi) introduced under community phytosanitation conditions in Chato yielded 86% more than the same variety from the same source planted in the no-phytosanitation control location. Although there was an 81% reduction in CBSD incidence in the new variety Kiroba introduced under community phytosanitation compared to control conditions in Mkuranga, there was no concomitant yield increase. Variety Kiroba is known to be tolerant to the effects of CBSD, and tuberous roots of infected plants are frequently asymptomatic. Community phytosanitation has the potential to deliver area-wide and sustained reductions in the incidence of CBSD, which also provide significant productivity gains for growers, particularly where introduced varieties do not have high levels of resistant/tolerance to CBSD. The approach should therefore be considered as a potential component for integrated cassava virus management programmes, particularly where new cassava plantations are being established in areas severely affected by CBSD.

Factors of Concern Regarding Zika and Other Aedes aegypti-Transmitted Viruses in the United States.

The recent explosive outbreaks of Zika and chikungunya throughout the Americas has raised concerns about the threats that these and similar diseases may pose to the United States (U.S.). The commonly accepted association between tropical climates and the endemicity of these diseases has led to concerns about the possibility of their redistribution due to climate change and transmission arising from cases imported from endemic regions initiating outbreaks in the United States. While such possibilities are indeed well founded, the analysis of historical records not only confirms the potential critical role of traveling and globalization but also reveals that the climate in the United States currently is suitable for local transmission of these viruses. Thus, the main factors preventing these diseases from occurring in the United States today are more likely socioeconomic such as lifestyle, housing infrastructure, and good sanitation. As long as such conditions are maintained, it seems unlikely that local transmission will occur to any great degree, particularly in the northern states. Indeed, a contributing factor to explain the current endemicity of these diseases in less-developed American countries may be well explained by socioeconomic and some lifestyle characteristics in such countries.

Household Dengue Prevention Interventions, Expenditures, and Barriers to Aedes aegypti Control in Machala, Ecuador.

The Aedes aegypti mosquito is an efficient vector for the transmission of Zika, chikungunya, and dengue viruses, causing major epidemics and a significant social and economic burden throughout the tropics and subtropics. The primary means of preventing these diseases is household-level mosquito control. However, relatively little is known about the economic burden of Ae. aegypti control in resource-limited communities. We surveyed residents from 40 households in a high-risk community at the urban periphery in the city of Machala, Ecuador, on dengue perceptions, vector control interventions, household expenditures, and factors influencing purchasing decisions. The results of this study show that households spend a monthly median of US$2.00, or 1.90% (range: 0.00%, 9.21%) of their family income on Ae. aegypti control interventions. Households reported employing, on average, five different mosquito control and dengue prevention interventions, including aerosols, liquid sprays, repellents, mosquito coils, and unimpregnated bed nets. We found that effectiveness and cost were the most important factors that influence people's decisions to purchase a mosquito control product. Our findings will inform the development and deployment of new Ae. aegypti control interventions by the public health and private sectors, and add to prior studies that have focused on the economic burden of dengue-like illness.

Zika in Rio de Janeiro: Assessment of basic reproduction number and comparison with dengue outbreaks.

Zika virus infection was declared a public health emergency of international concern in February 2016 in response to the outbreak in Brazil and its suspected link with congenital anomalies. In this study, we use notification data and disease natural history parameters to estimate the basic reproduction number (R 0) of Zika in Rio de Janeiro, Brazil. We also obtain estimates of R 0 of dengue from time series of dengue cases in the outbreaks registered in 2002 and 2012 in the city, when DENV-3 and DENV-4 serotypes, respectively, had just emerged. Our estimates of the basic reproduction number for Zika in Rio de Janeiro based on surveillance notifications (R 0 = 2·33, 95% CI: 1·97-2·97) were higher than those obtained for dengue in the city (year 2002: R 0 = 1·70 [1·50-2·02]; year 2012: R 0 = 1·25 [1·18-1·36]). Given the role of Aedes aegypti as vector of both the Zika and dengue viruses, we also derive R 0 of Zika as a function of both dengue reproduction number and entomological and epidemiological parameters for dengue and Zika. Using the dengue outbreaks from previous years allowed us to estimate the potential R 0 of Zika. Our estimates were closely in agreement with our first Zika's R 0 estimation from notification data. Hence, these results validate deriving the potential risk of Zika transmission in areas with recurring dengue outbreaks. Whether transmission routes other than vector-based can sustain a Zika epidemic still deserves attention, but our results suggest that the Zika outbreak in Rio de Janeiro emerged due to population susceptibility and ubiquitous presence of Ae. aegypti.

An integrated approach for the assessment of the Aedes aegypti and Aedes albopictus global spatial distribution, and determination of the zones susceptible to the development of Zika virus.

The Zika virus, one of the new epidemic diseases, is reported to have affected millions of people in the past year. The suitable climate conditions of the areas where Zika virus has been reported, especially in areas with a high population density, are the main cause of the current outbreak and spread of the disease. Indeed, the suitable climatic conditions of certain territories constitute perfect breading nest for the propagation and outbreak of worldwide diseases. The main objective of this research is to analyze the global distribution and predicted areas of both mosquitoes Ae. aegypti and Ae. albopictus which are the main vectors of Zika virus. Physical (SRTM) and climatic variables (WorldClim) were used to obtain the susceptibility maps based on the optimum conditions for the development of these mosquitoes. The susceptibility model was developed using a Species Distribution Model - correlative model, namely the Maximum Entropy, that used as input the spatial references of both vectors (Dryad Digital Repository). The results show the most important classes of each independent variable used in assessing the presence of each species of mosquitoes and the areas susceptible to the presence of these vector species. It turns out that Ae. aegypti has greater global dispersion than the Ae. albopictus specie, although two common regions stand out as the most prone to the presence of both mosquito species (tropical and subtropical zones). The crossing of these areas of greater susceptibility with areas of greater population density (e.g. India, China, Se of USA and Brazil) shows some agreement, and these areas stand out due to the presence of several records of Zika virus (HealthMap Project). In this sense, through the intersection of susceptibility and human exposure the areas with increased risk of development and spread of Zika virus are pinpointed, suggesting that there may be a new outbreak of this virus in these places, if preventive measures are not adopted.

Epidemiological and Molecular Studies on Lumpy Skin Disease Outbreaks in Turkey during 2014-2015.

This study was carried out to explore epidemiological and molecular features of lumpy skin disease virus (LSDV) in the Aegean, Central Anatolian and Mediterranean regions of Turkey, to evaluate the risk factors associated with LSDV infection and to investigate the financial impact of LSD and potential role of the Culicoides spp. in the transmission of LSDV. Samples were obtained from 611 cattle, each from different farms, and each clinically suspected to be infected with LSDV during the months of July 2014 and June 2015. Culicoides spp. were trapped from April to June 2015. Genetic characterization of the local LSDV field isolates was conducted by sequencing G-protein-coupled chemokine receptor gene segment. Real-time PCR high-resolution melting analysis was used for distinguishing each type of capripoxviruses. Viral DNA was detected in 448 of the 611 animals and Culicoides midges. Three hundred and ninety-three of the 448 affected farms were surveyed. The morbidity and mortality rates detected were 12.3% and 6.4%, respectively. Phylogenetic analysis showed that the field isolates in this study were clustered together with other Africa and Middle East isolates. Genotyping of isolates from infected cattle has revealed the presence of LSDV. A generalized mixed linear model showed that there were positive associations between LSDV infection, European breeds, small-sized family-type farms and nearness of farm to a lake. The financial cost of disease presence in surveyed cattle farms was estimated to be 72.75 GBP per head. The sequence analysis of the mitochondrial cytochrome oxidase subunit I gene showed that the species of Culicoides in LSDV-positive pools was Culicoides punctatus. Detection of LSDV in Culicoides punctatus suggests that it may have played a role in transmitting LSDV. Furthermore, movement of infected animals into disease-free areas increases the risk of the transmission of LSD. Control strategies for LSDV infection should include consideration of the risk factors identified in this study.

Risk of Zika virus transmission in the Euro-Mediterranean area and the added value of building preparedness to arboviral threats from a One Health perspective.

In the alarming context of risk of Zika virus (ZIKV) transmission in the Euro-Mediterranean area, there is a need to examine whether capacities to detect, diagnose and notify ZIKV infections in the region are in place and whether ongoing capacity-building initiatives are filling existing gaps.The MediLabSecure network, created in 2014, comprises 55 laboratories of virology and medical entomology and 19 public health institutions in 19 countries in the Balkans, North-Africa, the Middle-East and the Black Sea regions. It aims to set up awareness, risk assessment, monitoring and control of emerging and re-emerging vector-borne viruses. We here examine the actions and strategies that MediLabSecure has been implementing and how they will contribute to the prevention and control of the ZIKV threat in the Euro-Mediterranean area.Capacity-building for arbovirus diagnostics is a major objective of the project and follows a methodological rather than disease-driven approach. This enables the implementation of laboratory trainings on techniques that are common to several arboviruses, including ZIKV, and putting into action appropriate diagnostic tools in the target region.Moreover, by its One Health approach and the interaction of its four sub-networks in human virology, animal virology, medical entomology and public health, MediLabSecure is fostering intersectoral collaboration, expertise and sharing of information. The resulting exchanges (methodological, communication and operational) across disciplines and across countries, dedicated research on intersectoral collaboration and increasing diagnostic capacities are providing new paths and tools to public health professionals to face emerging viral threats such as a ZIKV epidemic in the Euro-Mediterranean region.

Assessing Interventions to Manage West Nile Virus Using Multi-Criteria Decision Analysis with Risk Scenarios.

The recent emergence of West Nile virus (WNV) in North America highlights vulnerability to climate sensitive diseases and stresses the importance of preventive efforts to reduce their public health impact. Effective prevention involves reducing environmental risk of exposure and increasing adoption of preventive behaviours, both of which depend on knowledge and acceptance of such measures. When making operational decisions about disease prevention and control, public health must take into account a wide range of operational, environmental, social and economic considerations in addition to intervention effectiveness. The current study aimed to identify, assess and rank possible risk reduction measures taking into account a broad set of criteria and perspectives applicable to the management of WNV in Quebec under increasing transmission risk scenarios, some of which may be related to ongoing warming in higher-latitude regions. A participatory approach was used to collect information on categories of concern to relevant stakeholders with respect to WNV prevention and control. Multi-criteria decision analysis was applied to examine stakeholder perspectives and their effect on strategy rankings under increasing transmission risk scenarios. Twenty-three preventive interventions were retained for evaluation using eighteen criteria identified by stakeholders. Combined evaluations revealed that, at an individual-level, inspecting window screen integrity, wearing light colored, long clothing, eliminating peridomestic larval sites and reducing outdoor activities at peak times were top interventions under six WNV transmission scenarios. At a regional-level, the use of larvicides was a preferred strategy in five out of six scenarios, while use of adulticides and dissemination of sterile male mosquitoes were found to be among the least favoured interventions in almost all scenarios. Our findings suggest that continued public health efforts aimed at reinforcing individual-level preventive behaviours combined with the application of larvicides to manage the risk of WNV infection are the interventions most acceptable and effective at reaching current management objectives now and under future theoretical transmission risk.

Improving public health intervention for mosquito-borne disease: the value of geovisualization using source of infection and LandScan data.

Epidemiological studies use georeferenced health data to identify disease clusters but the accuracy of this georeferencing is obfuscated by incorrectly assigning the source of infection and by aggregating case data to larger geographical areas. Often, place of residence (residence) is used as a proxy for the source of infection (source) which may not be accurate. Using a 21-year dataset from South Australia of human infections with the mosquito-borne Ross River virus, we found that 37% of cases were believed to have been acquired away from home. We constructed two risk maps using age-standardized morbidity ratios (SMRs) calculated using residence and patient-reported source. Both maps confirm significant inter-suburb variation in SMRs. Areas frequently named as the source (but not residence) and the highest-risk suburbs both tend to be tourist locations with vector mosquito habitat, and camping or outdoor recreational opportunities. We suggest the highest-risk suburbs as places to focus on for disease control measures. We also use a novel application of ambient population data (LandScan) to improve the interpretation of these risk maps and propose how this approach can aid in implementing disease abatement measures on a smaller scale than for which disease data are available.