A quantitative risk assessment approach for mosquito-borne diseases: malaria re-emergence in southern France.

BACKGROUND: The Camargue region is a former malaria endemic area, where potential Anopheles vectors are still abundant. Considering the importation of Plasmodium due to the high number of imported malaria cases in France, the aim of this article was to make some predictions regarding the risk of malaria re-emergence in the Camargue. METHODS: Receptivity (vectorial capacity) and infectivity (vector susceptibility) were inferred using an innovative probabilistic approach and considering both Plasmodium falciparum and Plasmodium vivax. Each parameter of receptivity (human biting rate, anthropophily, length of trophogonic cycle, survival rate, length of sporogonic cycle) and infectivity were estimated based on field survey, bibliographic data and expert knowledge and fitted with probability distributions taking into account the variability and the uncertainty of the estimation. Spatial and temporal variations of the parameters were determined using environmental factors derived from satellite imagery, meteorological data and entomological field data. The entomological risk (receptivity/infectivity) was calculated using 10,000 different randomly selected sets of values extracted from the probability distributions. The result was mapped in the Camargue area. Finally, vulnerability (number of malaria imported cases) was inferred using data collected in regional hospitals. RESULTS: The entomological risk presented large spatial, temporal and Plasmodium species-dependent variations. The sensitivity analysis showed that susceptibility, survival rate and human biting rate were the three most influential parameters for entomological risk. Assessment of vulnerability showed that among the imported cases in the region, only very few were imported in at-risk areas. CONCLUSION: The current risk of malaria re-emergence seems negligible due to the very low number of imported Plasmodium. This model demonstrated its efficiency for mosquito-borne diseases risk assessment.

Using remote sensing to map larval and adult populations of Anopheles hyrcanus (Diptera: Culicidae) a potential malaria vector in Southern France.

BACKGROUND: Although malaria disappeared from southern France more than 60 years ago, suspicions of recent autochthonous transmission in the French Mediterranean coast support the idea that the area could still be subject to malaria transmission. The main potential vector of malaria in the Camargue area, the largest river delta in southern France, is the mosquito Anopheles hyrcanus (Diptera: Culicidae). In the context of recent climatic and landscape changes, the evaluation of the risk of emergence or re-emergence of such a major disease is of great importance in Europe. When assessing the risk of emergence of vector-borne diseases, it is crucial to be able to characterize the arthropod vector's spatial distribution. Given that remote sensing techniques can describe some of the environmental parameters which drive this distribution, satellite imagery or aerial photographs could be used for vector mapping. RESULTS: In this study, we propose a method to map larval and adult populations of An. hyrcanus based on environmental indices derived from high spatial resolution imagery. The analysis of the link between entomological field data on An. hyrcanus larvae and environmental indices (biotopes, distance to the nearest main productive breeding sites of this species i.e., rice fields) led to the definition of a larval index, defined as the probability of observing An. hyrcanus larvae in a given site at least once over a year. Independent accuracy assessments showed a good agreement between observed and predicted values (sensitivity and specificity of the logistic regression model being 0.76 and 0.78, respectively). An adult index was derived from the larval index by averaging the larval index within a buffer around the trap location. This index was highly correlated with observed adult abundance values (Pearson r = 0.97, p < 0.05). This allowed us to generate predictive maps of An. hyrcanus larval and adult populations from the landscape indices. CONCLUSION: This work shows that it is possible to use high resolution satellite imagery to map malaria vector spatial distribution. It also confirms the potential of remote sensing to help target risk areas, and constitutes a first essential step in assessing the risk of re-emergence of malaria in southern France.

Biology and dynamics of potential malaria vectors in Southern France.

BACKGROUND: Malaria is a former endemic problem in the Camargue, South East France, an area from where very few recent data concerning Anopheles are available. A study was undertaken in 2005 to establish potential malaria vector biology and dynamics and evaluate the risk of malaria re-emergence. METHODS: Mosquitoes were collected in two study areas, from March to October 2005, one week every two weeks, using light traps+CO2, horse bait traps, human bait catch, and by collecting females in resting sites. RESULTS: Anopheles hyrcanus was the most abundant Anopheles species. Anopheles melanoon was less abundant, and Anopheles atroparvus and Anopheles algeriensis were rare. Anopheles hyrcanus and An. melanoon were present in summer, whereas An. atroparvus was present in autumn and winter. A large number of An. hyrcanus females was collected on humans, whereas almost exclusively animals attracted An. melanoon. Based on an enzyme-linked immunosorbent assay, almost 90% of An. melanoon blood meals analysed had been taken on horse or bovine. Anopheles hyrcanus and An. melanoon parity rates showed huge variations according to the date and the trapping method. CONCLUSION: Anopheles hyrcanus seems to be the only Culicidae likely to play a role in malaria transmission in the Camargue, as it is abundant and anthropophilic.

Rainfall patterns and population dynamics of Aedes (Aedimorphus) vexans arabiensis, Patton 1905 (Diptera: Culicidae), a potential vector of Rift Valley Fever virus in Senegal.

The importance of rainfall for the development of Aedes vexans arabiensis populations, one of the potential vectors of Rift Valley Fever in West Africa, was demonstrated in a two-year follow-up study conducted in the Ferlo region of Senegal. In 2003, the rainy season began with heavy rains and, as a result, temporary ponds, the breeding places for mosquitoes, were flooded at their maximum level immediately. In such conditions, Aedes vexans arabiensis populations are abundant at the very beginning of the season, when the majority of eggs in quiescence are flooded. Females, hatching from eggs laid the year before, quickly lay eggs on the pond's wet soil, which will undergo dormancy as the water level goes down. Rainless periods longer than seven days, the time needed for embryogenesis, followed by significant rainfall, will result in the hatching of very large numbers of new eggs. Thus, several generations of adults may exist during the same rainy season. Because of potential vertical transmission of Rift Valley Fever virus in Aedes species, viral transmission and disease risk can appear as early as the beginning of the rainy season and if late rains occur, at the end of the season. This dynamic maximizes the virus' chance to persist from one year to another, thus facilitating endemisation of Rift Valley Fever in areas where Aedes vexans arabiensis exists.

Intraspecific nucleotide variation in Anopheles gambiae: new insights into the biology of malaria vectors.

The Anopheles gambiae genome sequence, together with the recent development of molecular tools for genome-wide analysis, promises new insights into the biology of the malaria vector. These insights should help define the best possible breakdown point for interrupting transmission in the mosquito vector. A survey of the intraspecific nucleotide diversity in coding regions of three different mosquito strains showed an average of one single nucleotide polymorphism (SNP) every 125 coding base pairs. High levels of nucleotide polymorphism were observed in mosquito immune-related genes and pathogen recognition receptors harbored higher replacement substitutions. Genotyping at SNP loci in natural populations of An. gambiae from three malaria foci showed contrasting patterns. The distribution of mutation Y443H in the thioester-containing protein 3 (TEP3) gene suggested this mutational event has occurred under selective constraints. Our results show that SNP-based studies will be valuable in identifying the sequence variation associated with phenotypic traits shaping vector competence.

Risk of malaria reemergence in southern France: testing scenarios with a multiagent simulation model.

The Camargue, a region in southern France, is considered a potential site for malaria reemergence. All the suitable factors of the disease transmission system are present -- competent mosquito vectors, habitats for their breeding, and susceptible people -- except for the parasite. The objective of this study was to test potential drivers of malaria reemergence in this system after possible changes in biological attributes of vectors, agricultural practices, land use, tourism activities, and climate. Scenarios of plausible futures were formulated and then simulated using a spatially explicit and dynamic multiagent simulation: the MALCAM model. Scenarios were developed by varying the value of model inputs. Model outputs were compared based on the contact rate between people and potential malaria vectors, and the number of new infections in case of reintroduction of the parasite in the region. Model simulations showed that the risk of malaria reemergence is low in the Camargue. If the disease would reemerge, it would be the result of a combination of unfavorable conditions: introduction of a large population of infectious people or mosquitoes, combined with high levels of people-vector contacts resulting from significant changes in land use, tourism activities, agricultural policies, biological evolution of mosquitoes, and climate changes. The representation in the MALCAM model of interactions and feedbacks between different agents, and between agents and their environment, led in some cases to counterintuitive results. Results from scenario analyses can help local public health authorities in policy formulation.

Possible autochthonous malaria from Marseille to Minneapolis.

We report 2 cases of Plasmodium falciparum malaria in southern France in a French woman and an American man of Togolese origin who reported no recent travel to malaria-endemic countries. Both infections occurred after a stay near Marseille, which raises the possibility of autochthonous transmission. Entomologic and genotypic investigations are described.

Effects of local anthropogenic changes on potential malaria vector Anopheles hyrcanus and West Nile virus vector Culex modestus, Camargue, France.

Using historical data, we highlight the consequences of anthropogenic ecosystem modifications on the abundance of mosquitoes implicated as the current most important potential malaria vector, Anopheles hyrcanus, and the most important West Nile virus (WNV) vector, Culex modestus, in the Camargue region, France. From World War II to 1971, populations of these species increased as rice cultivation expanded in the region in a political context that supported agriculture. They then fell, likely because of decreased cultivation and increased pesticide use to control a rice pest. The species increased again after 2000 with the advent of more targeted pest-management strategies, mainly the results of European regulations decisions. An intertwined influence of political context, environmental constraints, technical improvements, and social factors led to changes in mosquito abundance that had potential consequences on malaria and WNV transmission. These findings suggest that anthropogenic changes should not be underestimated in vectorborne disease recrudescence.