A modeling approach to investigate epizootic outbreaks and enzootic maintenance of Rift Valley fever virus.

We propose a mathematical model to investigate the transmission dynamics of Rift Valley fever (RVF) virus among ruminants. Our findings indicate that in endemic areas RVF virus maintains at a very low level among ruminants after outbreaks and subsequent outbreaks may occur when new susceptible ruminants are recruited into endemic areas or abundant numbers of mosquitoes emerge when herd immunity decreases. Many factors have been shown to have impacts on the severity of RVF outbreaks; a higher probability of death due to RVF among ruminants, a higher mosquito:ruminant ratio, or a shorter lifespan of animals can amplify the magnitude of the outbreaks; vaccination helps to reduce the magnitude of RVF outbreaks and the loss of animals efficiently, and the maximum vaccination effort (a high vaccination rate and a larger number of vaccinated animals) is recommended before the commencement of an outbreak but can be reduced later during the enzootic.

Modeling the distribution of the West Nile and Rift Valley Fever vector Culex pipiens in arid and semi-arid regions of the Middle East and North Africa.

BACKGROUND: The Middle East North Africa (MENA) region is under continuous threat of the re-emergence of West Nile virus (WNV) and Rift Valley Fever virus (RVF), two pathogens transmitted by the vector species Culex pipiens. Predicting areas at high risk for disease transmission requires an accurate model of vector distribution, however, most Cx. pipiens distribution modeling has been confined to temperate, forested habitats. Modeling species distributions across a heterogeneous landscape structure requires a flexible modeling method to capture variation in mosquito response to predictors as well as occurrence data points taken from a sufficient range of habitat types. METHODS: We used presence-only data from Egypt and Lebanon to model the population distribution of Cx. pipiens across a portion of the MENA that also encompasses Jordan, Syria, and Israel. Models were created with a set of environmental predictors including bioclimatic data, human population density, hydrological data, and vegetation indices, and built using maximum entropy (Maxent) and boosted regression tree (BRT) methods. Models were created with and without the inclusion of human population density. RESULTS: Predictions of Maxent and BRT models were strongly correlated in habitats with high probability of occurrence (Pearson's r=0.774, r=0.734), and more moderately correlated when predicting into regions that exceeded the range of the training data (r=0.666,r=0.558). All models agreed in predicting high probability of occupancy around major urban areas, along the banks of the Nile, the valleys of Israel, Lebanon, and Jordan, and southwestern Saudi Arabia. The most powerful predictors of Cx. pipiens habitat were human population density (60.6% Maxent models, 34.9% BRT models) and the seasonality of the enhanced vegetation index (EVI) (44.7% Maxent, 16.3% BRT). Maxent models tended to be dominated by a single predictor. Areas of high probability corresponded with sites of independent surveys or previous disease outbreaks. CONCLUSIONS: Cx. pipiens occurrence was positively associated with areas of high human population density and consistent vegetation cover, but was not significantly driven by temperature and rainfall, suggesting human-induced habitat change such as irrigation and urban infrastructure has a greater influence on vector distribution in this region than in temperate zones.

A statistical model of Rift Valley fever activity in Egypt.

Rift Valley fever (RVF) is a viral disease of animals and humans and a global public health concern due to its ecological plasticity, adaptivity, and potential for spread to countries with a temperate climate. In many places, outbreaks are episodic and linked to climatic, hydrologic, and socioeconomic factors. Although outbreaks of RVF have occurred in Egypt since 1977, attempts to identify risk factors have been limited. Using a statistical learning approach (lasso-regularized generalized linear model), we tested the hypotheses that outbreaks in Egypt are linked to (1) River Nile conditions that create a mosquito vector habitat, (2) entomologic conditions favorable to transmission, (3) socio-economic factors (Islamic festival of Greater Bairam), and (4) recent history of transmission activity. Evidence was found for effects of rainfall and river discharge and recent history of transmission activity. There was no evidence for an effect of Greater Bairam. The model predicted RVF activity correctly in 351 of 358 months (98.0%). This is the first study to statistically identify risk factors for RVF outbreaks in a region of unstable transmission.

Linking land cover and species distribution models to project potential ranges of malaria vectors: an example using Anopheles arabiensis in Sudan and Upper Egypt.

BACKGROUND: Anopheles arabiensis is a particularly opportunistic feeder and efficient vector of Plasmodium falciparum in Africa and may invade areas outside its normal range, including areas separated by expanses of barren desert. The purpose of this paper is to demonstrate how spatial models can project future irrigated cropland and potential, new suitable habitat for vectors such as An. arabiensis. METHODS: Two different but complementary spatial models were linked to demonstrate their synergy for assessing re-invasion potential of An. arabiensis into Upper Egypt as a function of irrigated cropland expansion by 2050. The first model (The Land Change Modeler) was used to simulate changes in irrigated cropland using a Markov Chain approach, while the second model (MaxEnt) uses species occurrence points, land cover and other environmental layers to project probability of species presence. Two basic change scenarios were analysed, one involving a more conservative business-as-usual (BAU) assumption and second with a high probability of desert-to-cropland transition (Green Nile) to assess a broad range of potential outcomes by 2050. RESULTS: The results reveal a difference of 82,000 sq km in potential An. arabiensis range between the BAU and Green Nile scenarios. The BAU scenario revealed a highly fragmented set of small, potential habitat patches separated by relatively large distances (maximum distance = 64.02 km, mean = 12.72 km, SD = 9.92), while the Green Nile scenario produced a landscape characterized by large patches separated by relatively shorter gaps (maximum distance = 49.38, km, mean = 4.51 km, SD = 7.89) that may be bridged by the vector. CONCLUSIONS: This study provides a first demonstration of how land change and species distribution models may be linked to project potential changes in vector habitat distribution and invasion potential. While gaps between potential habitat patches remained large in the Green Nile scenario, the models reveal large areas of future habitat connectivity that may facilitate the re-invasion of An. arabiensis from Sudan into Upper Egypt. The methods used are broadly applicable to other land cover changes as they influence vector distribution, particularly those related to tropical deforestation and urbanization processes.

Geographic profiling as a novel spatial tool for targeting infectious disease control.

BACKGROUND: Geographic profiling is a statistical tool originally developed in criminology to prioritise large lists of suspects in cases of serial crime. Here, we use two data sets--one historical and one modern--to show how it can be used to locate the sources of infectious disease. RESULTS: First, we re-analyse data from a classic epidemiological study, the 1854 London cholera outbreak. Using 321 disease sites as input, we evaluate the locations of 13 neighbourhood water pumps. The Broad Street pump--the outbreak's source--ranks first, situated in the top 0.2% of the geoprofile. We extend our study with an analysis of reported malaria cases in Cairo, Egypt, using 139 disease case locations to rank 59 mosquitogenic local water sources, seven of which tested positive for the vector Anopheles sergentii. Geographic profiling ranks six of these seven sites in positions 1-6, all in the top 2% of the geoprofile. In both analyses the method outperformed other measures of spatial central tendency. CONCLUSIONS: We suggest that geographic profiling could form a useful component of integrated control strategies relating to a wide variety of infectious diseases, since evidence-based targeting of interventions is more efficient, environmentally friendly and cost-effective than untargeted intervention.

Comparison of mosquito control programs in seven urban sites in Africa, the Middle East, and the Americas

Mosquito control programs at seven urban sites in Kenya, Egypt, Israel, Costa Rica, and Trinidad are described and compared. Site-specific urban and disease characteristics, organizational diagrams, and strengths, weaknesses, obstacles and threats (SWOT) analysis tools are used to provide a descriptive assessment of each mosquito control program, and provide a comparison of the factors affecting mosquito abatement. The information for SWOT analysis is collected from surveys, focus-group discussions, and personal communication. SWOT analysis identified various issues affecting the efficiency and sustainability of mosquito control operations. The main outcome of our work was the description and comparison of mosquito control operations within the context of each study site's biological, social, political, management, and economic conditions. The issues identified in this study ranged from lack of inter-sector collaboration to operational issues of mosquito control efforts. A lack of sustainable funding for mosquito control was a common problem for most sites. Many unique problems were also identified, which included lack of mosquito surveillance, lack of law enforcement, and negative consequences of human behavior. Identifying common virtues and shortcomings of mosquito control operations is useful in identifying "best practices" for mosquito control operations, thus leading to better control of mosquito biting and mosquito-borne disease transmission.

Comparison of mosquito control programs in seven urban sites in Africa, the Middle East, and the Americas.

Mosquito control programs at seven urban sites in Kenya, Egypt, Israel, Costa Rica, and Trinidad are described and compared. Site-specific urban and disease characteristics, organizational diagrams, and strengths, weaknesses, obstacles and threats (SWOT) analysis tools are used to provide a descriptive assessment of each mosquito control program, and provide a comparison of the factors affecting mosquito abatement. The information for SWOT analysis is collected from surveys, focus-group discussions, and personal communication. SWOT analysis identified various issues affecting the efficiency and sustainability of mosquito control operations. The main outcome of our work was the description and comparison of mosquito control operations within the context of each study site's biological, social, political, management, and economic conditions. The issues identified in this study ranged from lack of inter-sector collaboration to operational issues of mosquito control efforts. A lack of sustainable funding for mosquito control was a common problem for most sites. Many unique problems were also identified, which included lack of mosquito surveillance, lack of law enforcement, and negative consequences of human behavior. Identifying common virtues and shortcomings of mosquito control operations is useful in identifying "best practices" for mosquito control operations, thus leading to better control of mosquito biting and mosquito-borne disease transmission.

Remote sensing as a tool for mapping mosquito breeding habitats and associated health risk to assist control efforts and development plans: a case study in Wadi El Natroun, Egypt.

Limited mosquito ground surveys were combined with remote sensing and GIS technologies to identify mosquito breeding habitats in Natroun lakes area and to delineate associated health risks. Mosquito larval surveys were carried out in a small area to characterize positive breeding habitats and determine their geographic coordinates. Mosquitoes (Anopheles multicolor, Culex antennatus and Cx. theileri) were found breeding in water-flooded habitats with dense vegetation cover spatially associated to existing lakes. Chemical analysis indicated that mosquito breeding water was found to be polluted by several sources including agriculture, industrial and domestic sources. This information served as a training set to characterize the spectral signature of mosquitogenic (mosquito-producing) habitats using reflectance data of the Thematic Mapper (TM) sensor aboard Landsat 5 satellite. Following characterization of the spectral signature, satellite data were used to predict, potential mosquito breeding patches over the whole study area. Field surveys were then carried out to assess the accuracy of predicted habitats and those surveys have indicated that all checked sites were positive for mosquito larvae demonstrating an accuracy of 100%. Based on an average adult mosquito flight range of 2 km, GIS was used to create buffer zones around breeding habitats describing areas at risk from mosquito nuisance and disease transmission. The obtained results could thus provide a new basis for directing the control of mosquito vectors as they provide health authorities with precise maps of mosquito breeding habitats in a timely manner. Moreover, the generated map delineating risk areas could be used by project developers to either re-site the project or invest in mosquito control activities in order to avoid health risks and ensure sustainability of their development. The approach adopted in this investigation demonstrated the practical and successful application of remote sensing and GIS in assisting health and development decision making.

Bancroftian filariasis: spatial patterns, environmental correlates and landscape predictors of disease risk.

Lymphatic filariasis has been identified as the second leading cause of permanent and long-term disability. This article is an attempt to discuss the disease spatial context in light of current interest in GIS and satellite remote sensing. Field validation of outputs obtained through the application of these technologies in the Nile Delta, Egypt is also summarized.

Isolation of west nile and sindbis viruses from mosquitoes collected in the Nile Valley of Egypt during an outbreak of Rift Valley fever.

As part of an evaluation of potential vectors of arboviruses during a Rift Valley fever (RVF) outbreak in the Nile Valley of Egypt in August 1993, we collected mosquitoes in villages with known RVF viral activity. Mosquitoes were sorted to species, pooled, and processed for virus isolation both by intracerebral inoculation into suckling mice and by inoculation into cell culture. A total of 33 virus isolates was made from 36,024 mosquitoes. Viruses were initially identified by indirect fluorescent antibody testing and consisted of 30 flaviviruses (all members of the Japanese encephalitis complex, most probably West Nile [WN] virus) and three alphaviruses (all members of western equine encephalitis complex, most probably Sindbis). The identity of selected viruses was confirmed by reverse transcriptase-polymerase chain reaction and sequencing. Culex antennatus (Becker) and Culex perexiguus Theobald accounted for five (17%) and 23 (77%) of the WN virus isolations, respectively. Despite isolation of viruses from 32 pools of mosquitoes (both WN and Sindbis viruses were isolated from a single pool), RVF virus was not isolated from these mosquitoes, even though most of them are known competent vectors collected during an ongoing RVF outbreak. Thus, it should be remembered, that even during a known arbovirus outbreak, other arboviruses may still be circulating and causing disease.