Serological evidence of ongoing transmission of dengue virus in permanent residents of Key West, Florida.

INTRODUCTION: Dengue fever is the most important mosquito-borne viral disease in the world, with 40% of the global population at risk of infection. Dengue virus is responsible for infections in over 100 countries, including the Americas and Caribbean Basin; however, it has been largely eradicated from the United States through the implementation of effective vector control programs. However, between 2009 and 2010, 27 permanent residents of Key West, Florida, were reported to have locally acquired infections, marking the first autochthonous cases detected in Florida since 1934. Despite this recent and unusual transmission, and the potential risk of serious illness associated with sequential infections, no active surveillance had been conducted since. MATERIALS AND METHODS: A serosurvey of permanent residents of Key West, Florida, was conducted in March of 2012. After informed consent, enrolled participants (n=173) were given a dengue virus rapid diagnostic test and completed a corresponding questionnaire. RESULTS: The presence of immunoglobulin G (IgG) antibodies was indicated in 12 participants (6.9%), all of whom reported travel to endemic countries within the past 2 years. Surprisingly, six participants (3.5%) without any recent travel outside the state of Florida gave positive results for IgM antibodies. The presence of birdbaths and bromeliads on the property and sleeping outdoors emerged as significant factors related to previous exposure, whereas home air conditioning without the use of open windows and the use of mosquito repellent were protective. CONCLUSIONS: These findings suggest local transmission occurred in Key West in early 2012, indicating that transmission may not have subsided in 2010.

Evaluation of a novel emergence trap to study Culex mosquitoes in urban catch basins.

Stormwater catch basins in urban areas provide important larval habitat for Culex mosquitoes. In this study we quantified adult Culex emergence using a newly designed emergence trap deployed in catch basins in suburban Chicago, IL. Traps were deployed from late June to mid-October, 2009-10, in 19 catch basins for a total of 461 trap-days. Based on laboratory trials, the percentage of adults emerging under the trap and reaching the collection cup ranged from 37.7 +/- 6.5% for closed-cup and 50.5 +/- 3.8% for open-cup configurations. In 2009, catch basins containing immature mosquitoes produced an estimated 58.9 +/- 30.8 female and 86.2 +/- 36.4 male Culex spp. per day. Most (84.4%) were Culex pipiens and the remainder were Cx. restuans. The trap was also effective in documenting reductions in adult emergence following intense precipitation events that caused "flushing" of larvae and pupae. In general, the new emergence trap was effective for studying Culex production in catch basins and should be broadly useful in studies of container-breeding mosquitoes.

Parameterization and sensitivity analysis of a complex simulation model for mosquito population dynamics, dengue transmission, and their control.

Models can be useful tools for understanding the dynamics and control of mosquito-borne disease. More detailed models may be more realistic and better suited for understanding local disease dynamics; however, evaluating model suitability, accuracy, and performance becomes increasingly difficult with greater model complexity. Sensitivity analysis is a technique that permits exploration of complex models by evaluating the sensitivity of the model to changes in parameters. Here, we present results of sensitivity analyses of two interrelated complex simulation models of mosquito population dynamics and dengue transmission. We found that dengue transmission may be influenced most by survival in each life stage of the mosquito, mosquito biting behavior, and duration of the infectious period in humans. The importance of these biological processes for vector-borne disease models and the overwhelming lack of knowledge about them make acquisition of relevant field data on these biological processes a top research priority.

Epidemiology of dengue virus in Iquitos, Peru 1999 to 2005: interepidemic and epidemic patterns of transmission.

BACKGROUND: Comprehensive, longitudinal field studies that monitor both disease and vector populations for dengue viruses are urgently needed as a pre-requisite for developing locally adaptable prevention programs or to appropriately test and license new vaccines. METHODOLOGY AND PRINCIPAL FINDINGS: We report the results from such a study spanning 5 years in the Amazonian city of Iquitos, Peru where DENV infection was monitored serologically among approximately 2,400 members of a neighborhood-based cohort and through school-based absenteeism surveillance for active febrile illness among a subset of this cohort. At baseline, 80% of the study population had DENV antibodies, seroprevalence increased with age, and significant geographic variation was observed, with neighborhood-specific age-adjusted rates ranging from 67.1 to 89.9%. During the first 15 months, when DENV-1 and DENV-2 were co-circulating, population-based incidence rates ranged from 2-3 infections/100 person-years (p-years). The introduction of DENV-3 during the last half of 2001 was characterized by 3 distinct periods: amplification over at least 5-6 months, replacement of previously circulating serotypes, and epidemic transmission when incidence peaked at 89 infections/100 p-years. CONCLUSIONS/SIGNIFICANCE: Neighborhood-specific baseline seroprevalence rates were not predictive of geographic incidence patterns prior to the DENV-3 introduction, but were closely mirrored during the invasion of this serotype. Transmission varied geographically, with peak incidence occurring at different times among the 8 geographic zones in approximately 16 km(2) of the city. The lag from novel serotype introduction to epidemic transmission and knowledge of spatially explicit areas of elevated risk should be considered for more effective application of limited resources for dengue prevention.

Skeeter Buster: a stochastic, spatially explicit modeling tool for studying Aedes aegypti population replacement and population suppression strategies.

BACKGROUND: Dengue is the most important mosquito-borne viral disease affecting humans. The only prevention measure currently available is the control of its vectors, primarily Aedes aegypti. Recent advances in genetic engineering have opened the possibility for a new range of control strategies based on genetically modified mosquitoes. Assessing the potential efficacy of genetic (and conventional) strategies requires the availability of modeling tools that accurately describe the dynamics and genetics of Ae. aegypti populations. METHODOLOGY/PRINCIPAL FINDINGS: We describe in this paper a new modeling tool of Ae. aegypti population dynamics and genetics named Skeeter Buster. This model operates at the scale of individual water-filled containers for immature stages and individual properties (houses) for adults. The biology of cohorts of mosquitoes is modeled based on the algorithms used in the non-spatial Container Inhabiting Mosquitoes Simulation Model (CIMSiM). Additional features incorporated into Skeeter Buster include stochasticity, spatial structure and detailed population genetics. We observe that the stochastic modeling of individual containers in Skeeter Buster is associated with a strongly reduced temporal variation in stage-specific population densities. We show that heterogeneity in container composition of individual properties has a major impact on spatial heterogeneity in population density between properties. We detail how adult dispersal reduces this spatial heterogeneity. Finally, we present the predicted genetic structure of the population by calculating F(ST) values and isolation by distance patterns, and examine the effects of adult dispersal and container movement between properties. CONCLUSIONS/SIGNIFICANCE: We demonstrate that the incorporated stochasticity and level of spatial detail have major impacts on the simulated population dynamics, which could potentially impact predictions in terms of control measures. The capacity to describe population genetics confers the ability to model the outcome of genetic control methods. Skeeter Buster is therefore an important tool to model Ae. aegypti populations and the outcome of vector control measures.

Simulation models examining the effect of Brugian filariasis on dengue epidemics.

Concurrent ingestion of microfilariae (mf) and arboviruses by mosquitoes can enhance the transmission of virus compared with when virus is ingested alone. We studied the effect of mf enhancement on the extrinsic incubation period (EIP) of dengue 1 virus within Aedes aegypti mosquitoes by feeding mosquitoes on blood that either contained virus plus Brugia malayi mf or virus only. Mosquitoes were sampled over time to determine viral dissemination rates. Co-ingestion of mf and virus reduced viral EIP by over half. We used the computer simulation program, DENSiM, to compare the predicted patterns of dengue incidence that would result from such a shortened EIP versus the EIP derived from the control (i.e., virus only) group of mosquitoes. Results indicated that, over the 14-year simulation period, mf-induced acceleration of the EIP would generate more frequent (but not necessarily more severe) epidemics. Potential interactions between arboviruses and hematozoans deserve closer scrutiny.

Toxorhynchites as biocontrol agents.

Toxorhynchites is an unusual and interesting genus of large, non-biting mosquitoes. In spite of their size, they are--like many species of mosquitoes--completely harmless to man. The larvae are predaceous on other mosquitoes and aquatic organisms that inhabit both natural and artificial containers. Because this habitat is the source of several medically important species of mosquitoes, there is warrant for evaluating the potential of Toxorhynchites as a biological control agent under various conditions. Toxorhynchites is not seen as a panacea for the control of all container-inhabiting mosquitoes. However, it has demonstrated practical potential in certain restricted but important situations.

Abridged pupa identification key to the common container-breeding mosquitoes in urban Southeast Asia.

Pupal surveys have been advocated as an alternative or surrogate surveillance method for estimating densities of adult Aedes aegypti and Aedes albopictus. Usually, this survey strategy has required that collected pupae eclose to adults before attempting species identification. Using the pupal survey method in Yogyakarta, Indonesia, this rearing step was obviated with the pupal morphological key described herein for identifying preserved or live pupae. Examination of pupae for the identification of various container-inhabiting mosquito genera and target aedine species proved to be accurate and far less time-consuming and problematic than rearing pupae to adults.

Transmission thresholds for dengue in terms of Aedes aegypti pupae per person with discussion of their utility in source reduction efforts

The expense and ineffectiveness of drift-based insecticide aerosols to control dengue epidemics has led to suppression strategies based on eliminating larval breeding sites. The present work attempts to estimate transmission thresholds for dengue based on an easily-derived statistic, the standing crop of Aedes aegypti pupae per person in the environment. We have developed these thresholds for use in the assessment of risk of transmission and to provide targets for the actual degree of suppression required to prevent or eliminate transmission in source reduction programs. The notion of thresholds is based on 2 concepts: the mass action principal- the course of an epidemic is dependent on the rate of contact between susceptible hosts and infectious vectors, and threshold theory - the introduction of a few infectious individuals into a community of susceptible individuals will not give rise to an outbreak unless the density of the vectors exceeds a certain critical level. We use validated transmission models to estimate thresholds as a function of levels of pre-existing antibody levels in human populations, ambient air temperatures, and the size and frequency of viral introduction. Threshold levels were estimated to range between about 0.5 and 1.5 Ae. aegypti pupae per person for ambient air temperatures of 28 degrees C and initial seroprevalences ranging between 0 percent to 67 percent. Suprisingly, the size of the viral introduction used in these studies, ranging between 1 and 12 infectious individuals per year was not seen to significantly influence the magnitude of the threshold. From a control perspective, these results are not particularly encouraging. The ratio of Ae. aegypti pupae to human density has been observed in limited field studies to range between 0.3 and >60 in 25 sites in dengue-epidemic of dengue-susceptible areas in the Caribbean, Central America, and South East Asia. If, for purposes of illustration, we assume an initial seroprevalence of 33 percent, the degree of suppression required to essentially eliminate the possibility of summertime transmission in Puerto Rico, Honduras, and Bangkok, Thailand was estimated to range between 10 percent and 83 percent; however in Mexico and Trinidad, reductions of >90 percent would be required.(AU)

Pupal index: an epidemiologically significant surveillance method for aedes aegypti: an example using data from Trinidad

We report the results of a country-wide pupal survey of Aedes aegypti (L.) in Trinidad designed to identify the most important Aedes aegypti-producing containers, importance being a function of a container's abundance and productivity. Numerically, the most common loci were outdoor drums, water storage tanks and buckets, laundry tubs, discarded tyres and small miscellaneous containers. The average number of foci per hectare was 287 (range 65 to 499). The average standing crop per container of Ae.aegypti pupae was 9.5 and ranged 12-fold, the most and least productive being the flower pot (> 30) and the small indoor vase (<3), respectively. Seven of the 11 types were responsible for < 10 percent of all Ae.aegypti pupae and the remaining 4 types, outdoor drums, tubs, buckets and small containers, accounted for > 90 percent. If targeted, source reduction programmes were directed by the importance of various container types, efforts designed to eliminate the ubiquitous small receptacle and tyres would reduce mosquito densities by 43 percent and the provision of an adequate water supply, precluding the need for water storage, could eliminate an additional 38 percent for a total of > 80 percent of Ae.aegypti in the country. The traditional Stegomyia indices used to document the density of Ae.aegypti and predict the threat of transmission - the house, container, and Breteau indices - were seen to have virtually no correspondence with the actual number of pupae per hectare or per person. We conclude that pupal survey is more appropriate for assessing risk and directing control operations (AU)