The mosquito Aedes (Stegomyia) albopictus (Skuse) (Diptera: Culicidae), originally indigenous to South-east Asia, islands of the Western Pacific and Indian Ocean, has spread during recent decades to Africa, the mid-east, Europe and the Americas (north and south) after extending its range eastwards across Pacific islands during the early 20th century. The majority of introductions are apparently due to transportation of dormant eggs in tyres. Among public health authorities in the newly infested countries and those threatened with the introduction, there has been much concern that Ae. albopictus would lead to serious outbreaks of arbovirus diseases (Ae. albopictus is a competent vector for at least 22 arboviruses), notably dengue (all four serotypes) more commonly transmitted by Aedes (Stegomyia) aegypti (L.). Results of many laboratory studies have shown that many arboviruses are readily transmitted by Ae. albopictus to laboratory animals and birds, and have frequently been isolated from wild-caught mosquitoes of this species, particularly in the Americas. As Ae. albopictus continues to spread, displacing Ae. aegypti in some areas, and is anthropophilic throughout its range, it is important to review the literature and attempt to predict whether the medical risks are as great as have been expressed in scientific journals and the popular press. Examination of the extensive literature indicates that Ae. albopictus probably serves as a maintenance vector of dengue in rural areas of dengue-endemic countries of South-east Asia and Pacific islands. Also Ae. albopictus transmits dog heartworm Dirofilaria immitis (Leidy) (Spirurida: Onchocercidae) in South-east Asia, south-eastern U.S.A. and both D. immitis and Dirofilaria repens (Raillet & Henry) in Italy. Despite the frequent isolation of dengue viruses from wild-caught mosquitoes, there is no evidence that Ae. albopictus is an important urban vector of dengue, except in a limited number of countries where Ae. aegypti is absent, i.e. parts of China, the Seychelles, historically in Japan and most recently in Hawaii. Further research is needed on the dynamics of the interaction between Ae. albopictus and other Stegomyia species. Surveillance must also be maintained on the vectorial role of Ae. albopictus in countries endemic for dengue and other arboviruses (e.g. Chikungunya, EEE, Ross River, WNV, LaCrosse and other California group viruses), for which it would be competent and ecologically suited to serve as a bridge vector.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.0269-283X.2004.00513.x

Critical review of the vector status of Aedes albopictus

Recently, the Vaccines to Vaccinate (v2V) initiative was reconfigured into the Partnership for Dengue Control (PDC), a multi-sponsored and independent initiative. This redirection is consistent with the growing consensus among the dengue-prevention community that no single intervention will be sufficient to control dengue disease. The PDC's expectation is that when an effective dengue virus (DENV) vaccine is commercially available, the public health community will continue to rely on vector control because the two strategies complement and enhance one another. Although the concept of integrated intervention for dengue prevention is gaining increasingly broader acceptance, to date, no consensus has been reached regarding the details of how and what combination of approaches can be most effectively implemented to manage disease. To fill that gap, the PDC proposed a three step process: (1) a critical assessment of current vector control tools and those under development, (2) outlining a research agenda for determining, in a definitive way, what existing tools work best, and (3) determining how to combine the best vector control options, which have systematically been defined in this process, with DENV vaccines. To address the first step, the PDC convened a meeting of international experts during November 2013 in Washington, DC, to critically assess existing vector control interventions and tools under development. This report summarizes those deliberations.

/pdf/a-critical-assessment-of-vector-control-for-dengue-55260ddrc3.pdf

A Critical Assessment of Vector Control for Dengue Prevention

Dengue virus belongs to family Flaviviridae, having four serotypes that spread by the bite of infected Aedes mosquitoes. It causes a wide spectrum of illness from mild asymptomatic illness to severe fatal dengue haemorrhagic fever/dengue shock syndrome (DHF/DSS). Approximately 2.5 billion people live in dengue-risk regions with about 100 million new cases each year worldwide. The cumulative dengue diseases burden has attained an unprecedented proportion in recent times with sharp increase in the size of human population at risk. Dengue disease presents highly complex pathophysiological, economic and ecologic problems. In India, the first epidemic of clinical dengue-like illness was recorded in Madras (now Chennai) in 1780 and the first virologically proved epidemic of dengue fever (DF) occurred in Calcutta (now Kolkata) and Eastern Coast of India in 1963-1964. During the last 50 years a large number of physicians have treated and described dengue disease in India, but the scientific studies addressing various problems of dengue disease have been carried out at limited number of centres. Achievements of Indian scientists are considerable; however, a lot remain to be achieved for creating an impact. This paper briefly reviews the extent of work done by various groups of scientists in this country.

Dengue in India

Background
Although a vaccine could be available as early as 2016, vector control remains the primary approach used to prevent dengue, the most common and widespread arbovirus of humans worldwide. We reviewed the evidence for effectiveness of vector control methods in reducing its transmission.

Methodology/Principal Findings
Studies of any design published since 1980 were included if they evaluated method(s) targeting Aedes aegypti or Ae. albopictus for at least 3 months. Primary outcome was dengue incidence. Following Cochrane and PRISMA Group guidelines, database searches yielded 960 reports, and 41 were eligible for inclusion, with 19 providing data for meta-analysis. Study duration ranged from 5 months to 10 years. Studies evaluating multiple tools/approaches (23 records) were more common than single methods, while environmental management was the most common method (19 studies). Only 9/41 reports were randomized controlled trials (RCTs). Two out of 19 studies evaluating dengue incidence were RCTs, and neither reported any statistically significant impact. No RCTs evaluated effectiveness of insecticide space-spraying (fogging) against dengue. Based on meta-analyses, house screening significantly reduced dengue risk, OR 0.22 (95% CI 0.05–0.93, p = 0.04), as did combining community-based environmental management and water container covers, OR 0.22 (95% CI 0.15–0.32, p 0.5), but insecticide aerosols (OR 2.03; 95% CI 1.44–2.86) and mosquito coils (OR 1.44; 95% CI 1.09–1.91) were associated with higher dengue risk (p = 0.01). Although 23/41 studies examined the impact of insecticide-based tools, only 9 evaluated the insecticide susceptibility status of the target vector population during the study.

Conclusions/Significance
This review and meta-analysis demonstrate the remarkable paucity of reliable evidence for the effectiveness of any dengue vector control method. Standardised studies of higher quality to evaluate and compare methods must be prioritised to optimise cost-effective dengue prevention.

Author Summary
Dengue fever has increased dramatically over the past 50 years and today is the most widespread mosquito-borne arboviral disease, affecting nearly half the world’s population in 128 countries. Until the arrival of a vaccine, control of its Aedes vectors has been the only method to prevent dengue infection. With dengue outbreaks occurring at increasing frequency and intensity, we undertook a systematic review and meta-analysis of the literature, to evaluate the evidence for effectiveness of vector control strategies currently available. Forty-one studies (from 5 months to 10 years duration) were included in the review. Most studies investigated combinations of approaches but only 9 studies were randomized controlled trials (RCTs). Remarkably, no RCTs evaluated effectiveness against dengue of insecticide space-spraying (outdoor fogging), the main response to dengue outbreaks used worldwide. Nevertheless, there was limited evidence indicating that house screening and to a lesser extent, community-based environmental management with water container covers could reduce risk of dengue infection. However, skin repellents, bed nets and mosquito traps had no effect while insecticide aerosols and mosquito coils were associated with higher dengue risk. However, the quality of the few studies eligible for inclusion was poor overall, and the evidence base is very weak, compromising the knowledge base for making recommendations on delivery of appropriate and effective control. Given this paucity of reliable evidence, standardised studies of higher quality must now be a priority.

/pdf/is-dengue-vector-control-deficient-in-effectiveness-or-3ztm00qi91.pdf

Is Dengue Vector Control Deficient in Effectiveness or Evidence?: Systematic Review and Meta-analysis.

Background 
Zika virus (ZIKV; genus Flavivirus, family Flaviviridae) is maintained in a zoonotic cycle between arboreal Aedes spp. mosquitoes and nonhuman primates in African and Asian forests. Spillover into humans has been documented in both regions and the virus is currently responsible for a large outbreak in French Polynesia. ZIKV amplifications are frequent in southeastern Senegal but little is known about their seasonal and spatial dynamics. The aim of this paper is to describe the spatio-temporal patterns of the 2011 ZIKV amplification in southeastern Senegal.


Methodology/Findings 
Mosquitoes were collected monthly from April to December 2011 except during July. Each evening from 18∶00 to 21∶00 hrs landing collections were performed by teams of 3 persons working simultaneously in forest (canopy and ground), savannah, agriculture, village (indoor and outdoor) and barren land cover sites. Mosquitoes were tested for virus infection by virus isolation and RT-PCR. ZIKV was detected in 31 of the 1,700 mosquito pools (11,247 mosquitoes) tested: Ae. furcifer (5), Ae. luteocephalus (5), Ae. africanus (5), Ae. vittatus (3), Ae. taylori, Ae. dalzieli, Ae. hirsutus and Ae. metallicus (2 each) and Ae. aegypti, Ae. unilinaetus, Ma. uniformis, Cx. perfuscus and An. coustani (1 pool each) collected in June (3), September (10), October (11), November (6) and December (1). ZIKV was detected from mosquitoes collected in all land cover classes except indoor locations within villages. The virus was detected in only one of the ten villages investigated.


Conclusions/Significance 
This ZIKV amplification was widespread in the Kedougou area, involved several mosquito species as probable vectors, and encompassed all investigated land cover classes except indoor locations within villages. Aedes furcifer males and Aedes vittatus were found infected within a village, thus these species are probably involved in the transmission of Zika virus to humans in this environment.

/pdf/zika-virus-emergence-in-mosquitoes-in-southeastern-senegal-59x6mtkvmr.pdf

Zika virus emergence in mosquitoes in southeastern Senegal, 2011.

Background: Dengue is highly endemic in Chennai city, South India, in spite of continuous vector control efforts. This intervention study was aimed at establishing the efficacy as well as the favouring and limiting factors relating to a community-based environmental intervention package to control the dengue vector Aedes aegypti.Methods: A cluster randomized controlled trial was designed to measure the outcome of a new vector control package and process analysis; different data collection tools were used to determine the performance. Ten randomly selected intervention clusters (neighbourhoods with 100 houses each) were paired with ten control clusters on the basis of ecological/entomological indices and sociological parameters collected during baseline studies. In the intervention clusters, Aedes control was carried out using a community-based environmental management approach like provision of water container covers through community actors, clean-up campaigns, and dissemination of dengue informa...

https://www.tandfonline.com/doi/pdf/10.1179/2047773212Y.0000000056

Community-based control of Aedes aegypti by adoption of eco-health methods in Chennai City, India

We conducted a 2-year (1997-1999) longitudinal, entomological and virological study in three dengue endemic villages in Vellore district, Tamil Nadu, to understand the dynamics of dengue transmission. Aedes aegypti (Linn.), Ae. albopictus (Skuse) and Ae. vittatus (Bigot) were the prevalent vector species. Aedes aegypti was breeding throughout the year with a Breteau index ranging from 9.05 to 45.49. Aedes albopictus and Ae. vittatus were prevalent mainly in the rainy season. Small water holding containers (cemented tanks/cisterns) were the perennial breeding source of Ae. aegypti, and its abundance was significantly higher in semi-urbanized central areas than the peripheral areas of the villages. From 271 pools (4016 specimens) of adult females, eight dengue virus (DENV) isolates were obtained of which seven were from Ae. aegypti and one from Ae. albopictus. This is the first report of DENV isolation from Ae. albopictus in rural India. Infection rates in the two species were comparable. However, due to higher and perennial prevalence, Ae. aegypti is considered as primary vector with Ae. albopictus playing a secondary role. Despite circulation of all four serotypes (DENV 1-4) detected mainly during the transmission season, the high anthropophilic index of the vectors and their abundance, no human dengue case was reported, suggesting silent dengue transmission.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1365-3156.2004.01103.x

Dengue vector prevalence and virus infection in a rural area in south India

BACKGROUND & OBJECTIVE Dengue viruses are spread and maintained in an Aedes aegypti-human- Ae. aegypti cycle in urban areas of the tropics. Dengue viruses are also maintained in nature by vertical transmission by Ae. aegypti. A study was undertaken in Chennai, a known endemic city in south India, to comprehend the natural vertical transmission dynamics in Ae. aegypti and to assess its epidemiological importance. METHODS Ae. aegypti males collected in resting and landing collections were tested for dengue virus infection by antigen-capture enzyme-linked immunosorbent assay (ELISA) and further examined by insect bioassay, Toxorhynchites splendens inoculation-indirect immunofluorescence technique (Toxo-IFA) using serotype-specific monoclonal antibodies (Mabs), if found positive by ELISA. RESULTS Of the 509 pools of Ae. aegypti males (n=5408) screened, 15 pools, collected in April, June- July, November-December in 2003 and March, May in 2004, were found positive for dengue virus infection and the minimum infection rate (MIR) among adult males was high in June 2003 (28.0/ 1000). Three positive pools could be serotyped as dengue-2 (2 pools) and dengue-3 (1 pool). INTERPRETATION & CONCLUSION Dengue virus isolations from wild caught males of Ae. aegypti indicate the occurrence of transovarial transmission. Vertical transmission was mainly observed in summer months when dengue infections in humans were low suggesting that dengue viruses adopt a novel strategy of surviving adverse climatic conditions.

Natural vertical transmission of dengue viruses by Aedes aegypti in Chennai, Tamil Nadu, India.

Summary


Objective To investigate the role of Anopheles subpictus Grassi as a vector of Japanese encephalitis virus (JEV) transmission in Cuddalore, an area of Tamil Nadu endemic for the disease.



Method  We collected 98 pools (4900 specimens) of wild adult male An. subpictus mosquitoes outdoors during dusk hours and screened them for JEV antigen by antigen-capture Enzyme Linked Immunosorbent Assay. Additionally, over a period of 1 year, we tested 166 pools (8300 specimens) of wild adult female An. subpictus mosquitoes collected indoors for JEV.



Results  Four pools of male An. subpictus tested positive. This indicates possible natural transovarial transmission of the virus through An. subpictus. Nineteen female pools were positive with a minimum infection rate of 2.3. From January through March the maximum infection rate was highest: 5.0 compared with 1.7 between April and September and 2.1 from October to December, although the difference was not statistically significant. From the 19 positive female pools, four isolates were confirmed as JEV by insect bioassay.



Conclusion  The role of An. subpictus as a secondary vector in JEV transmission in Cuddalore, Tamil Nadu lends support to the hypothesis of periodic epidemics in the region.




Objectif  Investiguer le role de Anopheles subpictus Grassi comme vecteur dans la transmission du virus de l'encephalite japonaise a Cuddalore, une region de Tamil Nadu, endemique pour la maladie.



Methodes  Nous avons collecte 98 pools (49 000 specimens) de mâles adultes et sauvages du moustique An. subpictusa l'exterieur, au coucher du soleil, et les avons teste pour rechercher l'antigene du virus de l'encephalite japonaise au moyen d'un test ELISA de capture d'antigene. Nous avons egalement teste sur une periode d'une annee, 166 pools (83000 specimens) de femelles adultes sauvages du moustique An subpictus collectes a l'interieur pour JEV.



Resultats  4 pools de An. subpictus mâles etaient positifs au test. Cela indique une transmission trans-ovarienne possible du virus chez An. subpictus. 19 pools de femelles etaient positifs avec un taux d'infection minimum de 2.3. De janvier a mars le taux maximum d'infection etait le plus elevee: 5.0 comparea 1.7 entre avril et septembre, et 2.1 entre octobre et decembre, quoique les differences n’etaient pas statistiquement significatives. Des 19 pools femelles positives, 4 souches ont ete confirmees pour le virus de l'encephalite japonaise par un test biologique.



Conclusion  Le role de An. subpictus comme vecteur secondaire dans la transmission du virus de l'encephalite japonaise a Cuddalore, Tamil Nadu procure un soutien a l'hypothese d'une epidemie periodique dans la region.





Objetivo  Investigar el papel del Anopheles subpictus Grassi como vector transmisor del virus de la encefalitis Japonesa en Cuddalore, un area en Tamil Nadu, endemica para esta enfermedad.



Metodo  Se recolectaron en el exterior, durante horas de penumbra, 98 grupos (4900 especimenes) de mosquitos machos adultos salvajes de An. subpictus, y se probaron para el antigeno del virus de la encefalitis japonesa mediante un ensayo inmunoabsorbente ligado a enzimas de captura de antigenos. Adicionalmente, durante un periodo de 1 ano, se probaron 166 grupos (8300 especimenes) de mosquitos hembras adultas salvajes de An. subpictus recolectadas intradomiciliariamente.



Resultados  Cuatro grupos de machos de An. subpictus fueron positivos. Esto indica una posible transmision natural transovarica del virus a traves de An. subpictus. Diecinueve lotes de hembras fueron positivos, con una tasa de infeccion minima del 2.3. Entre Enero y Marzo la tasa de infeccion maxima fue 5.0; la mayor, comparada con 1.7 entre Abril y Septiembre, y 2.1 entre Octubre y Diciembre, aunque la diferencia no fue estadisticamente significativa. De los 19 lotes de hembras positivos, 4 aislados fueron confirmados como virus de la encefalitis Japonesa mediante bioensayo con insectos.



Conclusion  El papel del An. subpictus como un vector secundario en la transmision del virus de la encefalitis Japonesa en Cuddalore, Tamil Nadu, apoya la hipotesis de epidemias periodicas en la region.

Long‐term study of Japanese encephalitis virus infection in Anopheles subpictus in Cuddalore district, Tamil Nadu, South India

In 2001, a major dengue outbreak was recorded in Chennai city, with 737 cases (90%) out of a total of 861 cases recorded from Tamil Nadu state. A KAP survey was carried out to assess the community knowledge, attitude and practice on dengue fever (DF), following the major dengue outbreak in 2001. A pre- tested, structured questionnaire was used for data collection. The multistage cluster sampling method was employed and 640 households (HHs) were surveyed. Among the total HHs surveyed, 34.5% of HHs were aware of dengue and only 3.3% of HHs knew that virus is the causative agent for DF. Majority of the HHs (86.5%) practiced water storage and only 3% of them stored water more than 5 days. No control measures were followed to avoid mosquito breeding in the water holding containers by majority of HHs (65%). Sixty percent of HHs did not know the biting behaviour of dengue vector mosquitoes. The survey results indicate that the community knowledge was very poor on dengue, its transmission, vector breeding sources, biting behavior and preventive measures. The lack of basic knowledge of the community on dengue epidemiology and vector bionomics would be also a major cause of increasing trend of dengue in this highly populated urban environment. There is an inevitable need to organize health education programmes about dengue disease to increase community knowledge and also to sensitize the community to participate in integrated vector control programme to resolve the dengue problem.

R. Manavalan

Papers

Community-based control of Aedes aegypti by adoption of eco-health methods in Chennai City, India

Dengue vector prevalence and virus infection in a rural area in south India

Natural vertical transmission of dengue viruses by Aedes aegypti in Chennai, Tamil Nadu, India.

Long‐term study of Japanese encephalitis virus infection in Anopheles subpictus in Cuddalore district, Tamil Nadu, South India

Studies on community knowledge and behavior following a dengue epidemic in Chennai city, Tamil Nadu, India.