How far do mosquitoes fly?

There is no single answer to one of the most commonly asked questions I’m asked. “How far does a mosquito fly?” Notwithstanding those blown long distances by cyclonic winds or transported in vehicles, the distances travelled by mosquitoes varies greatly from mosquito to mosquito. But how do scientists work it out?

My latest published research demonstrates that Australia’s saltmarsh mosquito (Aedes vigilax) flies many kilometres from urban estuarine wetlands. This has great implications for improving our understanding of their role in outbreaks of mosquito-borne disease as well as designing mosquito control programs.

There are a few different ways you can work out how far mosquitoes fly.

Firstly, given we know that mosquitoes are closely associated with certain habitats, it is sometimes possible to track back collections of mosquitoes to their preferred habitats. For example, knowing a coastal wetlands mosquito is found many kilometres away from the nearest estuarine wetland may indicate it disperses widely.

Secondly, scientists can conducted mark-release-recapture experiments. In these studies, mosquitoes are marked with some kind of substance, released, and then specimens collected in traps operated in a surrounding network can be checked to see how many of those marked mosquitoes have been recaptured and how far they’ve travelled.

In this recently published study, I marked over 200,000 Aedes vigilax with a fluorescent powder (usually used to create paint) and released them close to their larval habitats in estuarine wetlands along the Parramatta River. For the next week, I set dozens of traps around the local area hoping to recollect some of those marked mosquitoes. By scanning the mosquitoes under a UV light, the marked mosquitoes were (relatively) easily identified.

Recapture rates for these types of experiments are notoriously low. While I was only able to recapture less than 1% of those marked mosquitoes released, marked mosquitoes were recaptured many kilometres from their release point. The results demonstrated that these mosquitoes of pest and public health concern disperse so widely from saltmarsh and mangrove habitats that their impacts can be felt quite widely, highlighting the need for targeted mosquito control to minimise potentially widespread pest and public health impacts.

There is an important implication here for current “mosquito aware” urban planning strategies. The incorporation of “buffer zones” between residential developments and mosquito habitats is often proposed but this research clearly demonstrated that this strategy just isn’t practical when it comes to saltmarsh mosquitoes. They just fly too far!

While this study demonstrated marked mosquitoes were travelling up to 3km, other work I’ve done has highlighted how differently the dispersal ranges of mosquitoes can be.  In a study of yellow fever mosquitoes (Aedes aegypti) in far north QLD, we found marked mosquitoes were only traveling between 100-200m. Similarly, other work with Australian backyard mosquitoes (e.g. Aedes notoscriptus) has shown they don’t fly more than 200m. That’s still enough to fly over from your neighbour’s backyard full of mosquito breeding opportunities.

There is a practical application to this work for the management of dengue in far north QLD. Knowing that the mosquitoes involved in transmission are flying less than 200m, mosquito surveillance and control can be concentrated around the homes of those infected individuals. A great example of how understanding mosquito biology can better inform cost-effective response strategies.

There is still plenty to learn about the dispersal of mosquitoes in Australia. I’ve got some ideas so if you’re looking for a research projects, get in touch!

Check out the Journal of Medical Entomology for the full paper titled “Dispersal of the Mosquito Aedes vigilax (Diptera: Culicidae) From Urban Estuarine Wetlands in Sydney, Australia“.

The abstract is below:

Aedes vigilax (Skuse) is a pest and vector species associated with coastal wetlands and the abundance of this mosquito has been identified as contributing to increased risk of mosquito-borne disease outbreaks. As urban development continues to encroach on these coastal wetlands, pest and public health impacts are becoming of increasing concern and in the absence of broadscale mosquito control. Urban planners are looking to buffer zones and other land use planning options to minimize contact between mosquitoes and humans but gaps in the understanding of dispersal ranges of mosquitoes hamper the adoption of these strategies. A mark-release-recapture experiment was conducted to measure the dispersal of this mosquito from an urban estuarine wetland in Sydney, Australia. An estimated total of over 150,000 wild caught female mosquitoes were marked with fluorescent dust and then released. A network of 38 traps was then operated for 5 d within an area of 28 km². A total of 280 marked mosquitoes was recaptured, representing less than 1% of the estimate 250,000 marked mosquitoes released. Marked mosquitoes were recaptured up to 3 km from the release point, providing an insight into the dispersal range of these mosquitoes. The mean distance traveled by marked mosquitoes was 0.83 km, a result reflecting the greater proportion of marked mosquitoes recaptured near release point. The findings of this study indicate that effective buffer zones between estuarine wetlands and high-density urban developments would be an impractical approach to minimizing pest and public health impacts associated with this mosquito.

Join the conversation on Twitter or check out some of the other articles I’ve written on mosquitoes and other biting insects at The Conversation. You can also learn more about Australia’s wonderful mosquitoes in the award winning field guide available from CSIRO Publishing.

 

 

 

A Guam visit to battle Zika virus and discover new mosquitoes

There are few places on earth where you can search in water-filled canoes for one of the most dangerous mosquitoes on the planet less than a stone’s throw from tourists posing for selfies alongside their inflatable novelty swans in the nearby lagoon.

Guam is the place to go if you need to tick that off your “to do” list!

I was fortunate to be invited to speak at the Pacific Island Health Officers Association (PIHOA) Regional Zika Summit and Vector Control Workshop in Guam 25-29 June 2017. The theme of the summit was “Break Down the Silos for Preparedness and Management of Emergencies and Disasters in United States Affiliated Islands” and had objectives to critical analyze the regional responses to recent mosquito-borne disease outbreaks while developing policies to strengthening public health emergency response and preparedness systems and capabilities within the region.

The tranquil lagoons of the Pacific Islands may seem a very long way from the hustle and bustle of the busy South American cities that held the 2016 Olympics but just as Zika virus was grabbing the attention of sports reporters everywhere, health authorities active in the Pacific were growing concerned too.

The Pacific has been far from free of mosquito-borne disease outbreaks. Previous outbreaks of dengue, chikungunya and even Ross River virus had struck numerous times. While sometimes widespread, at other times outbreaks were more sporadic or isolated. As is the case for many non-endemic countries, outbreaks are prompted by movement of infected travelers and the prevalence of local mosquitoes.

Across the region there are four mosquitoes of primary concern, Aedes aegypti, Aedes albopictus, Aedes polynesiensis and Aedes hensilli. The greatest concerns are associated with Aedes aegypti and in those countries where the mosquito is present, the risks of mosquito-borne disease outbreak are greatest. For this reason alone, it is imperative that good entomological surveillance data is collected to confirm the distribution of these mosquitoes but also to develop strategies to eradicate, where possible, Aedes aegypti should it be introduced to new jurisdictions.

With a growing interest in developing mosquito surveillance and control programs for exotic mosquitoes here in Australia, it was a perfect opportunity for me to get a closer look at how the threats of these mosquitoes and associated outbreaks of disease are managed.

On the third day of the meeting, vector control took centre stage. A brilliant day of talks from each of the jurisdictions on the disease outbreaks they’ve faced and how they’re preparing for future threats. There were presentations from the United States Affiliated Pacific Islands (USAPI) including Guam, the Federated States of Micronesia (Yap, Kosrea, Chuuk, Pohnpei), the Commonwealth of the Northern Marianas (CNMI), the Republic of Palau, the Republic of Marshall Islands (RMI), and American Samoa.

Hearing from these teams doing their best to protect their local communities from the threat of mosquito-borne disease, with only limited resources, was quite eye opening. There was passion and dedication but each territory faced unique challenges to ensure the burden of disease is minimised.

Just outside the workshop venue were a series of water-filled canoes. Most contained larvae!

There is little doubt that climate variability will have a strong role to play in the impacts of mosquito-borne disease across the region in the future but there are so many other issues that could be contributing to increased risk too. One of the biggest problems is rubbish.

Time and time again, the issue of accumulated waste, especially car bodies and discarded tyres, was raised as a major problem. As many of the key pest mosquitoes love these objects that trap water, treatment of these increasing stockpiles becomes more of a concern. Community wide cleanups can help reduce the sources of many mosquitoes but the rubbish more often than not remains on the island and requires continued management to ensure is not becoming a home to millions of mosquitoes.

It is a reminder that successful mosquito control relies on much more than just insecticides. An integrated approach is critical.

There was a “hands on” session of surveillance and control. Coordinated by PIHOA’s Eileen Jefferies and Elodie Vajda, the workshop was a great success. It provided an opportunity for many to see how to prepare ovitraps and BGS traps (one of the most widely used mosquito traps) and discuss the various considerations for choosing and using the right insecticides to reduce mosquito-borne disease risk. Workshop attendees were also the luck recipients of a selection of cleaver public awareness material produced in Guam, from personal fans and anatomically incorrect plush mosquitoes to Frisbees and mosquito-themes Pokemon cards!

Guam “mozzie” team: Elodie Vajda, Claire Baradi, Michelle Lastimoza, Eileen Jefferies and me

Following the summit, there was a chance to visit the new Guam “Mosquito Laboratory”, newly established as part of the Guam Environmental Public Health Laboratory (GEPHL). I’ll go out of my way to visit any mosquito laboratory but I was particularly keen to see this one as one of my previous students was playing a key role in establishing the mosquito rearing and identification laboratories. Elodie has been doing an amazing job and it was brilliant to geek out with her over some hard core mosquito taxomony as we tried to ID a couple of tricky specimens. [Make sure you check out our recent paper on the potential impact of climate change on malaria outbreaks in Ethiopia]

It actually turned out that one of their “tricky specimens” was a new species record for Guam – an exotic mosquito Wyeomyia mitchellii! The paper reporting this finding has just been published “New Record of Wyeomyia mitchellii (Diptera: Culicidae) on Guam, United States“.

Mosquito-borne disease in the Pacific isn’t going anywhere and it’s important that once the focus fades from Zika virus, dengue and chikungunya viruses will again take centre stage and their potential impacts are significant. With the added risks that come with gaps in the understanding of local pest and vector species, the prevalence of insecticide resistance among local mosquitoes, climate variability and a struggle to secure adequate funding, challenges lay ahead in ensuring the burden of mosquito-borne disease doesn’t increase.

A modified version of this article appears in the latest issue (Winter 2017; 12(1)) of Mosquito Bites Magazine, (a publication of the Mosquito Control Association of Australia)

 

Preserve and protect? Exploring mosquito communities in urban mangroves

This is a special guest post from Dr Suzi Claflin. Suzi found herself in Sydney, Australia, (via Cornell University, USA) in 2015 to undertake a research project investigating the role of urban landscapes in determining mosquito communities associated with urban mangroves. She was kind enough to put this post together to celebrate the publication of our research in Wetlands Ecology and Management!

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Sometimes you’ve got to make hard choices for the greater good. These situations can arise anywhere, but here – as usual – we are concerned with mosquitoes. There’s a balancing act carried out by public health officials and wetland managers trying to both preserve endangered habitat and protect human health. In this guest post, I’ll explain the science behind research I recently published in collaboration with Dr Cameron Webb, and suggest one way forward for addressing human and environmental health concerns in urban wetlands.

During my PhD, I studied how the landscape surrounding small-scale farms affects the spread of a crop virus and the community of insect pests that carry it. When I came to Australia to work with Cameron, I was surprised to find myself applying the same type of landscape ecology to mosquitoes and mangroves in urban Sydney.

The misfortune of mangroves

Mangroves are real team players. They provide a range of services to the surrounding ecosystem and to the humans lucky enough to live near them. Mangroves are extremely effective at protecting the shoreline (but this can sometimes be a problem). They prevent erosion by gripping the soil in their complex root systems and buffer the beach by serving as a wave break. By filtering sediment out of the water that flows over them, mangroves also prevent their neighbouring ecosystems, such as coral reefs and seagrass forests, from being smothered.

Despite all their good work, mangroves have an almost fatal flaw; they prefer waterfront property. Unfortunately for them, so do humans. Urban and agricultural development has eaten away at mangroves, leaving them highly endangered.

The mosquito menace

Mozzies are a public health menace, because they spread human diseases like Ross River virus (RRV). Because of this, public health officials rightly spend time considering how to supress mosquito populations in order to reduce the risk of disease transmission.

Here’s where things get tricky: mangroves are great for mosquitoes.

That leaves public health officials and wetland managers in a difficult position. On the one hand, mangroves are delicate, at-risk ecosystems that need to be preserved. On the other, mangroves and surrounding habitats potentially harbor both the animal carriers of the RRV (e.g. wallabies) and a load of mosquitoes, which means that people nearby may need to be protected.

How can we do both?

 

Dr Suzi Claflin trapping mosquitoes in the mangroves along the Parramatta River, Sydney, Australia.

 

The potential power of prediction

This is a hard question to answer. One approach is prediction: using measurements of the environment, like rainfall and tide level, to estimate what the mosquito community will look like in a given region. The mosquito community determines what management actions, like spraying an insecticide, need to be taken, based on the threat it poses to public health.

We set out to explore how the way we use land (e.g. for residential areas or industrial areas) near urban mangroves affects the mosquito communities that live in those mangroves. The project involved dropping over retaining walls, slipping down banks, and tromping through muddy mangroves along the Parramatta River in Sydney. We set mosquito traps (billy cans of dry ice with a container on the bottom) and left them overnight to capture the mozzies when they are most active. We did this at two points in the summer, to see if there was any change over time.

We found that yes, the way we use land around a mangrove makes a difference. Mangroves with greater amounts of bushland and residential land in the surrounding area had fewer mosquitos, and fewer species of mosquitos. On the other hand, mangroves with greater amounts of industrial land surrounding them had a greater number of mosquito species, and those surrounded by greater amounts of mangrove had more mosquitos.

And, just to muddy the waters a bit more (pun intended), several of these relationships changed over time. These results show that although prediction based on the surrounding environment is a powerful technique for mangrove management, it is more complicated than we thought.

Another way forward: site-specific assessments

Our work suggests another way forward: site-specific assessments, measuring the mosquito community at a particular site in order to determine what management approaches need to be used. This is a daunting task; it requires a fair number of man-hours, and mangroves are not exactly an easy place to work. But it would be time well spent.

By assessing a site individually, managers can be confident that they are taking the best possible action for both the mangroves and the people nearby. It turns out that the best tool we have for striking a balance between environmental and public health concerns, the best tool we have for preserving and protecting, is information. In mangrove management—as in everything—knowledge is power.

Check out the abstract for our paper, Surrounding land use significantly influences adult mosquito abundance and species richness in urban mangroves, and follow the link to download from the journal, Wetlands Ecology and Management:

Mangroves harbor mosquitoes capable of transmitting human pathogens; consequently, urban mangrove management must strike a balance between conservation and minimizing public health risks. Land use may play a key role in shaping the mosquito community within urban mangroves through either species spillover or altering the abundance of mosquitoes associated with the mangrove. In this study, we explore the impact of land use within 500 m of urban mangroves on the abundance and diversity of adult mosquito populations. Carbon dioxide baited traps were used to sample host-seeking female mosquitoes around nine mangrove forest sites along the Parramatta River, Sydney, Australia. Specimens were identified to species and for each site, mosquito species abundance, species richness and diversity were calculated and were analyzed in linear mixed effects models. We found that the percentage of residential land and bushland in the surrounding area had a negative effect on mosquito abundance and species richness. Conversely, the amount of mangrove had a significant positive effect on mosquito abundance, and the amount of industrial land had a significant positive effect on species richness. These results demonstrate the need for site-specific investigations of mosquito communities associated with specific habitat types and the importance of considering surrounding land use in moderating local mosquito communities. A greater understanding of local land use and its influence on mosquito habitats could add substantially to the predictive power of disease risk models and assist local authorities develop policies for urban development and wetland rehabilitation.

Dr Suzi Claflin completed her PhD at Cornell University exploring environmental factors driving the spread of an aphid-borne potato virus on small-scale farms. She is now a postdoctoral research fellow at the Menzies Institute for Medical Research in Hobart, TAS. In her spare time she runs her own blog, Direct Transmission, focusing on disease and other public health issues (check it out here). To learn more about her doctoral research, follow this link!

Around the world in a thousand fleas

The International Congress for Tropical Medicine and Malaria (ICTMM) kicks off in Brisbane, QLD, Australia this week running from 18 through 22 September. This is a big conference and wonderful for local researchers to be showcased to an audience of international scientists from our own backyard in QLD.

I couldn’t make this meeting unfortunately but luckily my wonderful PhD student Andrea Lawrence will be presenting some of our flea research as part of the Australian Society of Parasitology conference that is incorporated into ICTMM this time around.

Andrea has been doing some excellent research during her candidature and you can read some of it here [Evaluation of the bacterial microbiome of two flea species using different DNA isolation techniques provides insights into flea host ecology] and here [Integrated morphological and molecular identification of cat fleas (Ctenocephalides felis) and dog fleas (Ctenocephalides canis) vectoring Rickettsia felis in central Europe].

This week she will be sharing her research into the genetics of global cat flea populations. You can catch Andrea on Tuesday 20 September in the Zoonoses session in M4, 13:00-15:00.

Our abstract is below:

One thousand fleas from fifty countries: global genetic structure and morphometrics of the common cat flea (genus Ctenocephalides) reveals phylogeographic patterns and resolves the generic complex.

Andrea Lawrence, Cameron E. Webb and Jan Šlapeta

School of Life and Environmental Sciences (SoLES), Faculty of Veterinary Science, The University of Sydney, Australia and Department of Medical Entomology, The University of Sydney and Pathology West, ICPMR, Westmead, Australia

The common cat flea and its relatives (genus Ctenocephalides) are considered the most successful ectoparasites on earth. The widespread parasitisation of these insects on mammals closely associated with humans (e.g. dogs and cats) represents significant potential for vector borne disease transmission. Fleas of the genus Ctenocephalides represent a unique model to study the effects of modern human migration and geographic and climatic barriers on parasite diversity and diversification. We have amassed a world-wide collection of Ctenocephalides over a period of 7 years, and analysed over 1000 flea samples from ca. 50 countries representing all continents bar Antarctica. Novel integration of morphology, morphometrics and molecular identification and phylogenetics using a combination of four mitochondrial and nuclear DNA markers, reveals phylogeographic patterns and evolutionary relationships of global cat flea populations. These techniques provide resolution of the long disputed Ctenocephalides generic complex, which has not yet been definitively resolved despite its significance in veterinary and public health. Understanding of contemporary population structure inferred from global phylogeographic analysis has implications for parasite and flea-borne disease management. It is hoped that this work will form the authoritative estimation of the origin of the genus Ctenocephalides and the subsequent species evolution and migratory radiation.

Keep an eye on the official conference hashtag [#ICTMM2016] and why not follow Andrea on Twitter for more!

The lead image on this article is modified from Andrea’s paper, “High phylogenetic diversity of the cat flea (Ctenocephalides felis) at two mitochondrial DNA markers”

 

 

 

 

 

Can social media help translate research to practice and promote informed public health messages?

I’m a Senior Investigator with the Centre for Infectious Diseases and Microbiology – Public Health. One of our primary focuses is translating research into improved public health outcomes. With NSW Population Health and Health Services Research Support Program assisting our work, we’re exploring new ways to achieve this objective. My experience of using social media was selected to be showcased among other case studies in 2015. 

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Nuisance-biting mosquitoes and mosquito-borne disease are concerns for local authorities in Australia. 2015 saw the largest outbreak of mosquito-borne Ross River virus disease for more than 20 years with over 9,500 cases nationwide. In NSW, there were 1,633 cases compared to the annual average since 1993 of 742 cases per year. Notwithstanding the current outbreak, other endemic, as well as exotic, mosquito-borne pathogens represent future threats to public health.

As there is no large-scale mosquito control program in NSW, reducing the contact between mosquitoes and people is primarily achieved through the promotion of personal protection measures. NSW Health promotes the use of topical insect repellents in combination with behavioural change to avoid natural mosquito habitats and the creation of mosquito habitats around the home. This information is typically provided in the form of posters, brochures, online factsheets, and seasonal or outbreak-triggered public health messages issued by Local Health Districts or the NSW Ministry of Health.

With the emergence of new communications technologies, particularly the rise in popularity of social media, there are new opportunities for public health communications.

The aim of the current research was to determine the reach of public health messages through social media by tracking engagement, audience and relative value as assessed by media monitoring organisations and metrics provided by hosting services of social media platforms.

Assessing activities and processes

Dr Cameron Webb (CIDM-PH) has focused much attention on filling the gaps between current public health messages and findings from recent research into topical mosquito repellents.[1] For example, while public health messages provide accurate information on the insect repellents that provide the best protection, there is a paucity of information provided on how best these products should be used by individuals and those they care for.

Dr Webb’s engagement with mass media, online media (e.g. The Conversation), a personal blog (e.g. Mosquito Research and Management) and social media (e.g. Twitter) has resulted in substantial exposure of focused and informed public health messages. From mid-2014 through to the end of 2015, Dr Webb participated in over 80 mass media articles and interviews in print, online, radio and television media with public health information reaching an estimated audience of over 10 million people.[2] The focus of his messaging around mosquito-borne disease was to highlight the best way for the community to choose and use mosquito repellents; stressing the importance of active ingredients and application methods. This fills a gap in the current provision of public health information while also augmenting public health alerts and messages associated with the 2015 outbreak of Ross River virus disease.

Social media has become a “go to” source of information for much of the community. Information shared on Facebook, Twitter, Instagram, and YouTube has the potential to shape the habitats and behaviour of the community. Dr Webb is active on Twitter (currently followed by over 4,500 people); he uses the platform to engage with the social media accounts of journalists and broadcasters to establish a voice of authority in the field of mosquito-borne disease prevention and extend the reach and exposure of public health messages broadcast through mass media. Using Twitter to share links to informed articles following interviews reached hundreds of thousands of people by being shared by the social media accounts of journalists, media outlets, government organisations and community groups. During the 2014-2015 summer, tweets by Dr Webb reached an estimate 1.28 million people.[3]

Dr Webb regularly writes open access articles on his website, attracting around 250 daily visitors with over 117,000 article views.[4] In addition to his personal website, Dr Webb regularly contributes articles to The Conversation (a website for academics to share expert opinion and write about their latest research). His articles have attracted over 120,000 readers. However, one article “why mosquitoes seem to bite some people more” (published 26 January 2015) has alone been read by over 1.3 million people.[5] This “non-scholarly” writing not only establishes CIDM-PH scientists as authorities in public health matters but can also assist in directing the public to official health guidance provided on official websites and other sources.

Dr Webb’s activities provide a framework for how health authorities may engage with social media to extend public health messages. Organisations or individuals can connect health authority information with the community through media outlets. He has been invited to share his experiences in this field at local and international conferences and workshops including those coordinated by the Public Health Association of Australia, Australian Entomological Society and Entomological Society of America. In addition, Dr Webb has been invited to provide lectures on the benefits of social media for public health advocacy to undergraduate and post-graduate students at the University of Sydney.

While traditional messaging provided by health authorities will remain a staple in public health campaigns, social media provides a connection between traditional and emerging media and communication organisations. This increased connectivity between public health advocates, the media and community has the potential to greatly improve the awareness of mosquito-borne disease and increase the rate of uptake and application of strategic personal protection measures.

References

1. Webb C.E. (2015). Are we doing enough to promote the effective use of mosquito repellents? Medical Journal of Australia, 202(3): 128-129.
2. Estimated audience reported by Kobi Print, Media and Public Relations, University of Sydney, 23 April 2015, based on data provided by media monitoring organisation isentia.
3. Estimated from total “tweet impressions” for the period October 2014 through April 2015 provided by Twitter Analytics (https://analytics.twitter.com/user/Mozziebites/home accessed 30 April 2015)
4. Data provided by WordPress statistics (accessed 18 December 2015)
5. Data provided by The Conversation metrics (accessed 18 December 2015)

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This article was originally published by NSW Health showcasing some of the work within the NSW Population Health and Health Services Research Support Program. You can see the original article here.

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Beware the thick skinned bed bugs (they’re beating our bug sprays)

Think you’re got thick skin? You may be able to brush off the odd insult but for bed bugs, their thick skin can ward off fatal doses of insecticides! This is just one way they’re beating our commonly used bug sprays.

The resurgence of bed bugs over the past couple of decades has been great fuel for media and pest control companies alike. From Paris to London and New York to Sydney, infestations in all forms of accommodation has made headlines.

Eradicating an infestation of bed bugs can be tricky, tricky and expensive. While control within the hospitality industry is improving, the impacts of bed bugs are now being felt in lower socioeconomic groups in the community. There are often financial barriers to effectively controlling infestations and controlling infestations is not getting any easier.

Working out why bed bugs are hard to kill

David Lilly is currently a postgraduate student in our lab undertaking his PhD with the University of Sydney. He has been doing some great work and its wonderful as a supervisor to see him starting to publish some of his research as he approaches the end of his candidature.

We’ve already published some research on bed bugs and insecticide resistance and the role of metabolic detoxification in driving this resistance (you can read about that work via at Entomology Today). However, some of the most exciting research has just been published and indicates that “thicker skinned” bed bugs are more resistant to pyrethroid insecticides.

It is one thing to demonstrate insecticide resistance in a pest but understanding why that resistance occurs is critical if we’re to develop more effective strategies to control bed bugs.

This project was inspired by a study that demonstrated that mosquitoes resistant to insecticides had thicker cuticle. Could the same phenomenon occur in bed bugs?

Working with the Australian Centre for Microscopy & Microanalysis at The University of Sydney, we were able to capture images of cross-sections of legs from resistant and susceptible strains of bed bugs. Measuring the cuticle thickness at various points and comparing those between the two strains of bed bugs allowed an assessment of changes in cuticle.

Those bed bugs resistant to insecticides had thicker cuticle. In fact, the cuticle of the resistant bed bugs was around 15% thicker. Thicker the cuticle, the tougher it is for insecticides to penetrate.

Given human’s propensity to use insecticides, it is little wonder our most loathsome pests, such as mosquitoes and bed bugs, are developing resistance. While there really aren’t many other options available to control bed bugs, insecticides will remain part of our pest control tool kit. Alternative strategies are always being considered but while insecticides remain, we need to be mindful of the development of resistance and ways we can slow (or overcome) that process.

Bed bug’s thick skins grab the media’s attention

The research has already received international media coverage thanks to the fantastic team at University of Sydney Media and Communications team. A quick “google news” search turns up over 70 news items reporting on the paper! You can catch up with coverage at Popular Science (Australia), Wired, USA Today, Daily Mail, Sydney Morning Herald, BBC, Newsweek, Gizmodo and Mirror.

The abstract for our paper is below:

Thickening of the integument as a mechanism of resistance to insecticides is a well recognised phenomenon in the insect world and, in recent times, has been found in insects exhibiting pyrethroid-resistance. Resistance to pyrethroid insecticides in the common bed bug, Cimex lectularius L., is widespread and has been frequently inferred as a reason for the pest’s resurgence. Overexpression of cuticle depositing proteins has been demonstrated in pyrethroid-resistant bed bugs although, to date, no morphological analysis of the cuticle has been undertaken in order to confirm a phenotypic link. This paper describes examination of the cuticle thickness of a highly pyrethroid-resistant field strain collected in Sydney, Australia, in response to time-to-knockdown upon forced exposure to a pyrethroid insecticide. Mean cuticle thickness was positively correlated to time-to-knockdown, with significant differences observed between bugs knocked-down at 2 hours, 4 hours, and those still unaffected at 24 hours. Further analysis also demonstrated that the 24 hours survivors possessed a statistically significantly thicker cuticle when compared to a pyrethroid-susceptible strain of C. lectularius. This study demonstrates that cuticle thickening is present within a pyrethroid-resistant strain of C. lectularius and that, even within a stable resistant strain, cuticle thickness will vary according to time-to-knockdown upon exposure to an insecticide. This response should thus be considered in future studies on the cuticle of insecticide-resistant bed bugs and, potentially, other insects.

The full citation is: Lilly DG, Latham SL, Webb CE, Doggett SL (2016) Cuticle Thickening in a Pyrethroid-Resistant Strain of the Common Bed Bug, Cimex lectularius L. (Hemiptera: Cimicidae). PLoS ONE 11(4): e0153302. doi:10.1371/journal.pone.0153302

Download the paper for free directly from PLoS ONE!

Oh, and if you’re worried about picking up bed bugs on your next holiday, here are some tips!

 

Asian tigers and shifting mosquito control from the swamps to the suburbs

One of the world’s most troublesome nuisance-biting mosquitoes is perfectly adapted to summer life in southern cities in Australia. This is bad news for communities in temperate climate regions in Australia that would otherwise be immune from the threats of exotic mosquito vectors of dengue and chikungunya virus otherwise limited to tropical regions of the world.

I’ve been invited to speak in the “Managing Current & Future Exotic Mosquito Threats” symposium at the Australian Entomological Society conference to share some of the experiences in temperate Australia regarding exotic and endemic mosquito threats and how the threat of the Asian Tiger Mosquito is being addressed.

Australia has annual activity of mosquito-borne disease. Around 5,000 people a year fall ill following a mosquito bite each year in Australia, most commonly due to Ross River virus. These pathogens are generally spread by native “wetland” mosquitoes such as Aedes vigilax or Culex annulirositrs). Australia has also had major outbreaks of dengue in the past but the only mosquito in Australia able to spread the viruses, Aedes aegypti, is restricted to far north QLD. It is unlikely to spread to southern cities beyond Brisbane based on temperature change alone but there is another mosquito that may pose a threat of dengue or chikungunya virus transmission in southern regions.

The Asian Tiger Mosquito (Aedes albopictus), poses a significant threat to Australia. It was discovered in the Torres Strait in 2005, having thought to have hitchhiked on fishing boats from Indonesia. Although the mosquito hasn’t yet managed to set up home on mainland Australia, its a more likely a question of when, not if, this mosquito will make its way here.

The container-inhabiting (not wetland living) mosquito has already hitchhiked to Europe and North America with eggs carried with people and their belongings. Movement of people, not shifts in climate is the biggest risk. Should it reach one of our major southern cities, there is little doubt that mosquito could become a persistent summer pest and possible public health threat. The way we respond to water shortages in our cities, by increasing water storage around our homes, may set the scene for this mozzie to move in.

Once the mosquito is established in our cities, all we need are travellers to bring in the viruses. Travellers introduce dengue virus into Far North QLD every year. Last year Japan experienced its biggest outbreak of dengue in over 70 years thanks to a traveller introducing the virus to local mosquitoes in downtown Tokyo. This Tokyo outbreak of dengue has implications for local authorities in Australia.

In my presentation at the Australian Entomological Society conference, I’ll highlight some of the issues to consider when assessing the risks posed by exotic mosquitoes in New South Wales as well as outline some of the problems local authorities may have to face when dealing with these mosquitoes that differ from the current focus of mosquito and mosquito-borne disease surveillance and control strategies.

You can view my presentation slides and abstract below:

Developing a strategic response to exotic mosquito threats in NSW

Cameron E Webb (1,2), Jay Nicolson (3), Andrew van den Hurk (4) & Stephen L Doggett (1)

(1)Department of Medical Entomology, Pathology West – ICPMR Westmead, Level 3, ICPMR, Westmead Hospital, Westmead NSW 2145 Australia; (2) Marie Bashir Institute of Infectious Disease and Biosecurity, University of Sydney, NSW 2006, Australia; (3) School of Pathology and Laboratory Medicine, The University of Western Australia, Nedlands, WA 6009, Australia; (4) Virology, Public and Environmental Health, Forensic and Scientific Services, Department of Health, Queensland Government, Brisbane, QLD 4108, Australia.

Mosquito-borne disease management in Australia faces challenges on many fronts. Home growth threats posed by endemic mosquito-borne pathogens (e.g. Ross River virus (RRV)) may increase with a changing climate but exotic mosquitoes and pathogens are an emerging threat. In the absence of a national strategy to address these exotic threats, local authorities must develop regionally specific surveillance and response programs to identify and respond to exotic mosquito incursion. The Asian tiger mosquito, Aedes albopictus, poses the greatest risk to temperate regions of Australia due to their close ecological associations with urban habitats and ability to transmit exotic pathogens (e.g. dengue viruses (DENV) and chikungunya virus (CHIKV)). The mosquito is widespread in local regions, has been detected at international ports and, given the increasing frequency of local travellers to regions where this mosquito is abundant, it raises the potential that an incursion into metropolitan Sydney in the coming years is probable. When this happens, what is the likelihood that this mosquito becomes established? Laboratory studies have confirmed Ae. albopictus could survive in the egg stage under climatic conditions typical of a Sydney winter. Despite the endemic mosquito, Aedes notoscriptus, sharing the same ecological niche to Ae. albopictus, cohabitation studies demonstrated that no interspecies competition would act to limit the local spread of Ae. albopictus and the mosquito could proliferating in the summer. Critically, vector competence experiments have demonstrated the ability of Ae. albopictus to transmit endemic pathogens and, given their propensity to bite humans, could contribute to human-mosquito-human outbreaks of RRV in urban areas of NSW, complementing the enzootic vectors that currently limit transmission to the metropolitan fringe. Local authorities need to develop a multiagency strategic approach to surveillance concomitant with strategic response to reduce the pest and public health threats associated with exotic mosquitoes.

Make sure you check out the tweets from the Australian Entomological Society Annual Conference in Cairns, QLD, 27 September through 1 October 2015, by clicking on #AusEntoSoc15

Should we mix mosquito repellents and sunscreens?

Combining mosquito repellents with sunscreens, as well as other cosmetics, sounds like a great idea but perhaps it isn’t to best way to protect ourselves from exposure to both the sun and mosquitoes.

There are formulations that combine mosquito repellents with various skin moisturizers but the most common combination formulations contain sunscreen and repellents. A combined formulation make sense given that Australia has one of the highest rates of skin cancer anywhere in the world. Even the Cancer Council have their own “Repel Sunscreen” formulations.

Combined formulations but conflicting risks

As well as questions regarding the efficacy of these formulations, there have also been some questions regarding their safety. Do they lessen the protection against the sun? Do they lessen the protection against mosquitoes? Do they increase the potential risk of toxic reactions to mosquito repellents?

One study found that the inclusion of mosquito repellent in sunscreen actually reduced the sun protection factor of the sunscreen. In 2009, I published a paper in Australian and New Zealand Journal of Public Health that investigated the efficacy of combined sunscreen and insect repellent formulations. The key finding was that no loss of protection from mosquito bites was provided by these combined formulations when compared to low and high dose “mosquito repellent only” formulations. The finding supported previous studies that indicated sunscreen does not reduce the efficacy of insect repellent. However, where we went further was to try and provide some guidelines for use of these products to maximise mosquito bite protection but also to minimise any potential adverse reactions to repellents.

I’ve provided plenty of detail of how to choose and use mosquito repellents in the “Beating the Bite” guidelines freely available for download

This issue of conflicted use was highlighted in a review of sunscreen labelling recommendations and combination sunscreen/insect repellent products that outlined concerns that “the application of a combination product too frequently poses the risk of insect repellent toxicity, whereas application too infrequently invites photodamage”.

Could combined formulations raise potential over exposure to mosquito repellents?

It is important to note that many published studies and reviews have shown that DEET does not pose a significant health concern (see here too). A recent review of safety surveillance from extensive humans use reveals no association with severe adverse events. In short, if a DEET-based mosquito repellent is used as recommended, there are no major concerns for health risk.

What if the use of a combined repellent and sunscreen formulations results in the application rate of repellent above and beyond recommended rates?

How much repellent are you using with sunscreen?

The recommended use of sunscreens and repellents are quite different. As well as the frequency of reapplications (sunscreen every two hours; repellent reapplication is determined by the “strength” but may be up to four hours for mid-range formulations), the quantity used will vary. Mosquito repellents require a thin application over all exposed skin to provide effectiveness. When the applications rates providing effective protection in mosquito repellent studies are compared to those for sunscreen use (i.e. approximately 30ml applied across the forearms, legs, torso and back 20 minutes before going outside and reapplied every two hours), application rates for sunscreens are approximately 3-5 times greater.

Are you using repellent when you don’t need to?

It is interesting to note the differences in the use pattern of sunscreen and mosquito repellent use. In many instances, nuisance-biting mosquitoes will generally be more active during periods when sun exposure risk is low (e.g. late afternoon, evening and early morning). However, as I pointed out in this paper on mosquito repellent use to reduce the risk of dengue, protection against these day-biting mosquitoes could call for the use of both products simultaneously. There is also no doubt that under some circumstances in coastal regions of Australia, mosquitoes can be out and about biting in shaded environments (places like mangrove forests and coastal swamp forests) during the day.

The Yellow Fever Mosquito, Aedes aegypti (Photo: Stephen Doggett)

What should you do?

I’m not aware of any review in Australia to reconsider the registration or recommendations surrounding the use of combined mosquito repellent and sunscreen formulations. In most instances, the advice provided by local authorities is simply to “follow label instructions”.

Combined mosquito repellent and sunscreen formulations are not recommended by the CDC. It is worth noting that also in Canada, combined sunscreen and insect repellents are not recommended. It is suggested to apply the sunscreen first, then the insect repellent over the top. The only problem is that as repellent will generally last longer than sunscreen, you end up alternating application of the two products.

We tested the idea that repellents should be applied first and then sunscreen over the top. While testing the efficacy of sunscreen wasn’t in the scope fo our study, we found that the efficacy of repellent (as measured by the duration of protection) was actually reduced. The reduction, we concluded, was probably due to physical disruption of the original mosquito repellent application during subsequent sunscreen application.

It should be noted once again that repeated reviews have concluded that DEET-based repellents pose a very low risk of adverse health impacts. However, if you were to take a cautious approach, if there is a risk of possible adverse reaction to repellents, this may be more likely to happen when using high dose DEET-based repellents (e.g. “tropical strength” repellents that may contain over 80% DEET) in combination with sunscreen. If you want to lower the risks as much as possible, using a low-dose DEET-based (e.g. containing less than 10% DEET), or picaridin-based, repellent will more closely align the recommended reapplication times of the two products.

If you’re looking for sunscreen advice, visit the Cancer Council website here.

The full reference for our 2009 paper is below:

Webb, C. E. and Russell, R. C. (2009) Insect repellents and sunscreen: implications for personal protection strategies against mosquito-borne disease. Australian and New Zealand Journal of Public Health, 33: 485–490.

Want to learn more about the amazing world of Australian mosquitoes? Check out “A Field Guide to Mosquitoes of Australia” out now through CSIRO Publishing. Over 200 pages containing a pictorial guide to almost 100 different mosquitoes along with tips on beating their bite and protecting your family from the health risks of mosquitoes. You can order online or through your favourite local bookstore or online retailer.

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Read more at The Conversation: Are mosquito coils good or bad for our health?

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Read more at The Conversation: What can I eat to stop mosquitoes biting me?

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Read more at The Conversation: The best (and worst) ways to beat mosquito bites

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Solving the common mystery of the cat flea

You may be inclined to think that we know everything we need to know about the flea but we don’t. They infest our pets and our homes; we treat them with a variety of substances and yet they are near impossible to exterminate. Importantly, they occasionally bite people, causing annoyance and sometimes severe skin reactions. You may also think this is all we really need to know them. In fact, these parasites are often overlooked in terms of their significance to animal health, their competence as disease vectors and the impacts they make on our everyday lives. There is much more to these irritating insects than meets the eye.

This is the first “guest post” on my blog and comes from my PhD student Andrea Lawrence (University of Sydney) ahead of her presentations at the Australian Society for Parasitology conference in Canberra next week (looks like a wonderful program of events this year!). I’m hoping that there will be plenty more guest posts from Andrea and my other students in the near future.

The most common flea encountered in Australia is the cat flea, Ctenocephalides felis. Just because your dog has fleas, it doesn’t mean it has dog fleas (Ctenocephalides canis). This is a common misconception. In fact, it appears as if the dog flea is something of a mythical creature in Australia. Despite historical records and anecdotal reports of dog flea infestations, there is no recent literature confirming their presence. A recent study of over 2,500 pets failed to find a dog flea. As such, if your pet is troubled with fleas, you can likely lay the blame solely on the cat flea.

The cat flea is the top ectoparasite affecting cats and dogs globally for a variety of reasons. They are the cause of up to 50% of all dermatological cases presented to vet clinics world-wide. Pet owners are spending $40 to $70 on flea and tick control products per month and, based on figures from the United States, over $1 billion annually. That is a lot of money to spend only to have the fleas come back time after time.

As well as the nuisance-biting, the cat flea also carries zoonotic pathogens such as Bartonella (bacteria that causes cat scratch disease in hypersensitive or immunocompromised people) and Rickettsia (bacteria that causes murine typhus and flea-borne spotted fever).

There may also be many cases of underdiagnosed febrile illnesses caused by flea-borne pathogens that fly under the radar due to the presentation of generic fever and flu-like symptoms that rarely warrant further pathological investigation. Of course, the most famous and historically significant pathogen spread by fleas is the plague bacteria: Yersinia pestis. Plague is certainly not a thing of the past with recent outbreaks in Madagascar and up to 17 cases reported from North America each year. Considering the highly ubiquitous nature of fleas in human environments, and many species’ tendency to be host generalists – particularly the cat flea – shouldn’t we be more concerned, or at least more aware, of their biology, taxonomy and potential public health risks?

Although the pathogens that cause plague are not endemic to Australia, plague has touched Australia with significant impact. Here are some professional ratcatchers from Sydney, Australia, during the plague outbreak in 1900 (Source: State Library Image Collection)

Given the impact these little parasites have on our lives, it is baffling how little we know about them. The genetic profile of the cat flea is highly understudied and yet within the genetic code lies hidden implications for the evolution of insecticide resistance, disease transmission and the passage of fleas across continents and the global sphere. A study from the Veterinary Parasitology unit at the University of Sydney found that in 2011 across 5 states of Australia cat fleas collected from veterinary practices were 100% genetically identical at the mitochondrial DNA. This was a very unusual result as populations of other flea species are generally very diverse. The result was comforting news at the time for the regulation of veterinary pharmaceuticals as the efficacy of flea control products were able to be compared against flea populations across the entire country.

Taken from “How to get rid of fleas at home” via Appliances online blog.

We know fleas from Australia are genetically similar but what about elsewhere? We broadened the scope of the investigation and compared the fleas from Australia to those collected from Thailand, Fiji and Seychelles: a group of Islands north-east of Madagascar. These results showed that from a global perspective, cat fleas are genetically diverse. The 2013 flea season yielded a novel second Australian haplotype found in north-east Australia which contradicts the unanimous results from the previous study in 2011. This haplotype was shared with most fleas tested from Fiji, suggesting some recent flea transfer between the two countries. With the rapid emergence of this second haplotype since the previous study, it sparks the question of whether there may be a division of fitness between the two haplotypes. Could this division be resulting in a steady ‘invasion’ of Australia by the second haplotype?

To investigate the haplotype diversity in this study we developed a novel genetic marker capable of clearly delineating different flea species, subspecies and haplotypes. Previously, genetic studies primarily used a mitochondrial DNA marker called cox2. However, there is an emerging global standard of genetic taxonomy called DNA barcoding, which uses a similar gene called cox1. This method involves storing massive amount of short DNA sequences in an electronic database, accessible to anyone with internet access. Currently the database called Barcode of Life Database or BOLD holds 3 million ‘barcodes’, 2 million of which are arthropod barcodes. I wanted to align fleas with this emerging global standard by developing a cox1 marker that would work for fleas. It is surprising given the global significance fleas that the marker has not been optimised before. The ‘barcodes’ collected from this study are now available on BOLD and can be searched allowing greater dissemination of and accessibility to flea genetic data.

A change in the genetic makeup of Australia’s flea population as discovered recently has implications for the pharmaceutical companies who can no longer apply a blanket approach to flea control efficacy testing. Research is continuing this year in the Veterinary Parasitology Unit at The University of Sydney to monitor the rate of spread of this second haplotype. In time I hope this may yield greater understanding of the cat flea genetic puzzle that will lead to finding the key to effective control of these tenacious blood-sucking creatures and the diseases they carry.

The abstract for Andrea’s paper is below:

The cat flea, Ctenocephalides felis (Siphonaptera: Pulicidae) (Bouché), is the most common flea species found on cats and dogs worldwide. We investigated the genetic identity of the cosmopolitan subspecies C. felis felis and evaluated diversity of cat fleas from Australia, Fiji, Thailand and Seychelles using mtDNA sequences from cytochrome c oxidase subunit I (cox1) and II (cox2) genes. Both cox1 and cox2 confirmed the high phylogenetic diversity and paraphyletic origin of C. felis felis. The African subspecies C. felis strongylus (Jordan) is nested within the paraphyletic C. felis felis. The south East Asian subspecies C. felis orientis (Jordan) is monophyletic and is supported by morphology. We confirm that Australian cat fleas belong to C. felis felis and show that in Australia they form two distinct phylogenetic clades, one common with fleas from Fiji. Using a barcoding approach, we recognize two putative species within C. felis (C. felis and C. orientis). Nucleotide diversity was higher in cox1 but COX2 outperformed COX1 in amino acid diversity. COX2 amino acid sequences resolve all phylogenetic clades and provide an additional phylogenetic signal. Both cox1 and cox2 resolved identical phylogeny and are suitable for population structure studies of Ctenocephalides species.

The full reference of the paper is:

Lawrence, A. L., Brown, G. K., Peters, B., Spielman, D. S., Morin-Adeline, V. and Šlapeta, J. (2014), High phylogenetic diversity of the cat flea (Ctenocephalides felis) at two mitochondrial DNA markers. Medical and Veterinary Entomology [early view]doi: 10.1111/mve.12051 [Online]

(The image of the cat flea, Ctenocephalides felis, at the top of this blog post is taken from the PaDIL image collection by K Walker)

What do you need to know about West Nile virus?

With the arrival of mosquito season in North America, health authorities have started issuing warnings about prevention of potentially fatal West Nile virus. My latest coauthored publication reviews the epidemiological and clinical aspects of this mosquito-borne pathogen.

West Nile virus is a pathogen generally spread by mosquitoes from birds to humans. While only about one in five people infected develop symptoms (inc fever, headache, body aches, nausea, vomiting, swollen lymph glands or a skin rash.), for those over 50, there can be more serious implications and the illness may be fatal. There is currently no vaccine, avoiding mosquito bites is the only way to prevent disease.

The virus was first detected in North America in 1999 and has since spread from coast to coast, having a significant impact on the health of both people (resulting in an economic burden of around $56 million per year) and wildlife (particularly birds). Interestingly, from 2007 there was a steady decline in the activity of the virus and many thought that major outbreaks would be a thing of the past but 2012 saw a one of the largest outbreaks in almost a decade. During this time, Texas was particularly hard hit with 1,868 cases and estimated costs of around US$47.6 million.

The activity of the virus in 2013 wasn’t insignificant either.

Annual total numbers of West Nile virus disease cases and deaths reported by CDC 1999-2013.

It hasn’t only been North America that has been impacted by West Nile virus. Outbreaks of human and animal illness have also been reported in Europe. In fact, cases of West Nile virus were reported from France in the 1960s. However, there wasn’t a major outbreak until 1996-1997; prompting warnings from health authorities about the future risks associated with this pathogen in Europe. The activity of the virus in North American, Europe and Africa provides interesting opportunities to research the genetic differences between regions and potential implications for surveillance and disease control. Europe has developed an extensive surveillance program to assess activity of endemic and exotic mosquitoes and activity of the virus.

Human illness in Europe resulting from West Nile virus infection during 2012 (European Centre for Disease Prevention and Control)

It is interesting to note that one of the key factors linking outbreaks of West Nile virus in both North America and Europe is the presence of closely related mosquitoes. Unlike dengue, chikungunya or yellow fever viruses that are spread by Aedes mosquitoes, and malaria parasites by Anopheles mosquitoes, West Nile virus is primarily spread by Culex mosquitoes. In particular, the bird-feeding mosquitoes within the Culex pipiens group.

The Culex pipiens group, particularly Culex pipiens, Culex quinquefasciatus and Culex molestus, are closely associated with urban environments. With mosquitoes found in close contact with humans, there is greater risk associated with potential outbreaks.

Our recent review article in the International Journal of General Medicine provides an overview of the clinical and epidemiological aspects of West Nile virus and is a good starting point for anyone interested in this pathogen and the factors that drive outbreaks in North America and Europe.

The abstract of our paper is here:

The reurgence of West Nile virus (WNV) in North America and Europe in recent years has raised the concerns of local authorities and highlighted that mosquito-borne disease is not restricted to tropical regions of the world. WNV is maintained in enzootic cycles involving, primarily, Culex spp. mosquitoes and avian hosts, with epizootic spread to mammals, including horses and humans. Human infection results in symptomatic illness in approximately one-fifth of cases and neuroinvasive disease in less than 1% of infected persons. The most consistently recognized risk factor for neuroinvasive disease is older age, although diabetes mellitus, alcohol excess, and a history of cancer may also increase risk. Despite the increasing public health concern, the current WNV treatments are inadequate. Current evidence supporting the use of ribavirin, interferon α, and WNV-specific immunoglobulin are reviewed. Nucleic acid detection has been an important diagnostic development, which is particularly important for the protection of the donated blood supply. While effective WNV vaccines are widely available for horses, no human vaccine has been registered. Uncertainty surrounds the magnitude of future risk posed by WNV, and predictive models are limited by the heterogeneity of environmental, vector, and host factors, even in neighboring regions. However, recent history has demonstrated that for regions where suitable mosquito vectors and reservoir hosts are present, there will be a risk of major epidemics. Given the potential for these outbreaks to include severe neuroinvasive disease, strategies should be implemented to monitor for, and respond to, outbreak risk. While broadscale mosquito control programs will assist in reducing the abundance of mosquito populations and subsequently reduce the risks of disease, for many individuals, the use of topical insect repellents and other personal protective strategies will remain the first line of defense against infection.

The full paper can be downloaded for free here.

You can also read more background to West Nile virus and the 2012 outbreak in my piece for The Conversation. For a comprehensive look at how the pathogen is managed in North America, download the CDC publication “West Nile Virus in the United States: Guidelines for Surveillance, Prevention, and Control“.

Why not join the conversation on Twitter by following me at @mozziebites?

The image at the top of this piece is taken from Mother Jones.