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Mosquito-borne Disease on Statia:Dengue, Chikungunya and Beyond
Joe Wagman, Ph.D.Belize Vector and Ecology Center
Science Café at theCaribbean Netherlands Science Institute
April 2015
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Tonight’s Outline
• Dengue and Chikungunya Viruses: The basics– Disease Symptoms and Natural History– Burden of Disease/Epidemiology– Disease Transmission
• Other viruses vectored by Aedes• Current work on Statia• Vector Surveillance and Control• Future Research Possibilities• Summary• Questions and Discussion
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Mosquito-Borne Disease: A global threat
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DENV and CHIKV: The Basics
Both are mosquito-borne viruses, spread by the same species of mosquitoes (primarily Aedes aegypti and Aedes albopictus).
US CDC Public image Library US CDC Public image Library
Aedes aegypti Aedes albopictus
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DENV and CHIKV: The Basics
• Flavivirus (Yellow Fever)
• Hosts include only humans and other non-human primates
• 4 serotypes
Zhang et al., 2013. Nat. Struct. Mol. Biol.20(1):105-10
• Alphavirus (VEE)
• Can also infect birds, cattle, and rodents
• 1 serotype
Sun, et al., 2013. Elife 2:00435
DENV CHIKV
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Symptoms
Dengue Fever•May be asymptomatic or uncomplicated fever
•Sudden High Fever (Cyclical)
•Headache (behind the eyes)
•Muscle and joint pains (“breakbone fever”)
•Rash
•Nausea and Vomiting
•Severe Dengue (rare, <5%) = all of the above with:
•Hemorrhage and Bleeding
•Fluid Imbalances
•Shock
Chikungunya Fever•May be asymptomatic or uncomplicated fever
•Sudden High Fever (Cyclical)
•Muscle and joint pains (“that which bends you up”)
•Headache
•Rash
•Nausea and Vomiting
•No hemorrhagic complications like dengue
•Symptoms can last months to years in some patients
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Disease Burden
Dengue Fever
•4 Serotypes
•Every Year:
•400 Million infections
• 500,000 hospitalizations
•25,000 deaths
•Large outbreaks can cost as much as $100million USD in lost productivity
http://www.who.int/en
http://www.cdc.govStahl HC, Butenschoen VM, Tran HT, Gozzer E, Skewes R, et al. 2013. BMC Public Health 13:1048
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Disease Burden
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Disease Burden
Chikungunya fever
•New to the Americas
•St. Martin, DEC 2013
•1.25 million cases reported by PAHO in March, 2015
http://www.who.int/en
http://www.cdc.gov
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Chikungunya on Statia, 2015:At least 300 cases
300/3,000 = 10% of population (probably a large underestimate)
Disease Burden
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Disease Transmission
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Disease Transmission
• No Vaccines
• No specific drugs or therapy
– Acetaminophen (Tylenol) for pain and fever
– Hydration
– Rest
– Avoid Mosquitoes!
• VECTOR CONTROL
– “Know the vector, know the threat”
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Disease Transmission
The mosquito Aedes aegypti is the most important DENV vector
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Vector Distribution on Statia: Everyone at Risk
Couch, WJ. 2013. Surveillance and Spatial Characterization of Ae. aegypti in St. Eustatius
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Vector Surveillance and Control
• Mosquito Life Cycle
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Vector Surveillance and Control
• Which mosquitoes bite human?
– (A) Males
– (B) Females
– (C) Both
• What attracts mosquitoes to people?
– (A) Colors
– (B) Smells
– (C) Body Heat
– (D) All of the above
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Vector Surveillance and Control
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Vector Surveillance and Control
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Vector Surveillance and Control
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Vector Surveillance and Control
Typical Dengue control activities include:• Source Reduction/Larvaciding (Temephos/Bti)• Truck mounted ULV spraying• Handheld thermal fogging• Public Outreach and Personal Protection
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Vector Surveillance and ControlSource Reduction
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Vector Surveillance and ControlTruck Spraying
House Spraying
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Vector Surveillance and ControlPublic Outreach
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On the Horizon: Other Viruses Vectored by Aedes mosquitoes
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Current Work in Statia
• Oviposition Trap Surveillance
• Determine presence and distribution of Aedes albopictus
• Describe Insecticide Susceptibility Patterns on the Island
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Summary/Future Work• Dengue, Chikungunya and other Aedes aegypti
spread viruses are a constant threat on Statiaand throughout the Caribbean
• Vector Control is currently the only preventative measure available: How can we improve?
• BVEC, The University of Notre Dame, CNSI, ECPHF, and the Statia Department of Public Health– Local Capacity Building and Collaboration
– Basic Research (ND Students)
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Thank You!
John GriecoNicole AcheeSusana Castillo
Teresa Leslie
Carol John
Gerwyn Schobe
Rodney Vlitjeg
Javier GomezJohan Stapel
Pepita Cannegieter