- Author: Kathy Keatley Garvey
Travelers know Iquitos as the "capital of the Peruvian Amazon" but scientists know it as a hot spot for dengue, a mosquito-borne viral disease with raging outbreaks in many tropical and subtropical countries.
Amy Morrison, stationed in Iquitos full-time, has directed dengue research activities there for the past 15 years. An epidemiologist who joined the UC Davis laboratory of medical entomologist Thomas Scott (now professor emeritus) in 1996, she's a project scientist and scientific director of the Naval Medical Research Unit No. 6 (NAMRU-6) Iquitos Laboratory.
Morrison is back in the states to present a UC Davis seminar on "Targeting Aedes Aegypti Adults for Dengue Control: Infection Experiments and Vector Control in Iquitos" from 4:10 to 5 p.m., Wednesday, Jan. 10, in 122 Briggs Hall, Kleiber Hall Drive.
Hosted by the UC Davis Department of Entomology and Nematology, it's the first in a series of winter seminars coordinated by assistant professor Rachel Vannette and Ph.D student Brendon Boudinot of the Phil Ward lab.
Dengue is a threat to global health, says Morrison, who holds a doctorate in epidemiology from Yale University and a master's degree in public health from UCLA. According to the World Health Organization (WHO), the incidence of dengue has increased 30-fold over the last 50 years and almost half of the world population is now at risk. It's ranked as "the most critical mosquito-borne viral disease in the world."
"Each year, an estimated 390 million dengue infections occur around the world," according to the World Mosquito Program. "Of these, 500,000 cases develop into dengue hemorrhagic fever, a more severe form of the disease, which results in up to 25,000 deaths annually worldwide."
Of the dengue project in Iquitos, Morrison says: "Comprehensive, longitudinal field studies that monitor both disease and vector populations for dengue viruses have been carried out since 1999 in Iquitos. In addition, to five large scale-vector control intervention trials, ongoing data collection has allowed the evaluation of Ministry of Health emergency vector control using indoor ULV space sprays with pyrethroids in concert with larviciding through multiple campaigns, as well as characterize local DENV (dengue virus) transmission dynamics through two and one novel DENV serotype and strain invasions into the city."
"Our research group has also been conducting contact cluster investigations on DENV-infected and febrile control individuals since 2008," Morrison relates. "These studies demonstrated that attack rates were consistent between houses where cases were first detected and recently visited contact houses independent of distance between these locations. Furthermore, contact cluster investigations allow us to identify viremic individuals across the spectrum of disease outcomes including inapparent infections."
"Using DENV positive individuals captured through these and other febrile surveillance protocols, we exposed laboratory reared (F2) Aedes aegypti mosquitoes directly on their arms or legs, and obtained blood samples with and without EDTA for exposure of mosquitoes in an artificial membrane feeder. After a 58-participant pilot study comparing feeding methods, we initiated a direct feeding protocol exposing participants (78 feeds in 31 participants to date). Feeding, survival, midgut infection and systemic dissemination are all higher using direct feeding than indirect feeding methods. Of 22 participants without detectable fluorescent focus assay titers in their serum at the time they were exposed to mosquitoes, 14 infected mosquitoes by at least one method."
"Although virus titer was a predictor of mosquito infection, mosquitoes became infected at low or undetectable titers and with subjects experiencing mild disease. We have evaluated insecticide-treated curtains and a novel lethal ovitrap (Attractive Lethal OviTrap = ALOT) for dengue control. Only the ALOT traps showed a significant impact on dengue incidence corresponding to a modest decrease in vector densities and a shift of the mosquito population age structure in the trap area to younger mosquitoes. Recent evaluations of indoor ULV interventions with pyrethroids suggest that ULV campaigns that reduce Aedes aegypti for at least 3 weeks through multiple fumigation cycles can mitigate DENV transmission during the same season."
Bottom line: "We argue that Aedes aegypti control should focus on interrupting transmission rather than long-term suppression at operationally unachievable levels and that emergency control should be applied at area-wide scales rather than reacting to individual DENV cases."
- Author: Kathy Keatley Garvey
The mosquito transmits the Zika virus, currently "the" hot medical topic.
But it also transmits dengue, yellow fever and chikungunya viruses.
“Dengue infects 400 million people worldwide each year, and 4 billion people or nearly half of the world's population are at risk for dengue,” says medical entomologist Thomas Scott, distinguished professor and now emeritus, UC Davis Department of Entomology and Nematology.
Scott, who has studied dengue more than 25 years and is recognized as the leading expert in the ecology and epidemiology of the disease, emphasizes that “There is no vaccine nor drug that is effective against this virus." There are four serotypes: DENV-1 through DENV-4.
Now for the groundbreaking news.
Scott and his colleagues just published a study in the Public Library of Science (PLOS), Neglected Tropical Diseases, that is sure to rock the world of everyone who has ever contracted dengue.
Well, yes, you can. "Lifetime of immunity" is false.
“Our most significant result from this study is that immunity to dengue viruses does not always provide perfect protection from reinfection,” Scott said. “The public health implications include evaluation of dengue vaccines, interpretation of a person's virus exposure history and susceptibility to new infections, and design of dengue surveillance programs.”
“Our data indicate that protection from homologous DENV re-infection may be incomplete in some circumstances, which provides context for the limited vaccine efficacy against DENV-2 in recent trials,” the research team wrote. “Further studies are warranted to confirm this phenomenon and to evaluate the potential role of incomplete homologous protection in DENV transmission dynamics.”
Former UC Davis researcher Steve Stoddard and senior author of the paper said it well:
“It has long been thought that infection with any one of the viruses produced lifetime immunity to that virus. This finding could help explain results of dengue vaccine trials that showed poor efficacy against one of the four serotype. It also has broad implications for vaccine development.”
The research team investigated the "validity of the fundamental assumption" by analyzing a large epidemic caused by a new strain of DENV-2 that invaded Iquitos, Peru, in 2010-2011, 15 years after the first outbreak of DENV-2 in the region.