RESUMO
The expense and ineffectiveness of drift-based insecticide aerosols to control dengue epidemics has led to suppression strategies based on eliminating larval breeding sites. With the notable but short-lived exceptions of Cuba and Singapore, these source reduction efforts have met with little documented success; failure has chiefly been attributed to inadequate participation of the communities involved. The present work attempts to estimate transmission thresholds for dengue based on an easily-derived statistic, the standing crop of Aedes aegypti pupae per person in the environment. We have developed these thresholds for use in the assessment of risk of transmission and to provide targets for the actual degree of suppression required to prevent or eliminate transmission in source reduction programs. The notion of thresholds is based on 2 concepts: the mass action principal-the course of an epidemic is dependent on the rate of contact between susceptible hosts and infectious vectors, and threshold theory-the introduction of a few infectious individuals into a community of susceptible individuals will not give rise to an outbreak unless the density of vectors exceeds a certain critical level. We use validated transmission models to estimate thresholds as a function of levels of pre-existing antibody levels in human populations, ambient air temperatures, and size and frequency of viral introduction. Threshold levels were estimated to range between about 0.5 and 1.5 Ae. aegypti pupae per person for ambient air temperatures of 28 degrees C and initial seroprevalences ranging between 0% to 67%. Surprisingly, the size of the viral introduction used in these studies, ranging between 1 and 12 infectious individuals per year, was not seen to significantly influence the magnitude of the threshold. From a control perspective, these results are not particularly encouraging. The ratio of Ae. aegypti pupae to human density has been observed in limited field studies to range between 0.3 and >60 in 25 sites in dengue-endemic or dengue-susceptible areas in the Caribbean, Central America, and Southeast Asia. If, for purposes of illustration, we assume an initial seroprevalence of 33%, the degree of suppression required to essentially eliminate the possibility of summertime transmission in Puerto Rico, Honduras, and Bangkok, Thailand was estimated to range between 10% and 83%; however in Mexico and Trinidad, reductions of >90% would be required. A clearer picture of the actual magnitude of the reductions required to eliminate the threat of transmission is provided by the ratio of the observed standing crop of Ae. aegypti pupae per person and the threshold. For example, in a site in Mayaguez, Puerto Rico, the ratio of observed and threshold was 1.7, meaning roughly that about 7 of every 17 breeding containers would have to be eliminated. For Reynosa, Mexico, with a ratio of approximately 10, 9 of every 10 containers would have to be eliminated. For sites in Trinidad with ratios averaging approximately 25, the elimination of 24 of every 25 would be required. With the exceptions of Cuba and Singapore, no published reports of sustained source reduction efforts have achieved anything near these levels of reductions in breeding containers. Practical advice on the use of thresholds is provided for operational control projects.
Assuntos
Aedes/crescimento & desenvolvimento , Simulação por Computador , Dengue/transmissão , Insetos Vetores/crescimento & desenvolvimento , Modelos Biológicos , Animais , Anticorpos Antivirais/sangue , Dengue/epidemiologia , Dengue/prevenção & controle , Vírus da Dengue/crescimento & desenvolvimento , Feminino , Honduras/epidemiologia , Humanos , Mordeduras e Picadas de Insetos/epidemiologia , Mordeduras e Picadas de Insetos/virologia , México/epidemiologia , Porto Rico/epidemiologia , Pupa/crescimento & desenvolvimento , Medição de Risco , Processos Estocásticos , Temperatura , Tailândia/epidemiologia , Trinidad e Tobago/epidemiologiaRESUMO
The expense and ineffectiveness of drift-based insecticide aerosols to control dengue epidemics has led to suppression strategies based on eliminating larval breeding sites. With the notable but short-lived exceptions of Cuba and Singapore, these source reduction efforts have met with little documented success; failure has chiefly been attributed to inadequate participation of the communities involved. The present work attempts to estimate transmission thresholds for dengue based on an easily-derived statistic, the standing crop of Aedes aegypti pupae per person in the environment. We have developed these thresholds for use in the assessment of risk of transmission and to provide targets for the actual degree of suppression required to prevent or eliminate transmission in source reduction programs. The notion of thresholds is based on 2 concepts: the mass action principal-the course of an epidemic is dependent on the rate of contact between susceptible hosts and infectious vectors, and threshold theory-the introduction of a few infectious individuals into a community of susceptible individuals will not give rise to an outbreak unless the density of vectors exceeds a certain critical level. We use validated transmission models to estimate thresholds as a function of levels of pre-existing antibody levels in human populations, ambient air temperatures, and size and frequency of viral introduction. Threshold levels were estimated to range between about 0.5 and 1.5 Ae. aegypti pupae per person for ambient air temperatures of 28 degrees C and initial seroprevalences ranging between 0% to 67%. Surprisingly, the size of the viral introduction used in these studies, ranging between 1 and 12 infectious individuals per year, was not seen to significantly influence the magnitude of the threshold. From a control perspective, these results are not particularly encouraging. The ratio of Ae. aegypti pupae to human density has been observed in limited field studies to range between 0.3 and >60 in 25 sites in dengue-endemic or dengue-susceptible areas in the Caribbean, Central America, and Southeast Asia. If, for purposes of illustration, we assume an initial seroprevalence of 33%, the degree of suppression required to essentially eliminate the possibility of summertime transmission in Puerto Rico, Honduras, and Bangkok, Thailand was estimated to range between 10% and 83%; however in Mexico and Trinidad, reductions of >90% would be required. A clearer picture of the actual magnitude of the reductions required to eliminate the threat of transmission is provided by the ratio of the observed standing crop of Ae. aegypti pupae per person and the threshold. For example, in a site in Mayaguez, Puerto Rico, the ratio of observed and threshold was 1.7, meaning roughly that about 7 of every 17 breeding containers would have to be eliminated. For Reynosa, Mexico, with a ratio of approximately 10, 9 of every 10 containers would have to be eliminated. For sites in Trinidad with ratios averaging approximately 25, the elimination of 24 of every 25 would be required. With the exceptions of Cuba and Singapore, no published reports of sustained source reduction efforts have achieved anything near these levels of reductions in breeding containers. Practical advice on the use of thresholds is provided for operational control projects.
Assuntos
Animais , Humanos , Feminino , Aedes/crescimento & desenvolvimento , Anticorpos Antivirais/sangue , Simulação por Computador , Dengue/epidemiologia , Dengue/prevenção & controle , Dengue/transmissão , Vírus da Dengue/crescimento & desenvolvimento , Mordeduras e Picadas de Insetos/epidemiologia , Mordeduras e Picadas de Insetos/virologia , Insetos Vetores/crescimento & desenvolvimento , Pupa/crescimento & desenvolvimento , Modelos Biológicos , Medição de Risco , Processos Estocásticos , Temperatura , Trinidad e Tobago/epidemiologia , Tailândia/epidemiologia , México/epidemiologia , Porto Rico/epidemiologia , Honduras/epidemiologiaRESUMO
Fifty-one atopic asthmatic and/or allergic rhinitic children and 23 nonatopic control from Santo Domingo, the Dominican Republic, were skin tested with an extract mix of three cockroach species (Blattella germanica, Blatta orientalis, and Periplaneta americana). Sixteen percent of the atopics and none of the nonatopics demonstrated positive immediate skin reactions to the cockroach mix (chi 2 = 4.05, p = 0.04). Hypersensitivity was correlated with the quality of the homes; 22% (8/36) of the atopics who lived in a concrete home were skin test positive to the cockroach mix, while none (0/15) of the atopics who lived in a wood home were skin test positive (chi 2 = 4.86, p = 0.03). Although the incidence of cockroach allergy in this study is lower than that found elsewhere, these data support the notion that, in this tropical environment, sensitization to cockroaches is associated with housing quality.
Assuntos
Asma/epidemiologia , Baratas , Habitação , Rinite Alérgica Perene/epidemiologia , Adolescente , Alérgenos/efeitos adversos , Animais , Asma/etiologia , Hiper-Reatividade Brônquica/etiologia , Criança , Pré-Escolar , República Dominicana/epidemiologia , Feminino , Habitação/normas , Humanos , Incidência , Masculino , Rinite Alérgica Perene/etiologia , Testes Cutâneos , Fatores SocioeconômicosRESUMO
The ecology of several potential mosquito vectors of Venezuelan equine encephalitis (VEE) alphavirus was studied in an enzootic focus of that virus on the Pacific coast of Guatemala over a four-year period. Four species-Culex taeniopus, Mansonia titillans, Culex nigripalpus and Aedes taeniorhynchus-were most prevalent during the wet season when transmission normally occurs. However, only Cx. taeniopus yielded VEE virus. The bloodfeeding patterns of these species revealed that Ae. taeniorhynchus and Ma. titillans fed almost exclusively on bovine and equine hosts. Conversely, Cx. nigripalpus was highly ornithophilic but occasionally fed on mammals. Cx. taeniopus exhibited a wide host range, utilizing both large and small mammals as well as birds and, rarely, reptiles. The versatility in feeding pattern displayed by this mosquito coupled with its ability to become infected with relatively low levels of enzootic VEE virus suggests that vertebrates other than rodents may serve as amplifying hosts in this habitat. Nepuyo virus was also isolated from Cx. taeniopus, suggesting that this mosquito might be an endemic vector of this rodent-associated bunyavirus. A single isolate of St. Louis encephalitis virus was made from Cx. nigripalpus.
Assuntos
Culicidae/microbiologia , Vírus da Encefalite Equina Venezuelana/isolamento & purificação , Insetos Vetores/microbiologia , Aedes/microbiologia , Aedes/fisiologia , Animais , Bunyaviridae/isolamento & purificação , Culex/microbiologia , Culex/fisiologia , Culicidae/fisiologia , Vírus da Encefalite de St. Louis/isolamento & purificação , Encefalomielite Equina Venezuelana/epidemiologia , Encefalomielite Equina Venezuelana/transmissão , Comportamento Alimentar , Guatemala , Humanos , Insetos Vetores/fisiologia , Estações do AnoRESUMO
The minimal intestinal dose of an enzootic strain of Venezuelan encephalitis (VE) virus for Culex (Melanoconion) taeniopus mosquitoes caught at a marsh habitat of VE virus in Guatemala was less than five plaque forming units (pfu) of virus. Ingestion of this dose of virus in blood of viremic hamsters resulted in transmission of virus to other hamsters. This low intestinal threshold of an enzootic strain of VE virus indicates that the natural Guatemalan population of Cu. (Mel.) taeniopus can acquire VE virus from vertebrates that have viremia levels as low as 1,000-5,000 pfu/ml of blood, provided other factors do not limit virus interchange between mosquitoes and vertebrates.