Jonathan F. Day

Drought-Induced Amplification and Epidemic Transmission of West Nile Virus in Southern Florida

Abstract We show that the spatial-temporal variability of human West Nile (WN) cases and the transmission of West Nile virus (WNV) to sentinel chickens are associated with the spatial-temporal variability of drought and wetting in southern Florida. Land surface wetness conditions at 52 sites in 31 counties in southern Florida for 2001–2003 were simulated and compared with the occurrence of human WN cases and the transmission of WNV to sentinel chickens within these counties. Both WNV transmission to sentinel chickens and the occurrence of human WN cases were associated with drought 2–6 mo prior and land surface wetting 0.5–1.5 mo prior. These dynamics are similar to the amplification and transmission patterns found in southern Florida for the closely related St. Louis encephalitis virus. Drought brings avian hosts and vector mosquitoes into close contact and facilitates the epizootic cycling and amplification of the arboviruses within these populations. Southern Florida has not recorded a severe, widespread drought since the introduction of WNV into the state in 2001. Our results indicate that widespread drought in the spring followed by wetting during summer greatly increase the probability of a WNV epidemic in southern Florida.

Malaria renders mice susceptible to mosquito feeding when gametocytes are most infective.

Mice infected with Plasmodium berghei, P. chabaudi, or P. yoelii became lethargic and ceased to display normal antimosquito behavior. Periods of reduced defensiveness corresponded with maximum mosquito engorgement and with periods of maximum gametocyte infectivity to mosquitoes. Increased feeding success of mosquitoes during periods of peak gametocyte infectivity may be important to the natural maintenance of these malaria parasites.

West Nile Virus Infection Rates in Culex nigripalpus (Diptera: Culicidae) Do Not Reflect Transmission Rates in Florida

Abstract We describe the first documented field transmission of West Nile (WN) virus by a North American mosquito. WN was first detected in northern Florida in 2001. An intensive mosquito trapping and surveillance program was conducted in this region for four nights to assess mosquito transmission of WN. Four mosquito traps, each with a single sentinel chicken, were placed at five different locations on each of four nights. A total of 11,948 mosquitoes was collected, and 14 mosquito pools were found to contain WN, giving a minimum infection rate between 1.08 and 7.54 per 1,000. Only one of the 80 sentinel chickens seroconverted to WN, demonstrating a single mosquito transmission event during the study and a mosquito transmission rate of between 0.8 and 1 per 1,000. Culex nigripalpus Theobald was responsible for WN transmission to the sentinel chicken, although both Cx. nigripalpus and Culex quinquefasciatus Say were found infected with WN. Mosquito transmission rates are reported in this study for the first time for a WN outbreak. This information is essential to determine risk of human and animal infection.

Bivalirudin is superior to heparins alone with bailout GP IIb/IIIa inhibitors in patients with ST-segment elevation myocardial infarction transported emergently for primary percutaneous coronary intervention: a pre-specified analysis from the EUROMAX trial

Aims In the HORIZONS trial, in-hospital treatment with bivalirudin reduced bleeding and mortality in primary percutaneous coronary intervention (PCI) compared with heparin and routine glycoprotein IIb/IIIa inhibitors (GPI). It is unknown whether this advantage of bivalirudin is observed in comparison with heparins only with GPI used as bailout. Methods and results In the EUROMAX study, 2198 patients with ST-segment elevation myocardial infarction (STEMI) were randomized during transport for primary PCI to bivalirudin or to heparins with optional GPI. Primary and principal outcome was the composites of death or non-CABG-related major bleeding at 30 days. This pre-specified analysis compared patients receiving bivalirudin (n = 1089) with those receiving heparins with routine upstream GPI (n = 649) and those receiving heparins only with GPI use restricted to bailout (n = 460). The primary outcome death and major bleeding occurred in 5.1% with bivalirudin, 7.6% with heparin plus routine GPI (HR 0.67 and 95% CI 0.46–0.97, P = 0.034), and 9.8% with heparins plus bailout GPI (HR 0.52 and 95% CI 0.35–0.75, P = 0.006). Following adjustment by logistic regression, bivalirudin was still associated with significantly lower rates of the primary outcome (odds ratio 0.53, 95% CI 0.33–0.87) and major bleeding (odds ratio 0.44, 95% CI 0.24–0.82) compared with heparins alone with bailout GPI. Rates of stent thrombosis were higher with bivalirudin (1.6 vs. 0.6 vs. 0.4%, P = 0.09 and 0.09). Conclusion Bivalirudin, started during transport for primary PCI, reduces major bleeding compared with both patients treated with heparin only plus bailout GPI and patients treated with heparin and routine GPI, but increased stent thrombosis.

Reproductive phase locking of mosquito populations in response to rainfall frequency.

The frequency of moderate to heavy rainfall events is projected to change in response to global warming. Here we show that these hydrologic changes may have a profound effect on mosquito population dynamics and rates of mosquito-borne disease transmission. We develop a simple model, which treats the mosquito reproductive cycle as a phase oscillator that responds to rainfall frequency forcing. This model reproduces observed mosquito population dynamics and indicates that mosquito-borne disease transmission can be sensitive to rainfall frequency. These findings indicate that changes to the hydrologic cycle, in particular the frequency of moderate to heavy rainfall events, could have a profound effect on the transmission rates of some mosquito-borne diseases.

Simulation Studies of St. Louis Encephalitis and West Nile Viruses: The Impact of Bird Mortality

West Nile virus (WNv) has spread through much of the eastern United States following its introduction in 1999, and arrived in Florida in 2001. Prior to its arrival, we anticipated that its transmission cycle was likely to be similar to that of St. Louis encephalitis virus (SLEv). However, high levels of avian mortality have been reported for WNv in the northeastern United States, and it was unknown how this would impact the transmission dynamics of WNv. Simulation models were used to compare the two viruses by considering the impact of bird mortality on the transmission dynamics of arboviruses in south Florida. Transmission models without disease-induced mortality (SLEv) were compared with models including disease-induced mortality (WNv). Disease-induced mortality depressed transmission, eliminating epizootics in two of 14 simulations that were epizootic without the additional mortality. In both models, the most important factor in the likelihood of epizootics was mosquito population size; the mosquito mortality rate was also important. The additional avian mortality altered the factors most important in the size and timing of epizootics, although it did not always directly affect the outcome of the simulations. In some cases, low-level transmission occurred prior to the epizootic peak. When disease-induced avian mortality was included in the simulations, appreciable numbers of dead birds occurred prior to high levels of infection in mosquitoes. This has implications for the use of dead birds as a surveillance tool monitoring the spread and transmission of WNv.

HOST-SEEKING STRATEGIES OF MOSQUITO DISEASE VECTORS

ABSTRACT Disease transmission by arthropods normally requires at least 2 host contacts. During the first, a pathogen (nematode, protozoan, or virus) is acquired along with the blood from an infected vertebrate host. The pathogen penetrates the vectors midgut and infects a variety of tissues, where replication may occur during an extrinsic incubation period lasting 3–30, days depending on vector and parasite physiology and ambient temperature. Following salivary-gland infection, the pathogen is usually transmitted to additional susceptible vertebrate hosts during future probing or blood feeding. The host-seeking strategies used by arthropod vectors can, in part, affect the efficiency of disease transmission. Vector abundance, seasonal distribution, habitat and host preference, and susceptibility to infection are all important components of disease-transmission cycles. Examples of 3 mosquito vectors of human disease are presented here to highlight the diversity of host seeking and to show how specific behaviors may influence disease-transmission cycles. In the African tropics, Anopheles gambiae s.s. is an efficient vector of human malaria due to its remarkably focused preference for human blood. Aedes aegypti is the main vector of dengue viruses in the New and Old World tropics and subtropics. This mosquito has evolved a domestic lifestyle and shares human habitations throughout much of its range. It prospers in settings where humans are its main source of blood. In south Florida, Culex nigripalpus is the major vector of St. Louis encephalitis (SLE) and West Nile (WN) viruses. This mosquito is opportunistic and blood feeds on virtually any available vertebrate host. It serves as an arboviral vector, in part, due to its ability to produce large populations in a short period of time. These 3 host-seeking and blood-feeding strategies make the specialist, as well as the opportunist, equally dangerous disease vectors.

St. Louis encephalitis virus in wild birds during the 1990 south Florida epidemic: the importance of drought, wetting conditions, and the emergence of Culex nigripalpus (Diptera: Culicidae) to arboviral amplification and transmission.

Abstract We analyzed the prevalence of hemagglutination inhibition (HI) antibodies to St. Louis encephalitis (SLE) virus in wild birds during the 1990 SLE epidemic in Indian River County. The initial presence of SLE HI antibody was associated significantly with modeled drought 15 wk prior, wetting conditions 1 wk prior, and the emergence of the Florida SLE virus vector, Culex nigripalpus, 5 wk prior. Our findings indicated that three factors conspired to create the 1990 epidemic: (1) a large population of susceptible wild birds; (2) severe springtime drought, which facilitated amplification of the SLE virus among the Cx. nigripalpus and a portion of the wild bird population; and (3) continued rainfall and wetting of the land surface in the summer and early fall, which sustained a large, host-seeking Cx. nigripalpus population. The continued biting and reproductive activity of Cx. nigripalpus maintained epizootic transmission throughout the summer and early fall in Indian River County. The high level of SLE virus amplification resulted in spillover transmission to humans. We hypothesize that without the continued reproductive activity of the vector mosquito, brought about by excessive summer and fall wetness, the unprecedented SLE virus amplification and consequent transmission to humans would not have been realized in 1990.

Frequency of Saint Louis encephalitis virus in humans from Florida, USA: 1990-1999

Abstract Four general frequencies of human St. Louis encephalitis (SLE) virus (epidemic, focal, sporadic, and no transmission) occurred in Florida between 1990 and 1999. An epidemic with 226 clinical cases and 11 deaths was reported from 28 Florida counties between July 1990 and January 1991. During the autumn of 1993, a focal outbreak was reported from Lee (5 cases) and Collier (3) Counties in southwest Florida. During the autumn of 1997, sporadic transmission to nine humans was reported from five Florida counties (Brevard [1 case], Polk [3], Charlotte [1], Lee [2], and Palm Beach [2]). Human infection with SLE virus depends on a number of variables that drive virus transmission. These include vector, virus, and avian host abundance, and meteorological events, especially rainfall. We monitored the abundance and serological status of wild avian amplification hosts, virus isolations fromCulex nigripalpusTheobald females, and SLE virus transmission to sentinel chickens during 1990, 1993, and 1997. The epidemic of 1990 was characterized by conditions that produced an unusual abundance of vector mosquitoes and avian amplification hosts early in the year. We propose that epidemics may result when a specific combination of biotic and abiotic conditions favor SLE virus minimum field infection rates that approach 1:1,000 inCx. nigripalpusvectors.

Chemical Odorant of Colonial Seabird Repels Mosquitoes

Abstract The crested auklet, Aethia cristatella, emits a class of aldehydes shown to be potent invertebrate repellents when used by heteropterans against their predators. Our aim was to determine the efficacy of these aldehydes against mosquitoes in the laboratory. Synthetic analogues of the auklet odorant were strongly repellent to mosquitoes in controlled laboratory trials. Furthermore, the efficacy was similar to previous reports for commercial mosquito repellents. These results, in combination with a previously published study, show that constituents of the aldehyde odorant are broad spectrum in efficacy against ectoparasitic arthropods of birds. Our report is the first empirical evidence for an endogenous mosquito repellent in birds.