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BACKGROUND: Argentina is located at the southern temperate range of arboviral transmission by the mosquito Aedes aegypti and has experienced a rapid increase in disease transmission in recent years. Here we present findings from an entomological surveillance study that began in Córdoba, Argentina, following the emergence of dengue in 2009. METHODS: From 2009 to 2017, larval surveys were conducted monthly, from November to May, in 600 randomly selected households distributed across the city. From 2009 to 2013, ovitraps (n = 177) were sampled weekly to monitor the oviposition activity of Ae. aegypti. We explored seasonal and interannual dynamics of entomological variables and dengue transmission. Cross correlation analysis was used to identify significant lag periods. RESULTS: Aedes aegypti were detected over the entire study period, and abundance peaked during the summer months (January to March). We identified a considerable increase in the proportion of homes with juvenile Ae. aegypti over the study period (from 5.7% of homes in 2009-10 to 15.4% of homes in 2016-17). Aedes aegypti eggs per ovitrap and larval abundance were positively associated with temperature in the same month. Autochthonous dengue transmission peaked in April, following a peak in imported dengue cases in March; autochthonous dengue was not positively associated with vector or climate variables. CONCLUSIONS: This longitudinal study provides insights into the complex dynamics of arbovirus transmission and vector populations in a temperate region of arbovirus emergence. Our findings suggest that Córdoba is well suited for arbovirus disease transmission, given the stable and abundant vector populations. Further studies are needed to better understand the role of regional human movement.
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Dengue fever and other febrile mosquito-borne diseases place considerable health and economic burdens on small island nations in the Caribbean. Here, we used two methods of cluster detection to find potential hotspots of transmission of dengue and chikungunya in Barbados, and to assess the impact of input surveillance data and methodology on observed patterns of risk. Using Moran's I and spatial scan statistics, we analyzed the geospatial and temporal distribution of disease cases and rates across Barbados for dengue fever in 2013-2016, and a chikungunya outbreak in 2014. During years with high numbers of dengue cases, hotspots for cases were found with Moran's I in the south and central regions in 2013 and 2016, respectively. Using smoothed disease rates, clustering was detected in all years for dengue. Hotspots suggesting higher rates were not detected via spatial scan statistics, but coldspots suggesting lower than expected rates of disease activity were found in southwestern Barbados during high case years of dengue. No significant spatiotemporal structure was found in cases during the chikungunya outbreak. Spatial analysis of surveillance data is useful in identifying outbreak hotspots, potentially complementing existing early warning systems. We caution that these methods should be used in a manner appropriate to available data and reflecting explicit public health goals-managing for overall case numbers or targeting anomalous rates for further investigation.
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Febre de Chikungunya/epidemiologia , Vírus Chikungunya/patogenicidade , Vírus da Dengue/patogenicidade , Dengue/epidemiologia , Surtos de Doenças , Análise Espaço-Temporal , Aedes/virologia , Animais , Barbados/epidemiologia , Febre de Chikungunya/transmissão , Febre de Chikungunya/virologia , Vírus Chikungunya/fisiologia , Análise por Conglomerados , Dengue/transmissão , Dengue/virologia , Vírus da Dengue/fisiologia , Doenças Endêmicas/estatística & dados numéricos , Monitoramento Epidemiológico , Humanos , Incidência , Mosquitos Vetores/virologia , Saúde Pública , RiscoRESUMO
The distribution of arbovirus disease transmission is expanding from the tropics and subtropics into temperate regions worldwide. The temperate city of Córdoba, Argentina has been experiencing the emergence of dengue virus, transmitted by the mosquito Aedes aegypti, since 2009, when autochthonous transmission of the virus was first recorded in the city. The aim of this work is to characterize the emergence of dengue and related arboviruses (Zika and chikungunya) in Córdoba since 2009. Herein, we present a data set with all known information about transmission of dengue, Zika, and chikungunya viruses in Córdoba, Argentina from 2009-2018, including what information is known of dengue virus (DENV) serotypes in circulation and origins of imported cases. The data presented in this work will assist researchers in investigating drivers of arbovirus emergence and transmission in Córdoba, Argentina and contribute to a better understanding of the global problem of the expanding distribution of arbovirus disease transmission.
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Febre de Chikungunya/transmissão , Dengue/transmissão , Infecção por Zika virus/transmissão , Aedes/virologia , Animais , Arbovírus , Argentina/epidemiologia , Febre de Chikungunya/epidemiologia , Vírus Chikungunya , Cidades , Dengue/epidemiologia , Vírus da Dengue , Humanos , Zika virus , Infecção por Zika virus/epidemiologiaRESUMO
BACKGROUND: Small island developing states (SIDS) in the Caribbean region are challenged with managing the health outcomes of a changing climate. Health and climate sectors have partnered to co-develop climate services to improve the management of emerging arboviral diseases such as dengue fever, for example, through the development of climate-driven early warning systems. The objective of this study was to identify health and climate stakeholder perceptions and needs in the Caribbean, with respect to the development of climate services for arboviruses. METHODS: Stakeholders included public decision makers and practitioners from the climate and health sectors at the regional (Caribbean) level and from the countries of Dominica and Barbados. From April to June 2017, we conducted interviews (n = 41), surveys (n = 32), and national workshops with stakeholders. Survey responses were tabulated, and audio recordings were transcribed and analyzed using qualitative coding to identify responses by research topic, country/region, and sector. RESULTS: Health practitioners indicated that their jurisdiction is currently experiencing an increased risk of arboviral diseases associated with climate variability, and most anticipated that this risk will increase in the future. National health sectors reported financial limitations and a lack of technical expertise in geographic information systems (GIS), statistics, and modeling, which constrained their ability to implement climate services for arboviruses. National climate sectors were constrained by a lack of personnel. Stakeholders highlighted the need to strengthen partnerships with the private sector, academia, and civil society. They identified a gap in local research on climate-arbovirus linkages, which constrained the ability of the health sector to make informed decisions. Strategies to strengthen the climate-health partnership included a top-down approach by engaging senior leadership, multi-lateral collaboration agreements, national committees on climate and health, and shared spaces of dialogue. Mechanisms for mainstreaming climate services for health operations to control arboviruses included climatic-health bulletins and an online GIS platform that would allow for regional data sharing and the generation of spatiotemporal epidemic forecasts. Stakeholders identified a 3-month forecast of arboviral illness as the optimal time frame for an epidemic forecast. CONCLUSIONS: These findings support the creation of interdisciplinary and intersectoral 'communities of practice' and the co-design of climate services for the Caribbean public health sector. By fostering the effective use of climate information within health policy, research and practice, nations will have greater capacity to adapt to a changing climate.
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Aedes , Controle de Doenças Transmissíveis , Doenças Transmissíveis , Saúde Pública , Adolescente , Adulto , Aedes/virologia , Idoso , Animais , Infecções por Arbovirus/prevenção & controle , Barbados , Mudança Climática , Doenças Transmissíveis/epidemiologia , Atenção à Saúde , Dengue/prevenção & controle , Dengue/transmissão , Vetores de Doenças , Dominica , Feminino , Política de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Setor Público , Participação dos Interessados , Inquéritos e Questionários , Adulto JovemRESUMO
Barbados is a Caribbean island country of approximately 285,000 people, with a thriving tourism industry. In 2015, Zika spread rapidly throughout the Americas, and its proliferation through the Caribbean islands followed suit. Barbados reported its first confirmed autochthonous Zika transmission to the Pan American Health Organization in January 2016, a month before the global public health emergency was declared. After detection of suspected Zika cases on Barbados in 2015, 926 individuals were described as suspected cases, and 147 laboratory-confirmed cases were reported through December 2016, the end of the most recent epidemiological year. In this short report, we describe the epidemiological characteristics of 926 clinical case records that were originally suspected as cases of Zika, and which were subsequently sent for testing and confirmation; 147 were found positive for Zika, using reverse transcription-polymerase chain reaction methods, another 276 tested negative, and the remaining 503 were either pending results or still in the suspected category. Women were represented at about twice the rate of men in case records where gender was reported (71.9%), and confirmed cases (78.2%), and 19 of the confirmed positive cases were children under the age of 10.
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Surtos de Doenças , Saúde Global , Infecção por Zika virus/epidemiologia , Zika virus/fisiologia , Adolescente , Adulto , Barbados/epidemiologia , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Saúde Pública , Adulto Jovem , Infecção por Zika virus/virologiaRESUMO
On 16 April 2016, a 7.8 magnitude earthquake struck coastal Ecuador, resulting in significant mortality and morbidity, damages to infrastructure, and psychological trauma. This event coincided with the first outbreak of Zika virus (ZIKV) and co-circulation with dengue virus (DENV) and chikungunya virus (CHIKV). We tested whether the degree of psychological distress was associated with the presence of suspected DENV, CHIKV, ZIKV (DCZ) infections three months after the earthquake. In July 2016, 601 household members from four communities in Bahía de Caráquez, Manabí Province, Ecuador, were surveyed in a post-disaster health evaluation. Information was collected on demographics, physical damages and injuries, chronic diseases, self-reported psychological distress, and DCZ symptoms. We calculated the prevalence of arbovirus and distress symptoms by community. ANOVA was used to compare the mean number of psychological distress symptoms between people with versus without suspected DCZ infections by age, gender, community and the need to sleep outside of the home due to damages. The prevalence of suspected DCZ infections was 9.7% and the prevalence of psychological distress was 58.1%. The average number of psychological distress symptoms was significantly higher among people with suspected DCZ infections in the periurban community of Bella Vista, in women, in adults 40-64 years of age and in individuals not sleeping at home (p < 0.05). The results of this study highlight the need to investigate the interactions between psychological distress and arboviral infections following natural disasters.
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Febre de Chikungunya/epidemiologia , Dengue/epidemiologia , Terremotos , Estresse Psicológico/epidemiologia , Infecção por Zika virus/epidemiologia , Adolescente , Adulto , Surtos de Doenças , Equador/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
In February 2016, the World Health Organization declared the pandemic of Zika virus a public health emergency. On March 4, 2016, Dominica reported its first autochthonous Zika virus disease case; subsequently, 1,263 cases were reported. We describe the outbreak through November 2016, when the last known case was reported.