Assessment of data on vector and host competence for Japanese encephalitis virus: A systematic review of the literature.

Japanese encephalitis virus (JEV) is a virus of the Flavivirus genus that may result in encephalitis in human hosts. This vector-borne zoonosis occurs in Eastern and Southeastern Asia and an intentional or inadvertent introduction into the United States (US) would have major public health and economic consequences. The objective of this study was to gather, appraise, and synthesize primary research literature to identify and quantify vector and host competence for JEV, using a systematic review (SR) of the literature. After defining the research question, we performed a search in selected electronic databases and journals. The title and abstract of the identified articles were screened for relevance using a set of exclusion and inclusion criteria, and relevant articles were subjected to a risk of bias assessment, followed by data extraction. Data were extracted from 171 peer-reviewed articles. Most studies were observational studies (59.1%) and reported vector competence (60.2%). The outcome measures reported pertained to transmission efficiency, host preference, and vector susceptibility to infection within vector competence; and susceptibility to infection within host competence. Regarding vector competence, the proportion of JEV infection reported across all 149 mosquito species in all observational studies ranged from 0 to 100%. In experimental studies, infection, dissemination, and transmission rates varied between 0 and 100%. Minimum infection rates (MIR) varied between 0 and 333.3 per 1000 mosquitoes. Maximum likelihood estimation (MLE) values ranged from 0 to 53.8 per 1000 mosquitoes. The host species in which mosquitoes mostly fed consisted of pigs and cattle (total of 84 blood meals taken by mosquitoes from each of these host species). As for host competence, the proportion of JEV infection varied between 0 (in rabbits, reptiles, and amphibians) and 88.9% (cattle). This SR presents comprehensive data on JEV vector and host competence, which can be used to quantify risks associated with the introduction of JEV into the US.

Meta-Analyses of Japanese Encephalitis Virus Infection, Dissemination, and Transmission Rates in Vectors.

The objective of this work was to summarize and quantify Japanese encephalitis virus (JEV) infection, dissemination, and transmission rates in mosquitoes, using a meta-analysis approach. Data were obtained from experimental studies, gathered by means of a systematic review of the literature. Random-effects subgroup meta-analysis models by mosquito species were fitted to estimate pooled estimates and to calculate the variance between studies for three outcomes of interest: JEV infection, dissemination, and transmission rates in mosquitoes. To identify sources of heterogeneity among studies and to assess the association between different predictors (mosquito species, virus administration route, incubation period, and diagnostic method) with the outcome JEV infection rate in vectors, we fitted univariable meta-regression models. Mosquito species and administration route represented the main sources of heterogeneity associated with JEV infection rate in vectors. This study provided summary effect size estimates to be used as reference for other investigators when assessing transmission efficiency of vectors and explored sources of variability for JEV infection rates in vectors. Because transmission efficiency, as part of vector competence assessment, is an important parameter when studying the relative contribution of vectors to JEV transmission, our findings contribute to further our knowledge, potentially moving us toward more informed and targeted actions to prevent and control JEV in both affected and susceptible regions worldwide.