Aedes aegypti in Jamaica, West Indies: container productivity profiles to inform control strategies.

OBJECTIVE: To describe the Aedes aegypti container profile in the three parishes of Portland, St. Anns and St. Catherine, Jamaica. METHOD: Traditional stegomyia and pupae per person indices. RESULTS: A total of 8855 containers were inspected. A. aegypti were breeding in 19.2% of the 4728 containers in Portland, in 6.7% of the 2639 containers in St. Ann, and in 27.2% of the 1488 containers in Tryhall Heights, St. Catherine. Container types differed between Portland (P > 0.02) on one hand and St. Ann and Tryhall Heights, St. Catherine on the other hand: there were with no vases or potted plants with water saucers in St. Ann and St. Catherine. A. aegypti were breeding in more containers in St. Catherine (38%) (38% in wet season and 21% in the dry season) than in Portland (19%) or St. Ann (6%), both of which had more containers but A. aegypti breeding in fewer: 17.7% and 11.2% in the wet and 20.4% and 3.5% in the dry seasons respectively. The daily production of adult mosquitoes in the three study sites was 1.51, 1.29 and 0.66 adult female mosquitoes per person in Portland, St. Ann and St. Catherine during the dry season and 1.12, 0.23 and 1.04 female mosquitoes per person in the wet season respectively. CONCLUSION: All three communities are at risk for dengue outbreaks and vector control should concentrate on reducing the mosquito populations from the most productive containers before a new dengue virus serotype is introduced into Jamaica.

Aedes aegypti in Jamaica, West Indies: container productivity profiles to inform control strategies

OBJECTIVE: To describe the Aedes aegypti container profile in the three parishes of Portland, St. Anns and St. Catherine, Jamaica.METHOD: Traditional stegomyia and pupae per person indices.RESULTS: A total of 8855 containers were inspected. A. aegypti were breeding in 19.2% of the 4728 containers in Portland, in 6.7% of the 2639 containers in St. Ann, and in 27.2% of the 1488 containers in Tryhall Heights, St. Catherine. Container types differed between Portland (P > 0.02) on one hand and St. Ann and Tryhall Heights, St. Catherine on the other hand: there were with no vases or potted plants with water saucers in St. Ann and St. Catherine. A. aegypti were breeding in more containers in St. Catherine (38%) (38% in wet season and 21% in the dry season) than in Portland (19%) or St. Ann (6%), both of which had more containers but A. aegypti breeding in fewer: 17.7% and 11.2% in the wet and 20.4% and 3.5% in the dry seasons respectively. The daily production of adult mosquitoes in the three study sites was 1.51, 1.29 and 0.66 adult female mosquitoes per person in Portland, St. Ann and St. Catherine during the dry season and 1.12, 0.23 and 1.04 female mosquitoes per person in the wet season respectively.CONCLUSION: All three communities are at risk for dengue outbreaks and vector control should concentrate on reducing the mosquito populations from the most productive containers before a new dengue virus serotype is introduced into Jamaica.

Transmission thresholds for dengue in terms of Aedes aegypti pupae per person with discussion of their utility in source reduction efforts.

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.

Transmission thresholds for dengue in terms of Aedes aegypti pupae per person with discussion of their utility in source reduction efforts

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.

Dengue fever epidemic potential as projected by general circulation models of global climate change.

Climate factors influence the transmission of dengue fever, the world's most widespread vector-borne virus. We examined the potential added risk posed by global climate change on dengue transmission using computer-based simulation analysis to link temperature output from three climate general circulation models (GCMs) to a dengue vectorial capacity equation. Our outcome measure, epidemic potential, is the reciprocal of the critical mosquito density threshold of the vectorial capacity equation. An increase in epidemic potential indicates that a smaller number of mosquitoes can maintain a state of endemicity of disease where dengue virus is introduced. Baseline climate data for comparison are from 1931 to 1980. Among the three GCMs, the average projected temperature elevation was 1.16 degrees C, expected by the year 2050. All three GCMs projected a temperature-related increase in potential seasonal transmission in five selected cities, as well as an increase in global epidemic potential, with the largest area change occurring in temperate regions. For regions already at risk, the aggregate epidemic potential across the three scenarios rose on average between 31 and 47% (range, 24-74%). If climate change occurs, as many climatologists believe, this will increase the epidemic potential of dengue-carrying mosquitoes, given viral introduction and susceptible human populations. Our risk assessment suggests that increased incidence may first occur in regions bordering endemic zones in latitude or altitude. Endemic locations may be at higher risk from hemorrhagic dengue if transmission intensity increases.

Pupal survey: an epidemiologically significant surveillance method for Aedes aegypti: an example using data from Trinidad.

This report documents the results of a country-wide pupal survey of Aedes aegypti (L.) conducted in Trinidad. The survey was designed to identify the important Ae. aegypti-producing containers, importance being a function of a container's abundance and its productivity. Results are summarized on a country-wide basis and by county: urban versus rural comparisons are also made. Numerically, the most common water-filled containers positive for the larvae or pupae of Ae. aegypti (foci) were outdoor drums, water storage tanks and buckets, laundry tubs, discarded tires, and small miscellaneous containers such as drink bottles and cans. The island-wide average number of foci per hectare was 287 and ranged between 65 and 499. The average standing crop per container of Ae. aegypti pupae was 9.5 and ranged 12-fold, the most and least productive being the flower pot (> 30) and the small indoor vase (< 3), respectively. In terms of production by type of container, four of the 11 types, outdoor drums, tubs, buckets, and small containers, accounted for > 90% of all Ae. aegypti pupae: the remaining seven types were responsible for < 10%. If targeted source reduction programs were directed by how important various container types were in the production of Ae. aegypti, environmental sanitation efforts designed to actually eliminate the ubiquitous small receptacle and tires would reduce mosquito densities by 43%; the provision of an adequate water supply system precluding the need for water storage in drums and buckets would have the potential to eliminate an additional 38%. Combined, these two measures have the potential to reduce the sources responsible for > 80% of Ae. aegypti production in the country. In our survey, the traditional Stegomyia indices used to document the density of Ae. aegypti and predict the threat of dengue transmission, the House, Container, and Breteau indices, were seen to have virtually no correspondence with the actual number of pupae per hectare or per person. We conclude that pupal survey is more appropriate for assessing risk and directing control operations.

Pupal survey: an epidemiologically significant surveillance method for Aedes aegypti: an example using data from Trinidad

This report documents the results of a country-wide pupal survey of Aedes aegypti (L.) conducted in Trinidad. The survey was designed to identify the important Ae. aegypti-producing containers, importance being a function of a container's abundance and its productivity. Results are summarized on a country-wide basis and by country: urban versus rural comparisons are also made. Numerically, the most common water-filled containers positive for the larvae or pupae of Ae. aegypti (foci) were outdoor drums, water storage tanks and buckets, laundry tubs, discarded tires, and small miscellanous containers such as drink bottles and cans. The island-wide average number of foci per hectare was 287 and ranged between 65 and 499. The average standing crop per container of Ae. aegypti pupae was 9.5 and ranged 12-fold, the most and least productive being the flower pot (>30) and the small indoor vase (<3), respectively. In terms of production by type of container, four of the 11 types, outdoor drums, tubs, buckets, and small containers, accounted for > 90 percent of all Ae. aegypti pupae: the remaining seven types were responsible for <10 percent. If targeted source reduction programs were directed by how important various containers were in the production of Ae. aegypti, environmental sanitation efforts designed to actually eliminate the ubiquitous small receptacle and tires would reduce mosquito densities by 43 percent; the provision of an adequate water supply system precluding the need for water storage in drums and buckets would have the potential to eliminate an additional 38 percent. Combined, these two measures have the potential to reduce the sources responsible for >80 percent of Ae. aegypti production in the country. In our survey, the traditional Stegomyia indices used to document the density of Ae. aegypti and predict the threat of dengue transmission, the House, Container, and Breteau indices, were seen to have virtually no correspondence with the actual number of pupae per hectare or per person. We conclude that pupal survey is more appropriate for assessing risk and directing control operations (AU)

A simulation model of the epidemiology of urban dengue fever: literature analysis, model development, preliminary validation, and samples of simulation results.

We have developed a pair of stochastic simulation models that describe the daily dynamics of dengue virus transmission in the urban environment. Our goal has been to construct comprehensive models that take into account the majority of factors known to influence dengue epidemiology. The models have an orientation toward site-specific data and are designed to be used by operational programs as well as researchers. The first model, the container-inhabiting mosquito simulation model (CIMSiM), a weather-driven dynamic life-table model of container-inhabiting mosquitoes such as Aedes aegypti, provides inputs to the tranmission model, the dengue simulation model (DENSiM); a description and validation of the entomology model was published previously. The basis of the transmission model is the simulation of a human population growing in response to country- and age-specific birth and death rates. An accounting of individual serologies is maintained by type of dengue virus, reflecting infection and birth to seropositive mothers. Daily estimates of adult mosquito survival, gonotrophic development, and the weight and number of emerging females from the CIMSiM are used to create the biting mosquito population in the DENSiM. The survival and emergence values determine the size of the population while the rate of gonotrophic development and female weight estimates influence biting frequency. Temperature and titer of virus in the human influences the extrinsic incubation period; titer may also influence the probability of transfer of virus from human to mosquito. The infection model within the DENSiM accounts for the development of virus within individuals and its passage between both populations. As in the case of the CIMSiM, the specific values used for any particular phenomenon are on menus where they can be readily changed. It is possible to simulate concurrent epidemics involving different serotypes. To provide a modicum of validation and to demonstrate the parameterization process for a specific location, we compare simulation results with reports on the nature of epidemics and seroprevalence of antibody in Honduras in low-lying coastal urbanizations and Tegucigalpa following the initial introduction of dengue-1 in 1978 into Central America. We conclude with some additional examples of simulation results to give an indication of the types of questions that can be investigated with the models.

Baseline data on Aedes aegypti populations in Santo Domingo, Dominican Republic.

Baseline field studies were conducted from April 1987 to July 1988 on Aedes aegypti in Santo Domingo, an endemic area for dengue fever. Premise, container and Breteau indices were measured in one treated area and 2 nearby control areas. These indices averaged 69.6, 46.3 and 142.1, respectively. The principal larval habitats of Ae. aegypti were 208-liter (55-gal) concrete-lined drums. The estimated daily adult production was approximately 60 per house. Adult mosquito populations were monitored using oviposition traps and by sweep net collections. There was no correlation between adult abundance and the larval indices. Monitoring the natural adult densities was more efficient for evaluating the impact of ULV malathion application than the use of standard bioassay procedures.