European and global arbovirus surveillance systemsprepare.ersnet.org/lrmedia/2017/pdf/371.pdf · Malaria Filariasis Biting midges Blue tongue Schmallenberg Body lice Recurrent fever

Marieta Braks, Ph.D.Medical Entomologist

Arbovirus outbreak preparedness and response

European and globalarbovirus surveillance systems

30 March 201711:30-12:00

Content

1. Arboviruses2. Vector borne diseases3. Risk versus burden4. Surveillance strategy5. Entomological surveillance6. Take home messages7. EXTRA

ESCMID| 29-31 March 2017

1. Arboviruses

3

Arthropod-borne virusesVectors

a b

dc e

Number of species worldwide:

> 3500

> 800

> 850

> 1200

6

Arthropods Bacteria Virus Protozoa Filaria

Ticks √ √ √

Sand flies √ √

Mosquitoes √ √ √

Biting midges √ √

Body lice √

Fleas √

Mites √

Kissing bugs √Tsetse flies √

Black flies (?) √ √

Louse flies/ Keds √ √

Horse flies(mech) (√) (√)

√

Vectors

Vectors Bacteria Virus Protozoa FilariaTicks Lyme disease

RickettisosisTick borne enceph.Crimean Congo h. f.African swine fever

Babesiois

Sand flies Sandfly fever Leismaniasis

Mosquitoes a.o. WNV, RVF, CHIK, DEN, ZIK,

Malaria Filariasis

Biting midges Blue tongueSchmallenberg

Body lice Recurrent fever

Fleas Plague

Mites Epidemic typhus

Kissing bugs Chagas

Tsetse flies Sleeping Sickness

Black flies Venezuelan equineencephalitis

Avian Parasites Riverblindness

Louse flies/ Keds

Bartonellaschoenbuchensis

Avian Parasites

Horse flies(mech) (Tularemia) (Rift Valley Fever)

Loasis

Not everything is transmitted by everything

8

Co-evolution between pathogens and vectors

2. Arboviral diseases

9

1. tick borne2. sand fly borne3. mosquito borne

Vector borne diseases | 18 November 201310

1.Tick-borne

11

Tick borne encephalitis

12

Crimean Congo haemorrhagic fever


2. Sandfly-borne


Sandfly fever

Non-human reservoir unknown


3. Mosquito-borne


Dengue ChikungunyaZika

Rift Valley fever

West Nile fever

3. Disease burden versus threat

17

18

Context Endemic

disease Pathogen Vector Contexts of arboviral diseases for the

Netherlands 1 √ √ √ Tick borne encephalitis2 ‐ √ √ n/a 3 ‐ ‐ √ West Nile Fever 4 ‐ √ ‐ Zika 5 ‐ ‐ ‐ Crimean Congo haemorrhagic fever

Different contexts of arboviral diseases based on the current presence (√) or absence (-)

Disease burdenDisease burden

ThreatThreat

4. Surveillance strategy

19

20

• Pathogen data collection.• Serological data collection.• Clinical data collection.

• Syndromic data collection.

• Risk data collection.

Data collection

Surveilance information leads to action

21

vector: presence/absence/abundance/distribution

reservoir hosts: presence/absence/abundance/distribution

hospital

general practices

general pop.: Symptomatic

general pop.: (A)symptomatic infected

general population: Exposure

22

vector: presence/absence/abundance/distribution

reservoir hosts: presence/absence/abundance/distribution

hospital

general practices

general pop.: Symptomatic

general pop.: (A)symptomatic infected

general population: Exposure

Notifiable/reportable(Improved) treatment(s)

Vaccination

Vector control

Public education

Germ control

Sero-surveillance

Vector-surveillance

Germ-surveillanceThre

atD

isea

se b

urde

nIntervention Surveillance

23

BUILDING BLOCKSBraks et al. 2014, Frontiers

24

Tick borneencephaltitis

25

Crimean Congo haemorrhagicfever

26

Zika

Aedes aegypti

27

West Nile fever

28

Rift Valley fever

Context 1

Context 2

Context 3

Context 4

Context 5

Disease burden

Threat

Threat

Threat

Threat

Monitoring activities

Research

Intervention

Research

PH-authority:

National orPAN European

Har

mon

izat

ion

of

indi

cato

rsH

arm

oniz

atio

n of

in

dica

tors

Prio

ritiz

atio

nPr

ioritiz

atio

n

Decision to take action

LegislationContingency plan

29

Surveillanceand intervention

30

Context Endemic





ThreatThreat

31



ThreatThreat

Context Endemic



32



ThreatThreat

Context Endemic



Asian tiger mosquito surveillance and control

Context Endemic



33



ThreatThreat

34



ThreatThreat

Context Endemic



35



ThreatThreat

Context Endemic




5. Entomological surveillance

37

Internal Factors:Vector competence

External FactorsVector capacity

A good vector can 1) pick up, 2) replicate and

3) transmit a pathogen.


Externe FactorenvectorcapaciteitExample: arthropod borneviruses (arbo virus)



Kenney & Brault 2014 Adv. Vir. Res.

1. Midgut barrier

2. Salivary glandbarrier

3. Ovarial barrier

External FactorsVector capacity




4. Entomological surveillance

a. Vector identity

b. Vector presence/absence

in time and space

c. Vector abundance

d. Natural infection rate

6. Take home messages

Vector borne disease surveillance

● is multidisciplinary

43

● may largely differ between diseases

● needs to be tailored to each disease

● needs to be implemented in context

– May largely differ between countries and diseases

Not everything is transmitted by everything, everywhere,

always

7. EXTRA

Dear Marieta,

Last week we received a picture of a mosquito from a person who spend her holiday in South of Italy > Shementioned she was bitten by a certain mosquito species several time.Finally she has been able to make a picture of a dead examples. She asked whether this is a tiger mosquito. (she is 19 weeks pregnant and is worried).Our physicians are not sure and adviced me to ask you.

Hartelijke groet,

Dr. MD Huppeldepup

Documents

European and global arbovirus surveillance systemsprepare.ersnet.org/lrmedia/2017/pdf/371.pdf · Malaria Filariasis Biting midges Blue tongue Schmallenberg Body lice Recurrent fever