sábado, 7 de enero de 2017

An Innovative Approach to Combatting Infectious Diseases: An Engaged Community


04 January 2017 
Dear Colleagues,

Climate change, global commerce and travel, the impact of man-made changes to the environment, and insecticide resistance all contribute to an increased global burden of mosquito-borne disease. The range of the Aedes aegypti, the vector for viruses that cause Zika, Chikungunya, 100 million cases of Dengue and as many as 60,000 deaths from Yellow Fever world-wide annually, is expanding. There is reason to fear that A. aegypti may reach populated high elevation areas that have historically been free of this vector. A. aegypti is now present, albeit rare, from 1,700 - 2,130m; as climate change pushes expansion of mosquitos to higher elevations, the public health threat of A. aegypti-borne viruses will increase even further: at least ten urban areas with populations over a million could be affected, including the Mexico City metropolitan region with over 21 million residents.
Knowledge and access to information are the key ingredients for success in preventing the spread of disease. ProMED-mail brings together over 82,000 infectious disease experts, medical practitioners, research scientists, and public health professionals in a global community to improve disease surveillance, disseminate news, and support the exchange of information. But we can only do it with your help. Please, join your colleagues worldwide and demonstrate your commitment to combating infectious disease with a generous donation today.
Control of A. aegypti is extremely difficult because of the mosquito's biology and behavior. This mosquito will feed at dusk or dawn, indoors or out, and can breed not only in the tiny amounts of water collected in trash such as discarded plastic, broken bottles, and old tires, but also indoors in the stagnant water of showers or toilets. Elimination of these breeding sites is logistically near impossible. There is concern about the use of pesticides because of potential toxicity to people and animals, and their adverse effects on beneficial insects. Standard spraying of pyrethroids is problematic because of widespread resistance. And, except for intensive pesticide treatment in very small areas, such as the successful recent efforts in response to Zika in Miami, Florida, mosquito vector control over large areas and for long periods of time has not been efficacious. Finally, while a vaccine for Dengue has been developed and recently approved in eleven countries, widespread administration of the three-dose regimen may be constrained by cost. Vaccines for Zika are under development, but approvals by international drug agencies are years away.
In 2016, ProMED-mail disseminated over 3,300 reports on infectious disease outbreaks worldwide - roughly nine detailed, accurate, unbiased posts each day - including 144 reports on Yellow Fever, 66 on Zika, 34 Dengue update, 19 on Chikungunya, and 14 focused specifically on invasive mosquitoes. Where else do you get such comprehensive coverage of infectious disease surveillance? How else do you stay up to date on the topics that interest you most? Where else do you exchange information and ideas with your colleagues around the world? If you need ProMED, ProMED needs you. We need your participation. Please, start the New Year with a donation today to support ProMED-mail all year.
Novel methods are needed to control spread of mosquito-transmitted viruses. Fortunately, several promising innovative approaches are being explored. Release of genetically modified male mosquitoes that mate with local females to produce offspring that do not survive to become adults has been demonstrated to be successful in Bahia, Brazil, where it led to a 95% reduction in the population of A. aegypti. But this technique is not self-perpetuating and requires continual rearing and release, basically a factory process. Another line of attack, which has been tested to control Dengue virus transmission, is infection of A. aegypti with the endosymbiotic bacteria, Wolbachia. These bacteria not only reduce virus transmission, but are driven into the population through cytoplasmic incompatibility where females without the bacteria do not produce progeny, while those with the bacteria only produce viable offspring that carry Wolbachia, consequently controlling virus transmission and not only perpetuating, but spreading, the control mechanism. The R0 of Dengue has been estimated to decrease by 70% following release of Wolbachia-infected mosquitoes. Another innovative approach to mosquito control that reduces dependence on widespread spraying of insecticides is lethal ovitraps has been demonstrated to be highly effective in Puerto Rico. These traps employ insecticides or utilize sticky substances which prevent female mosquitoes from escaping the trap and larvae from developing. Lastly, a community science approach that engages members of the community in helping control mosquitoes is effective as people feel invested in their community.

Please, as an engaged member of the global community of professionals who work to understand, prevent, diagnose, and treat infectious diseases, make an investment in ProMED-mail. Join your colleagues, and please give today to support ProMED-mail all year.
On behalf of 82,000 ProMED-mail subscribers, thank you!

Laura D. Kramer ProMED-mail Viral Diseases Moderator
Professor of Biomedical Sciences, School of Public Health, State University of New York at Albany
International Society of Infectious Diseases | membership@isid.org |http://www.isid.org
9 Babcock St., Unit 3
Brookline, MA 02446

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