| Title | Control of vector-borne diseases in europe: mini-review article | |
| Author | Regina Vorou
Hellenic Center for Disease Control and Prevention, Athens, Hellas |
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| Citation | Vorou, R.: Control of vector-borne diseases in europe: mini-review article, Epitheorese Klin. Farmakol. Farmakokinet. 24(3): 239-246 (2010) | |
| Publication Date | Accepted for publication (Final Version): April 10, 2010 | |
| Full Text Language | English | |
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| Keywords | Crimean Congo haemorrhagic fever virus, Rickettsiae spp, tick-borne encephalitis virus group, Leishmania infantum, West Nile virus, Chikungunya virus. | |
| Other Terms | review article | |
| Summary | The transmission dynamics of vector borne diseases depend upon at least three distinct organisms and the factors affecting them: the infectious agent, the vector, and the human or animal host. This article provides an overview of the risk factors for emergence and the multiple dimensions of the control of vector borne diseases, based on worldwide data with a focus upon the European countries and the Mediterranean Basin current situation and discusses the spectrum of disciplines involved. Emerging vector borne pathogens in Europe are: Crimean Congo Haemorrhagic Fever (CCHF) Virus, Rickettsiae spp, Anaplasma phagocytophilum, Borrelia burgdorferi, Tick-borne encephalitis virus group, transmitted via tick-bite, Bartonella spp via body lice, Toscana virus, and Leishmania infantum via sandfly bite, West Nile virus, Sindbis virus, and Chikungunya virus being transmitted via mosquito bite. Ticks transmit Francisella tularensis as well. Ecological and Socioeconomic factors act synergistically to facilitate emergence. Vaccines are available for only a few diseases, they are not widely used, and the prospects for vaccine generation for vector borne infections are not encouraging. Integrated vector management comprises environmental management, chemical methods, and personal protective measures, the latter involving behavioral changes and chemicals. Regarding mosquitoes, the locations of larval infestation and development should be identified, treated and if possible remove away stagnant water or clean streams from vegetation. Environmental interventions can reduce or eliminate vector breeding sites via appropriate water resources handling as well as via biological controls such as bacterial larvicides and larvivorous fish that kill larvae selectively without chemical residuals in the ecosystem. Chemical methods used reasonably, such as indoor residual sprays, chemical larvicides and adulticides, reduce the vector population. The personal protective measures combine behavioral changes, and use of chemicals as mosquito repellents and insecticide treated nets. Regarding chikungunya virus, Aedes albopictus surveillance is encouraged in european level but uniform techniques have not been established as of yet. Aedes Aegypti, a competent vector for chikungunya, dengue and yellow fever viruses, has already been introduced to the Madeira Island, Portugal, and it has been speculated that it may travel to mainland Europe via the frequent flights. In CCHF endemic areas, high risk groups should be educated to take precautions against contact with ticks, blood or other tissues from infected animals using gloves, long sleeves and trousers, application of repellents on exposed skin and clothes, containing N,N-diethyl-m-toluamide (DEET) and permethrin respectively, inspection of skin and clothes for ticks and prompt tick removal, sleep in netted area, when sleeping on the ground or camping, avoid tick hosts, cats, dogs, mice, cattle, and apply acaricidals to cattle and ship. Tick borne pathogens such as Tick borne encephalitis virus group, Borellia burgdorferi, Anaplasma fagocytophilum, Ricketsiae spp, Babesia microti and B. divergens in Europe, can be prevented by avoidance of habitat and tick infested animals, by modification of the habitat, application of acaricidals to host nests and on the coats of animal hosts, prevention of tick exposure as aforementioned, and prompt tick removal. Illegal animal transportation among countries and the concomitant cross-border spread of infected ticks should be strictly banned and closely monitored with frequent inspections by the veterinary authorities. Farming areas should be clearly distinguished and strictly differentiated from residential and tourist ones, and farmers should be guided and supervised to keep farms neat so as to avoid tick proliferation. The sandfly transmitting Toscana virus in central Italy is the reservoir for the infection, as neither mammals nor birds have been recognized as potential reservoirs as of yet, highlighting the critical role of the vector in the epidemiology of the disease. Sandfly control and avoidance of its breeding sites have been followed by decreased incidence in human leishmaniasis. Additionally, the incidence of human leishmaniasis is directly related to the number of infectious dogs, but elimination of stray dogs provided controversial effect when not accompanied by vector control, thus imposing the latter as essential element in the leishmaniasis control, and probably cheaper. Synthetic insecticides reduce the number of sandflies in confined spaces such as rooms and tents. The National Centers for Disease Control and Prevention and the World Health Organization supervise the surveillance of human populations, the assessment of animal seroprevalence and the dissemination of information at national and international level. The close collaboration and the integrated action of Public Health Sector and Veterinarian Authorities ensure the surveillance of the vector populations, examination of pooled samples of vectors for these pathogens, monitoring of seroprevalence in zoonotic foci and supervised animal transportation among countries. National Centers for Disease Control and Prevention provide guidelines and epidemiologic data to clinicians. The International Health Regulation and Early Warning and Response System are competent tools for the preparedness and response to public health events internationally. | |
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