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ZOONOSIS:

FOCUS ON ARBOVIRUSES AND RODENT-


BORNE DISEASE

Musofa Rusli
Topics
o Arbovirus
Vectors
o List of vectors
o Life cycles of virus
o Important infections
Viruses
o Flaviviridae
o Alphavirus
Typical clinical manifestations

o Rodent-borne virus
Vectors
Viruses
o Bunyaviridae
o Arenaviridae
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Arbovirus: List of Vectors
o Mosquitos
Aedes spp
Culex spp
o Ticks (Ixodes spp)
o Sandflies (Phlebotomus spp)
o Midges (Culicoides spp)

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Arbovirus: Life cycles of virus

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Arbovirus: Important infections

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Arboviruses
o Flaviviridae
Dengue virus (DENV)
Japanese encephalitis virus (JEV)
West Nile virus (WNV)
Yellow fever virus (YFV)
Kyasanur Forest disease
Tick-borne encephalitis virus (TBEV)
Omsk HF
Alkhurma
o Alphavirus
Chikungunya (CHIKV)
Venezuela equine encephalitis (VEEV)
Ross River (RRV)
O'nyong -nyong (ONNV)
Mayaro (MAYV) 6
Dengue virus (DENV)
o Dengue (breakbone fever)
is a long established
disease in tropical
countries caused by a virus
transmitted by Aedes
mosquitoes
o Increasing incidence
o Increasing disease
spreading

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Dengue virus (DENV): Epidemiology

o Areas at risk: Tropics and subtropics worldwide


o Endemicity varies in SEA region countries 8
Variable endemicity
of DF/DHF in countries of the SEA Region
o Category A (Bangladesh, India, Indonesia, Maldives,
Myanmar, Sri Lanka, Thailand and Timor-Leste)
Major public health problem.
Leading cause of hospitalization and death among
children.
Hyperendemicity with all four serotypes circulating in
urban areas.
Spreading to rural areas.
o Category B (Bhutan, Nepal)
Endemicity uncertain.
Bhutan: First outbreak reported in 2004.
Nepal: Reported first indigenous dengue case in 2004
o Category C (DPR Korea)
No evidence of endemicity

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Risk factors associated with DF/DHF
o Demographic and societal changes: Demographic and societal changes
leading to unplanned and uncontrolled urbanization has put severe
constraints on civic amenities, particularly water supply and solid waste
disposal, hereby increasing the breeding potential of the vector species.
o Water supply: Insufficient and inadequate water distribution.
o Solid waste management: Insufficient waste collection and management.
o Mosquito control infrastructure: Lack of mosquito control infrastructure.
o Consumerism: Consumerism and introduction of non-biodegradable
plastic products, paper cups, used tyres, etc. that facilitate increased
breeding and passive spread of the disease to new areas (such as via the
movement of incubating eggs because of the trade in used tyres).
o Increased air travel and globalization of trade: Increased air travel and
globalization of trade has significantly contributed to the introduction of
all the DENV serotypes to most population centres of the world.
o Microevolution of viruses: The use of the most powerful molecular tools
has revealed that each serotype has developed many genotypes as a
result of microevolution. There is increasing evidence that virulent
strains are replacing the existing non-virulent strains. Introduction of
Asian DENV-2 into Cuba in 1981, which coincided with the appearance of
DHF, is a classic example. 10
Dengue virus (DENV): Transmission

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DHF Pathogenesis:
Role of Secondary Dengue Infection

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Dengue Fever Clinical Course

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Dengue Infection Manifestations

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Japanese encephalitis virus (JEV)
o JEV is enzootic in rural agricultural areas throughout
much of eastern and southern Asia and the Pacific
islands
o The principal enzootic transmission cycle involves Culex
mosquitoes and vertebrates
o Culex tritaeniorhynchus the most important vector
of human infections
o These mosquitoes:
breed mainly in rural areas
preferring to feed on swine and birds and to a lesser
extent on humans
o Causes estimated 35000 to 50000 clinical cases and
15000 deaths annually

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JEV Risk Area
o East and
south Asia
(Indonesia,
Malaysia),
Pacific Islands
o Indonesia:
Bali, Papua
(Timika), Jawa
(Tulungagung
, Kapuk)

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JEV Transmission

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JEV Infection Risks

o The risk of JE is highest among individuals who travel or


live in rural areas where rice is grown and swine are
raised in close proximity to human dwellings

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JEV Infection in Human
o JEV infection of humans can result in :
an asymptomatic infection with antibody
seroconversion,
mild febrile illness
aseptic meningitis
acute encephalomyelitis
o Some patients have a rapid recovery, but most will
develop a variety of neurologic manifestations
o Diagnosis IgM/ IgG seroconversion between acute and
convalescent sera (HI. IF, ELISA)
o Therapy supportive
o JEV vaccine licensed in US and Asia

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Yellow fever virus (YFV)
o Area: Sub-sahara Africa, South America
o Vectors: mosquito (Aedes africanus/ aegypti;
Haemagogus)
o Intermediate host: monkeys

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West Nile virus (WNV)
o Area: Africa, south and east Europe, Middle East, west
Asia, Australia, north America, Caribbean, central and
south America, SURABAYA
o Vector: Culex spp.

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Zika Virus
o Zika is spread mostly by the bite of an infected Aedes
species mosquito (Ae. aegypti and Ae. albopictus). These
mosquitoes bite during the day and night.
o Zika can be passed from a pregnant woman to her fetus.
Infection during pregnancy can cause certain birth
defects.
o There is no vaccine or medicine for Zika.
o Transmission:
Mosquito bites
From a pregnant woman to her fetus
Sex
Blood transfusion (very likely but not confirmed)
o Latest outbreak: Singapore

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Kyasanur Forest disease
o Vector: tick
o Intermediate host: cattle
o History: After
independence people
began clearing forests to
create grazing for cattle
o 1955: disease in monkeys
o 1957: humans dying with
hemorrhagic fever
o CFR 20%

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Tick-borne encephalitis virus (TBEV)
o Vector: tick (Ixodes spp)
o Area: Europa, Siberia, Far East

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Omsk HF
o Vectors: tick (Dermacentor spp), voles, muskrats,
mosquito
o Area: west Siberia

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Alkhurma
o Vector: tick
o Area: Middle East

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Flaviviruses: Treatment
o No specific treatment
o Supportive measure

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Arboviruses
o Flaviviridae
Dengue virus (DENV)
Japanese encephalitis virus (JEV)
West Nile virus (WNV)
Zika Virus (ZIKV)
Yellow fever virus (YFV)
Kyasanur Forest disease
Tick-borne encephalitis virus (TBEV)
Omsk HF
Alkhurma
o Alphavirus
Chikungunya (CHIKV)
Venezuela equine encephalitis (VEEV)
Ross River (RRV)
O'nyong -nyong (ONNV)
Mayaro (MAYV) 28
Alphaviruses

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Impotant Alphaviruses infections

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Epidemic and Epizootic Transmission Cycle

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Chikungunya (CHIKV)
o RNA virus, family Togaviridae, genus Alphavirus
o Chikungunya comes from Swahili, meaning that
which bends up characteristic posture assumed by
patients suffering severe, incapacitating joint pains
o First isolated during a 1952 epidemic in Tanzania, but
had probably occurred sporadically in India and
Southeast Asia for at least 200 years
o Area: most of sub-Saharan Africa, India, Southeast
Asia, Indonesia, and the Philippines

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CHIKV: Geographic Distribution prior 2005

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CHIKV: Transmission
o Vector: mosquito (Aedes spp)

o Two distinct transmission cycles:


1) a sylvatic African cycle between wild primates and
arboreal Aedes mosquitoes, similar to that of yellow
fever virus in the same region
2) urban, Ae. aegypti and Ae. albopictus-borne transmission
among humans

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CHIKV vs. DENV

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CHIKV: Laboratory Diagnosis
o Serology:
IgM ELISA (presumptive diagnosis)
IgG seroconversion
possible cross-reactivity beetween CHIKV and ONNV

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Venezuela equine encephalitis (VEEV)
o Area: Venezuela, Colombia
o Vectors:
mosquito (Culex (Melanoconion) spp, Aedes)
rats

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Ross River Virus (RRV)
o Area: Australia, South Pacific
o Vector: mosquito (Culex spp, Aedes spp)

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O'nyong -nyong Virus (ONNV)
o Area: sub-sahara Africa
o Vector: mosquito (Anopheles spp)

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Mayaro Virus (MAYV)
o Area: Trinidad, south America
o Vector: mosquito (Haemagogus spp)

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Alphaviruses: Treatment
o No specific treatment
o Supportive measures
o Non-routine treatment:
Ribavirin
Nucleoside analogue
IVIG

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Alphaviruses: Prevention
o No licensed human vaccines are available for
alphaviruses
o Control generally relies on :
interruption of transmission using vector control
vaccination of animal amplifying hosts
avoiding outdoor activities
o During peak mosquito biting times, use of protective
clothing:
permethrin-impregnated clothes, nets, and bedding)
regular application of repellents containing either
diethyltoluamide (DEET) or picardin

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Rodent-borne virus
o Vector: mouse
Peromyscus spp
Rattus norvegicus
Apodemus agrarius
o Viruses:
Bunyaviridae
Arenaviridae

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Bunyaviridae
o Viruses:
Hantavirus
Rift Valley Fever Virus (RVFV) = Phlebovirus
Crimean Congo HFV (CCHFV) = Nairovirus
o Area: Africa, West Asia

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Hantavirus
o Caused by virus family Bunyaviridae, genus Hantavirus
(23 species); RNA virus
o Seasonal disease: interaction between rodent population
dynamics and human
o Prevention: avoidance of infected rodent

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Hantaviruses: New Viruses
o The hantaviruses are a relatively newly
discovered genus of viruses
o An outbreak of Korean hemorrhagic fever
among American and Korean soldiers
during the Korean War (19501953) was
later found to be caused by a hantavirus
infection.
o More than 3000 troops became ill with
symptoms that included renal failure,
generalized hemorrhage, and shock. It
had a 10 percent mortality rate.
o This outbreak sparked a 25-year search
for the etiologic agent. Ho-Wang Lee, a
South Korean virologist, Karl M. Johnson,
an American tropical virologist, and
colleagues isolated Hantaan virus in 1976
from the lungs of striped field mice.
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Hantaviruses Distribution

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Hantaviruses Characteristics

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Hantaviruses: Hantaan, Seoul, Puumala
o Disease: Hemorrhagic fever with renal syndrome (HFRS)
o Area: worldwide, Indonesia

o During an outbreak of dengue in Indonesia (between May 1995


and May 1996) 118 consecutive adults (>13 years) suspected by
the WHO 1997 case definition of DF or DHF were investigated
(Suharti et al, 2009).
In 58 of the total 118 patients, recent dengue virus infection was
serologically confirmed.
In 20 of the remaining 60 patients, found serological evidence of
another recent infection:
o hantavirus (5),
o chikungunya virus (2),
o R. typhi (5),
o R. tsutsugamuchi (2),
o rubella virus (3),
o influenza A virus (1), and
o leptospira (2). 49
Hantaviruses: Sin Nombre, Black Creek Canal,
Bayou, Andes
o Navajo indians in the four
corners in the US hit by
strange illness in 1993 (75 per
cent case fatality).
o Sin Nombre virus (SNV, in
Spanish, "virus sin nombre",
for "nameless virus")
o Abundant supply of penon
nuts after two mild winters
caused mouse population to
o Disease: hantavirus expand tenfold.
pulmonary syndrome (HPS) o Virus passed in urine is thrown
o Vector: eromyscus up in dust during cleaning.
maniculatus (deer mouse) o Navajo tell of whole families
being wiped out after spring
cleaning as far back as 1919. 50
Hantaviruses: Epizootic Cycle

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Arenaviridae

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Arenaviruses Distribution

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THANK YOU

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