An overview of emerging mosquito borne diseases, globalization ...
An overview of emerging mosquito borne diseases, globalization ...
An overview of emerging mosquito borne diseases, globalization ...
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<strong>An</strong> <strong>overview</strong> <strong>of</strong> <strong>emerging</strong> <strong>mosquito</strong><br />
<strong>borne</strong> <strong>diseases</strong>, <strong>globalization</strong> and<br />
climate change<br />
Carles Aranda<br />
President <strong>of</strong> EMCA<br />
Consell Comarcal del Baix<br />
Llobregat<br />
Catalonia, Spain
Tarragona 2005
Culicidae as pests and as vectors <strong>of</strong><br />
<strong>diseases</strong><br />
Pests Vectors<br />
Resources<br />
Tourism, quality <strong>of</strong> life<br />
Hemat<strong>of</strong>agous<br />
Health<br />
Diseases
Bulinus sp.<br />
Main vector groups<br />
Snails: Mollusca<br />
Different species<br />
Oncomelania<br />
Biomphalaria<br />
Bulinus<br />
Transmission <strong>of</strong><br />
Schistosoma spp. spp<br />
Schistosomiasis
Triatoma sp.<br />
Main vector groups<br />
Bugs: Triatominae<br />
Different species<br />
Triatoma infestans<br />
Rhodnius prolixus<br />
Transmission <strong>of</strong><br />
Trypanosoma cruzi<br />
Chagas Disease
Ixodes sp.<br />
Main vector groups<br />
Ticks: Ixodida<br />
Different species<br />
Ixodes<br />
Rhipicephalus<br />
Hyalomma<br />
Transmission <strong>of</strong><br />
Rickettsia spp.<br />
Borrelia burgdorferi<br />
Tifus, Lyme
Main vector groups<br />
Fleas: Siphonaptera<br />
Xenopsilla cheopis<br />
Different species<br />
Xenopsilla cheopis<br />
Tunga penetrans<br />
Transmission <strong>of</strong><br />
Yersinia pestis<br />
Plague
Glossina sp.<br />
Main vector groups<br />
Tsetse fleas: Glossinidae<br />
Different species<br />
Glossina<br />
Transmission <strong>of</strong><br />
Trypanosoma gambiense<br />
Trypanosoma rhodesiense<br />
Sleeping sickness or<br />
Trypanosomiasis
Main vector groups<br />
Sandflies: Phlebotominae<br />
Phlebotomus perniciosus<br />
Different species<br />
Phlebotomus<br />
Lutzomyia<br />
Transmission <strong>of</strong><br />
Leishmania spp.<br />
Leishmaniasis
Simulium sp.<br />
Main vector groups<br />
Blackflies: Simuliidae<br />
Different species<br />
Simulium<br />
Transmission <strong>of</strong><br />
Oncocerca volvulus<br />
Oncocerciasis or<br />
Blindness river
Life cycle <strong>of</strong> F. Culicidae:<br />
Culicidinae and <strong>An</strong>ophelinae<br />
Culicidinae<br />
Eggs<br />
<strong>An</strong>ophelinae
Life cycle <strong>of</strong> F. Culicidae:<br />
Culicidinae and <strong>An</strong>ophelinae<br />
Larvae<br />
Culicidinae <strong>An</strong>ophelinae
Life cycle <strong>of</strong> F. Culicidae:<br />
Culicidinae and <strong>An</strong>ophelinae<br />
Pupae<br />
Culicidinae <strong>An</strong>ophelinae
Life cycle <strong>of</strong> F. Culicidae:<br />
Culicidinae and <strong>An</strong>ophelinae<br />
Adults<br />
Culicidinae <strong>An</strong>ophelinae
Life cycle <strong>of</strong> F. Culicidae:<br />
Culicidinae and <strong>An</strong>ophelinae<br />
Female adults<br />
Culicidinae <strong>An</strong>ophelinae
TDR
Main <strong>diseases</strong> transmitted by<br />
Arbovirus<br />
Culicidae<br />
Yellow fever, Dengue, Hemorrhagic Dengue, Chikungunya,<br />
Encephalitis as Saint Louis, Japanese or West Nile<br />
Aedes aegypti, Ae. albopictus, Culex spp.<br />
Filariasis<br />
Lymphatic filariasis: Wuchereria bancr<strong>of</strong>ti, Brugia malayi<br />
Culex spp. <strong>An</strong>opheles spp. spp.<br />
Protozoan<br />
Malaria: Plasmodium falciparum,<br />
falciparum,<br />
P. vivax, vivax,<br />
P. malariae, malariae,<br />
P. ovale<br />
<strong>An</strong>opheles spp. spp.<br />
: <strong>An</strong>. funestus, <strong>An</strong>. arabiensis, <strong>An</strong>. labranchiae
Main aspects that can influence<br />
<strong>mosquito</strong>-<strong>borne</strong> <strong>mosquito</strong> <strong>borne</strong> <strong>diseases</strong><br />
Intrinsic aspects<br />
transmission<br />
• Related to the vector<br />
• Vector competence<br />
• Vector capacity<br />
• Presence <strong>of</strong> the pathogen<br />
• Related to humans<br />
• Presence <strong>of</strong> susceptible humans<br />
• Presence <strong>of</strong> infected humans<br />
New environmental aspects<br />
• Globalization (trade, travels)<br />
• Climate change
Arboviral <strong>diseases</strong>
Typical scheme <strong>of</strong> arbovirus:<br />
Flavivirus<br />
Adapt. from CDC<br />
ar = arthropod<br />
bo = <strong>borne</strong><br />
virus<br />
arbovirus<br />
West Nile Virus
Arboviral <strong>diseases</strong><br />
(Togaviridae: Alphavirus)<br />
Alphavirus)<br />
East Equine Encephalitis (EEE) Culicidae<br />
West Equine Encephalitis (WEE) <br />
Highlands J (HJ)<br />
Venezuelan Equine Encephalitis (VEE) <br />
Chikungunya (CHIK) <br />
O’nyong nyong-nyong nyong (ONN) <br />
Ross River (RR) <br />
Sindbis (SIN) <br />
Semliki Forest (SF) <br />
Barmah Forest (BF)
Arboviral <strong>diseases</strong><br />
(Flaviviridae: Flavivirus) Flavivirus)<br />
Rocio (ROC) Culicidae<br />
Wesselsbron (WSL)<br />
Yellow fever (YF) <br />
Saint Louis Encephalitis (SLE) <br />
Japanese Encephalitis (JE) <br />
Murray Valley Encephalitis (MVE) <br />
West Nile (WN) <br />
Dengue (DEN)
Arboviral <strong>diseases</strong><br />
(Bunyaviridae)<br />
Bunyamwera (BUN). (Bunyavirus<br />
Bunyavirus) ) Culicidae, Ceratopogonidae<br />
Phlebotominae<br />
Cache Valley (CV). (Bunyavirus<br />
Bunyavirus) ) <br />
California Encephalitis (CE). (Bunyavirus<br />
Bunyavirus) ) <br />
Jamestown Canyon (JC). (Bunyavirus<br />
Bunyavirus) ) <br />
LaCrosse (LAC). (Bunyavirus<br />
Bunyavirus) ) <br />
Snowshoe hare (SSH). (Bunyavirus<br />
Bunyavirus) ) <br />
Tahyna (TAH). (Bunyavirus<br />
Bunyavirus) ) <br />
Trivittatus (TVT). (Bunyavirus<br />
Bunyavirus) ) <br />
Oropuche (ORO). (Bunyavirus<br />
Bunyavirus) ) <br />
Rift Valley fever (RVF). (Phlebovirus) <br />
Sand fly fever (SFF). (Phlebovirus)
Arbovirus transmission cycle:<br />
Vector = culicid<br />
Host = different vertebrates<br />
West Nile Virus<br />
Vector<br />
Birds<br />
Humans<br />
Other mammals
WNV in birds<br />
Rapid multiplication <strong>of</strong><br />
the virus<br />
Permanence between<br />
20 and 200 days<br />
Detection <strong>of</strong> WNV in<br />
more than 30 European<br />
species<br />
Climate change can<br />
affect?
WNV in horses and other vertebate<br />
Low virus<br />
multiplication<br />
Permanence between 3<br />
and 6 days<br />
Detection <strong>of</strong> WNV<br />
mainly in horses<br />
although also in<br />
different vertebrates
WNV in humans<br />
Low virus<br />
multiplication<br />
Highest viremia in 4-8 4 8<br />
days<br />
Fever, joint pain,<br />
muscular hache and in<br />
< 15%, encephalitis<br />
and meningitis
WNV in <strong>mosquito</strong>es<br />
Multiplication <strong>of</strong> virus<br />
Permanence during all<br />
life in salivary glands<br />
About 100 species<br />
including genera like:<br />
Culex<br />
Aedes, Ochlerotatus<br />
<strong>An</strong>opheles<br />
Climate change can<br />
affect?
West Nile Virus distribution in<br />
Europe. 1999<br />
Hubálek & Halouzka, 1999<br />
Isolation from<br />
<strong>mosquito</strong>es<br />
or vertebrates<br />
Including<br />
humans<br />
Cases in horses<br />
or humans<br />
<strong>An</strong>tibodies<br />
in vertebrates
Recent West Nile outbreaks in<br />
Europe and Mediterranian Area<br />
Czech R. 1997, 2002, 2007<br />
France<br />
Rumania 1996, 1997, 2001, 2003, 2005-07 2005 07<br />
2000, 2002, 2004, 2006<br />
France 2003, 2007<br />
Italy 1998<br />
Portugal 2004 200<br />
Algeria 1994<br />
Morocco 1996, 2003<br />
Tunisia 1997<br />
Tunisia 2003<br />
Humans<br />
Vertebrate hosts including horses<br />
Israel 1999-2003 1999 2003-2007 2007
West Nile Virus distribution before<br />
1999
West Nile Virus distribution in USA<br />
1999<br />
Presence <strong>of</strong> WNV
West Nile Virus distribution in USA<br />
2000<br />
Presence <strong>of</strong> WNV
West Nile Virus distribution in USA<br />
2001<br />
Presence <strong>of</strong> WNV
West Nile Virus distribution in USA<br />
2002<br />
Presence <strong>of</strong> WNV
West Nile Virus distribution in USA<br />
2003<br />
Presence <strong>of</strong> WNV
West Nile Virus distribution in USA<br />
2004<br />
Presence <strong>of</strong> WNV
Chikungunya in Italy. 2007
Chikungunya in Italy. 2007<br />
Ravenna: Castiglione di Cervia<br />
Castiglione di Ravenna<br />
Between June 15th and September 28th there were more than<br />
200 confirmed cases (about 300 suspected)<br />
First case: traveler from Kerala, India that visited his cousin in<br />
June 23th and got fever July 4th.
European Center for Diseases<br />
Control, ECDC<br />
http://ecdc.europa.eu/Health_topics/Chikungunya_Fever
Present situation in Europe<br />
Chikungunya scenario<br />
•Presence Presence <strong>of</strong> Aedes albopictus<br />
potential vector <strong>of</strong> arbovirus<br />
•Presence Presence <strong>of</strong> Chikungunya<br />
virus (and others)<br />
•Presence Presence <strong>of</strong> susceptible humans<br />
•Presence Presence <strong>of</strong> other potential vectors<br />
Question <strong>of</strong> climate change or <strong>globalization</strong>?
Rift Valley Fever, can it reach<br />
Europe?
Rift Valley Fever, can it reach<br />
Europe?<br />
Phlebovirus (Bunyaviridae) transmitted mainly by <strong>mosquito</strong>es<br />
More than 40 species, including some <strong>of</strong> the most common in<br />
Europe:<br />
Culex pipiens<br />
Aedes vexans<br />
Ochlerotatus caspius<br />
Affects mainly cattle but also humans by <strong>mosquito</strong> bites and<br />
also other ways <strong>of</strong> entrance (fluids and aerosols, etc...)<br />
Originary <strong>of</strong> Africa and detected by first time in Kenya in the Rift Rift<br />
Valley, in 2000 there were some cases in Yemen and Saudi<br />
Arabia.
Rift Valley Fever, can it reach<br />
Europe?<br />
Incubation period in humans <strong>of</strong> 2 to 6 days.<br />
Mainly fever, joint and muscular pain and headache. Sometimes<br />
neck pain, vomiting and photosensibilization.<br />
End <strong>of</strong> simptmas in 7 days.<br />
In few percentages, meningoencephalitis, eye problems and/or<br />
hemorrhagic fever. Lethality about 1%.<br />
Period <strong>of</strong> incubation in animals
Yellow fever and dengue in XVIII<br />
Century in the Spanish empire
Learning from history: yellow fever<br />
and dengue in Europe<br />
Yellow fever<br />
1701 Canary islands, first outbreak<br />
1705 Cadiz<br />
1714 Malaga<br />
1723 Lisbon<br />
1744 Balearic Islands<br />
1700-1800 1700 1800 Spanish and Portuguese coast<br />
1800-1880 1800 1880 Inner parts <strong>of</strong> Iberian Peninsula and other Mediterranean<br />
regions: France, Italy<br />
More than 300,000 deaths in Spain in the first half <strong>of</strong> XIX century century<br />
including 20,000 deaths in Barcelona between 1822-1824 1822 1824
Learning from history: yellow fever<br />
Dengue<br />
and dengue in Europe<br />
1778 Cadiz<br />
<strong>An</strong> outbreak <strong>of</strong> infectious disease called<br />
“La La Piadosa” Piadosa = “Merciful Merciful”<br />
1927 South <strong>of</strong> Spain, <strong>An</strong>dalusia<br />
<strong>An</strong> outbreak <strong>of</strong> “colorado colorado” = “red red” with identical symptoms to actual<br />
dengue,<br />
5% mortality<br />
1883-1886 1883 1886 dengue is present in Greece<br />
1927-1928 1927 1928 Athens and Thessalonica<br />
<strong>An</strong> outbreak <strong>of</strong> dengue with 1 million cases and 1,000 deaths
Learning from history: yellow fever<br />
References<br />
and dengue in Europe<br />
<strong>An</strong>golotti, E. 1980.<br />
La fiebre amarilla. Historia y situación situaci n actual.<br />
La fiebre amarilla en la Barcelona de 1821. Rev. San. Hig. Púb. P b.<br />
54: 89-102. 89 102.<br />
Copanaris, P. 1928.<br />
L’é ’épid pidémie mie de dengue en Grèce Gr ce au cours de l’é l’été<br />
1928. Bull. Off. Intern. Hyg. Pub. 20: 1590- 1590<br />
1601.<br />
Nájera jera <strong>An</strong>gulo, L. 1943.<br />
Los Aedinos españoles espa oles y el peligro de la fiebre amarilla. Graellsia. 1: 29-35. 29 35.<br />
Pittaluga, G. 1928.<br />
El problema de la fiebre amarilla. Medicina de los Países Pa ses Cálidos. C lidos. 5-25. 5 25.<br />
Rico-Avello, Rico Avello, C. 1953.<br />
Fiebre amarilla en España. Espa a. Revista de Sanidad e Higiene Pública. P blica. 1-2: 1 2: 29-87. 29 87.
Learning from history: yellow fever<br />
Lazarettos <strong>of</strong> Maó Ma and<br />
San Simón Sim n in<br />
Spain<br />
and dengue in Europe
Learning from history: yellow fever<br />
and dengue in Europe<br />
Two main events:<br />
Arrival <strong>of</strong> the exotic <strong>mosquito</strong> Aedes aegypti to<br />
Europe (Spain) and continuous introduction<br />
through ships: International trade<br />
Presence <strong>of</strong> yellow fever and dengue viruses in<br />
Ae. aegypti and/or humans<br />
No climatic change !
Learning from history: yellow fever<br />
and dengue in Europe<br />
Ae. aegypti distribution following Rico- Rico<br />
Avelló Avell y Rico, 1953<br />
Aedes aegypti<br />
Distribution<br />
Data since 1899<br />
Common en Spain<br />
until 40’s 40<br />
Latest citation<br />
in 1953
Malaria
Situation <strong>of</strong> malaria in the world<br />
Areas with transmission <strong>of</strong> malaria<br />
Areas with moderate risk<br />
Áreas where malaria dissapearad,<br />
was eradicaed or never existed<br />
Adapt. Eldridge & Edman, 2000
Fertilización del macrogameto<br />
Por el micrigameto<br />
esquizontes<br />
exflagelación del<br />
Microgametocito<br />
gametocitos<br />
eritrocitos<br />
Adapt. Eldridge & Edman, 2000<br />
ooquiste<br />
ooquineto<br />
ERITROCITO<br />
esporozoitos<br />
Glándulas<br />
salivares<br />
hypnozoito<br />
HÍGADO<br />
Tr<strong>of</strong>ozoitos<br />
Malaria cycle<br />
merozoitos<br />
Gametocitos<br />
Esporozoitos<br />
Ooquiste<br />
Esporozoitos<br />
En glándulas salivares<br />
Esporozoitos<br />
Exflagelación<br />
Ooquineto<br />
Fertilización
Vectors <strong>of</strong> malaria in the world<br />
Epidemiologic zone Main vectors<br />
North America<br />
Central America<br />
South America<br />
North Eurasia<br />
Mediterranean<br />
Afro-Arabian<br />
Afro Arabian<br />
Afro-tropical<br />
Afro tropical<br />
Indo-Iranian<br />
Indo Iranian<br />
Indo-Chines<br />
Indo Chines<br />
Malaysian<br />
Chinese<br />
Australasian<br />
<strong>An</strong>. freeborni<br />
<strong>An</strong>. albimanus<br />
<strong>An</strong>. aquasalis<br />
<strong>An</strong>. darlingi<br />
<strong>An</strong>. albimanus<br />
<strong>An</strong>. albitarsus<br />
<strong>An</strong>. darlingi<br />
<strong>An</strong>. atroparvus<br />
<strong>An</strong>. atroparvus<br />
<strong>An</strong>. sacharovi<br />
<strong>An</strong>. superpictus<br />
<strong>An</strong>. culicifacies<br />
<strong>An</strong>. pharoensis<br />
<strong>An</strong>. arabiensis<br />
<strong>An</strong>. funestus<br />
<strong>An</strong>. gambiae<br />
<strong>An</strong>. culicifacies<br />
<strong>An</strong>. fluviatilis<br />
<strong>An</strong>. culicifacies<br />
<strong>An</strong>. dirus<br />
<strong>An</strong>. balabacensis<br />
<strong>An</strong>. dirus<br />
<strong>An</strong>. minimus<br />
<strong>An</strong>. sinensis<br />
<strong>An</strong>. farauti<br />
<strong>An</strong>. punctulatus
Factors affecting malaria<br />
transmission<br />
• Specific knowledge <strong>of</strong> vectors<br />
• Behavior <strong>of</strong> vectors in the studied area<br />
• Knowledge <strong>of</strong> ecosystem<br />
• Interactions between humans, vectors and<br />
ecosystem
Specific knowledge<br />
<strong>An</strong>opheles arabiensis
PCR for <strong>An</strong>. Gambiae complex
Exophagy<br />
<strong>An</strong>tropophily<br />
Behaviour <strong>of</strong> vectors<br />
Exophily<br />
Endophagy<br />
Endophily<br />
Zoophily
Knowledge <strong>of</strong> ecosystem
Interactions
Main factors for the reintroduction<br />
<strong>of</strong> malaria<br />
Increase <strong>of</strong> parasite carriers by<br />
immigration or travel (Globalization)<br />
Climate change<br />
Presence <strong>of</strong> potential vectors<br />
Sensibility <strong>of</strong> <strong>An</strong>opheline to different<br />
Plasmodium species and strains<br />
Important deterioration <strong>of</strong> health<br />
services and economic situation
Imported malaria in Spain and<br />
European Union. 1972 – 2007<br />
1.000<br />
900<br />
800<br />
700<br />
600<br />
500<br />
400<br />
300<br />
200<br />
100<br />
0<br />
BES, WHO http://data.euro.who.int/cisid<br />
72 74 76 78 80 82 84 86 88 90 92 94 96 98 00 02 04 06<br />
E<br />
Spain EU<br />
EU<br />
14.000<br />
12.000<br />
10.000<br />
8.000<br />
6.000<br />
4.000<br />
2.000<br />
0
Imported malaria in Spain and<br />
European Union. 2007<br />
WHO http://data.euro.who.int/cisid<br />
5000<br />
4500<br />
4000<br />
3500<br />
3000<br />
2500<br />
2000<br />
1500<br />
1000<br />
500<br />
0<br />
Austria<br />
Portugal<br />
Ireland<br />
Denmark<br />
Sweden<br />
Belgium<br />
Netherlands<br />
Spain<br />
Germany<br />
Italy<br />
UK<br />
France
Portugal. 1973-1976. 1973 1976. Independence <strong>of</strong><br />
<strong>An</strong>gola, Mozambique and Timor<br />
1973-1974:<br />
1973 1974: Arrival <strong>of</strong> 253,746 soldiers<br />
1975-1976:<br />
1975 1976: Arrival <strong>of</strong> 900,000 people<br />
80% P. falciparum,<br />
falciparum,<br />
P. vivax carriers<br />
Exposed to <strong>An</strong>. atroparvus bites<br />
Only one detected non imported malaria case<br />
Cambournac, 1977
Not imported malaria, possibly<br />
autochthonous in EU<br />
Country Cases Species Reference<br />
Italy, 97 Baldari et al., 98<br />
1 P. vivax<br />
Greece, 99, 00 1, 2 ? WHO, 06<br />
Spain, 01 1 P. ovale Cuadros et al., 02
Europe
Europe, WHO<br />
WHO http://data.euro.who.int/cisid
Countries included in Europe. WHO
Autochthonous malaria in WHO<br />
European region. 2002<br />
WHO http://data.euro.who.int/cisid
Autochthonous malaria in WHO<br />
European region. 1971 – 2007<br />
WHO http://data.euro.who.int/cisid
Main factors for the reintroduction<br />
<strong>of</strong> malaria<br />
Increase <strong>of</strong> parasite carriers by<br />
immigration or travel<br />
Climate change<br />
Presence <strong>of</strong> potential vectors<br />
Sensibility <strong>of</strong> <strong>An</strong>opheline to different<br />
Plasmodium species and strains<br />
Important deterioration <strong>of</strong> health<br />
services and economic situation
1,2<br />
1<br />
0,8<br />
0,6<br />
0,4<br />
0,2<br />
Climatic change and malaria<br />
0<br />
13 15 17 19 21 23 25 27 29 31 33 35 37 39<br />
Ep = 1/k{-log( 1/ log(p)/ )/a2pn }<br />
Mod. <strong>of</strong> Martens et al. 1995
Main factors for the reintroduction<br />
<strong>of</strong> malaria<br />
Increase <strong>of</strong> parasite carriers by<br />
immigration or travel<br />
Climate change<br />
Presence <strong>of</strong> potential vectors<br />
Sensibility <strong>of</strong> <strong>An</strong>opheline to different<br />
Plasmodium species and strains<br />
Important deterioration <strong>of</strong> health<br />
services and economic situation
Rice field areas in Spain by<br />
provinces. 2005<br />
Total ha: 117,026<br />
Provinces with rice fields
Main factors for the reintroduction<br />
<strong>of</strong> malaria<br />
Increase <strong>of</strong> parasite carriers by<br />
immigration or travel<br />
Climate change<br />
Presence <strong>of</strong> potential vectors<br />
Sensibility <strong>of</strong> <strong>An</strong>opheline to different<br />
Plasmodium species and strains<br />
Important deterioration <strong>of</strong> health<br />
services and economic situation
Sensibility <strong>of</strong> <strong>An</strong>. maculipennis s.l<br />
for Plasmodium genus<br />
Mosq. Plasmod. Ooq. Sporo. Mosq. Plasmod. Ooq. Sporo.<br />
origin origin + + origin origin + +<br />
P. falciparum P. vivax<br />
<strong>An</strong>. atroparvus UK India 0/109 ----- <strong>An</strong>. atroparvus USSR Laos 66/273 20/134<br />
<strong>An</strong>. atroparvus UK West Africa 0/310 ----- <strong>An</strong>.atroparvus USSR Nigeria 4/33 3/41<br />
<strong>An</strong>. atroparvus Italy Kenya 2/48 0/15 <strong>An</strong>. atroparvus USSR India 5/38 1/8<br />
<strong>An</strong>. atroparvus Italy Kenya 0/69 0/41 <strong>An</strong>. atroparvus USSR Pakistan 3/43 2/40<br />
<strong>An</strong>. atroparvus USSR Mali 0/214 0/246 <strong>An</strong>. atroparvus USSR Yemen 53/212 41/275<br />
<strong>An</strong>. atroparvus USSR Guinea 0/38 0/29 <strong>An</strong>. atroparvus USSR Brazil 15/98 7/48<br />
<strong>An</strong>. atroparvus USSR Costa Marfl 0/33 0/22<br />
<strong>An</strong>. atroparvus USSR H. Volta 0/86 0/60 P. malariae<br />
<strong>An</strong>. atroparvus USSR Somalia 0/65 0/38<br />
<strong>An</strong>. atroparvus USSR Togo 0/37 0/24 <strong>An</strong>. atroparvus USSR Laos 0/10 ----<br />
<strong>An</strong>. Atroparvus USSR Zambia 0/33 0/35 <strong>An</strong>. atroparvus Rum. Nigeria 29/283 ----<br />
<strong>An</strong>. atroparvus USSR Guinea Ec. 0/107 0/114 <strong>An</strong>. atroparvus UK Nigeria 5/72 18/45<br />
<strong>An</strong>. atroparvus USSR India 0/45 0/44<br />
<strong>An</strong>. atroparvus USSR Pakistan 0/49 0/31 P. ovale<br />
<strong>An</strong>. subalpinus USSR R. Centroafr. ----- 1/4<br />
<strong>An</strong>. atroparvus Port. East Africa ----- 0 <strong>An</strong>. atroparvus USSR Guinea 0/41 0/50<br />
<strong>An</strong>. atroparvus UK ¿? 1/43 0/43 <strong>An</strong>. atroparvus USSR Mali 0/27 0/24<br />
<strong>An</strong>. atroparvus Spain ¿? 0/57 0/57 <strong>An</strong>. atroparvus USSR Tanzania 0/31 0/32<br />
<strong>An</strong>. atroparvus USSR Mozambique 0/29 0/16<br />
<strong>An</strong>. atroparvus USSR Centroafr. Rep. 0/68 0/27<br />
Shute, Ramsdale &Coluzzi, Daskova & Rasnicyn, Ribeiro<br />
et al., Marchant et al., Gemert & Hoogh<strong>of</strong>. Different years
Main factors for the reintroduction<br />
<strong>of</strong> malaria<br />
Increase <strong>of</strong> parasite carriers by<br />
immigration or travel<br />
Climate change<br />
Presence <strong>of</strong> potential vectors<br />
Sensibility <strong>of</strong> <strong>An</strong>opheline to different<br />
Plasmodium species and strains<br />
Important deterioration <strong>of</strong> health<br />
services and economic situation
Important loss <strong>of</strong> economic and<br />
sanitary conditions<br />
Tajikistan
Basic reproductive rate R 0<br />
MacDonald, 1957<br />
R0 0 = (ma (m 2 Pn / -ln ln P) b c 1/r<br />
If R0 >1, will be more cases after the first one<br />
m Vector density to humans<br />
a Proportion <strong>of</strong> vectors feeding in humans (bites per human,<br />
<strong>mosquito</strong>, day)<br />
b Efficiency <strong>of</strong> transmission from an infected <strong>mosquito</strong> to a human<br />
c Efficiency <strong>of</strong> transmission from an infected human to a <strong>mosquito</strong><br />
P daily survival rate <strong>of</strong> the vector<br />
n Extrinsic period <strong>of</strong> incubation <strong>of</strong> the virus (EIP) in days<br />
1/r Human infectious period (in days)
Some remarks or conclusions<br />
There is a constant entrance and increase <strong>of</strong> pathogen carriers<br />
in Europe and all around the world.<br />
Increase <strong>of</strong> temperature in geographic areas such as Europe may have have<br />
an incidence in the potential transmission <strong>of</strong> <strong>diseases</strong>.<br />
Increase <strong>of</strong> temperature may increase extension <strong>of</strong> vectors distribution distribution<br />
but, there are other factors that can act in an opposite way.<br />
Mosquito vectors are well distributed and in contact with humans. humans<br />
Sensibility <strong>of</strong> European vectors to different pathogens is variable variable<br />
according species and pathogens but it is not neglectable.<br />
Introduction <strong>of</strong> more exotic vectors seems to be difficult but possible possible<br />
depending on diverse factors like climate and apropiate habitats. habitats<br />
Socioeconomic conditions are important factors that can influence influence<br />
dramatically outbreaks, especially in <strong>diseases</strong> such as malaria.
Photography:<br />
C. Aranda, H. H. Arentsen, M.M. Cutwa, R. Eritja, J. Gathany (CDC), (CDC),<br />
R. Khun, E. Marquès, Marqu s, L. Munsterman, R. Torres
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