Vector Volume 11 Issue 2 - 2017

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serotypes 3 (72%) and 4 (77%) than for serotypes 1 (55%) and 2 (43%).[52] Further study is ongoing to determine whether dengue illness and hospitalisation has reduced in nations that have implemented Dengvaxia.[53, 54] However, with varying efficacy, and questions regarding long-term safety and cost-effectiveness, it is predicted that vaccination will only be possible in the Pacific Islands if it is priced competitively. [53, 54] Thus, for the time being, vector control will remain the focus of dengue control strategy in the Pacific Islands, with the aim of integrating vaccination once it is more efficacious and cost-effective.[55] At present, it is far more affordable and effective to combat dengue by improving vector control mechanisms, and vaccination will be most useful as an adjunct if appropriate for specific nations. Vector Control: Currently Used Methods Vector control currently offers the best option for preventing dengue, but delivery of prevention programmes in the Pacific Islands is often inefficient, ineffective or both. [7] Several mechanisms exist in various Pacific Islands to control outbreaks once they occur, however some of the most common efforts, such as pesticide spraying, have limited effectiveness.[56] Factors that increase the risk of dengue transmission have included poor household drainage and hygiene problems, issues that can be addressed by health education programs to build a ‘prevention attitude’ among Pacific residents.[57, 58] However, it is believed that improving health education, awareness campaigns and technical support is necessary to ensure successful vector control.[8] Environmental factors such as buckets of stagnant water, allowing mosquitoes to breed, and host larvae and pupae, are other key risk factor which could be targeted through education campaigns. [59] Chemical treatment of breeding sites, insecticide spraying and biological control by introducing predators are mechanisms already utilised by some Pacific Islands which could be further implemented for vector control in the future. [60] Vector Control: Innovative Approaches Novel vector-based approaches aimed at controlling dengue include the use of obligate intracellular bacterium Wolbachia pipientis,[61] which interferes with reproduction in over 40% of insect species.[62] Although Wolbachia does not occur naturally in Aedes aegypti species, transinfection has been shown to be successful.[63] Recent studies in Cairns, Australia have shown stable transinfection of natural A. aegypti populations with the wMel strain of Wolbachia, rising to near-fixation within a matter of months and remaining established in those field sites unaided.[64] The antiviral activity of wMel has shown to be highly effective in laboratory studies even one year after field release.[65] The evidence supports the long-term stability of Wolbachia against the dengue virus, however, the effects on reduction of human disease in dengue-endemic regions is yet to be established, this is currently under investigation in Indonesia and Vietnam. [61] Another promising vector control method is the sterile insect technique (SIT), which has historically been successful against a multitude of agricultural pests.[66] In the 1960s, large-scale SIT programs enabled the elimination of A. aegypti from 23 American countries.[67] SIT has recently re-emerged as a vector control strategy due to innovative technological advances including genetic modification of mosquitoes.[68] Using SIT, Cuba has come close to the eradication of A. aegypti [69] and Singapore has kept levels of the mosquitoes down for more than 30 years.[70] Though neither of these methods is currently used widely in Pacific Islands, these innovative strategies are potential costeffective vector reduction methods. Emergency Response Capacity There is a significant need to grow emergency-response and outbreak-response to combat dengue.[8] Currently, the WHO and Red Cross manage the majority of outbreak control, both logistically and financially[14, 71] The Pacific Public Health Surveillance Network has provided some support in capacity building, and multiagency response teams have successfully been implemented during some outbreaks, but there remains a need to engage Pacific Directors and Ministers of Health to help prepare these multidisciplinary response teams for future outbreaks.[2, 14] Conclusion Dengue remains a significant threat in the Pacific Islands, with prevalence levels and the number of outbreaks continuing to increase. Until Dengvaxia or another dengue vaccine has a proven cost-effective public health benefit beyond the currently calculated values, it is unlikely to be deployed in Pacific Islands.[5, 51] The best hope for containing dengue is by improving region-wide surveillance and cost-effective, sustainable vector control mechanisms [6-8]. This requires Pacific Island governments to integrate dengue prevention into their environmental and public health policy, and work to improve vector surveillance and control methods, which may involve implementing innovative approaches [8, 48]. Another area that requires significant improvement is outbreak response, and upskilling all Pacific doctors to appropriately respond to dengue outbreaks [8, 60]. Ultimately, until the objectives outlined by the WHO are addressed, dengue will remain a growing challenge in the Pacific Islands. [7, 47] These islands must engage with the growing body of organisations working in the region to develop new and innovative surveillance and control approaches and combat dengue in the future.[7] Conflicts of interest None declared Correspondance dtom4@student.monash.edu References 1. Arima Y, Chiew M, Matsui T. Epidemiological update on the dengue situation in the Western Pacific Region, 2012. Western Pacific Surveillance and Response Journal. 2015;6(2):82-89. 2. Roth A, Mercier A, Lepers C, Hoy D, Duituturaga S, Benyon E 41
et al. Concurrent outbreaks of dengue, chikungunya and Zika virus infections – an unprecedented epidemic wave of mosquito-borne viruses in the Pacific 2012–2014. Eurosurveillance. 2014;19(41):1 - 8. 3. Dengue Guidelines for Diagnosis, Treatment, Prevention and Control [Internet]. World Health Organization (WHO) and the Special Programme for Research and Training in Tropical Diseases (TDR); 2009 [cited 27 July 2017]. Available from: http://www.who.int/tdr/ publications/documents/dengue-diagnosis.pdf 4. Dengue and Severe Dengue [Internet]. World Health Organization. 2017 [cited 11 August 2017]. Available from: http:// www.who.int/mediacentre/factsheets/fs117/en/ 5. Wilder-Smith A, Vannice KS, Hombach J, Farrar J, Nolan T. Population Perspectives and World Health Organization Recommendations for CYD-TDV Dengue Vaccine. J Infect Dis. 2016;214(12):1796-1799. 6. Olivera-Botello G, Coudeville L, Fanouillere K, Guy B, Chambonneau L, Noriega F et al. Tetravalent Dengue Vaccine Reduces Symptomatic and Asymptomatic Dengue Virus Infections in Healthy Children and Adolescents Aged 2-16 Years in Asia and Latin America. J Infect Dis. 2016;214(7):994-1000. 7. Guzman M, Halstead S, Artsob H, Buchy P, Farrar J, Gubler D et al. Dengue: a continuing global threat. Nature Reviews Microbiology. 2010;8(12):S7-S16. 8. Tambo E, Chen J, Zhou X, Khater E. Outwitting dengue threat and epidemics resurgence in Asia-Pacific countries: strengthening integrated dengue surveillance, monitoring and response systems. Infectious Diseases of Poverty. 2016;5(1). 9. Kline K, McCarthy J, Pearson M, Loukas A, Hotez P. Neglected Tropical Diseases of Oceania: Review of Their Prevalence, Distribution, and Opportunities for Control. PLoS Neglected Tropical Diseases. 2013;7(1):1 - 6. 10. Pacific: Dengue Outbreak – Oct 2016 [Internet]. Disasters. ReliefWeb. 2017 [cited 11 August 2017]. Available from: http:// reliefweb.int/disaster/ep-2016-000112-slb 11. Duncombe J, Lau C, Weinstein P, Aaskov J, Rourke M, Grant R et al. Seroprevalence of Dengue in American Samoa, 2010. Emerging Infectious Diseases. 2013;19(2):324-326. 12. Dupont-Rouzeyrol M, Aubry M, O’Connor O, Roche C, Gourinat A, Guigon A et al. Epidemiological and molecular features of dengue virus type-1 in New Caledonia, South Pacific, 2001–2013. Virology Journal. 2014;11(1):61. 13. Dengue in the Western Pacific Region [Internet]. World Health Organization Western Pacific Region. 2017 [cited 26 February 2017]. Available from: http://www.wpro.who.int/emerging_diseases/ Dengue/en/ 14. Taulung L, Masao C, Palik H, Samo M, Barrow L, Pretrick M et al. Dengue Outbreak — Federated States of Micronesia, 2012– 2013 [Internet]. Morbidity and Mortality Weekly Report. 2013 [cited 26 February 2017]. Available from: https://www.cdc.gov/mmwr/ preview/mmwrhtml/mm6228a3.htm 15. Dupont-Rouzeyrol M, Aubry M, O’Connor O, Roche C, Gourinat AC, Guigon A et al. Epidemiological and molecular features of dengue virus type-1 in New Caledonia, South Pacific, 2001-2013. Virol J. 2014;11:61. 16. Sabin AB. Research on dengue during World War II. Am J Trop Med Hyg. 1952;1:30–50. 17. Halstead SB. Dengue virus – mosquito interactions. Annu Rev Entomol. 2008;53:273-91. 18. A-Nuegoonpipat A, Berlioz-Arthaud A, Chow V, Endy T, Lowry K, le Mai Q et al. Sustained transmission of dengue virus type 1 in the Pacific due to repeated introductions of different Asian strains. Virology. 2004;329(2):505-12. 19. Morens DM. Dengue fever: a prevention summary for Pacific health workers. Pacific Health Dialog. 1996;3(1):240-52. 20. Singh N, Kiedrzynski T, Lepers C, Benyon EK. Dengue in the Pacific – an update of the current situation. Pacific Health Dialog. 2005;12(2):111-9. 21. Roth A, Mercier A, Lepers C, Hoy D, Duituturaga S, Benyon E et al. Concurrent outbreaks of dengue, chikungunya and Zika virus infections - an unprecedented epidemic wave of mosquito-borne viruses in the Pacific 2012-2014. Euro Surveill. 2014;19(41):20929. 22. Centers for Disease Control and Prevention (CDC). Dengue outbreak – Federated States of Micronesia, 2012-2013. MMWR. Morbidity and mortality weekly report. 2013;62(28):570-3. 23. Cao-Lormeau VM, Roche C, Musso D, Mallet HP, Dalipanda T, Dofai A, et al. Dengue virus type 3, South Pacific Islands, 2013. Emerg Infect Dis. 2014;20(6):1034-6. 24. World Health Organization. Dengue haemorrhagic fever. Diagnosis, Treatment, Prevention and Control. Geneva (CH); 1997. 92 p. Report No.: 2. 25. Calvez E, Guillaumot L, Millet L, Marie J, Bossin H, Rama V et al. and Phylogeny of Aedes aegypti, the Main Arbovirus Vector in the Pacific. PLoS Negl Trop Dis. 2016;10(1):1-2. 26. Guillaumot L. Arboviruses and their vectors in the Pacific – status report. Pac Health Dialog. 2005;12(2):45-52. 27. Lounibos LP. Invasions by insect vectors of human disease. Annu Rev Entomol. 2002;47(1):233-66. 28. Paupy C, Vazeille-Falcoz M, Mousson L, Rodhain F, Failloux AB. Aedes aegypti in Tahiti and Moorea (French Polynesia): isoenzyme differentiation in the mosquito population according to human population density. Am J Trop Med Hyg. 2000;62(2):217-24. 29. Carrington LB, Simmons CP. Human to Mosquito Transmission of Dengue Viruses. Front Immunol. 2014;5:290. 30. Scott T, Takken W. Feeding strategies of anthropophilic mosquitoes result in increased risk of pathogen transmission. Trends Parasitol. 2012;28(3):114-121. 31. Rallu JL. Tendance recentes des migrations dans le Pacifique Sud. Espace, population, sociétés. 1994;12(2):201-212. 32. Perry WJ. The mosquitoes and mosquito-borne diseases on New Caledonia, an historic account; 1885–1946. Am J Trop Med Hyg. 1950;30(1):103-14. 33. Chow CY. Aedes aegypti in the Western Pacific Region. Bull World Health Organ. 1967;36(4):544-6. 34. Kuno G. Research on dengue and dengue-like illness in East Asia and the Western Pacific during the First Half of the 20th century. Rev Med Virol. 2007;17(5):327-41. 35. Hopp MJ, Foley JA. Worldwide fluctuations in dengue fever cases related to climate variability. Clim Res. 2003;25:85-94. 36. Descloux E, Mangeas M, Menkes CE, Lengaigne M, Leroy A, Tehei T et al. Climate-Based Models for Understanding and Forecasting Dengue Epidemics. PLoS Negl Trop Dis. 2012;6(2):e1470. 37. Hales S, Weinstein P, Souares Y, Woodward A. El Nino and the Dynamics of Vectorborne Disease Transmission. Environ Health Perspect. 1999;107(2):99-102. 38. Hales S, de Wet N, Maindonald J, Woodward A. Potential effect of population and climate changes on global distribution of dengue fever: an empirical model. Lancet. 2002;360:830-834. 39. Jetten TH, Focks DA. Potential changes in the distribution of dengue transmission under climate warming. Am J Trop Med Hyg. 1997;57:285-297. 40. Masahiro U, Sengebau-Kinzio M, Nakamura K, Ridep E, Watanabe M, Takano T. Household risk factors associated with dengue-like illness, Republic of Palau, 2000-2001. BioScience Trends. 2007;1(1):33 - 37. 41. Aubry M, Roche C, Dupont-Rouzeyrol M, Aaskov J, Viallon J, Marfel M et al. Use of serum and blood samples on filter paper to improve the surveillance of dengue in Pacific Island Countries. Journal of Clinical Virology. 2012;55(1):23-29. 42. Cao-Lormeau VM, Roche C, Descloux E, Viallon J, Lastere S, Wiegandt A et al. Lost in French Polynesia: which strategies for a dengue virus to spread? Am J Trop Med Hyg Suppl. 2007;12:111-19. 43. Guidance on regulations for the transport of infectious substances 2011–2012 [Internet]. World Health Organization; 2010 [cited 31 July 2017]. Available from: http://www.who.int/entity/ihr/ 42
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Page 3 and 4: Contents Editor’s Note: Turning U
Page 5 and 6: Non-Health for Non-Persons: Rohingy
Page 7 and 8: Rohingyan regions of Myanmar. Force
Page 9 and 10: Individual and interpersonal While
Page 11 and 12: LGBTQIA+ individuals is topical. LG
Page 13 and 14: Commercial surrogacy in Australia:
Page 15 and 16: with an uncertain future.[11] Anoth
Page 17 and 18: school, were from middle income ear
Page 19 and 20: foreign policy motives has undermin
Page 21 and 22: Western institutions including Brow
Page 23 and 24: Key messages • Fossil fuel divest
Page 25 and 26: Coal combustion affects the water a
Page 27 and 28: is questionable. The Northern Austr
Page 29 and 30: Paddling upstream: Experiences from
Page 31 and 32: Similar to the obstetric department
Page 33 and 34: iced tea and coffee, and lemonade.
Page 35 and 36: eformulation targets, health star r
Page 37 and 38: Drug Control in Australia: Where to
Page 39 and 40: and substance use programs).[9] Cri
Page 41 and 42: Dengue in the Pacific Islands [Revi
Page 43: public health problem, showed that
Page 47 and 48: Family, Unity and Success - Austral
Page 49 and 50: should start talking about the idea
Page 51 and 52: Ultimately, the conference epitomis
Page 53 and 54: Welfare cuts to refugees, AMSA Glob
Page 55 and 56: Start where you are, use what you h
Page 57 and 58: Where to now? - Vector Journal & GH
Page 59 and 60: major hurdle. As detainee 982 (name

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