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Prototype early warning systems for vector-borne diseases in Europe.

Semenza JC - Int J Environ Res Public Health (2015)

Bottom Line: Temperature deviations from a thirty year average proved to be associated with the 2010 outbreak.Drivers of subsequent outbreaks were computed through multivariate logistic regression models and included monthly temperature anomalies for July and a normalized water index. (3) Dengue is a tropical disease but sustained transmission has recently emerged in Madeira.The risk of dengue importation into Europe in 2010 was computed with the volume of international travelers from dengue affected areas worldwide.These prototype early warning systems indicate that monitoring drivers of infectious diseases can help predict vector-borne disease threats.

View Article: PubMed Central - PubMed

Affiliation: European Centre for Disease Prevention and Control, Tomtebodavagen 11A, SE-171 83 Stockholm, Sweden. Jan.Semenza@ecdc.europa.eu.

ABSTRACT
Globalization and environmental change, social and demographic determinants and health system capacity are significant drivers of infectious diseases which can also act as epidemic precursors. Thus, monitoring changes in these drivers can help anticipate, or even forecast, an upsurge of infectious diseases. The European Environment and Epidemiology (E3) Network has been built for this purpose and applied to three early warning case studies: (1) The environmental suitability of malaria transmission in Greece was mapped in order to target epidemiological and entomological surveillance and vector control activities. Malaria transmission in these areas was interrupted in 2013 through such integrated preparedness and response activities. (2) Since 2010, recurrent West Nile fever outbreaks have ensued in South/eastern Europe. Temperature deviations from a thirty year average proved to be associated with the 2010 outbreak. Drivers of subsequent outbreaks were computed through multivariate logistic regression models and included monthly temperature anomalies for July and a normalized water index. (3) Dengue is a tropical disease but sustained transmission has recently emerged in Madeira. Autochthonous transmission has also occurred repeatedly in France and in Croatia mainly due to travel importation. The risk of dengue importation into Europe in 2010 was computed with the volume of international travelers from dengue affected areas worldwide.These prototype early warning systems indicate that monitoring drivers of infectious diseases can help predict vector-borne disease threats.

No MeSH data available.


Related in: MedlinePlus

Map of predicted probability of WNV infection based on environmental predictors, Europe and neighboring countries, 2012 and 2013. Note: Reprinted with permission from [49].
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ijerph-12-06333-f006: Map of predicted probability of WNV infection based on environmental predictors, Europe and neighboring countries, 2012 and 2013. Note: Reprinted with permission from [49].

Mentions: The number of WNF cases from 2002 to 2011 was assembled from ECDC surveillance data, peer-reviewed papers and the grey literature to fit the models [49]. ECDC surveillance data for 2012 and 2013 were used for external validation. We used univariate and multivariate logistic regression models to assess the probability of a district to be categorized as WNV positive [49]. The status of infection was set as the response variable, and anomalies of temperature, wetlands, bird migratory routes, etc. as explanatory variables. In the final multivariate logistic regression model, parameters of WNV risk at district level for 2002–2011 were: July temperatures anomalies, the anomaly of the Modified Normalized Difference Water Index (MNDWI) [50] in early June, an outbreak the previous year, the size of the human population, wetlands and the type of avian flyways [49]. Model validation with 2012 and 2013 data showed a good level of prediction; thus, July temperatures anomalies and MNDWI can be considered determinants for WNV transmission in Europe. Summer temperature anomaly before the upsurge as the main driver of the outbreak was also confirmed in independent analyses, along with other ecological variables such as occurrence of irrigated croplands and highly fragmented forests [51]. These models indicate that risk maps for WNV transmission can be assembled with up-to-date anomalies of July temperatures for a given year along with the MNDWI [49]. These two environmental determinants lend themselves for an integration of environmental monitoring in public health surveillance systems of human cases, serological surveillance of domestic and wild avifauna, and entomological surveillance [47,52,53]. Figure 6 displays the spatial heterogeneity of the probability of WNV infection per district in 2012 and 2013 as predicted by this model [49]. Central and Eastern Europe, Turkey, Israel, and Tunisia were predicted to have higher risk values for 2012. In comparison with Figure 5, WNF cases were notified in all of the predicted high risk areas, excepted in Ukraine, and Turkey. Tunisia, Northern Italy, Northern Greece, Central Europe and South Russia scored the highest predicted values in agreement with main areas of transmission in 2013 (Figure 6). These findings indicate that the variables in this model can in part describe the variability in WNV transmission in Europe at the district level. Applying temperature anomalies for July can produce short-term and even long-term predictive maps of the probability of WNV infections.


Prototype early warning systems for vector-borne diseases in Europe.

Semenza JC - Int J Environ Res Public Health (2015)

Map of predicted probability of WNV infection based on environmental predictors, Europe and neighboring countries, 2012 and 2013. Note: Reprinted with permission from [49].
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4483704&req=5

ijerph-12-06333-f006: Map of predicted probability of WNV infection based on environmental predictors, Europe and neighboring countries, 2012 and 2013. Note: Reprinted with permission from [49].
Mentions: The number of WNF cases from 2002 to 2011 was assembled from ECDC surveillance data, peer-reviewed papers and the grey literature to fit the models [49]. ECDC surveillance data for 2012 and 2013 were used for external validation. We used univariate and multivariate logistic regression models to assess the probability of a district to be categorized as WNV positive [49]. The status of infection was set as the response variable, and anomalies of temperature, wetlands, bird migratory routes, etc. as explanatory variables. In the final multivariate logistic regression model, parameters of WNV risk at district level for 2002–2011 were: July temperatures anomalies, the anomaly of the Modified Normalized Difference Water Index (MNDWI) [50] in early June, an outbreak the previous year, the size of the human population, wetlands and the type of avian flyways [49]. Model validation with 2012 and 2013 data showed a good level of prediction; thus, July temperatures anomalies and MNDWI can be considered determinants for WNV transmission in Europe. Summer temperature anomaly before the upsurge as the main driver of the outbreak was also confirmed in independent analyses, along with other ecological variables such as occurrence of irrigated croplands and highly fragmented forests [51]. These models indicate that risk maps for WNV transmission can be assembled with up-to-date anomalies of July temperatures for a given year along with the MNDWI [49]. These two environmental determinants lend themselves for an integration of environmental monitoring in public health surveillance systems of human cases, serological surveillance of domestic and wild avifauna, and entomological surveillance [47,52,53]. Figure 6 displays the spatial heterogeneity of the probability of WNV infection per district in 2012 and 2013 as predicted by this model [49]. Central and Eastern Europe, Turkey, Israel, and Tunisia were predicted to have higher risk values for 2012. In comparison with Figure 5, WNF cases were notified in all of the predicted high risk areas, excepted in Ukraine, and Turkey. Tunisia, Northern Italy, Northern Greece, Central Europe and South Russia scored the highest predicted values in agreement with main areas of transmission in 2013 (Figure 6). These findings indicate that the variables in this model can in part describe the variability in WNV transmission in Europe at the district level. Applying temperature anomalies for July can produce short-term and even long-term predictive maps of the probability of WNV infections.

Bottom Line: Temperature deviations from a thirty year average proved to be associated with the 2010 outbreak.Drivers of subsequent outbreaks were computed through multivariate logistic regression models and included monthly temperature anomalies for July and a normalized water index. (3) Dengue is a tropical disease but sustained transmission has recently emerged in Madeira.The risk of dengue importation into Europe in 2010 was computed with the volume of international travelers from dengue affected areas worldwide.These prototype early warning systems indicate that monitoring drivers of infectious diseases can help predict vector-borne disease threats.

View Article: PubMed Central - PubMed

Affiliation: European Centre for Disease Prevention and Control, Tomtebodavagen 11A, SE-171 83 Stockholm, Sweden. Jan.Semenza@ecdc.europa.eu.

ABSTRACT
Globalization and environmental change, social and demographic determinants and health system capacity are significant drivers of infectious diseases which can also act as epidemic precursors. Thus, monitoring changes in these drivers can help anticipate, or even forecast, an upsurge of infectious diseases. The European Environment and Epidemiology (E3) Network has been built for this purpose and applied to three early warning case studies: (1) The environmental suitability of malaria transmission in Greece was mapped in order to target epidemiological and entomological surveillance and vector control activities. Malaria transmission in these areas was interrupted in 2013 through such integrated preparedness and response activities. (2) Since 2010, recurrent West Nile fever outbreaks have ensued in South/eastern Europe. Temperature deviations from a thirty year average proved to be associated with the 2010 outbreak. Drivers of subsequent outbreaks were computed through multivariate logistic regression models and included monthly temperature anomalies for July and a normalized water index. (3) Dengue is a tropical disease but sustained transmission has recently emerged in Madeira. Autochthonous transmission has also occurred repeatedly in France and in Croatia mainly due to travel importation. The risk of dengue importation into Europe in 2010 was computed with the volume of international travelers from dengue affected areas worldwide.These prototype early warning systems indicate that monitoring drivers of infectious diseases can help predict vector-borne disease threats.

No MeSH data available.


Related in: MedlinePlus