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Vector-borne Disease Surveillance in Southeast Asia – Challenges and Opportunities in Vector Collection and Pathogen Detection MAJ Brian Evans, Ph.D.; Jim McAvin; Alongkot Ponlawat, PhD; Ratree Takhampunya, PhD; LTC Jason Richardson, PhD . Mission Intelligence requirements

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Vector-borne Disease Surveillance in Southeast Asia – Challenges and Opportunities in Vector Collection and Pathogen Detection

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Vector borne disease surveillance in southeast asia challenges and opportunities in vector collection and pathogen d

Vector-borne Disease Surveillance in Southeast Asia –

Challenges and Opportunities in Vector Collection and

Pathogen Detection

MAJ Brian Evans, Ph.D.; Jim McAvin; Alongkot Ponlawat, PhD; Ratree

Takhampunya, PhD; LTC Jason Richardson, PhD


Agenda

Mission

Intelligence requirements

PM detachment capabilities

Detection capabilities (JBAIDS)

Value of pathogen assays

Where is the gap?

Conclusion

Agenda


Mission

To accurately asses the risk of vector-borne disease in an AO and to recommend/ implement measures that reduce the disease threat among soldiers.

Mission


Intelligence requirements

Human case data

Vector data (presence/absence)

Pathogen data (presence/absence)

Environmental data

Intelligence Requirements


Pm detachment capabilities

Pre-deployment intelligence

Gather case data (non-specific/specific)

Limited vector surveillance

Limited or no pathogen detection capability.

PM Detachment Capabilities


Detection capability

Detection Capability


Value of pathogen assays

Value of Pathogen Assays

Assumptions:

Case data is specific in number and location.

Vector surveillance, pathogen detection tools, and control tools are effective.


Vector borne disease surveillance in southeast asia challenges and opportunities in vector collection and pathogen d

Case data

is valuable!


Where is the gap

Adult mosquito/sand fly collection devices minimally effective; taxonomic keys

1 or 2 Ae. aegypti /house (15 mins/house); countless man-hours and houses needed for sufficient sample sizes (1 in 1000 infected); this is an area where there is transmission of dengue year-round.

Where is the gap?


Where is the gap1

Where is the gap?

BG Sentinel (BG Lure)

Bed net trap - NAMRU-2


Where is the gap2

Rodent-baited traps as a tool for collecting chigger mites, vectors of scrub typhus.

Where is the gap?

Figure 13: Field caught rodent on snap trap

&

Figure 4: Rodent with chiggers


Other challenges

Low densities; seasonality?

How does pathogen/vector data translate into risk?

What does it mean to have 6 in 1000 infected; should I be concerned?

Even when we know the vector locations and where the pathogen is most prevalent in the vector, do we understand the biology?

Not one-size fits all solutions; same species from different locations may have evolved independently; different vector ecology

Other Challenges?


Conclusion

Bottom-line: Pathogen detection has greatest added value for risk determination and control efficacy in instances where there is limited or no case data. If disease is seasonal, a valuable forecasting tool.

Challenge: Relevancy of pathogen detection data is highly-dependent on the vector surveillance tool.

Pathogen surveillance should be a critical part of the PM mission; need more effective surveillance tools to complement this mission; need trained soldiers who can interpret information/data.

Where time/resources/money are limited, should be very selective about when and where to use pathogen detection assays.

Conclusion


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