Gert van der Hoek
In Memoriam - Editor, Senior Moderator
ECDC Meeting Report - Mosquito-borne disease transmission risk in Europe
Full Report (PDF)
Conclusions, recommendations and next steps
The number of recent notifications of vector-borne diseases in the EU MS in 2010 is unusual. The current events
imply the identification of new risk areas for WNV, dengue, chikungunya and malaria transmission in Europe.
The presence of WNV is well-documented in several European countries and there has been an increase in the
number of cases in the EU over the past decade. Different drivers are contributing to this upsurge, but the basic
knowledge required to fully appreciate the possible changing epidemiology of WNV in Europe is lacking.
The current autochthonous cases of dengue fever and chikungunya are significant public health events, and
indicate that autochthonous transmission in continental Europe is possible where the vector Aedes albopictus is
present. The widespread epidemic of dengue and chikungunya in endemic areas creates an increasing risk of
importation of cases into the EU which, in combination with the increasing spread and abundance of Aedes
albopictus, enhances the risk of autochthonous transmission.
The following is a list of recommendations:
? The risk for dengue and chikungunya, and possibly other mosquito-borne viruses, is strongly related to the
presence of the vector Aedes albopictus. Early detection of its presence will increase the chance to control
this species if effective means are available. It is recommended to strengthen the surveillance of the exotic
mosquito species Aedes albopictus and Aedes aegypti in areas at risk of mosquito importation and virus
transmission.
? The importation of viraemic cases increases the potential of further transmission of arboviruses such as
dengue and chikungunya. Therefore, ECDC and MS epidemic intelligence activities should continue
monitoring the spread of these diseases worldwide.
? Increased awareness is needed of the importation of viruses other than chikungunya and dengue (e.g., St
Louis encephalitis virus) as well as other viruses transmitted in enzootic cycles (e.g., Usutu virus).
? The risk of transmission through blood, cells and tissues needs further consideration.
? The effectiveness of vector control methods applied to prevent and contain WNV and other mosquito-borne
virus outbreaks is not well known. It is recommended to collate existing information and examples and
make a systematic review of the potential prevention and control strategies and their impact.
? West Nile virus transmission is multi-factorial and to understand transmission different drivers related to the
pathogen, the host, the vector, ecology and weather need to be taken into account. However, basic
knowledge on WNV transmission is missing. Several projects addressing different aspects are ongoing or
will be starting soon. It is recommended that ECDC brings together the different initiatives (e.g., EDENext,
ArboZooNet, EuroWestNile) to improve coordination between these initiatives and to identify gaps of
knowledge.
? Meeting participants recommended a closer association with wildlife disease specialists and ornithologists
(e.g., the European Wildlife Disease Association) to study the involvement of birds in WNV transmission.
? Meeting participants expressed the need for cross-discipline awareness of the increasing potential for
mosquito-borne disease transmission in the EU.
The following is a list of future actions and next steps:
? The report of the meeting will be shared.
? A West Nile virus decision tool is being developed and will be distributed for comments. Experts will be
asked for their input on the tool.
? Upcoming meetings:
− Follow-up meetings related to West Nile outbreak: January 2010, Greece, where blood safety
issues will be discussed.
− Workshop to review the tool scheduled in 2011.
− Kick-off meetings of EDENext, EuroWestNile.
? The survey conducted by the VBORNET project will give an overview of the activities and resources in the
MS related to vector-borne diseases. The first preliminary results will be presented at the Annual General
Meeting scheduled in April 2011.
Full Report (PDF)
Conclusions, recommendations and next steps
The number of recent notifications of vector-borne diseases in the EU MS in 2010 is unusual. The current events
imply the identification of new risk areas for WNV, dengue, chikungunya and malaria transmission in Europe.
The presence of WNV is well-documented in several European countries and there has been an increase in the
number of cases in the EU over the past decade. Different drivers are contributing to this upsurge, but the basic
knowledge required to fully appreciate the possible changing epidemiology of WNV in Europe is lacking.
The current autochthonous cases of dengue fever and chikungunya are significant public health events, and
indicate that autochthonous transmission in continental Europe is possible where the vector Aedes albopictus is
present. The widespread epidemic of dengue and chikungunya in endemic areas creates an increasing risk of
importation of cases into the EU which, in combination with the increasing spread and abundance of Aedes
albopictus, enhances the risk of autochthonous transmission.
The following is a list of recommendations:
? The risk for dengue and chikungunya, and possibly other mosquito-borne viruses, is strongly related to the
presence of the vector Aedes albopictus. Early detection of its presence will increase the chance to control
this species if effective means are available. It is recommended to strengthen the surveillance of the exotic
mosquito species Aedes albopictus and Aedes aegypti in areas at risk of mosquito importation and virus
transmission.
? The importation of viraemic cases increases the potential of further transmission of arboviruses such as
dengue and chikungunya. Therefore, ECDC and MS epidemic intelligence activities should continue
monitoring the spread of these diseases worldwide.
? Increased awareness is needed of the importation of viruses other than chikungunya and dengue (e.g., St
Louis encephalitis virus) as well as other viruses transmitted in enzootic cycles (e.g., Usutu virus).
? The risk of transmission through blood, cells and tissues needs further consideration.
? The effectiveness of vector control methods applied to prevent and contain WNV and other mosquito-borne
virus outbreaks is not well known. It is recommended to collate existing information and examples and
make a systematic review of the potential prevention and control strategies and their impact.
? West Nile virus transmission is multi-factorial and to understand transmission different drivers related to the
pathogen, the host, the vector, ecology and weather need to be taken into account. However, basic
knowledge on WNV transmission is missing. Several projects addressing different aspects are ongoing or
will be starting soon. It is recommended that ECDC brings together the different initiatives (e.g., EDENext,
ArboZooNet, EuroWestNile) to improve coordination between these initiatives and to identify gaps of
knowledge.
? Meeting participants recommended a closer association with wildlife disease specialists and ornithologists
(e.g., the European Wildlife Disease Association) to study the involvement of birds in WNV transmission.
? Meeting participants expressed the need for cross-discipline awareness of the increasing potential for
mosquito-borne disease transmission in the EU.
The following is a list of future actions and next steps:
? The report of the meeting will be shared.
? A West Nile virus decision tool is being developed and will be distributed for comments. Experts will be
asked for their input on the tool.
? Upcoming meetings:
− Follow-up meetings related to West Nile outbreak: January 2010, Greece, where blood safety
issues will be discussed.
− Workshop to review the tool scheduled in 2011.
− Kick-off meetings of EDENext, EuroWestNile.
? The survey conducted by the VBORNET project will give an overview of the activities and resources in the
MS related to vector-borne diseases. The first preliminary results will be presented at the Annual General
Meeting scheduled in April 2011.