Proposed algorithm of dengue diagnostic testing in acute serum of patients suspected of dengue.

<p>Proposed algorithm of dengue diagnostic testing in acute serum of patients suspected of dengue.</p

Comparison of Vector Competence of <i>Aedes mediovittatus</i> and <i>Aedes aegypti</i> for Dengue Virus: Implications for Dengue Control in the Caribbean

<div><p>Background</p><p><i>Aedes mediovittatus</i> mosquitoes are found throughout the Greater Antilles in the Caribbean and often share the same larval habitats with <i>Ae. Aegypti</i>, the primary vector for dengue virus (DENV). Implementation of vector control measures to control dengue that specifically target <i>Ae. Aegypti</i> may not control DENV transmission in Puerto Rico (PR). Even if <i>Ae. Aegypti</i> is eliminated or DENV refractory mosquitoes are released, DENV transmission may not cease when other competent mosquito species like <i>Ae. Mediovittatus</i> are present. To compare vector competence of <i>Ae. Mediovittatus</i> and <i>Ae. Aegypti</i> mosquitoes, we studied relative infection and transmission rates for all four DENV serotypes.</p><p>Methods</p><p>To compare the vector competence of <i>Ae. Mediovittatus</i> and <i>Ae. Aegypti</i>, mosquitoes were exposed to DENV 1–4 <i>per os</i> at viral titers of 5–6 logs plaque-forming unit (pfu) equivalents. At 14 days post infectious bloodmeal, viral RNA was extracted and tested by qRT-PCR to determine infection and transmission rates. Infection and transmission rates were analyzed with a generalized linear model assuming a binomial distribution.</p><p>Results</p><p><i>Ae. Aegypti</i> had significantly higher DENV-4 infection and transmission rates than <i>Ae. mediovittatus</i>.</p><p>Conclusions</p><p>This study determined that <i>Ae. Mediovittatus</i> is a competent DENV vector. Therefore dengue prevention programs in PR and the Caribbean should consider both <i>Ae. Mediovittatus</i> and <i>Ae. Aegypti</i> mosquitoes in their vector control programs.</p></div

Transmission efficiency of dengue virus infected <i>Aedes mediovittatus</i> and <i>Aedes aegypti</i> mosquitoes at 14 days.

<p>DENV artificial transmission for mosquitoes infected with dengue-1 (DENV-1) (HAW), DENV-2 (New Guinea C), DENV-3 (H87), DENV-4 (H241) <i>per os</i>.</p><p>* Statistically significant differences for comparisons between serotypes DENV-1 >DENV-3 using Sidak’s method for multiple comparisons with simultaneous 95% confidence intervals.</p><p>^# Statistically significant differences for comparisons between serotypes DENV-4 > DENV-2 andDENV-3 using Sidak’s method for multiple comparisons with simultaneous 95% confidence intervals.</p><p>Transmission efficiency of dengue virus infected <i>Aedes mediovittatus</i> and <i>Aedes aegypti</i> mosquitoes at 14 days.</p

Infection rates and body titers of <i>Aedes mediovittatus</i> and <i>Aedes aegypti</i> mosquitoes 14 days post bloodmeal.

<p>Mosquitoes were exposed to dengue-1 (DENV-1) (HAW), DENV-2 (New Guinea C), DENV-3 (H87), DENV-4 (H241) <i>per os</i>.</p><p>Infection rates and body titers of <i>Aedes mediovittatus</i> and <i>Aedes aegypti</i> mosquitoes 14 days post bloodmeal.</p

Body (infection) and saliva (transmission) titers of dengue virus-infected <i>Aedes mediovittatus</i> and <i>Aedes aegypti</i> mosquitoes 14 days after oral challenge with dengue-1 (DENV-1) (HAW), DENV-2 (New Guinea C), DENV-3 (H87), DENV-4 (H241).

<p>Non-zero mean titer, 25 percentile titer, and 75 percentile titers are indicated on the graphs.</p

False positive rate of anti-DENV IgM rapid diagnostic tests in DENV negatives and challenge panel specimens.

<p>False positive rate of anti-DENV IgM rapid diagnostic tests in DENV negatives and challenge panel specimens.</p

Characteristics of specimens from dengue patients in the panel to evaluate dengue virus (DENV) non-structural protein 1 (NS1) detection kits.

<p>*Primary  = 1 DENV infection, Secondary ≥2DENV infections.</p>¶<p>days post onset of fever  = 0–5.</p>#<p>days post onset of fever  = 6–14.</p><p>Characteristics of specimens from dengue patients in the panel to evaluate dengue virus (DENV) non-structural protein 1 (NS1) detection kits.</p

False positive rate of anti-DENV IgM ELISA (Venture Technologies Sdn Bhd) in DENV negatives and challenge panel specimens.

<p>False positive rate of anti-DENV IgM ELISA (Venture Technologies Sdn Bhd) in DENV negatives and challenge panel specimens.</p

Characteristics of DENV negative specimens and challenge specimens for the evaluation of NS1 and anti-DENV IgM tests.^*

<p>NS1  =  non-structural protein 1, DENV  =  dengue virus.</p><p>*specimens from persons living in dengue non-endemic areas and negative for IgM and IgG antibody and reverse transcriptase polymerase chain reaction (RT-PCR) to dengue virus (DENV).</p><p>**specimens from systemic conditions, other febrile illnesses, related flavivirus infections and past DENV infections.</p><p>Characteristics of DENV negative specimens and challenge specimens for the evaluation of NS1 and anti-DENV IgM tests.^{<a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0003171#nt109" target="_blank">*</a>}</p

Dengue virus NS1 antigen detection and IgM anti-dengue virus tests submitted for evaluation.

<p>Dengue virus NS1 antigen detection and IgM anti-dengue virus tests submitted for evaluation.</p