In addition, it has been previously established that this area of the country could be receptive to dengue. In the event of an outbreak in New Zealand, the long-term forecast for the transmission, spread, and possible establishment of the disease in the country is unclear. However, this scenario may alter under the influence of global climate change. Vertical transmission is one mechanism in which a virus can remain in the mosquito populations when climate is unfavorable for adult mosquito survival, because the virus may persist in desiccation-tolerant eggs.
It should be noted that New Zealand would be particularly vulnerable to an arboviral outbreak because there are no recognized alphaviruses known to affect humans in New Zealand, and it is therefore unlikely that any immunity exists among the general population. As it has been the case in a number of other countries, 34 there is the potential of CHIKV importation into New Zealand by infected humans. Asymptomatic viremic travelers could arrive in New Zealand, and once in the country be exposed to local vectors so that a locally acquired epidemic occurs.
With the ever-increasing rate of international travel as well as migration , there is therefore an increasing flux of people arriving in New Zealand from areas where CHIKV is endemic. As CHIKV continues to re-emerge and emerge in new areas, it is likely that the number of viremic travelers arriving will increase. Although such cases appear to be rare in New Zealand, with only one reported case of imported CHIKV infection per year, a single infected person may be enough to initiate an outbreak in the presence of an efficient vector in large-enough density, as occurred in the outbreak in Italy.
In the case of New Zealand, this situation is compounded by the paucity of confirmatory arboviral testing ability. A further issue in New Zealand is its population's apparent ignorance of the need for basic mosquito control and avoidance measures. Aedes notoscriptus mosquitoes have greatly benefited from such artificial breeding grounds, where they now thrive. Finally, there is the growing issue of global climate change to add to the mix. It is widely acknowledged that climate change may have an effect on vector biology and thus alter vector seasonality, abundance, and distributions.
Likewise, climate change may affect hosts and pathogens and influence human behavior and thus exposure risk. In this complex scenario, it is difficult to predict how climate change will affect vector-borne disease risk in the region. However, it is likely that arboviruses, such as CHIKV, will continue to emerge in new areas and be associated with a changing global climate.
Epstein recently suggested that the explosive re-emergence of CHIK fever in was associated with intensifying extreme weather patterns affecting Africa. In the case of New Zealand, under current climatic conditions, Ae. For Ae. In the future, changing climate and weather patterns may facilitate the establishment of these vectors, consequently maximizing the likelihood of a CHIKV outbreak, and possibly other arboviruses.
The public health threat in association with arboviral outbreaks would likely be intertwined in New Zealand and other South Pacific islands. Nations in the region are geographically proximal and closely linked culturally and economically, with a regular flow of travelers among them. In , dengue outbreaks in the South Pacific led to a significant increase in the number of imported dengue cases reported in New Zealand, most of which originated in the Cook Islands and Samoa.
In New Zealand, this would likely occur in the case of any arbovirus outbreak. Early detection of any sentinel cases is fundamental to prevent an outbreak from occurring. However, this would be hindered by the paucity of confirmatory arboviral testing ability in New Zealand. However, much greater capacity is needed to address not only the testing requirements of this country, but also to provide support for South Pacific nations that are much less able to afford it.
Nonetheless, to manage adequately the risk of a CHIKV outbreak or to contain such an event if it occurs, it is necessary to develop a regional approach to public health.
In the case of New Zealand, to minimize the risk associated with mosquito-borne diseases among its own people, it is necessary to assist with public health prevention in more vulnerable populations in poorer nations in the South Pacific that could act as sources of emerging infectious diseases. Furthermore, the perception of public health risk e. As a result, it is not possible to adopt a single approach to prevent or mitigate a CHIKV outbreak across the whole of the South Pacific.
In fact, this is applicable also within an individual nation, where considerably different ethnic and cultural groups exist. Thus, they believed they were in control and, in any case, often questioned whether the mosquitoes were causing the disease.
To be effective, public health education and intervention against mosquito-borne disease would need to take such differences into account, as has already been implemented in community-specific public health messages for such issues as smoking and exercise. Finally, it is important to highlight that the costs of programs to prevent mosquito-borne diseases are relatively small compared with the effects on human health and the human, political, and financial costs of the epidemics, as well as the costs of attendant vector control and other public health measures a CHIKV epidemic would require in the region.
Therefore, in view of the increasing threat of a CHIKV outbreak in the South Pacific, we strongly recommend the support and expansion of preventive action by appropriate authorities in the region. Edwin R. National Center for Biotechnology Information , U. Am J Trop Med Hyg. Nye , and Philip Weinstein. Author information Article notes Copyright and License information Disclaimer. E-mail: moc. Received Feb 24; Accepted Jun This article has been cited by other articles in PMC.
Abstract There has never been a locally transmitted outbreak of mosquito-borne disease in New Zealand, but the risk of an outbreak occurring is increasing with on-going interceptions of exotic mosquito vectors across its border, increasing traffic of goods and passengers, higher numbers of viremic travelers arriving, and local, regional, and global environmental change.
New Zealand New Zealand has a relatively poor mosquito fauna, with only 12 native and 4 introduced mosquito species Table 1. Table 1 Mosquito species present in New Zealand and their potential significance as vectors of chikungunya virus on the basis of available evidence. Aedes chatamicus 0 Recorded indoors and appears to bite humans. However, it seems to be restricted to the Chatham Islands, 41 where the cooler climate and its breeding habitats probably saline pools likely rules it out as a species of concern.
Aedes subalbirostris 0 Its distribution is restricted to southeastern South Island, 42 and it seems to only rarely bite humans. Coquillettidia iracunda 10 Aggressive biter that is common in and around native forests, and it is closely related to an efficient laboratory vector of chikungunya virus. Coquillettidia tenuipalpis 1 Although widespread, this species is rarely recorded biting humans.
Culex pervigilans 1 The most common and widespread mosquito in New Zealand, but which seems to be primarily ornithophilic and is rarely recorded biting humans. In addition, Culex spp. There are no records of this species in CO 2 -baited traps or actively biting a host, and attempts to induce blood feeding in laboratory conditions have failed. Introduced Aedes australis 1 Although a laboratory vector of dengue and Ross River virus, 50 it is mostly restricted to saline rock pools on the southern coasts of the South Island.
Culex quinquefasciatus 1 Despite viral isolations in the field, it is refractory to chikungunya virus infection. Open in a separate window. South Pacific The public health threat in association with arboviral outbreaks would likely be intertwined in New Zealand and other South Pacific islands. References 1. Enserink M. Atypical manifestations of chikungunya infection.
A major epidemic of chikungunya virus infection on Reunion Island, France, — Chikungunya fever: an epidemiological review of a re-emerging infectious disease.
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