June 15, 2022 | Volume 2 | Issue 5 | As of Week 23
Welcome to the Florida Disease Activity Update from the desk of Dr. Jonathan Day.
It continues to be Clarke’s privilege to share Dr. Day's weekly analysis of arbovirus disease activity in Florida with mosquito control professionals across the state. Our shared goal with Dr. Day is to provide timely and actionable information that mosquito control programs can use to make operational decisions and protect public health from vector-borne diseases.

An archive of all past newsletter issues remains available on the Clarke website.
A QUESTION FROM OUR READERS

Spencer from Merritt Island, FL has a follow-up question from
Issue 4: “What in the world is a human botfly?”

A:* The human botfly (Dermatobia hominis) is one of the most fascinating insects on earth.

It ranges from the southern half of Central America through the northern half of South America. Its larvae parasitize humans along with a wide range of other animals including non-human primates. Larvae burrow under the skin and feed in the fatty subcutaneous dermal layer.

The adult female botfly is about the size of a bumblebee and is a very loud flyer. This presents her with a problem; how does she approach a host to lay eggs without provoking a defensive, and possibly fatal, reaction? Dermatobia hominis has solved this problem in two amazing ways.

First, gravid botflies ambush one of more than 40 mosquito species (as well as muscoid flies and even ticks), pin them to the ground, lay three to six eggs on their thorax, and send them on their way unharmed. Then, some of these egg-bearing mosquitoes in search of a blood meal approach a vertebrate host. The mosquito usually lands around the head and begins to probe, initiating the second amazing part of this life cycle.

Stimulated by host body heat, the botfly eggs hatch, and a fully developed first instar larva drops onto the host and burrows under the skin. From there, larval development takes about eight weeks. The mosquito messenger part of this remarkable life cycle has been captured photographically by Dr. Larry Reeves of the UF Florida Medical Entomology Laboratory. In the image below, four botfly eggs can be seen attached to a female Psorophora spp. One of the botfly eggs is in the process of hatching!
THE CURRENT OUTLOOK FOR ARBOVIRAL TRANSMISSION IN FLORIDA DURING 2022

There have been profound changes in Florida groundwater levels during the past two weeks, due in part to Tropical Storm Alex that crossed South Florida on June 4th. The Keetch-Byram Drought Index (KBDI) for May 20th, 2022 shows dry conditions in most of South Florida. The transition zone between dry South Florida and wet North Florida is marked by the red oval. Within this transition zone, we expect to see mid-summer transmission of EEEV.
Figure 1. The KBDI reported for Florida on May 20, 2022. The marked area is the transition zone between wet North Florida and dry South Florida where there is currently a higher than normal risk of EEEV transmission.
In fact, the transmission of EEEV so far in 2022, as measured by sentinel chickens, has been focused in the transition zone shown in Figure 1. In addition to the sentinel chicken EEEV seroconversions shown in Figure 2, two equine infections were recently reported in Osceola County, both with mid-May infection dates. 
Figure 2. The 2022 transmission of EEEV in Florida as measured by sentinel chicken seroconversions.
The Florida KBDI report as of 6/13/22 is shown in Figure 3. South Florida has gone from very dry to very wet in a short period of time. This rainfall pattern may favor the transmission of WNV in South Florida during the upcoming weeks. 
Figure 3. The KBDI reported for Florida on June 13, 2022 showing the extreme wetting event in South Florida resulting from Tropical Storm Alex on June 4. This rapid change from dry to wet may favor the transmission of WNV in the coming weeks.
The ideal groundwater levels for a heavy EEEV transmission year (1991) and a SLEV epidemic year (1990) are shown in Figure 4 with arrows indicating the prime mid-June groundwater levels that support the transmission of EEEV and SLEV/WNV. 
Figure 4. Groundwater profiles for heavy EEEV (1991) and SLEV (1990) transmission years with arrows indicating Week 23 in mid-June.
For the SLEV 1990 groundwater curve, we are within a week of the major wetting event that will support Flavivirus transmission in South Florida. If WNV was efficiently amplified in South Florida during the spring and early summer of 2022, the rainfall event in early June may trigger the dispersal of WNV-infected mosquitoes and support widespread transmission of this virus in the coming weeks.
Year to Date Summary of Mosquito-Borne Disease Transmission

As of Week 23, 2022 the following mosquito-borne disease transmission events and pathogen introductions have been reported in Florida:
Table 1. Summary of mosquito-borne disease transmission and introductions in Florida as of June 11, 2022 
Currently, most of the EEEV transmission reported in Florida is in the wet-to-dry transition zone around Orange County (Figure 2). Based on recent rainfall patterns, South Florida is the region at the highest risk of WNV transmission in the coming weeks. 
OPERATIONAL STRATEGIES TO CONSIDER
Vector and arboviral surveillance remain some of the most important tools that vector control agencies currently have at their disposal. Arboviral transmission indices (sentinel chickens, positive equines, positive exotics such as emus), positive humans, and positive mosquito pools) provide indicators of local virus transmission, although sometimes not in a timely manner. Monitoring mosquito populations and their age structure gives additional information about potential transmission risks. Supplemental vector control efforts in and around sites where virus transmission is known or suspected of recently occurring provide another mechanism to mitigate viral transmission.
 
Specific operational strategies will be discussed during the 2022 arboviral transmission season depending on where and when vector-borne disease transmission becomes obvious in Florida.
 
There is currently a moderate risk of arboviral transmission in some parts of Florida. It is important to note that arboviral transmission risk is never zero. The transmission of EEEV in the wet-dry transition zone in Central Florida will continue to be an issue of concern during the coming weeks (Figures 2, 3, and 4). The rapid change from dry to wet groundwater conditions in South Florida (Figures 3 and 4) may favor the transmission of WNV in the coming weeks.  
 
It is also important to continue monitoring travel-related introductions of DENV and malaria. Historically, introductions of DENV into Miami Dade and Monroe Counties have sparked outbreaks of locally-acquired DEN. 
ABOUT DR. JONATHAN DAY
Jonathan Day, Professor Emeritus of Medical Entomology from the University of Florida, is a national expert on mosquitoes and other blood-feeding arthropods that transmit diseases to humans, domestic animals, and wildlife. In collaboration with other researchers, Dr. Day has developed an effective system for monitoring and predicting epidemics of mosquito-borne diseases.
Acknowledgments: This analysis would not be possible without the tireless efforts of multiple agencies across Florida. At least 27 Florida agencies collect serum samples from sentinel chickens each week and mail them to the Florida Department of Health Tampa Branch Laboratory for analysis, compilation and reporting. Data are summarized by researchers at the Florida Department of Health in Tallahassee and reported weekly as the Florida Arbovirus Surveillance Report.

Contributors to this summary and full report include: Andrea Morrison, PhD, MSPH, Rebecca Zimler, PhD, MPH, and Danielle Stanek, DVM, Florida Department of Health, Bureau of Epidemiology; Lea Heberlein-Larson, DrPH; Alexis LaCrue, PhD, MS; Maribel Castaneda, and Valerie Mock, BS, Florida Department of Health Bureau of Public Health Laboratories, and Carina Blackmore, DVM, PhD, FDOH Division of Disease Control and Health Protection. And, Dr. Rachel Lacey, Florida Department of Agriculture and Consumer Services, Animal Disease Diagnostic Laboratory in Kissimmee, FL.

Daily updates of the Keetch-Byram Drought Index (KBDI) are produced by the Florida Department of Agriculture and Consumer Services, Forest Service.

All of the graphics used in issues of this Newsletter are designed and developed by Gregory Ross.

*The reader question this week was answered with the assistance of Dr. Lawrence Reeves at the Florida Medical Entomology Laboratory in Vero Beach.
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