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Advanced Multiplex PCR Technology: For the simultaneous detection of multiple mosquito-borne pathogens

Mosquitoes are known to carry pathogens, namely Dengue virus, Zika virus, West Nile virus, Chikungunya virus, and plasmodium species, which cause mosquito-borne diseases. These diseases are spread from the bite of a mosquito(1) . Although most people may be asymptomatic or have mild symptoms from mosquito bites, severe cases of mosquito-borne illnesses can cause long-term illness or even death. People at risk include outdoor workers, business travelers who may travel to areas with mosquito-borne diseases, lab workers who may work with infected samples, and healthcare workers who may handle infected patients (2).

The Super Villain Mosquito

The geographical distribution of mosquito-borne diseases has historically been concentrated in rural, hot, and humid areas with abundant stagnant water bodies, such as ponds and lakes, ideal for mosquito breeding. Geographically favorable regions included parts of Central and South America, the Caribbean, Africa, Asia, and the Pacific Islands. The lifespan of mosquitoes is short (six to seven weeks) and they evolve very rapidly to adapt to changes in the environment (3). Over the last 20-40 years, mosquitoes have adapted to survive and thrive in dry urban city conditions, with less water available and they can now tolerate a broader range of temperatures to survive.  Urbanization, dense human populations, and hotter climates due to climate change are bringing mosquitos to areas they have never been found before, and they are spreading disease. In the United States, the geographical range of mosquito borne diseases has expanded significantly to entire south, east coast, and most of the west coast with some cases reported as far north as Montana (3,4).

Source: https://www.cdc.gov/mosquitoes/php/toolkit/potential-range-of-aedes.html

Apart from adapting to the climatic changes, mosquitoes have also evolved to be resistant to commonly used insecticides and pesticides undermining the strategies for disease management. Use of insecticides and pesticides have played a critical role in global strategy to manage mosquito borne diseases over the years. However, mosquito-borne diseases are on the rise, mainly due to resistance to these insecticides and pesticides (5,6).

Importance of testing due to overlapping symptoms

Mosquito-borne diseases cause millions of deaths globally each year. It is important to test for these infections to optimize patient care and reduce costs. Dengue, West Nile, chikungunya, Zika, and malaria all have similar and overlapping symptoms that make it hard to differentiate between the different infections without diagnostic testing. All these illnesses are characterized by fever, muscle pain, joint pain, headaches, and fatigue. With proper testing, healthcare professionals can accurately determine cause of illness and prescribe the appropriate treatment plan.

There are three different methods to test for mosquito-borne pathogens: antigen testing, serologic testing, and molecular testing. Antigen testing detects specific antigens produced by viruses/parasites in the blood of an infected individual, and sometimes requires a confirmation test using molecular methods. Serologic testing is used to detect the presence or level of virus specific antibodies in the blood. Because of the time required for the development of the antibodies, serologic testing is not effective for routine diagnosis of mosquito-borne infections. Molecular testing (PCR) is usually used as a confirmatory test once a preliminary diagnosis has been established by an antigen test. PCR can have higher sensitivity and quicker turnaround time than other methods and can help healthcare professionals provide proper and timely treatment. Because mosquito-borne infections have overlapping symptoms, multiplex PCR testing is important when trying to diagnose and treat a patient. Multiplex assays allow lab professionals to test for multiple infection-causing pathogens within a single test and can shorten time to diagnosis and treatment.

With climate change, changing habitats, and pesticide resistance, mosquitos are on the rise and on the move.  An epidemic is coming – will we be ready?

References

  1. https://www.cdc.gov/niosh/topics/outdoor/mosquito-borne/default.html
  2. https://www.bcm.edu/departments/molecular-virology-and-microbiology/emerging-infections-and-biodefense/mosquitoes
  3. https://www.nytimes.com/2023/10/05/podcasts/the-daily/mosquitos-malaria.html?
  4. Bradshaw, W.E., Fujiyama, S. and Holzapfel, C.M. (2000), ADAPTATION TO THE THERMAL CLIMATE OF NORTH AMERICA BY THE PITCHER-PLANT MOSQUITO, WYEOMYIA SMITHII. Ecology, 81: 1262-1272. https://doi.org/10.1890/00129658(2000)081[1262:ATTTCO]2.0.CO;2
  5. Liu, N. (2015). Insecticide resistance in mosquitoes: Impact, mechanisms, and research directions. Annual Review of Entomology, 60(1), 537-559. https://doi.org/10.1146/annurev-ento-010814-020828
  6. Hemingway J, Field L, Vontas J. 2002. An overview of insecticide resistance. Science 298:96–97
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