epidemiology, molecular epidemiology and surveillance of dengue viruses in the south pacific...

Epidemiology, Molecular Epidemiology and Surveillance of Dengue Viruses in the South Pacific

Cao-Lormeau V.M., Aubry M., Dupont-Rouzeyrol M., Roche C., O’Connor O., Chanteau S., Aaskov J.

Epidemiology, Molecular Epidemiology and Surveillance of Dengue Viruses in the South Pacific

Cao-Lormeau V.M., Aubry M., Dupont-Rouzeyrol M., Roche C., O’Connor O., Chanteau S., Aaskov J.

Institut Louis Malardé, Papeete, French Polynesia ECTMIH Barcelona - October 4, 2011


I - IntroductionI - Introduction

South Pacific Ocean

Equator


<300,000

<100,000

Nation Population

Australia 22,422,601

Papua New Guinea 6,888,000

New Zealand 4,383,800

Fiji 854,000

Solomon Islands 436,000

French Polynesia (France) 264,000

New Caledonia (France) 249,000

Vanuatu 243,304

Samoa 179,000

Tonga 104,000

Kiribati 98,000

American Samoa (United States) 65,628

Cook Islands (New Zealand) 19,569

Wallis and Futuna (France) 15,289

Nauru 14,015

Tuvalu 12,373

Norfolk Island (Australia) 2,141

Tokelau (New Zealand) 1,416

Niue (New Zealand) 1,398

Pitcairn Islands (United Kingdom) 50

Total 36 149 584

Total (without Australia) 13 726 983

Source: http://en.wikipedia.org/wiki/List_of_Oceanian_countries_by_population



• Flaviviridae familly, Flavivirus genus (YFV, WNV, JEV,…)

• 4 DENV serotypes (DENV-1 to DENV-4)

• several genotypes (phylogenetic analysis - E gene)

Dengue virus (DENV)



Transmission cycle

Within the Pacific region « man-mosquito-man »

Mosquito vectors in PICTs

Aedes aegypti (Pacific - late 19th)

Aedes albopictus (PNG, Solomon, Fiji, Micronesia, Hawaii)

Aedes polynesiensis(French Polynesia, Cook, Am Samoa, Samoa, Fiji, Wallis & Futuna, Tokelau, Tuvalu)

Aedes cooki (Niue, Tonga)

Aedes hebrideus (PNG, Solomon Isl., Vanuatu)

Aedes kesseli (Tonga)

Aedes pseudoscutellaris (Fiji) Source: Guillaumot L (2005)


http://www.2.bishopmuseum.org/

http://www.tolweb.org/


1940 1960 1970 1980 1990 2000 2010

Papua NG

Fiji

Solomon Isl.

French Pol.

New Cal.

Vanuatu

Samoa

Tonga

Kiribati

Am. Samoa

Cook Islands

Wallis Fut.

Nauru

Tuvalu

Norfolk Isl.

Tokelau

Niue

Pitcairn Isl.

DENV-1DENV-2DENV-3DENV-4Other

DENV-1DENV-2DENV-3DENV-4Other

Sources: Li et al., 2010; INVS-DIT (août 2008, juin 2007) ; Inform’Action N°28, 29, 27, 25, 18; Singh N et al. (2005)

II - EpidemiologyII - Epidemiology

1940 1960 1970 1980 1990 2000 2010

Papua NG

Fiji

Solomon Isl.

French Pol.

New Cal.

Vanuatu

Samoa

Tonga

Kiribati

Am. Samoa

Cook Islands

Wallis Fut.

Nauru

Tuvalu

Norfolk Isl.

Tokelau

Niue

Pitcairn Isl.


3 2 1 4 [1] 3 4(1)2 1 3(?)

2016



Long term circulation of a predominant serotype (20/25 yrs)

molecular data (E gene) => same genotype(Li et al., 2010; Imrie et al., 2010; Descloux et al., 2009; A-Nuegoonpipat et al., 2004;

Chungue et al, 1998, 1997; Lanciotti et al., 1997, 1994)

No persistent co-circulation of multiple DENV serotypes

endemic virus replaced by the epidemic serotype

except 2008-2010 (NC, Vanuatu): DENV-1 transmission occurred before,

during and after DENV-4 circulated



Epidemic profiles (local specificities)

French Polynesia

- one phase epidemic that can start at any season

- endemic circulation

- 5/6 years re-emergence

New Caledonia

- bi-phasic epidemic (warm/rainy season)

- endemic circulation (frequent imported cases of any serotype)

- re-emergence



Phylogenetic analysis (E gene)

Interests

• Which region the DENVs circulating in PICTs might have been introduced from ?

• Are there main routes of PICT-to-PICT distribution of DENVs?

• Do the molecular data corroborate epidemiological data?

DEN-PACSUD projectI.Epidemiology, molecular epidemiology and genetic evolution of DENVs in SPICsII. Intra-host genetic diversity of DENV in human and mosquito

DENV-4 (1980s-2000yrs), DENV-3 (1990s), DENV-1 (1980s-2000yrs) -> E gene, full genome sequencing

III – Molecular EpidemiologyIII – Molecular Epidemiology


V

I

III

II

IV

DENV-1


V

I

III

II

IV

DENV-1 Genotype IVDENV-1


V

I

III

II

IV

DENV-1 Genotype IV Asia/Southeast Asia (1974-2007)Nauru (1974)Australia (1983)

Samoa (2001)Yap (2004)Indian Ocean (2003-2006)74

DENV-1


V

I

III

II

IV

DENV-1 Genotype IV

74

DENV-1

French Polynesia

New Caledonia

Vanuatu

Pacific clade (2001-2010)

Hawaii

Asia/Southeast Asia (1974-2007)Nauru (1974)Australia (1983)

Samoa (2001)Yap (2004)Indian Ocean (2003-2006)


II

IIIIIV

DENV-4


II

IIIIIV

DENV-4 Genotype IIaDENV-4


II

IIIIIV

DENV-4 Genotype IIaDENV-4

Asia/Southeast Asia (1973-2007)


II

IIIIIV

DENV-4 Genotype IIa

French Polynesia

New Caledonia

FijiTonga

Solomon

Vanuatu

Pacific clade (2007-2010)

Wallis and FutunaKiribatiWestern Samoa

DENV-4

Asia/Southeast Asia (1973-2007)



Genetic analysis (nt mutations -> aa substitutions)

DENV-1 (2001-2010)

Previous results FP strains (Descloux et al., 2009)

-> E (S222T) = 2001 (0%), 2002 (10%), 2003 (67%), 2004-2006 (100%)

-> E (K363R) = 7 strains from FP islands, main vector Ae polynesiensis

-> other aa substitutions (E, NS4B, NS5)

Analysis of complementary strains

-> E (S222T) = 2006-2010 FP, NC, Vanuatu (100%)

-> full genome sequencing (on going work...)



Genetic analysis (nt mutations -> aa substitutions)

DENV-4 (2007-2010)

-> E (T365I) = Pacific clade (Li et al., 2010; Cao-Lormeau et al., under revision)

-> other substitutions on E = specific to strains from Tonga, Kiribati, WF (but only one representative)

-> full genome sequencing (on going work...)


• Weekly epidemiological reports Regional syndromic surveillance net-work (PPHSN)

• Physicians sentinel network

• Laboratory surveillanceReal time RT-PCR (Taqman multiplex) type specificNS1 diagnostic test (ELISA)IgM diagnostic test

• Vector control unit

Local surveillance (ex. FP & NC)

IV - SurveillanceIV - Surveillance

Pilot study on the use of filter papers for the surveillance of the DENV serotypes circulating in PICTs (ILM, IPNC, QUT, SPC)


Institut Pasteur de Nouvelle Calédonie (NC)Pr Suzanne ChanteauDr Myrielle Dupont-RouzeyrolMrs Olivia O’Connor

Queensland University of technology (Australia)Pr John Aaskov

Direction de la Santé (FP)Dr Henri-Pierre MalletMrs Elise Daudens

Medical analysis lab, Sia hospital (Wallis) Dr Jean François Yvon

Université de la Polynésie française (FP)Pr Marcel Le Pennec

Institut Louis Malardé (FP)

Research lab. in medical virologyMrs Claudine RocheMrs Maite AubryMr Jérôme ViallonDr Vaea Richard

Medical analysis lab.Dr Didier MussoDr Stéphane LastèreMrs Anita Teissier

Research lab. In medical entomologyDr Hervé BossinMr Jérôme Marie

AcknowledgementsAcknowledgements

Secretariat of the Pacific Community (NC)Mrs Salanieta Elbourne

Grants: Fonds Pacifique (2008, 2009, 2010); Agence Nationale pour la Recherche (ANR 09 MIEN-028-01)

Asia-Pacific Institute of Tropical Medicine and Infectious Diseases (Hawaii)

Pr Duane J GublerDr Shannon Bennett

Mauruuru!Gracias!

Thank you!

Mauruuru!Gracias!

Thank you!Institut Louis Malardé, Papeete, French Polynesia ECTMIH Barcelona - October 4, 2011

epidemiology, molecular epidemiology and surveillance of dengue viruses in the south pacific...

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