Zahedan University of Medical Sciences

Aedes Mosquito-Borne Disease in Our Backyard: preventing Dengue and Chikungunya infections in Sistan & Balouchestan Province

Aedes-borne viruses are responsible for high-impact neglected tropical diseases. Recent outbreaks of these diseases continue to attract considerable global attention. Aedes-borne viruses (such as Dengue, Chikungunya, and Zika viruses) account for almost 100 million cases of mosquito-borne disease per year. In the last 50 years, their incidence has increased 30-fold by expanding into new countries and new geographical areas.

Aedes mosquitoes are one of the world"s most efficient arthropod vectors that spread different arboviruses, and they are responsible for the continuous emergence and reemergence of these pathogens. There are no vaccines available to prevent dengue or chikungunya, controlling vector populations and reducing bites are currently the most effective prevention measures.

The Islamic Republic of Iran is under threat of potential outbreak of Aedes borne diseases and in 2008, the first imported case of dengue was reported in the country. In a study published in 2013, presence of dengue infection was reported in six cases were from the Sistan and Baluchistan province in southeast Iran (Travel Med Infect Dis. 2013 May-Jun; 11(3):166-9). Active mosquito surveillance has been established in the province since 2015. And larva and adult mosquitoes have been collected from 34 sentinel sites and 4 of them belonged to genus Aedes.

In order to assess Entomological surveillance of Aedes mosquitoes in I.R. of Iran, Dr. Raman Velayudhan, WHO Coordinator for Vector Ecology and Management,  and a  group of experts from Diseases Control Department, Ministry of Health, Iran, visited Chabahar  and Nikshahr districts in southeast of Iran between 12-15 December 2017.

Visiting the seaport of Chabahar, I.R. of Iran, 14 December, 2017

Visiting Pasabandar& Guatr ports, I.R. of Iran, 14 December, 2017

Visiting the  Chabahar city suburban area, I.R. of Iran, 14 December, 2017

Meeting with Mr. Ebrahimi, Deputy Director General of Ports  and Maritime Organization. Also, Dr Boozrgzadeh , Deputy for Health, Chabahar Free Trade Zone participated in the meeting.

Field visit  in Nikshahr district, organized by Iranshahr Faculty of Medicine, I.R. of Iran, 13 December, 2017

Confirmation of the presence of Aedes Albopictus in Sistan & Baluchestan province, coupled with the detection of dengue virus in some patients, indicates the need for active detection and application of control measures against these species in Iran. In the conclusion of the mission in a meeting that was held in Konarak District, the following points were discussed.

• Technical support for improving entomological surveillance of Aedes mosquito-borne infections.
• Developing standards for reporting of the entomological surveillance data
• Capacity building and training of entomological surveillance staff
• Developing mechanisms for integration of entomological surveillance for Aedes mosquito-borne infections into malaria vector control activities.
•  GIS and remote sensing to be integrated in the entomological surveillance of Aedes mosquito-borne infections, given the fact that the internet infrastructure is rapidly improving in both urban & rural areas.
• Develop a mechanism for Aedes mosquito-borne diseases information exchange between neighboring countries, i.e. Afghanistan, Islamic Republic of Iran and Pakistan and select focal points in each country;
• Establish mechanisms for  regional and international networking  and collaboration in the control of Aedes mosquito-borne diseases (using the experience from initiatives such as "United Dengue"  and Singapore  "National Environmental Agency")
• Scaling up IHR activities in the province
• Engagement of the Community Health Volunteers in vector control activities, especially in urban outskirts & suburban areas.
• Advocacy  for allocation of enough resources needed for vector management and control
• Development of new diagnostic methods, using molecular biology  techniques

A careful entomological surveillance of Aedes mosquitoes should be continuously used to determine changes in geographical distribution and for obtaining relative measurements of the vector population over time, for monitoring and evaluating control programmes, and for facilitating appropriate and timely decisions regarding interventions.

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