SofiiaF's Quick takes

Quick Take:

In most educational settings or even healthcare campaigns for the general public, the only mosquito-borne disease highlighted prominently in the UK tends to be malaria, and most mosquito-borne diseases may be non-domestic in countries we'd consider HICs and with healthcare infrastructure, and yet turns out quite a few are considered now natively established in regions such as Spain, France, US, Croatia.

Currently doing a lit review on different methods of reducing populations, transmission or exposure to bites to control mosquito borne diseases, and that has more context, information and sources, but if anyone was considering doing some cause prio on types/vectors of disease we may want to work on/should consider, then here are some key mosquito-borne diseases that I feel get mentioned less.

Working on a longer write up but if it helps anyone considering wrapping their head around mosquito borne diseases, here is a short list of the most prominent diseases in terms of the burden of morbidity and mortality from worldwide disease, with a mention of endemic to HICs diseases:

Malaria

• Protist Plasmodium spread by female Anopheles mosquitos
• Spread directly during bites, minority spread through contaminated needles with infected blood and congenital in utero
• Agnostic to most innate risk factors but sickle cell uni-recessive carriers appear to be immune, and external factors are mainly climatic region (living in endemic countries, near equator, international travel), malnutrition, working outdoors especially during evenings, working with animals
• children or elderly are more susceptible
• 90% of malarial deaths occur in Africa south of the Sahara and most are in children under 5
• Testing is recommended after suspected bites or during local outbreaks, through microscopic blood smears or RDTs (expensive but can detect small pieces of malarial parasites), or lab PCR testing (most accurate especially to determine species but highly rare, specialised and very expensive)
• Prevention involves removing stagnant water, pouring oil in wells, reducing malarial breeding, spraying insecticides, barrier nets, remaining indoors and during peak mosquito periods, staying away from hotspots, and more
• Currently no protective individual measures are highly effective, some very expensive chemicals (especially DEET insect repellants) are good external measures but can cause injury to living beings, and anti malarial drugs have questionable protection or cost effectiveness
• Treatment depends on the type of malaria and severity of illness, and is usually artemisinin-based combination therapy (ACT) and are typically used for chloroquine-resistant malaria
• Treatments can not be given preventatively in a cheap or safe way, and have severe side effects, or contribute to resistance if incorrect treatments are given (eg chloroquine phosphates for resistant strains)

Chikungunya

• Found usually in Africa, Americas, Asia, Europe and Indian islands but infected travellers can spread further
• Most common symptoms are fevers and joint pain so can be confused or mistreated as other conditions such as flu
• No medication to treat chikungunya so only prevention to either limit likelihood of being bitten or having vaccinations before travels
• A type of alphavirus (such as Mayaro and Ross River virus), and spreads during bites, and people with high enough levels of virus in their blood (viremia) in the first few days can transmit the virus to new mosquitos that bite them, or spread during blood exchanges such as transfusions, in utero, during organ transplants, through contaminated needles and more
• The virus is not spread through touching, coughing or person to person however many fear campaigns and misinformation around it can cause isolation which further complicates access to care and can be detrimental to the social and emotional wellbeing of infected individuals
• One vaccine (IXCHIQ) is available (mainly in the US for foreign travellers) but is very expensive and not approved for under 18s

Dengue fever

• Of most of these diseases, dengue is the most likely to get better on its own and is usually mild, but in some people can cause severe illness
• Found mainly in tropical areas, but also in Croatia, France, Italy, Spain and Portugal
• Symptoms are once again vague, such as temperature, headache, pain behind the eyes, muscle and joint pain and rash
• Severe dengue can lead to seizures, dehydration, bleeding gums, and death
• Treatment is usually resting and fluids and over the counter painkillers, but anti inflammatories such as NSAIDs (aspirin, ibuprofen) can intensify bleeding
• Dengue is also multiinfective and having dengue previously increases the risk of severe illness at reinfection
• The only prevention is preventing mosquito bites, a vaccine is available but is usually limited to US and UK travellers and is only privately funded

Yellow fever

• Found mainly in Africa, the South and Central America
• Vaccines are much more common but still only readibly available in countries that have robust healthcare access
• Aside from vaccines, the only prevention is avoiding mosquito bites, and symptoms are once again common such as temperature and headache, but can also lead to bleeding from the eyes and mouth, dark pee and jaundice
• Treatment also includes over the counter painkillers and fluids, but yellow fever tends to be quite deadly in young children, those with preexisting liver conditions, and elderly
• Unlike the previous disorders, the vaccine is more available (for a price) and is highly effective and safe for anyone over 9 months old, and recommendations include vaccines at least 10 days before travelling to at risk areas, and revaccination is also safe if past exposure is unknown
• The prophylaxis effect is lifelong, the cost tends to be around £85 which is highly affordable for most travellers, but out of reach for most endemic countries

Eastern Equine Encephalitis

• Found mainly in North America and the Caribbean and is one of the 2 most deadly mosquito-borne diseases in the US, and is closely related to Madariaga virus
• Can circulate between mosquitos and birds that are near freshwater hardwood swamps, some animals (emus) can also become bridge vectors by feeding birds and humans, whilst people (and horses) are ‘dead end’ hosts as they do not spread the virus, even if they get infected. (but one case did have 3 recipients of organ transplants from an infected donor who were infected)
• Prevention also relies on preventing mosquito bites, and no specific treatment exists, only  pain control and hydration to try to reduce meningeal symptoms as supportive measures

West Equine Encephalitis

• Very similar to EEE but most people who get infected don’t get sick, no vaccines or prevention aside from avoiding bites, and tends to cause sporadic outbreaks of disease in horses and people, but risk increases from summer to fall

St Louis Encephalitis

• Very similar to previous diseases, but most people don’t display symptoms, however encephalitis complications and meningitis is common in at risk groups, and no vaccine or prevention aside from avoiding bites exists

West Nile

• 80% of people don’t display symptoms but about 1% develop severe CNS encephalitis and 50% of infections occur in over 60s, about 10% of those who get nervous inflammation pass away
• No specific treatment or vaccine but lifelong immunity is common in healthy individuals after a past infection

Marburg

HEAs

In my eyes, I have not made an effective impact yet in any cause area, especially biosecurity or public health, and yet I think compared to most 18 year olds I have started making choices that will set me up to have an effective career and mindset, plus I have been gaining comm building skills throughout my work.

Next year @Jian Xin Lim🔹 kindly offered for me to take over EABath (when I start uni) and I also help out a bit at Leaf. And it got me thinking

What is the ideal outcome of a HEA? Are all HEAs on the same path? Say someone took on all reasoning, and chose earn to give and donated millions to GiveWell (think similar to FTX without any integrity issues in terms of involvement), if all EAs did that we'd get diminishing returns on the top charities, we'd lose the community, other cause areas may suffer and also it just would feel a bit of an afterthought. And yet would we consider that individual a HEA if his reasoning for all the earning and donation aligned with the 4 tenets and had that idea of helping others effectively?

Compared to someone who maybe is against animal welfare issues. If that person earned to give as a head of factories with poor conditions, they may lower costs and conditions to donate more (let's say purely to donate more) whilst the person concerned with animal welfare who is also an EA may try to do the opposite. So are they both HEAs? Do we have a metric?

Just some rough thoughts swirling around, nothing concrete or important but would love to hear 

Sofya Lebedeva has been so wonderfully kind and helpful and today she suggested changing the plethora of links to a linktree. I was expecting a very difficult set up process and a hefty cost but the lifetime free plan took me 5 min to set up and I'd say it works amazingly to keep it all in one place.

https://linktr.ee/sofiiaf

I would say societies (eg EA uni groups) may benefit, and perhaps even the cost (around £40 a year) to be able to advertise events on Linktree may be helpful.

Commented on an article but expanding to a  (very) quick take:

the absolute rabbit holes I've gotten into from "hmm, I should check about diseases in dogs to keep an eye on" to "wow, mosquito borne diseases are very high" to " oh my goodness, why do I have so many papers saved on impeding the ventral nerves in mosquitos to test blood hunting mechanism inhibitions..." have nearly all converted to genetically engineered mosquitos with Ago2 gene disactivation or susceptibility to infection symptoms. The fears of genetic engineering to evade diseases by almost the flip side of making the vector susceptible strikes me with the same ethical, biological and genetic risks, plus the huge issues with bioweaponory and double use tech.

Seems as if the media stories of non technical nature of 30 mainstream sources (e.g. BBC news, Times, Guardian) from all sides of the spectrum are favourable of genetic engineering to prevent spread but make no mention of the information hazards or dual use. Wonder if that's just journalism doesn't favour nuance but also perhaps maybe some intentional silence....

New podcast episode S1E2 releases soon

on 

WHO, WHAT, WHERE, WHEN, (S)WHY(NE FLU)

THE 5 W'S OF EPIDEMIOLOGY

We look at the basics of what it is, why we use it, and how a case study of H1N1 reveals so many questions yet to be answered