bims-mosdis 2023-07-30 papers

bims-mosdis

Biomed News

on Mosquito distribution and disease

Issue of 2023–07–30
thirteen papers selected by
Richard Halfpenny, Staffordshire University

Resistance of Anopheles stephensi to selected insecticides used for indoor residual spraying and long-lasting insecticidal nets in Ethiopia.
Characterisation of human exposure to nocturnal biting by malaria and arbovirus vectors in a rural community in Chókwè district, southern Mozambique.
Imported and autochthonous dengue in Spain.
Detection of La Crosse Virus In Situ and in Individual Progeny to Assess the Vertical Transmission Potential in Aedes albopictus and Aedes aegypti.
Cryptic Diversity and Demographic Expansion of Plasmodium knowlesi Malaria Vectors in Malaysia.
Analyses of Mosquito Species Composition, Blood-Feeding Habits and Infection with Insect-Specific Flaviviruses in Two Arid, Pastoralist-Dominated Counties in Kenya.
Shotgun Metagenomic Sequencing Reveals Virome Composition of Mosquitoes from a Transition Ecosystem of North-Northeast Brazil.
Travel-Associated Dengue Cases - United States, 2010-2021.
Temporal trends of dengue cases and deaths from 2007 to 2020 in Belo Horizonte, Brazil.
The 2022 West Nile Virus Season in Greece; A Quite Intense Season.
Monitoring the epidemic of West Nile virus in equids in Spain, 2020-2021.
Dengue is breaking records in the Americas - what's behind the surge?
Rapid Epidemic Expansion of Chikungunya Virus East/Central/South African Lineage, Paraguay.

Malar J. 2023 Jul 27. 22(1): 218

Resistance of Anopheles stephensi to selected insecticides used for indoor residual spraying and long-lasting insecticidal nets in Ethiopia.

Abebe Teshome, Berhanu Erko, Lemu Golassa, Gedeon Yohannes, Seth R Irish, Sarah Zohdy, Melissa Yoshimizu, Sisay Dugassa.

   BACKGROUND: Malaria, transmitted by the bite of infective female Anopheles mosquitoes, remains a global public health problem. The presence of invasive Anopheles stephensi, capable of transmitting Plasmodium vivax and Plasmodium falciparum, was first reported in Ethiopia in 2016. The ecology of this mosquito species differs from that of Anopheles arabiensis, the primary malaria vector in Ethiopia. This study aimed to evaluate the efficacy of selected insecticides, which are used in indoor residual spraying (IRS) and selected long-lasting insecticidal nets (LLINs) for malaria vector control against adult An. stephensi.
METHODS: Anopheles stephensi mosquitoes were collected as larvae and pupae from Awash Subah Kilo Town and Haro Adi village, Ethiopia. Adult female An. stephensi, reared from larvae and pupae collected from the field, aged 3-5 days were exposed to impregnated papers of IRS insecticides (propoxur 0.1%, bendiocarb 0.1%, pirimiphos-methyl 0.25%), and insecticides used in LLINs (alpha-cypermethrin 0.05%, deltamethrin 0.05% and permethrin 0.75%), using diagnostic doses and WHO test tubes in a bio-secure insectary at Aklilu Lemma Institute of Pathobiology, Addis Ababa University. For each test and control tube, batches of 25 female An. stephensi were used to test each insecticide used in IRS. Additionally, cone bioassay tests were conducted to expose An. stephensi from the reared population to four brands of LLINs, MAGNet™ (alpha-cypermethrin), PermaNet® 2.0 (deltamethrin), DuraNet© (alpha-cypermethrin) and SafeNet® (alpha-cypermethrin). A batch of ten sugar-fed female mosquitoes aged 2-5 days was exposed to samples taken from five positions/sides of a net. The data from all replicates were pooled and descriptive statistics were used to describe features of the data.
RESULTS: All An. stephensi collected from Awash Subah Kilo Town and Haro Adi village (around Metehara) were resistant to all tested insecticides used in both IRS and LLINs. Of the tested LLINs, only MAGNet™ (alpha-cypermethrin active ingredient) caused 100% knockdown and mortality to An. stephensi at 60 min and 24 h post exposure, while all other net brands caused mortality below the WHO cut-off points (< 90%). All these nets, except SafeNet®, were collected during LLIN distribution for community members through the National Malaria Programme, in December 2020.
CONCLUSIONS: Anopheles stephensi is resistant to all tested insecticides used in IRS and in the tested LLIN brands did not cause mosquito mortality as expected, except MAGNet. This suggests that control of this invasive vector using existing adult malaria vector control methods will likely be inadequate and that alternative strategies may be necessary.

Keywords:  Anopheles stephensi; Indoor residual spraying; Long-lasting insecticidal nets; Malaria; Resistance; Susceptibility; Vector control

DOI:  https://doi.org/10.1186/s12936-023-04649-5
Wellcome Open Res. 2023 ;8 193

Characterisation of human exposure to nocturnal biting by malaria and arbovirus vectors in a rural community in Chókwè district, southern Mozambique.

Ayubo Kampango, João Pinto, Ana Paula Abílio, Elias Machoe, Júlio Matusse, Philip J McCall.

  Background: Understanding the magnitude of human exposure to mosquito biting is fundamental to reduce pathogen transmission. Here we report on a study quantifying the levels of mosquitoes attacking humans throughout the night in a rural area of Southern Mozambique. Methods: Surveys were carried out in Massavasse village, southern Mozambique. The abundance and composition of host-seeking mosquito communities at night were assessed by human-landing catches (HLC) at one-hour intervals. Periods when people were located predominantly outdoors or indoors were used to estimate the amount of residents' exposure to mosquito bites in either location, to explore the potential impact a bed net could have had in reducing biting by each vector species. Results: A total of 69,758 host-seeking female mosquitoes comprising 23 species in four genera were collected. The exposure to biting by virtually all vector species was consistently high outdoors, typically at early evening and morning, with exception of An. gambiae s.l which was likely of biting a person with nearly same intensity indoors and outdoors throughout the night. Bed nets use could have reduced biting by An. gambiae s.l (dominated by An. arabiensis), Ma. africana, Ma. uniformis, Cx. pipiens, Cx. antennatus, and Cx. poicilipes by 53%, 47%, 46%, 38%, 31%, and 28% respectively, compared to non-users. Conversely, a bed net user would have had little protection against An. pharoensis, An. ziemanni, An. tenebrosus, and Cx. tritaeniorhynchus biting exposures. Conclusions: This study showed that Massavasse residents were exposed to high levels of outdoor biting by malaria and arbovirus vectors that abound in the village. The findings help to identify entomological drivers of persistent malaria transmission in Mozambique and identify a wide range of arbovirus vectors nocturnally active in rural areas, many with outbreak potential. The study highlights the need for a surveillance system for monitoring arboviral diseases vectors in Mozambique.

Keywords:  Malaria; Massavasse village; Mozambique; arboviruses; endophily; exophagy; man-biting exposure; mosquito vectors

DOI:  https://doi.org/10.12688/wellcomeopenres.19278.1
Rev Clin Esp (Barc). 2023 Jul 26. pii: S2254-8874(23)00093-0. [Epub ahead of print]

Imported and autochthonous dengue in Spain.

J-M Herrero-Martínez, M Sánchez-Ledesma, J-M Ramos-Rincón.

  Dengue is globally the most important arboviral infection. It is caused by the dengue virus and it is generally transmitted by Aedes mosquitoes' bites (Ae aegypti or Ae albopictus). In Spain it was initially eradicated in the 20th century, together with the Ae aegypti vector, and currently most of the cases reported in Spain are imported by travelers from countries with dengue transmission (imported dengue). However, in recent years, cases of dengue have been described in people residing in Spain who had not traveled to areas with known transmission (autochthonous dengue), transmitted by Aedes albopictus (the so-called tiger mosquito), present especially in the Mediterranean basin. Therefore, a good knowledge of this potentially severe disease is required, so that it can be diagnosed early, and managed correctly, thus reducing its mortality, as well as its eventual autochthonous transmission.

Keywords:  Dengue; autochthonous dengue; clinical; dengue autóctono; dengue importado; diagnosis; diagnóstico; epidemiology; epidemiología; imported dengue; manifestaciones clínicas

DOI:  https://doi.org/10.1016/j.rceng.2023.07.007
Insects. 2023 Jul 03. pii: 601. [Epub ahead of print]14(7):

Detection of La Crosse Virus In Situ and in Individual Progeny to Assess the Vertical Transmission Potential in Aedes albopictus and Aedes aegypti.

Christie S Darby, Kyah M Featherston, Jingyi Lin, Alexander W E Franz.

  La Crosse virus (LACV) is circulating in the midwestern and southeastern states of the United States and can cause human encephalitis. The main vector of the virus is the eastern tree-hole mosquito, Aedes triseriatus. Ae. albopictus has been also described as a natural LACV vector, while Ae. aegypti has been infected with the virus under laboratory conditions. Here, we compare the vertical transmission potential of LACV in Ae. albopictus and Ae. aegypti, with emphasis given to the ovarian infection patterns that the virus generates in both species. Both mosquito species received artificial bloodmeals containing LACV. At defined time points post-infection/bloodmeal, midguts, head tissue, and ovaries were analyzed for the presence of virus. Viral infection patterns in the ovaries were visualized via immunofluorescence confocal microscopy and immunohistopathology assays using an LACV-specific monoclonal antibody. In Ae. aegypti, LACV was confronted with midgut infection and escape barriers, which were much less pronounced in Ae. albopictus, resulting in a significantly higher prevalence of infection in the latter. Following the ingestion of a single virus-containing bloodmeal, no progeny larvae were found to be virus-infected. Regardless, females of both species showed the presence of LACV antigen in their ovariole sheaths. Furthermore, in a single Ae. albopictus female, viral antigen was associated with the nurse cells inside the primary follicles. Following the ingestion of a second non-infectious bloodmeal at 7- or 10-days post-ingestion of an LACV-containing bloodmeal, more progeny larvae of Ae. albopictus than of Ae. aegypti were virus-infected. LACV antigen was detected in the egg chambers and ovariole sheaths of both mosquito species. Traces of viral antigen were also detected in a few oocytes from Ae. albopictus. The low level of vertical transmission and the majority of the ovarian infection patterns suggested the transovum rather than transovarial transmission (TOT) of the virus in both vector species. However, based on the detection of LACV antigen in follicular tissue and oocytes, there was the potential for TOT among several Ae. albopictus females. Thus, TOT is not a general feature of LACV infection in mosquitoes. Instead, the TOT of LACV seems to be dependent on its particular interaction with the reproductive tissues of a female.

Keywords:  Aedes aegypti; Aedes albopictus; La Crosse virus; bloodmeal; follicle; nurse cell; ovary; oviposition; progeny; vector competence; vertical transmission

DOI:  https://doi.org/10.3390/insects14070601
Genes (Basel). 2023 Jun 28. pii: 1369. [Epub ahead of print]14(7):

Cryptic Diversity and Demographic Expansion of Plasmodium knowlesi Malaria Vectors in Malaysia.

Sandthya Pramasivan, Van Lun Low, Nantha Kumar Jeyaprakasam, Jonathan Wee Kent Liew, Romano Ngui, Indra Vythilingam.

  Although Malaysia is considered free of human malaria, there has been a growing number of Plasmodium knowlesi cases. This alarming trend highlighted the need for our understanding of this parasite and its associated vectors, especially considering the role of genetic diversity in the adaptation and evolution among vectors in endemic areas, which is currently a significant knowledge gap in their fundamental biology. Thus, this study aimed to investigate the genetic diversity of Anopheles balabacensis, Anopheles cracens, Anopheles introlatus, and Anopheles latens-the vectors for P. knowlesi malaria in Malaysia. Based on cytochrome c oxidase 1 (CO1) and internal transcribed spacer 2 (ITS2) markers, the genealogic networks of An. latens showed a separation of the haplotypes between Peninsular Malaysia and Malaysia Borneo, forming two distinct clusters. Additionally, the genetic distances between these clusters were high (2.3-5.2% for CO1) and (2.3-4.7% for ITS2), indicating the likely presence of two distinct species or cryptic species within An. latens. In contrast, no distinct clusters were observed in An. cracens, An. balabacensis, or An. introlatus, implying a lack of pronounced genetic differentiation among their populations. It is worth noting that there were varying levels of polymorphism observed across the different subpopulations, highlighting some levels of genetic variation within these mosquito species. Nevertheless, further analyses revealed that all four species have undergone demographic expansion, suggesting population growth and potential range expansion for these vectors in this region.

Keywords:  Anopheles; Malaysia; Plasmodium knowlesi; genetic diversity; mosquitoes

DOI:  https://doi.org/10.3390/genes14071369
Pathogens. 2023 Jul 24. pii: 967. [Epub ahead of print]12(7):

Analyses of Mosquito Species Composition, Blood-Feeding Habits and Infection with Insect-Specific Flaviviruses in Two Arid, Pastoralist-Dominated Counties in Kenya.

Edwin O Ogola, Armanda D S Bastos, Gilbert Rotich, Anne Kopp, Inga Slothouwer, Dorcus C A Omoga, Rosemary Sang, Baldwyn Torto, Sandra Junglen, David P Tchouassi.

  Insect-specific flaviviruses (ISFs), although not known to be pathogenic to humans and animals, can modulate the transmission of arboviruses by mosquitoes. In this study, we screened 6665 host-seeking, gravid and blood-fed mosquitoes for infection with flaviviruses and assessed the vertebrate hosts of the blood-fed mosquitoes sampled in Baringo and Kajiado counties; both dryland ecosystem counties in the Kenyan Rift Valley. Sequence fragments of two ISFs were detected. Cuacua virus (CuCuV) was found in three blood-fed Mansonia (Ma.) africana. The genome was sequenced by next-generation sequencing (NGS), confirming 95.8% nucleotide sequence identity to CuCuV detected in Mansonia sp. in Mozambique. Sequence fragments of a potential novel ISF showing nucleotide identity of 72% to Aedes flavivirus virus were detected in individual blood-fed Aedes aegypti, Anopheles gambiae s.l., Ma. africana and Culex (Cx.) univittatus, all having fed on human blood. Blood-meal analysis revealed that the collected mosquitoes fed on diverse hosts, primarily humans and livestock, with a minor representation of wild mammals, amphibians and birds. The potential impact of the detected ISFs on arbovirus transmission requires further research.

Keywords:  CuaCua virus; Flavivirus; Kenya; arbovirus surveillance; blood-fed; mosquitoes

DOI:  https://doi.org/10.3390/pathogens12070967
Genes (Basel). 2023 Jul 14. pii: 1443. [Epub ahead of print]14(7):

Shotgun Metagenomic Sequencing Reveals Virome Composition of Mosquitoes from a Transition Ecosystem of North-Northeast Brazil.

Carine Fortes Aragão, Sandro Patroca da Silva, Bruna Laís Sena do Nascimento, Fábio Silva da Silva, Joaquim Pinto Nunes Neto, Valéria Cristina Soares Pinheiro, Ana Cecília Ribeiro Cruz.

  A wide diversity of pathogenic mosquito-borne viruses circulate in the Brazilian Amazon, and the intense deforestation can contribute to the spread of these viruses. In this context, this study aimed to investigate the viral diversity in mosquitoes of the genera Aedes, Culex, Haemagogus, and Sabethes from a transition area between the Amazon, Cerrado, and Caatinga biomes in Brazil. Metagenomic high-throughput sequencing was used to characterize the virome of 20 mosquito pools. A total of 15 virus-like genomes were identified, comprising species genomically close to insect-specific viruses of the families Iflaviridae, Metaviridae, Lispiviridae, Rhabdoviridae, Xinmoviridae, and Parvoviridae and species of plant viruses of the families Solemoviridae, Virgaviridae, and Partitiviridae. However, sequences of viruses associated with human and animal diseases were not detected. Most of the recovered genomes were divergent from those previously described. These findings reveal that there are a large number of unknown viruses to be explored in the middle-north of Brazil.

Keywords:  Culicidae; metagenomic; metavirome; next-generation sequencing; viruses

DOI:  https://doi.org/10.3390/genes14071443
MMWR Morb Mortal Wkly Rep. 2023 Jul 28. 72(30): 821-826

Travel-Associated Dengue Cases - United States, 2010-2021.

Joshua M Wong, Aidsa Rivera, Hannah R Volkman, Brenda Torres-Velasquez, Dania M Rodriguez, Gabriela Paz-Bailey, Laura E Adams.

Dengue, the leading cause of arboviral disease worldwide, can be fatal without appropriate treatment. Among 7,528 confirmed or probable travel-associated U.S. dengue cases reported during 2010-2021, one in five (1,474, 20%) was reported in 2019. This is 168% higher than the annual average number of cases reported during 2010-2018 and 2020-2021 (approximately 550 per year) and 61% higher than the 913 cases reported in 2016, the second highest year on record. The number of cases as a fraction of air traffic volume to international destinations outside North America or Europe was also highest in 2019, with 41.9 cases per million trips, compared with 21.0 per million in other years during 2010-2021. This report compares the number and characteristics of travel-associated dengue cases reported to national surveillance in the United States in 2019 with cases reported during 2010-2018 and 2020-2021. Areas with conditions suitable for dengue transmission as well as the population at risk for dengue are expected to increase, placing U.S. travelers at higher risk for infection. Health care providers should be aware that dengue is a common cause of fever in the returning traveler and be familiar with its signs and symptoms, testing, and management. Dengue vaccines are not currently recommended for U.S. travelers; therefore, persons should review areas of dengue risk and follow guidance for preventing mosquito bites.

DOI: https://doi.org/10.15585/mmwr.mm7230a3
Int J Environ Health Res. 2023 Jul 24. 1-16

Temporal trends of dengue cases and deaths from 2007 to 2020 in Belo Horizonte, Brazil.

Maria da Consolação Magalhães Cunha, Bianca Conrad Bohm, Maria Helena Franco Morais, Natalia Bruna Dias Campos, Olivia Lang Schultes, Nádia Pereira Campos Bruhn, Fabio Raphael Pascoti Bruhn, Waleska Teixeira Caiaffa.

  Dengue, a disease with multifactorial determinants, is linked to population susceptibility to circulating viruses and the extent of vector infestation. This study aimed to analyze the temporal trends of dengue cases and deaths in Belo Horizonte, Minas Gerais, Brazil, from 2007 to 2020. Data from the Notifiable Diseases Information System (Sinan) were utilized for the investigation. To assess the disease's progression over the study period and predict its future incidence, time series analyses were conducted using a generalized additive model (GAM) and a seasonal autoregressive integrated moving average (SARIMA) model. Over the study period, a total of 463,566 dengue cases and 125 deaths were reported. Notably, there was an increase in severe cases and deaths, marking hyperendemics characterized by simultaneous virus circulation (79.17% in 2016-50% in 2019). The generalized additive model revealed a non-linear pattern with epidemic peaks in 2010, 2013, 2016, and 2019, indicating an explosive pattern of dengue incidence. The SARIMA (3,1,1) (0,0,0)12 model was validated for each year (2015 to 2019). Comparing the actual and predicted numbers of dengue cases, the model demonstrated its effectiveness for predicting cases in the municipality. The rising number of dengue cases emphasizes the importance of vector surveillance and control. Enhanced models and predictions by local health services will aid in anticipating necessary control measures to combat future epidemics.

Keywords:  arbovirus; epidemic; prediction; time-series; vulnerability

DOI:  https://doi.org/10.1080/09603123.2023.2237420
Viruses. 2023 Jun 29. pii: 1481. [Epub ahead of print]15(7):

The 2022 West Nile Virus Season in Greece; A Quite Intense Season.

Danai Pervanidou, Chrysovaladou Niki Kefaloudi, Anna Vakali, Ourania Tsakalidou, Myrsini Karatheodorou, Katerina Tsioka, Maria Evangelidou, Kassiani Mellou, Styliani Pappa, Konstantina Stoikou, Vasiliki Bakaloudi, George Koliopoulos, Kostas Stamoulis, Eleni Patsoula, Constantina Politis, Christos Hadjichristodoulou, Anna Papa.

  Since 2010, the West Nile virus (WNV) has been established in Greece. We describe the epidemiology of diagnosed human WNV infections in Greece with a focus on the 2022 season. During the transmission period, clinicians were sending samples from suspected cases for testing. Active laboratory-based surveillance was performed with immediate notification of diagnosed cases. We collected clinical information and interviewed patients on a timely basis to identify their place of exposure. Besides serological and molecular diagnostic methods, next-generation sequencing was also performed. In 2022, 286 cases of WNV infection were diagnosed, including 278 symptomatic cases and 184 (64%) cases with neuroinvasive disease (WNND); 33 patients died. This was the third most intense season concerning the number of WNND cases, following 2018 and 2010. Most (96%) cases were recorded in two regions, in northern and central Greece. The virus strain was a variant of previous years, clustering into the Central European subclade of WNV lineage 2. The 2022 WNV season was quite intense in Greece. The prompt diagnosis and investigation of cases are considered pivotal for the timely response, while the availability of whole genome sequences enables studies on the molecular epidemiology of the disease.

Keywords:  Greece; West Nile virus; mosquito-borne disease; vector-borne disease

DOI:  https://doi.org/10.3390/v15071481
Prev Vet Med. 2023 Jul 13. pii: S0167-5877(23)00139-3. [Epub ahead of print]217 105975

Monitoring the epidemic of West Nile virus in equids in Spain, 2020-2021.

Moisés Gonzálvez, Juan J Franco, Jesús Barbero-Moyano, Javier Caballero-Gómez, María J Ruano, Remigio Martínez, David Cano-Terriza, Ignacio García-Bocanegra.

  The largest epidemic of West Nile virus (WNV) reported ever in Spain in both humans and equines occurred in 2020, affecting 77 humans and 139 equine herds. Here, we aimed to monitor the outbreaks detected in equid herds in Andalusia (southern Spain), the Spanish region where 89.9% of the outbreaks were reported, and to evaluate the virus circulation and risk factor associated with WNV exposure in the affected herds. The first WNV case was detected in mid-July 2020, the number of outbreaks peaked in mid-August and the last one was confirmed on 26th October 2020. WNV lineage 1 was detected in 12 clinically affected horses using real time RT-PCR. Molecular analysis evidenced high nucleotide identity with WNV sequences obtained from humans, birds and mosquitoes from Spain and Italy between 2020 and 2022. Between five and eight months after the WNV epidemic, a total of 724 equids (including 485 unvaccinated and 239 vaccinated animals) from 113 of the 125 affected herds in Andalusia were sampled. IgM and IgG antibodies against WNV were detected in 1.6% (8/485; 95%IC: 0.0-2.5) and 61.9% (300/485; 95%IC: 58.3-65.5) of the unvaccinated individuals, respectively. The seropositivity in vaccinated horses was 86.6% (207/239). The main risk factors associated with WNV exposure in unvaccinated equids were the breed (crossbreed), the location of animals in spring-summer (outside), and the presence of natural water ponds close to the surveyed herds. The high individual seroprevalence obtained in the affected herds indicates that WNV circulation was more widespread than the reported by passive surveillance during the WNV epidemic in 2020. The re-emergence of WNV in 2020 in southern Spain evidenced the needed to improve integrated surveillance systems, minimizing the impact of future cases in equids and humans in high-risk areas.

Keywords:  Arbovirus; Equines; Flavivirus; Outbreak; Risk factors; Zoonoses

DOI:  https://doi.org/10.1016/j.prevetmed.2023.105975
Nature. 2023 Jul 27.

Dengue is breaking records in the Americas - what's behind the surge?

Mariana Lenharo.



Keywords:  Diseases; Public health

DOI:  https://doi.org/10.1038/d41586-023-02423-w
Emerg Infect Dis. 2023 Jul 24. 29(9):

Rapid Epidemic Expansion of Chikungunya Virus East/Central/South African Lineage, Paraguay.

Marta Giovanetti, Cynthia Vazquez, Mauricio Lima, Emerson Castro, Analia Rojas, Andrea Gomez de la Fuente, Carolina Aquino, Cesar Cantero, Fatima Fleitas, Juan Torales, Julio Barrios, Maria J Ortega, Maria L Gamarra, Shirley Villalba, Tania Alfonzo, Joilson Xavier, Talita Adelino, Hegger Fritsch, Felipe C M Iani, Glauco C Pereira, Carla de Oliveira, Gabriel Schuab, Evandra S Rodrigues, Simone Kashima, Juliana Leite, Lionel Gresh, Leticia Franco, Houriiyah Tegally, Wesley C Van Voorhis, Richard Lessels, Ana Maria Bispo de Filippis, Andrea Ojeda, Guillermo Sequera, Romeo Montoya, Edward C Holmes, Tulio de Oliveira, Jairo M Rico, José Lourenço, Vagner Fonseca, Luiz C J Alcantara.

  The spread of Chikungunya virus is a major public health concern in the Americas. There were >120,000 cases and 51 deaths in 2023, of which 46 occurred in Paraguay. Using a suite of genomic, phylodynamic, and epidemiologic techniques, we characterized the ongoing large chikungunya epidemic in Paraguay.

Keywords:  ECSA lineage; East/Central/South African lineage; Paraguay; chikungunya virus; genomic monitoring; meningitis/encephalitis; rapid epidemic expansion; vector-borne infections; viruses

DOI:  https://doi.org/10.3201/eid2909.230523