OJPHI: Vol. 5
Journal Information
Journal ID (publisher-id): OJPHI
ISSN: 1947-2579
Publisher: University of Illinois at Chicago Library
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©2013 the author(s)
open-access: This is an Open Access article. Authors own copyright of their articles appearing in the Online Journal of Public Health Informatics. Readers may copy articles without permission of the copyright owner(s), as long as the author and OJPHI are acknowledged in the copy and the copy is used for educational, not-for-profit purposes.
Electronic publication date: Day: 4 Month: 4 Year: 2013
collection publication date: Year: 2013
Volume: 5E-location ID: e4
Publisher Id: ojphi-05-4

Enhancing Surveillance for Arboviral Infections in the Arizona Border Region
Orion McCotter*1
Frank Vanskike12
Kacey Ernst2
Ken Komatsu3
Harold Margolis4
Stephen Waterman5
Laura Tippit1
Kay Tomashek4
Anne Wertheimer2
Sonia Montiel5
Catherine Golenko1
Elizabeth Hunsperger4
1Arizona Department of Health Services, Office of Border Health, Tucson, AZ, USA;
2University of Arizona, Mel and Enid Zuckerman College of Public Health, Tucson, AZ, USA;
3Arizona Department of Health Services, Phoenix, AZ, USA;
4Centers for Disease Control and Prevention, Division of Vector-Borne Diseases, Dengue Branch, San Juan, Puerto Rico;
5Centers for Disease Control and Prevention, Division of Global Migration and Quarantine, U.S. - Mexico Unit, San Diego, CA, USA
*Orion McCotter, E-mail: Orion.McCotter@azdhs.gov


To enhance arboviral surveillance and laboratory capacity to establish a surveillance baseline for the emerging threat of Dengue fever in the Arizona-Mexico border region.


West Nile Virus (WNV) and dengue virus (DENV) are both arboviruses which are transmitted to humans by an infected mosquito bite during blood-meal feeding. The clinical presentations of non-neuroinvasive WNV and dengue fever are similar, and symptoms may include acute onset of high fever, headache, myalgia, arthralgia, nausea, vomiting, and often a maculopapular rash. More serious manifestations of these viruses include fatal encephalitis and meningitis in WNV patients and fatal hemorrhagic disease in dengue patients. Over the last decade, WNV has spread rapidly across North America, reaching Arizona in 2004, and has become a significant cause of human illness since that time. Even though dengue has been described as primarily a disease of the tropics and sub-tropical areas, there is a small but significant risk for dengue outbreaks in the continental United States as evidenced by surveillance efforts in Texas that identified local dengue transmission in 2005. In recent years, outbreaks of dengue have occurred in Mexico border states, most notably Sonora in 2010. That same year, Arizona had the highest incidence of WNV cases in the U.S. including number of neuroinvasive disease cases, total cases, and number of deaths per state. The emergence of DENV and WNV as important public health problems maybe have been due to non-effective mosquito control, global demographic changes (urbanization and population growth), increased air travel, and inadequate surveillance.


Vector mapping: Mapping techniques will be utilized to visually depict Aedes aegypti populations captured from previous seasonal public health environmental vector trapping programs.

Laboratory capacity: Multi-state laboratory training by CDC Dengue Branch was held in October 2012.

Surveillance: The WNV cases that present to medical services for WNV testing and reported to public health officials are the most severe nueroinvasive cases. Much less is understood about the non-neuroinvasive cases with often present with non-descript symptoms.


Vector mapping: Comparative densities of Ae. aegypti with academic partners of the Entomology and Public Health conducting a study capturing Ae. aegypti may help to enhance environmental programs.

Laboratory Capacity: The laboratory training will cover conventional serological methods as well as recently FDA cleared molecular RT-PCR. Participants will include public health laboratory personnel working in molecular and serology diagnostics and other binational partners.

Surveillance: A convenient seroprevalence study at sentinel-hospital site of symptomatic patients presenting in Arizona border hospital sites will be performed to better understand circulating levels of arboviral infections.


Appropriate and timely response to surveillance data is the key to identification human and animal disease associated with WNV, DENV, and other arboviruses. The mosquito vector Ae. aegypti is well established widespread and thriving in Arizona yet there is no autochthonous transmission of DENV identified to date. The results from this study will identify gaps and potential prevention and control measures for emerging infectious diseases including WNV and DENV in Arizona.


US-Mexico Border States, Local Health Departments, Sonora Secretariat de Salud, Arizona State Public Health Laboratory.

Hayden MH. Microclimate and human factors in the divergent ecology of Aedes aegypti along the Arizona, U.S./Sonora, MX borderEcohealth 2010;7(1):64–77.
Walker KR. Human and environmental factors affecting Aedes aegypti distribution in an arid urban environmentJ Am Mosq Control Assoc 2011;27(2):135–41.
Hoeck PA. Population and parity levels of Aedes aegypti collected in TucsonJ Vector Ecol 2003;28(1):65–73.
Botz JT. Survey of Aedes aegypti eggs in and around homes in Tucson, ArizonaJ Am Mosq Control Assoc 2002;18(1):63–4.
Fink TM. Aedes aegypti in Tucson, ArizonaEmerg Infect Dis 1998;4(4):703–4.
Engelthaler DM. The reemergence of Aedes aegypti in ArizonaEmerg Infect Dis 1997;3(2):241–2.

Article Categories:
  • ISDS 2012 Conference Abstracts

Keywords: Dengue, Surveillance, Emerging infections, Dengue fever, Arboviral.

Online Journal of Public Health Informatics * ISSN 1947-2579 * http://ojphi.org