Aedes albopictus AS A VECTOR OF ARBOVIRUSES IN BRAZIL: A CHALLENGE FOR PRIMARY HEALTH CARE

Abstract

The control of vector-transmitted diseases in Brazil is dependent upon a range of health surveillance, primary health care and social mobilization strategies. As the point of entry for the public health system, primary health care services are considered key for the efficient and effective control of these events. The Aedes albopictus mosquito represents a potential vector for several infectious processes. Despite the fact that Ae. albopictus is present throughout the world, it has not yet been systematically addressed within national disease control programs. The objectives of this study are to describe the potential of Ae. albopictus as a vector of arboviruses in Brazil through a review of the literature and to analyze risks within the current context. Further, the authors seek to contribute to a wider discussion of this subject among the spectrum of services offered in the primary care network. The first known record of the mosquito in Brazil is dated to 1986, most likely the result of passive introduction from maritime commerce. This vector presents significant ecological valence given that it is a potential transmitter of 22 arboviruses, which makes its introduction an epidemiologically significant event. Ae. albopictus is also an experimental vector of seven alphaviruses: Eastern equine encephalitis, Mayaro, Western equine encephalitis, Venezuelan equine encephalitis, Chikungunya, Ross River and Sinbidis; in addition to the diseases caused by flavivirus such as Dengue fever, Japanese encephalitis fever, West Nile fever and Yellow Fever. Due to its considerable ecological valence, easily adapting to rural, urban and peri-urban environments, it is presumed that Ae. albopictus could serve as a bridge between the urban and sylvan cycles of yellow fever. Other diseases such as Oropouche fever, lymphatic filariasis and human infections with Keystone, Tensaw, Cache Valley and Potosi viruses might eventually be transmitted by the mosquito. The population of Ae. albopictus present in Brazil has demonstrated the capacity to transmit dengue, yellow fever and Venezuelan equine encephalitis viruses under laboratory conditions. The study concludes that Ae. albopictus is a potential vector for several arboviruses that need to be incorporated into the national disease control programs. Specific vector control initiatives should be considered using a multisectoral approach that involves health surveillance working in conjunction with primary health care.