A sticky situation: the unexpected stability of malaria elimination

Malaria eradication involves eliminating malaria from every country where transmission occurs. Current theory suggests that the post-elimination challenges of remaining malaria-free by stopping transmission from imported malaria will have onerous operational and financial requirements. Although resurgent malaria has occurred in a majority of countries that tried but failed to eliminate malaria, a review of resurgence in countries that successfully eliminated finds only four such failures out of 50 successful programmes. Data documenting malaria importation and onwards transmission in these countries suggests malaria transmission potential has declined by more than 50-fold (i.e. more than 98%) since before elimination. These outcomes suggest that elimination is a surprisingly stable state. Elimination''s ‘stickiness’ must be explained either by eliminating countries starting off qualitatively different from non-eliminating countries or becoming different once elimination was achieved. Countries that successfully eliminated were wealthier and had lower baseline endemicity than those that were unsuccessful, but our analysis shows that those same variables were at best incomplete predictors of the patterns of resurgence. Stability is reinforced by the loss of immunity to disease and by the health system''s increasing capacity to control malaria transmission after elimination through routine treatment of cases with antimalarial drugs supplemented by malaria outbreak control. Human travel patterns reinforce these patterns; as malaria recedes, fewer people carry malaria from remote endemic areas to remote areas where transmission potential remains high. Establishment of an international resource with backup capacity to control large outbreaks can make elimination stickier, increase the incentives for countries to eliminate, and ensure steady progress towards global eradication. Although available evidence supports malaria elimination''s stickiness at moderate-to-low transmission in areas with well-developed health systems, it is not yet clear if such patterns will hold in all areas. The sticky endpoint changes the projected costs of maintaining elimination and makes it substantially more attractive for countries acting alone, and it makes spatially progressive elimination a sensible strategy for a malaria eradication endgame.     

Quantifying the Impact of Expanded Age Group Campaigns for Polio Eradication

A priority of the Global Polio Eradication Initiative (GPEI) 2013–2018 strategic plan is to evaluate the potential impact on polio eradication resulting from expanding one or more Supplementary Immunization Activities (SIAs) to children beyond age five-years in polio endemic countries. It has been hypothesized that such expanded age group (EAG) campaigns could accelerate polio eradication by eliminating immunity gaps in older children that may have resulted from past periods of low vaccination coverage. Using an individual-based mathematical model, we quantified the impact of EAG campaigns in terms of probability of elimination, reduction in polio transmission and age stratified immunity levels. The model was specifically calibrated to seroprevalence data from a polio-endemic region: Zaria, Nigeria. We compared the impact of EAG campaigns, which depend only on age, to more targeted interventions which focus on reaching missed populations. We found that EAG campaigns would not significantly improve prospects for polio eradication; the probability of elimination increased by 8% (from 24% at baseline to 32%) when expanding three annual SIAs to 5–14 year old children and by 18% when expanding all six annual SIAs. In contrast, expanding only two of the annual SIAs to target hard-to-reach populations at modest vaccination coverage—representing less than one tenth of additional vaccinations required for the six SIA EAG scenario—increased the probability of elimination by 55%. Implementation of EAG campaigns in polio endemic regions would not improve prospects for eradication. In endemic areas, vaccination campaigns which do not target missed populations will not benefit polio eradication efforts.     

Pandemic potential of poxviruses: From an ancient killer causing smallpox to the surge of monkeypox

Smallpox caused by the variola virus (VARV) was one of the greatest infectious killers of mankind. Historical records trace back smallpox for at least a millennium while phylogenetic analysis dated the ancestor of VARV circulating in the 20th century into the 19th century. The discrepancy was solved by the detection of distinct VARV sequences first in 17th-century mummies and then in human skeletons dated to the 7th century. The historical records noted marked variability in VARV virulence which scientists tentatively associated with gene losses occurring when broad-host poxviruses narrow their host range to a single host. VARV split from camel and gerbil poxviruses and had no animal reservoir, a prerequisite for its eradication led by WHO. The search for residual pockets of VARV led to the discovery of the monkeypox virus (MPXV); followed by the detection of endemic smallpox-like monkeypox (mpox) disease in Africa. Mpox is caused by less virulent clade 2 MPXV in West Africa and more virulent clade 1 MPXV in Central Africa. Exported clade 2 mpox cases associated with the pet animal trade were observed in 2003 in the USA. In 2022 a world-wide mpox epidemic infecting more than 80,000 people was noted, peaking in August 2022 although waning rapidly. The cases displayed particular epidemiological characteristics affecting nearly exclusively young men having sex with men (MSM). In contrast, mpox in Africa mostly affects children by non-sexual transmission routes possibly from uncharacterized animal reservoirs. While African children show a classical smallpox picture, MSM mpox cases show few mostly anogenital lesions, low-hospitalization rates and 140 fatal cases worldwide. MPXV strains from North America and Europe are closely related, derived from clade 2 African MPXV. Distinct transmission mechanisms are more likely causes for the epidemiological and clinical differences between endemic African cases and the 2022 epidemic cases than viral traits.     

Differential population responses of native and alien rodents to an invasive predator,habitat alteration and plant masting

Invasive species and anthropogenic habitat alteration are major drivers of biodiversity loss. When multiple invasive species occupy different trophic levels, removing an invasive predator might cause unexpected outcomes owing to complex interactions among native and non-native prey. Moreover, external factors such as habitat alteration and resource availability can affect such dynamics. We hypothesized that native and non-native prey respond differently to an invasive predator, habitat alteration and bottom-up effects. To test the hypothesis, we used Bayesian state-space modelling to analyse 8-year data on the spatio-temporal patterns of two endemic rat species and the non-native black rat in response to the continual removal of the invasive small Indian mongoose on Amami Island, Japan. Despite low reproductive potentials, the endemic rats recovered better after mongoose removal than did the black rat. The endemic species appeared to be vulnerable to predation by mongooses, whose eradication increased the abundances of the endemic rats, but not of the black rat. Habitat alteration increased the black rat''s carrying capacity, but decreased those of the endemic species. We propose that spatio-temporal monitoring data from eradication programmes will clarify the underlying ecological impacts of land-use change and invasive species, and will be useful for future habitat management.     

Review article: The catastrophic impact of invasive mammalian predators on birds of the UK Overseas Territories: a review and synthesis

The UK has sovereignty over 16 Overseas Territories, which hold some of the world’s great seabird colonies and collectively support more endemic and globally threatened bird species than the whole of mainland Europe. Invasive alien mammalian predators have spread throughout most of the Territories, primarily since European expansion in the 16th century. Here we review and synthesize the scale of their impacts, historical and current, actions to reduce and reverse these impacts, and priorities for conservation. Mammalian predators have caused a catastrophic wave of extinctions and reductions in seabird colony size that mark the UKOTs as a major centre of global extinction. Mammal‐induced declines of threatened endemics and seabird colonies continue, with four Critically Endangered endemics on Gough Island (Tristan da Cunha), St Helena and Montserrat directly threatened by invasive alien House Mice Mus musculus, Feral Cats Felis catus and rats Rattus spp. Action to reduce these threats and restore islands has been modest in comparison with other developed countries, although some notable successes have occurred and a large number of ambitious eradication and conservation plans are in preparation. Priority islands for conservation action against mammalian predators include Gough (which according to one published prioritization scheme is the highest‐ranked island in the world for mammal eradication), St Helena and Montserrat, but also on Tristan da Cunha, Pitcairn and the Falkland Islands. Technical, financial and political will is required to push forward and fund the eradication of invasive mammalian predators on these islands, which would significantly reduce extinction risk for a number of globally threatened species.     

Control,Elimination, and Eradication of River Blindness: Scenarios,Timelines, and Ivermectin Treatment Needs in Africa

River blindness (onchocerciasis) causes severe itching, skin lesions, and vision impairment including blindness. More than 99% of all current cases are found in sub-Saharan Africa. Fortunately, vector control and community-directed treatment with ivermectin have significantly reduced morbidity. Studies in Mali and Senegal proved the feasibility of elimination with ivermectin administration. The treatment goal is shifting from control to elimination in endemic African regions. Given limited resources, national and global policymakers need a rigorous analysis comparing investment options. For this, we developed scenarios for alternative treatment goals and compared treatment timelines and drug needs between the scenarios. Control, elimination, and eradication scenarios were developed with reference to current standard practices, large-scale studies, and historical data. For each scenario, the timeline when treatment is expected to stop at country level was predicted using a dynamical transmission model, and ivermectin treatment needs were predicted based on population in endemic areas, treatment coverage data, and the frequency of community-directed treatment. The control scenario requires community-directed treatment with ivermectin beyond 2045 with around 2.63 billion treatments over 2013–2045; the elimination scenario, until 2028 in areas where feasible, but beyond 2045 in countries with operational challenges, around 1.15 billion treatments; and the eradication scenario, lasting until 2040, around 1.30 billion treatments. The eradication scenario is the most favorable in terms of the timeline of the intervention phase and treatment needs. For its realization, strong health systems and political will are required to overcome epidemiological and political challenges.     

Spread of disease with transport-related infection and entry screening

An SIQS model is proposed to study the effect of transport-related infection and entry screening. If the basic reproduction number is below unity, the disease free equilibrium is locally asymptotically stable. There exists an endemic equilibrium which is locally asymptotically stable if the reproduction number is larger than unity. It is shown that the disease is endemic in the sense of permanence if and only if the endemic equilibrium exists. Entry screening is shown to be helpful for disease eradication since it can always have the possibility to eradicate the disease led by transport-related infection and furthermore have the possibility to eradicate disease even when the disease is endemic in both isolated cities.     

Circulating Vaccine Derived Polio Viruses and their Impact on Global Polio Eradication

Poliomyelitis vaccination via live Oral Polio Vaccine (OPV) suffers from the inherent problem of reversion: the vaccine may, upon replication in the human gut, mutate back to virulence and transmissibility resulting in circulating vaccine derived polio viruses (cVDPVs). We formulate a general mathematical model to assess the impact of cVDPVs on prospects for polio eradication. We find that for OPV coverage levels below a certain threshold, cVDPVs have a small impact in comparison to the expected endemic level of the disease in the absence of reversion. Above this threshold, the model predicts a small but significant endemic level of the disease, even where standard models predict eradication. In light of this, we consider and analyze three alternative eradication strategies involving a transition from continuous OPV vaccination to either continuous Inactivated Polio Vaccine (IPV), pulsed OPV vaccination, or a one-time IPV pulse vaccination. Stochastic modeling shows continuous IPV vaccination is effective at achieving eradication for moderate coverage levels, while pulsed OPV is effective if higher coverage levels are maintained. The one-time pulse IPV method may also be a viable strategy, especially in terms of the number of vaccinations required and time to eradication, provided that a sufficiently large pulse is practically feasible. More investigation is needed regarding the frequency of revertant virus infection resulting directly from vaccination, the ability of IPV to induce gut immunity, and the potential role of spatial transmission dynamics in eradication efforts. B.G. Wagner’s research is supported by the Natural Sciences and Engineering Research Council of Canada (NSERC) Doctoral Scholarship. D.J.D. Earn’s research is supported by the Canadian Institutes of Health Research (CIHR), Natural Sciences and Engineering Research Council of Canada (NSERC) and the J.S. McDonnell Foundation.     

Public support for invasive alien species eradication programs: insights from the Netherlands

Over the last few decades, the number of invasive alien species (IAS) has increased worldwide. IAS can have negative impacts on biodiversity, human health, and the economy. For a number of reasons, IAS policies and management schemes that have been implemented have not been sufficient to tackle the problem. In this article, we focus on IAS eradication and a main obstacle to eradication, namely a lack of public support. By analyzing three specific cases of IAS eradication in the Netherlands (Indian house crow; Pallas's squirrel; and American bullfrog), we show how factors initially affecting public support for eradication interact with each other and influence the effectiveness of the measures that IAS eradication managers implement in order to achieve support for their eradication programs. Our analysis provides a better understanding of the manipulability of factors affecting public support. Finally, it reveals concrete measures that IAS managers can implement in order to gain public support. A lesson for IAS eradication managers is that they can effectively aim for support for eradication, even if low public support for eradication is to be expected in first instance. In addition, this article provides insight into practical measures that IAS eradication managers can implement.     

Macro- and microhabitat use of Telfair’s skink (Leiolopisma telfairii) on Round Island,Mauritius: implications for their translocation

The successful eradication of introduced rodents from islets off the coast of Mauritius has led to local conservation bodies investigating the possibility of translocation as a measure of safeguarding endemic reptile populations. The present study was the first to determine the habitat and microhabitat requirements of Telfair's skinks (Leiolopisma telfairii) on Round Island, Mauritius, with a view to aiding future translocation projects to islands within their historic range. Contrasting preferences found for Telfair's skink at macro- and micro- habitat levels underline the importance of sampling at multiple ecological scales in such investigations. Significantly fewer sightings of L. telfairii were recorded in bare rock habitats compared to more vegetated habitats. Conversely, at a microhabitat scale principal component analysis indicated structural characteristics were the primary determinant of microhabitat choice. The first dietary analysis of Telfair's skinks confirmed their status as omnivores. Cockroaches (Blattodea spp.) appeared to be a primary food source. Four exotic plant species were also present in faecal samples and the potential for L. telfairii to aid their dispersal is discussed. Implications for the long-term management and proposed translocation of Telfair's skinks are discussed.     

Epidemiology and control of malaria in Colombia

Malaria is currently one of the most serious public health problems in Colombia with an endemic/epidemic transmission pattern that has maintained endemic levels and an average of 105,000 annual clinical cases being reported over the last five years. Plasmodium vivax accounts for approximately 70% of reported cases with the remainder attributed almost exclusively to Plasmodium falciparum. A limited number of severe and complicated cases have resulted in mortality, which is a downward trend that has been maintained over the last few years. More than 90% of the malaria cases in Colombia are confined to 70 municipalities (about 7% of the total municipalities of Colombia), with high predominance (85%) in rural areas. The purpose of this paper is to review the progress of malaria-eradication activities and control measures over the past century within the eco-epidemiologic context of malaria transmission together with official consolidated morbidity and mortality reports. This review may contribute to the formulation of new antimalarial strategies and policies intended to achieve malaria elimination/eradication in Colombia and in the region.     

The final stages of the global eradication of poliomyelitis

The global incidence of poliomyelitis has dropped by more than 99 per cent since the governments of the world committed to eradication in 1988. One of the three serotypes of wild poliovirus has been eradicated and the remaining two serotypes are limited to just a small number of endemic regions. However, the Global Polio Eradication Initiative (GPEI) has faced a number of challenges in eradicating the last 1 per cent of wild-virus transmission. The polio endgame has also been complicated by the recognition that vaccination with the oral poliovirus vaccine (OPV) must eventually cease because of the risk of outbreaks of vaccine-derived polioviruses. I describe the major challenges to wild poliovirus eradication, focusing on the poor immunogenicity of OPV in lower-income countries, the inherent limitations to the sensitivity and specificity of surveillance, the international spread of poliovirus and resulting outbreaks, and the potential significance of waning intestinal immunity induced by OPV. I then focus on the challenges to eradicating all polioviruses, the problem of vaccine-derived polioviruses and the risk of wild-type or vaccine-derived poliovirus re-emergence after the cessation of oral vaccination. I document the role of research in the GPEI''s response to these challenges and ultimately the feasibility of achieving a world without poliomyelitis.     

Cats protecting birds revisited

In this paper, we revisit the dynamical interaction among prey (bird), mesopredator (rat), and superpredator (cat) discussed in [Courchamp, F., Langlais, M., Sugihara, G., 1999. Cats protecting birds: modelling the mesopredator release effect. Journal of Animal Ecology 68, 282–292]. First, we develop a prey-mesopredator-superpredator (i.e., bird-rat-cat, briefly, BRC) model, where the predator’s functional responses are derived based on the classical Holling’s time budget arguments. Our BRC model overcomes several model construction problems in Courchamp et al. (1999), and admits richer, reasonable and realistic dynamics. We explore the possible control strategies to save or restore the bird by controlling or eliminating the rat or the cat when the bird is endangered. We establish the existence of two types of mesopredator release phenomena: severe mesopredator release, where once superpredators are suppressed, a burst of mesopredators follows which leads their shared prey to extinction; and mild mesopredator release, where the mesopredator release could assert more negative impact on the endemic prey but does not lead the endemic prey to extinction. A sharp sufficient criterion is established for the occurrence of severe mesopredator release. We also show that, in a prey-mesopredator-superpredator trophic food web, eradication of introduced superpredators such as feral domestic cats in the BRC model, is not always the best solution to protect endemic insular prey. The presence of a superpredator may have a beneficial effect in such systems.     

Poliovirus sampling by using sodium dodecyl sulfate/EDTA-pretreated chromatography paper strips

To achieve the goal of poliovirus eradication, surveillance of endemic areas is a crucial step in the poliovirus eradication program. Currently, six countries still have endemic poliovirus. We have tested a novel method which uses SDS/EDTA-treated chromatography paper strips to collect and transport poliovirus-containing stool samples. The SDS/EDTA-treated paper strips were soaked with different dilutions of poliovirus-containing feces and stored at different temperatures. After storing the SDS/EDTA paper strips for 5 months at 37 degrees C, poliovirus RNA could be successfully amplified using RT-PCR. Infectivity of wild-type poliovirus type 1, 2, and 3 was lost upon contact with the SDS/EDTA-treated strips. This easy, inexpensive, and biosafe chromatography paper strip method for the collection and transportation of poliovirus samples can be of use in poliovirus surveillance and polio vaccination programs.     

Dynamics of an SIQS epidemic model with transport-related infection and exit-entry screenings

Population dispersal, as a common phenomenon in human society, may cause the spreading of many diseases such as influenza, SARS, etc. which are easily transmitted from one region to other regions. Exit and entry screenings at the border are considered as effective ways for controlling the spread of disease. In this paper, the dynamics of an SIQS model are analyzed and the combined effects of transport-related infection enhancing and exit-entry screenings suppressing on disease spread are discussed. The basic reproduction number is computed and proved to be a threshold for disease control. If it is not greater than the unity, the disease free equilibrium is globally asymptotically stable. And there exists an endemic equilibrium which is locally asymptotically stable if the reproduction number is greater than unity. It is shown that the disease is endemic in the sense of permanence if and only if the endemic equilibrium exists. Exit screening and entry screening are shown to be helpful for disease eradication since they can always have the possibility to eradicate the disease endemic led by transport-related infection and furthermore have the possibility to eradicate disease even when the isolated cites are disease endemic.     

On transmission and control of schistosomiasis, with comments on Macdonald''s model

A hybrid model for the transmission of schistosomiasis with snail latency is established, based on hypotheses that are essentially identical to those used by Macdonald. Measures of the efficiencies of control of endemic schistosomiasis are introduced. Relations are derived between control efficiency ratios and epidemiological quantities. A measure of resilience of an endemic infection is introduced; it quantifies the minimum effort required for eradication. Studies are made of the control efficiency ratios and an eradication effort ratio as functions of the minimum eradication effort. The results are applied in an objective analysis of Macdonald's 1965 model of schistosomiasis. Some weaknesses in Macdonald's methodology are discovered, and we prove that Macdonald's conclusion of inefficiency of improved sanitation does not have general validity.     

Diet analysis by next‐generation sequencing indicates the frequent consumption of introduced plants by the critically endangered red‐headed wood pigeon (Columba janthina nitens) in oceanic island habitats

Oceanic island ecosystems are vulnerable to the introduction of alien species, and they provide a habitat for many endangered species. Knowing the diet of an endangered animal is important for appropriate nature restoration efforts on oceanic islands because introduced species may be a major component of the diets of some endangered species. DNA barcoding techniques together with next‐generation sequencing may provide more detailed information on animal diets than other traditional methods. We performed a diet analysis using 48 fecal samples from the critically endangered red‐headed wood pigeon that is endemic to the Ogasawara Islands based on chloroplast trnL P6 loop sequences. The frequency of each detected plant taxa was compared with a microhistological analysis of the same sample set. The DNA barcoding approach detected a much larger number of plants than the microhistological analysis. Plants that were difficult to identify by microhistological analysis after being digested in the pigeon stomachs were frequently identified only by DNA barcoding. The results of the barcoding analysis indicated the frequent consumption of introduced species, in addition to several native species, by the red‐headed wood pigeon. The rapid eradication of specific introduced species may reduce the food resources available to this endangered bird; thus, balancing eradication efforts with the restoration of native food plants should be considered. Although some technical problems still exist, the trnL approach to next‐generation sequencing may contribute to a better understanding of oceanic island ecosystems and their conservation.     

Rabies in the Baltic States: Decoding a Process of Control and Elimination

Rabies is a fatal zoonosis that still causes nearly 70, 000 human deaths every year. In Europe, the oral rabies vaccination (ORV) of red foxes (Vulpes vulpes) was developed in the late 1970s and has demonstrated its effectiveness in the eradication of the disease in Western and some Central European countries. Following the accession of the three Baltic countries—Estonia, Latvia and Lithuania—to the European Union in 2004, subsequent financial support has allowed the implementation of regular ORV campaigns since 2005–2006. This paper reviews ten years of surveillance efforts and ORV campaigns in these countries resulting in the near eradication of the disease. The various factors that may have influenced the results of vaccination monitoring were assessed using generalized linear models (GLMs) on bait uptake and on herd immunity. As shown in previous studies, juveniles had lower bait uptake level than adults. For the first time, raccoon dogs (Nyctereutes procyonoides) were shown to have significantly lower bait uptake proportion compared with red foxes. This result suggests potentially altered ORV effectiveness in this invasive species compared to the red foxes. An extensive phylogenetic analysis demonstrated that the North-East European (NEE) rabies phylogroup is endemic in all three Baltic countries. Although successive oral vaccination campaigns have substantially reduced the number of detected rabies cases, sporadic detection of the C lineage (European part of Russian phylogroup) underlines the risk of reintroduction via westward spread from bordering countries. Vaccine induced cases were also reported for the first time in non-target species (Martes martes and Meles meles).     

Dispersal ability of island endemic plants: What can we learn using multiple dispersal traits?

Island endemic species are expected to have lower dispersal ability than their non-endemic congeners. Several studies have demonstrated differences in diaspore morphology between endemic species and their non-endemic congeners. It is, however, relatively difficult to translate the differences in morphology of the diaspores into differences in dispersal ability. To avoid this problem, we measured directly dispersal values (anemo-, hydro-, exozoo- and endozoo-chory) of 27 pairs of closely related endemic and non-endemic species from Canary Islands. We did not explicitly support the hypothesis about the loss of dispersal ability of island species. The comparison of pairs of endemic and non-endemic species showed the reduction in dispersal potential only for endozoochory. In many cases, endemic species had, in fact, the same or better dispersal ability than their non-endemic congeners. Higher dispersal ability of endemic species could have been evolved as a consequence of species subsequent dispersal to neighboring islands. As a support for this we found that the endemic species dispersing better than their non-endemic congeners also occupy more islands within the archipelago. We conclude that reduction of dispersal ability of species on islands may not be as general as previously expected and we need to take into account multiple species traits to understand the possible evolution of species dispersal potential.