Kyu-Sik Chang, Se Jin Chung, Heung-Chul Kim, Seung Jegal, Gi-Hun Kim, Terry A. Klein, Young-Ran Ha, Eun Jeung Kim, Seung Hwan Shin, Youngmee Jee, Eun Kyeong Jeong, and Young-Ran Ju
Flaviviruses, for example, dengue virus (DENV) and Zika virus (ZIKV), and Alphaviruses, for example, chikungunya virus (CHIKV), attracted little attention until 2000 when increasingly higher numbers of infections were reported in urban settings throughout much of the tropical and subtropical areas of the world. While Aedes aegypti is the primary vector in most areas, Aedes albopictus, which is present in relatively high numbers in forested areas of the Republic of Korea (ROK), as well as limited urban environments (e.g., where used tires are improperly stored), is considered a secondary vector. Aedes albopictus gained considerable attention in 2016 when > 100 imported cases of DENV were reported annually since 2010 in the ROK as travelers returned home from endemic countries,1 in addition to 16 imported cases of ZIKV in 2016. ZIKV, a member of the Family Flaviviridae, was first isolated in Uganda, Africa, from monkeys in 1947 and from Aedes africanus in 1948.2 While there were occasional cases and outbreaks, its recent adaptation to efficiently infect Ae. aegypti, Ae. albopictus, and several other Aedes spp. in the Pacific Islands has led to its widespread dispersal and outbreaks in many of the tropical and semitropical regions of the world, including nine countries in Asia, 47 in Central and South America, one in North America, 10 in Oceania, and two in Africa, with the potential to spread to temperate regions during “mosquito seasons”.3–6 ZIKV is a monkey-mosquito-monkey forest cycle zoonotic disease that has been adapted to an urban Ae. aegypti-man-Ae. aegypti (and related Aedes species) cycle with the potential for emergence in nonendemic areas where competent mosquito vectors (e.g., Ae. albopictus) are present.7 Worldwide, Ae. aegypti, and Ae. albopictus to a lesser degree because of its broader range of hosts, have been identified as primary and secondary vectors of ZIKV.8 Vector competence studies of Ae. albopictus and Ae. aegypti exposed to the same mice infected by ZIKV showed that the viremia levels in mice produced disseminated infections. However, Ae. albopictus infection rates were more dose dependent, requiring higher blood meal titers than titers required for Ae. aegypti infections.9 Unfortunately, as with other arboviruses, for example, West Nile virus and CHIKV, there are no government approved human vaccines or other specific treatments for ZIKV.10 Therefore, it is essential to implement effective vector control for target species near residences where imported ZIKV-infected patients in the ROK are identified to decrease the potential human-vector-human transmission risks during the late spring to fall mosquito season. An example of this type of approach occurred in Chiba City, Japan, in 2014, when emergency vector surveillance and control strategies of Ae. albopictus were implemented due to local transmission of DENV. The result was that Ae. albopictus populations were significantly reduced after adult control strategies were implemented, which also reduced the risks for future transmission of DENV.11 A total of 16 imported ZIKV cases, including one asymptomatic case, were identified from January to October 2016 in the ROK. Nine of the cases were reported during the primary mosquito season from June to October.12 All ZIKV cases were attributed to transmission by mosquitoes during their travels to foreign ZIKV endemic countries, with 77% of the cases attributed to travel to Southeast Asia (Philippines, Vietnam, and Thailand).13 While the Korean Centers for Disease Control & Prevention (KCDC) has established vector control guidelines for vivax malaria and Japanese encephalitis that are endemic in the ROK, there were no established guidelines for vector control of nonendemic vector-borne diseases, for example, ZIKV, DENV, and CHIKV, imported from tropical and subtropical countries where they are endemic. To reduce the potential for autochthonous transmission of imported mosquito-borne viruses during the mosquito season in the ROK, the KCDC established guidelines in 2016 for the control of Ae. albopictus, the primary vector in Korea.4 However, the efficacies of these guidelines have not been fully evaluated.