A Study on Culex Mosquitoes and Culex Transmitted Diseases in Al-Madinah, Saudi Arabia (2008) PDF
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Taibah University
2008
Khalil H. Al-Ali, Ayman A. El-Badry, Ahmed H. A. Eassa, Abdullah M. Al-Juhani, Saleem F. Al-Zubiany and El-Kheir D. Ibrahim
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Summary
This study investigated the role of Culex mosquitoes in transmitting diseases such as Wuchereria bancrofti, West Nile virus, Saint Louis encephalitis, and Eastern Equine encephalitis in Al-Madinah, Saudi Arabia. The research documented prevalent Culex species, their distribution, and bionomics. It also looked at potential transmission risks by analyzing collected mosquito samples.
Full Transcript
Parasitologists United Journal (PUJ) Vol. 1, No. 2 , July - December, 2008 101 - 108 A Study on Culex Species and Culex Transmitted Diseases in Al-Madinah Al...
Parasitologists United Journal (PUJ) Vol. 1, No. 2 , July - December, 2008 101 - 108 A Study on Culex Species and Culex Transmitted Diseases in Al-Madinah Al-Munawarah, Saudi Arabia Khalil H. Al-Ali1, Ayman A. El-Badry2, Ahmed H. A. Eassa3, Abdullah M. Al-Juhani4, Saleem F. Al-Zubiany4 and El-Kheir D. Ibrahim4 Departments of Microbiology1, Medical Parasitology2,3 and Vector-Borne Diseases4, College of Medicine, Taibah University, Al-Madinah Al-Munawarah, Saudi Arabia1,2, Faculty of Medicine, Cairo University, Egypt2,3, Medical Sciences Department, Community College, Taibah University, Al-Madinah Al-Munawarah, Saudi Arabia3, Ministry of Health, Al-Madinah Al-Munawarah, Saudi Arabia4 Received: October, 2008 Accepted: December, 2008 Abstract Background: Culex mosquitoes transmit bancroftian filariasis and arboviruses as West Nile Virus in the Middle East including Saudi Arabia. However, the prevalent Culex species in Al-Madinah region have not been reported and their role in disease transmission remains to be clarified. Objective: This work aimed to investigate the role of Culex in transmission of Wuchereria bancrofti, West Nile virus, Saint Louis encephalitis and Eastern Equine encephalitis in Al-Madinah, Saudi Arabia. Also, it was done to document the prevalent Culex species and to shed light on their bionomics and habits. Material and Methods: Culex mosquitoes were collected using spray sheets and CDC light traps with CO2 release from July 2007 till June 2008. Also, Culex larvae were collected for 8 months during that period. Culex seasonal distribution and bionomics were documented and taxonomical identification was done. Females were dissected and microscopically examined for filarial stages. In addition, they were screened by the Vec-Test for West Nile virus, Saint Louis encephalitis and Eastern Equine encephalitis. Results: A total of 3.6% human rooms and 4.7% of animal sheds were positive for Culex; more in the period of January-June 2008, compared to July-December 2007. Seven Culex species were found, two of which were recorded for the first time in the region; C. duttoni and C. decens. C. pipiens and C. quinquefasciatus were the most abundant; 59.3% of collected adults were C. pipiens, while C. quinquefasciatus constituted 22.1%. As for collected larvae, C. pipiens constituted 60% of them, whereas C. quinquefasciatus totalled 20%. Only C. pipiens was found to harbor West Nile Virus. In contrast, no other viruses or W. bancrfoti stages were detected in the examined mosquitoes. Conclusion: There is a potential danger of the transmission of West Nile Virus in Al-Madinah especially by C. pipiens. Also, the possibility of future transmission of W. bancrofti, and the establishment of new endemic foci of bancroftian filariasis in the region, couldn’t be overruled. Keywords: Culex, Filariasis, Vec-Test, West Nile Virus, Al-Madinah, Saudi Arabia Introduction sustained foci of the disease are likely to depend upon Culex mosquitoes, especially C. pipiens and C. the abundance of microfilaria carriers and density of quinquefasciatus, are the chief vectors of bancroftian vector mosquitoes feeding on carriers1. Therefore, other filariasis caused by Wuchereria bancrofti in many foci infested with Culex, including Al-Madinah, are also regions of the world including the Middle East and at risk and investigations are mandatory to reveal the Eastern Mediterranean countries(1-3). This disease has potential of such threats materializing. also been reported from the southwestern districts of Culex is also responsible for the transmission of several the Kingdom of Saudi Arabia (KSA) where expatriates serious viral diseases as Rift valley fever (RVF)(7), West constitute the majority of cases(4-6). In Abha, KSA, Culex Nile virus (WNV)(8-10), Saint Louis encephalitis (SLE)(11) pipiens is a potential vector of introduced bancroftian and Eastern Equine encephalitis (EEE)(11). Of these, the filariasis. The danger of bancroftian filariasis importation most prevalent in the Middle East is WNV(8). Similar and, more importantly, the establishment of new self- to other encephalitis viruses, it is cycled between birds 101 102 Al-Ali et al. and mosquitoes and transmitted to mammals and man Procedure of VecTest™ (Medical Analysis Systems, by infected mosquitoes. Therefore, elucidating the role USA): This test was performed in a Class II biohazard played by Culex mosquitoes in Al-Madinah region in hood according to manufacturer instructions. Based on disease transmission is essential. Indeed, Al-Madinah the dual monoclonal antibody “sandwich” principle, it has a special location, receiving millions of visitors is a rapid immunochromatographic assay intended for (Hajj and Umrah) and thousands of workers annually. the qualitative determination of WNV, SLE and EEE This opens the door for a greater possibility for the antigens in potentially infected mosquitoes. Collected spread of imported Culex-borne infectious diseases. Culex females were sorted by species and pools of 50 Furthermore, the risk of endemicity developing for mosquitoes were placed into a plastic culture tubes such diseases once introduced in the region cannot be provided in the Vec-Test kit. Then, 2.5 ml of Grinding underestimated. Therefore, this work was designed to Solution were dispensed onto the mosquitoes and four investigate some biological and ecological features of copper-coated ball bearings provided by the Vec-Test kit Culex in Al-Madinah region, in addition to documenting were added. The capped tube was vortexed for a minute at the urban Culex species in this area. Also, it was decided high speed until the mosquito pool was homogenized into to screen collected female mosquitoes for the presence slurry. The homogenized samples were stored at -20°C of filarial stages and WNV, SLE and EEE in order to until processed and examined for WNV, SLE, EEE where evaluate the potential of transmission of such diseases 250 µl of mosquito homogenates were each dispensed in the region. into a conical tube, placed into the tube stand, and a test strip from the canister with the arrows pointing down was Material and Methods inserted. The test was left for 15 minutes to be completed. Results were determined by removing the test strip and An entomologic survey was carried out in the Al-Madinah comparing it to the pictorial sample provided on the back central region and surrounding province in housing areas of the Vec-Test insert. If WNV, SLE, or EEE was present, (human dwellings and animal and bird sheds) were Culex the antigen bound to the specific antibodies on the test mosquitoes are highly prevalent, according to an annual strip and produced a reddish color change on the stick. It report by the Ministry of Health (unpublished data). These should be noted that the assay showed if the antigen was areas included Al-Qiblatein, Al-Mostarah and the Airport present, it is not meant to be a quantitative assessment of Road to the north, Al-Aliaa to the east, Salaa to the west viral antigen in the sample. Though the color intensity of and Qubaa and Al-Khazraj to the south. Culex mosquitoes the antigen reaction is a relative indication of the amount were captured using spray sheet collection and CDC of virus in a test sample, the numerical amount cannot miniature light traps with CO2 release(12). Traps were set up be determined, or whether virus present is due to one or in the early morning and collected monthly for a year from more infected mosquitoes in the same pool. July 2007 till June 2008. After collection, captured insects were sent back to the laboratory in cages and observed with a dissecting microscope to separate Culex from other Results insects caught, hence, estimating their density. Table (1) lists the numbers and percentages of The collected Culex were microscopically examined and the quarters (man and animal) where Culex adult sorted by sex. The decision of separating specimens by mosquitoes were found and collected, and their gender aims to maximize sample usage, taking in account density among all the insects falling into the traps. that females were the disease transmitters. Immediately In addition, table (2) shows the sex distribution of after segregation, male Culex mosquitoes were stored collected Culex mosquitoes. Table (3) shows the in 1.5 ml vials containing 95% ethanol for taxonomic percentages of each of the collected Culex species evaluation. Female Culex mosquitoes were kept in a humid (females only) and their individual distribution in and cool environment until taxonomically identified. human rooms and animal sheds. Table (4) details Females of all species were dissected for filarial parasitic the number of positive habitats for Culex larvae, stages(13). If positive, stained slides were made for accurate their density and numbers. Table (5) shows the identification. details of the nature of the habitats of the collected Larvae were also collected manually by hand nets for a Culex larvae, categorized by species. Table (6) period of 8 months from October 2007 to May 2008. They depicts the results of positivity of the examined were taxonomically identified after mounting in either female Culex mosquitoes in the present study for Hoyer’s or Berlese’s medium. All taxonomic identification the presence of viral pathogens by Vec-Test and for was based on Harbach’s pictorial key(14). filarial larval stage. 103 Culex Species in Al-Madinah Al-Munawarah, Saudi Arabia 104 Al-Ali et al. Culex Species in Al-Madinah Al-Munawarah, Saudi Arabia 105 Discussion June 2008 compared to that of July-December In the present work, adult 2007. mosquitoes Culex Although climatic conditions and water availability may be the reason for this difference, were collected in animal and man quarters from a decline in mosquito control strategies in the areas in Al-Madinah region, KSA throughout a former one-year period from July 2007 till June 2008. period cannot be overruled. As expected, being blood feeders, collectedfemale mosquitoes Their seasonal distribution and bionomics were Mosquitoes documented. were by classified outnumbered sex malesin the examined quarters. However, contrary to numerous expectations, and counted. Culex mosquitoes were abundant in males were indeed collected from those quarters both human quarters and animal sheds. However, throughout the study, this may be due to the the percentage of animal and bird sheds infested nature of the human dwellings in these areas with Culex from the total tested sheds was higher which almost always contain yards, porches and than human rooms. Inall positive locations, bird plants therein. In light addition, traps are known and animal sheds were concomitantly infested. to attract males as well(12) . This reflects opportunistic nature of these Regarding mosquito density, it was highest in mosquitoes, which is helped by the proximity 2007 November-December (0.4), while forthe of animal sheds and human dwellings in the part of the rest of the year it was slightly major region. In general, higher percentages of positive less (0.3). This difference does not appear to have quarters were found in the period of January- any bearing on the nature of Culex breeding and 106 Al-Ali et al. habitats in this region, but is more likely to be in Al-Madinah or its surroundings. In the present related to favorable cooler temperatures during study, 65.3% of collected C. pipiens and 55% of these two months. C. quinquefasciatus were found in human rooms, The first authentic information on Culicine which stresses their anthropophilic tendency(7-9,11). mosquitoes in KSA was reported by Mattingly and In contrast,72% of collected C. univittatus were Knight(15) who recorded nine species comprising from animal and bird sheds, which is in accordance five sugenera of Culex in southwestern KSA. Later, with reports indicating the strong ornithophilic Buttiker(16) reported a new species from urban and preference of this species(7-9,11,16,21). As for the rest semi-urban areas while Wills et al.(17) recorded the of the detected species, they were more abundant presence of new species from the Eastern part of in animal sheds, which is expected, since they are the Kingdom. Harbach(14,18) made comprehensive mostly not disease transmitters. Mosquito larvae studies on Culex species in southwestern Asia and were more abundant in May 2008, coinciding detailed nine species found in KSA, adding two with the begnining of the hot season in the region, new species to the previous lists. Later, Abdullah but not with the extreme summer temperature that and Merdan(19) found three Culex species alrady is unfavorable for the growth of aquatic Culex reported by the previous authors. Lately, Miller stages. This was evident in all types of tested et al.(20) reported the presence of four species, water sources; wells, irrigation canals, etc. It was including a first report of a species that had not also noted that surface water sources harbored been reported before, so totalling over 14 reported the least number of Culex larvae in winter of late species of Culex in KSA, mostly in southwestern 2007- early 2008, while there were appreciable areas. Most recently, Abdoon(21) has reported the numbers of such larvae in cisterns, wells, water first record of three Culex species but also in tanks and man-made reservoirs. This may be due southwestern localities; C. duttoni, C. decens and to the fact that some of the covered water sources C. bitaeniorhynchus. provide a better thriving environment and warmer temperature for the mosquitoes, than open waters However, there was no indication diversity of exposed to the climate. The difference may Culex species found in Al-Madinah area. This also be due to the nature of water itself and the was the main impetus for attempting detection ecotype, e.g. urban versus rural or desert. As and classification of Culex mosquitoes in this observed in the present work, the year-round geographical region of the Kingdom, considering presence of immature mosquitoes indicates that the implication of Culex in the transmission of the climatic conditions in the Arabian Peninsula viral and parasitic diseases. In the present work, are not limiting the development of most prevalent two of the previously reported(21) new species were recorded for the first time in Al-Madinah, species(22). In the present study, septic and turbid namely, C. duttoni and C. decens. However, C. water was found to be a favorite breeding place for pipiens and C. quinquefasciatus were the most C. quinquefasciatus, while C. pipiens preferred abundant of the collected mosquitoes in this stagnant water pools, among others. This is in work. Indeed, they are among the most prevalent accordance with previous reports on the ecology of all Culex species in the Middle East(14,18). Of of such mosquitoes(18,22). However, in contrast to the collected larvae, C. pipiens constituted 60%, reports that C. duttoni was highly abundant in compared to 20% for C. quinquefasciatus. The turbid water only(22), in the present work, it was remaining 20% were C. laticinctus, C. univittatus found to breed in diverse habitats, probably due and C. sinaiticus, which are not implicated in to differences between water constituents in Al- disease transmission, along with C. decens and Madinah and Asir. C. duttoni. The latter two species in particular As previously reported, species like C. sinaiticus were collected in the cooler somewhat rainy months, and C. lacticinitus seemed to thrive better in clear which were reported to favor their breeding(21). It must waters, although they were also able to breed be stressed that all these species were previously in other types of habitats(14,18,22). However, these reported elsewhere in the Kingdom(14-21), but not mosquitoes are of little medical importance, given Culex Species in Al-Madinah Al-Munawarah, Saudi Arabia 107 the fact that they were not reported to transmit any References pathogen. All in all, out of the examined potential 1. Omar MS. A survey of bancroftian filariasis among South- East Asian expatriate workers in Saudi Arabia. Trop Med mosquito breeding sites, 0.02% were found to Int Health; 1996, 1(2):155-60. harbor Culex larvae. This is not a presence to be 2. Omar MS, Sheikha AK, Al-Amari OM et al. Field ignored, given the exponential breeding potential evaluation of two diagnostic antigen tests for Wuchereria of such insects. bancrofti infection among Indian expatriates in Saudi Regarding disease transmission, C. pipiens was Arabia. 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Isolation and Medical Parasitology Department, genetic characterization of Rift Valley fever virus from College of Medicine, Taibah University Aedes vexans arabiensis, Kingdom of Saudi Arabia. Emerg Al-Madinah Al-Munwwarah, Saudi Arabia Infect Dis; 2002, 8(12):1492-4. E-mail: [email protected] ﺑﻌﻮﺽ ﺍﻟﻜﻴﻮﻟﻜﺲ ﻭﻣﺎﻳﻨﻘﻠﻪ ﻣﻦ ﺃﻣﺮﺍﺽ ﻓﻲ ﺍﻟﻤﺪﻳﻨﺔ ﺍﻟﻤﻨﻮﺭﺓ ،ﺍﻟﻤﻤﻠﻜﺔ ﺍﻟﻌﺮﺑﻴﺔ ﺍﻟﺴﻌﻮﺩﻳﺔ ﺧﻠﻴﻞ ﺣﺴﻴﻦ ﺍﻟﻌﻠﻲ) ،(1ﺃﻳﻤﻦ ﻋﺒﺪ ﺍﻟﻤﺆﻣﻦ ﺍﻟﺒﺪﺭﻱ) ،(2ﺃﺣﻤﺪ ﻫﻤﺖ ﺃﺣﻤﺪ ﻋﻴﺴﻰ)،(3 )(4 ﻋﺒﺪﺍﷲ ﻣﺼﻠﺢ ﺍﻟﺠﻬﻨﻲ) ،(4ﺳﻠﻴﻢ ﻓﺤﻴﻤﺎﻥ ﺍﻟﺬﺑﻴﺎﻧﻲ) ،(4ﺍﻟﺨﻴﺮ ﺇﺑﺮﺍﻫﻴﻢ ﺩﻓﻊ ﺍﷲ ﺃﻗﺴﺎﻡ ﺍﻟﻜﺎﺋﻨﺎﺕ ﺍﻟﺪﻗﻴﻘﺔ) ،(1ﻭﺍﻟﻄﻔﻴﻠﻴﺎﺕ ﺍﻟﻄﺒﻴﺔ) ،(2ﻭﺍﻟﻌﻠﻮﻡ ﺍﻟﻄﺒﻴﺔ ﻭﺗﻘﻨﻴﺎﺗﻬﺎ) ،(3ﻭﻧﻮﺍﻗﻞ ﺍﻷﻣﺮﺍﺽ ﻭﺍﻟﻌﻨﺎﻳﺔ ﺍﻷﻭﻟﻴﺔ) ،(4ﻛﻠﻴﺔ ﺍﻟﻄﺐ ،ﺟﺎﻣﻌﺔ ﻃﻴﺒﺔ ،ﺍﻟﻤﺪﻳﻨﺔ ﺍﻟﻤﻨﻮﺭﺓ) ،(2،1ﻛﻠﻴﺔ ﺍﻟﻤﺠﺘﻤﻊ ،ﺟﺎﻣﻌﺔ ﻃﻴﺒﺔ ،ﺍﻟﻤﺪﻳﻨﺔ ﺍﻟﻤﻨﻮﺭﺓ) ،(3ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ،ﺍﻟﻤﺪﻳﻨﺔ ﺍﻟﻤﻨﻮﺭﺓ ،ﺍﻟﻤﻤﻠﻜﺔ ﺍﻟﻌﺮﺑﻴﺔ ﺍﻟﺴﻌﻮﺩﻳﺔ)،(4 )(3،2 ﻛﻠﻴﺔ ﺍﻟﻄﺐ ،ﺟﺎﻣﻌﺔ ﺣﻠﺐ ،ﺳﻮﺭﻳﺎ) ،(1ﻛﻠﻴﺔ ﺍﻟﻄﺐ ،ﺟﺎﻣﻌﺔ ﺍﻟﻘﺎﻫﺮﺓ ،ﻣﺼﺮ ﺍﻟﻬﺪﻑ :ﺗﺤﺪﻳﺪ ﺃﻧﻮﺍﻉ ﺑﻌﻮﺽ ﺍﻟﻜﻴﻮﻟﻜﺲ ﻓﻲ ﺍﻟﻤﺪﻳﻨﺔ ﻭﺇﻣﻜﺎﻧﻴﺔ ﻧﻘﻞ ﺍﻷﻣﺮﺍﺽ ﺍﻟﻄﻔﻴﻠﻴﺔ ﻛﻤﺮﺽ ﺩﺍء ﺍﻟﻔﻴﻞ ﻭﺍﻟﻔﻴﺮﻭﺳﻴﺔ ﻛﺤﻤﻰ ﻏﺮﺏ ﺍﻟﻨﻴﻞ ﻭﺍﻟﺘﻬﺎﺏ ﺍﻟﺴﺤﺎﻳﺎ ﺍﻟﻔﻴﺮﻭﺳﻲ ﺳﺎﻧﺖ ﻟﻮﻳﺲ ﻭﺍﻳﺴﺘﺮﻥ ﺍﻛﻮﺍﻳﻦ. ﻃﺮﻕ ﺍﻟﺪﺭﺍﺳﺔ :ﺟﻤﻊ ﻋﻴﻨﺎﺕ ﺍﻟﻜﻴﻮﻟﻜﺲ ﺍﻟﺒﺎﻟﻐﺔ ﻭﺍﻟﻴﺮﻗﺎﺕ ﻋﻠﻰ ﻣﺪﺍﺭ ﻋﺎﻡ ﻛﺎﻣﻞ ﻣﻦ ﺃﻣﺎﻛﻦ ﻣﺘﻌﺪﺩﺓ ﻓﻲ ﺍﻟﻤﺪﻳﻨﺔ ﺍﻟﻤﻨﻮﺭﺓ ﺑﺎﺳﺘﺨﺪﺍﻡ ﻣﺼﺎﺋﺪ ﺧﺎﺻﺔ ﻭﺍﻟﻜﺸﻒ ﻋﻦ ﺃﺻﻨﺎﻓﻬﺎ ﺛﻢ ﺗﺸﺮﻳﺤﻬﺎ ﺗﺤﺖ ﺍﻟﻤﺠﻬﺮ ﻟﻠﻜﺸﻒ ﻋﻦ ﻃﻔﻴﻠﻲ ﺍﻟﻔﻴﻼﺭﻳﺎ ﻭﻣﻦ ﺛﻢ ﺇﺟﺮﺍء ﺍﻹﺧﺘﺒﺎﺭﺍﺕ ﺍﻟﻔﻴﺮﻭﺳﻴﺔ ﺑﺈﺳﺘﺨﺪﺍﻡ )ﻓﻴﻚ ﺗﺴﺖ( ﻟﻠﻜﺸﻒ ﻋﻦ ﻓﻴﺮﻭﺱ ﺣﻤﻰ ﻏﺮﺏ ﺍﻟﻨﻴﻞ ﻭﻓﻴﺮﻭﺱ ﺍﻟﺘﻬﺎﺏ ﺍﻟﺴﺤﺎﻳﺎ ﺳﺎﻧﺖ ﻟﻮﻳﺲ ﻭﺍﻳﺴﺘﺮﻥ ﺍﻛﻮﺍﻳﻦ. ﺍﻟﻨﺘﺎﺋﺞ :ﺗﻢ ﺗﺴﺠﻴﻞ ﺳﺒﻌﺔ ﺃﻧﻮﺍﻉ ﻣﻦ ﺍﻟﻜﻴﻮﻟﻜﺲ ﺍﺛﻨﺎﻥ ﻣﻨﻬﺎ ﺳﺠﻠﺖ ﻷﻭﻝ ﻣﺮﺓ ﻓﻲ ﺍﻟﻤﺪﻳﻨﺔ ﺍﻟﻤﻨﻮﺭﺓ ﻭﻫﻤﺎ ﻛﻴﻮﻟﻜﺲ ﺩﻳﺘﻮﻧﻲ ،ﻭﻛﻴﻮﻟﻜﺲ ﺩﻳﺴﻨﺲ ﺑﻴﻨﻤﺎ ﻛﺎﻥ ﺃﻛﺜﺮ ﺍﻷﻧﻮﺍﻉ ﺗﻮﺍﺟﺪﺍً ﻫﻮ ﺍﻟﻨﻮﻉ ﻛﻴﻮﻟﻜﺲ ﺑﺎﻳﺒﻨﺲ ﻭﻛﻴﻮﻟﻜﺲ ﻛﻴﻨﻜﻴﻔﺎﺳﻴﺎﺗﻮﺱ ﺣﻴﺚ ﺑﻠﻐﺖ ﺍﻟﻨﺴﺒﺔ ٪٥٩٫٣ﻭ ٪٢٢٫١ﻋﻠﻰ ﺍﻟﺘﻮﺍﻟﻲ.ﺗﻢ ﺍﻟﻜﺸﻒ ﻋﻦ ﻭﺟﻮﺩ ﻓﻴﺮﻭﺱ ﺣﻤﻰ ﻏﺮﺏ ﺍﻟﻨﻴﻞ ﻓﻘﻂ ﻋﻨﺪ ﺍﻟﻨﻮﻉ ﻛﻴﻮﻟﻜﺲ ﺑﺎﻳﺒﻴﻨﺲ ،ﺑﺎﺳﺘﺨﺪﺍﻡ ﺗﻘﻨﻴﺔ ﺍﻟﻔﻴﻚ ﺗﺴﺖ ﻭﻟﻢ ﻳﺘﻢ ﺍﻟﻌﺜﻮﺭ ﻋﻠﻰ ﺃﻱ ﻳﺮﻗﺎﺕ ﻓﻴﻼﺭﻳﺎ ﺑﺎﻟﺒﻌﻮﺽ ﺍﻟﻤﻔﺤﻮﺹ ﻣﻬﺠﺮﻳﺎ. ﺍﻟﺨﻼﺻﺔ :ﺍﻟﻜﺸﻒ ﻋﻦ ﻭﺟﻮﺩ ﻓﻴﺮﻭﺱ ﺣﻤﻰ ﻏﺮﺏ ﺍﻟﻨﻴﻞ ﻓﻲ ﻛﻴﻮﻟﻜﺲ ﺑﺎﻳﺒﻴﻨﺲ ﻳﻠﻘﻲ ﺍﻟﻀﻮء ﻋﻠﻰ ﺍﺣﺘﻤﺎﻟﻴﺔ ﺍﻧﺘﻘﺎﻝ ﺍﻟﻔﻴﺮﻭﺱ ﻟﻠﺒﺸﺮ ﺑﻴﻨﻤﺎ ﻋﺪﻡ ﺍﻟﻌﺜﻮﺭ ﻋﻠﻰ ﺃﻳﺔ ﻋﻴﻨﺔ ﺇﻳﺠﺎﺑﻴﺔ ﻟﻄﻔﻴﻠﻲ ﺍﻟﻔﻴﻼﺭﻳﺎ ﻻ ﻳﻌﻨﻲ ﺍﺳﺘﺒﻌﺎﺩ ﺍﻧﺘﻘﺎﻝ ﺍﻟﻤﺮﺽ ﻓﻲ ﺍﻟﻤﺴﺘﻘﺒﻞ ﺃﻭ ﺗﻮﻃﻨﻪ ﺑﺎﻟﻤﻨﻄﻘﺔ. 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