1:00 Dose of EIDology: Coming to America, It's...

...a few possible options!  

In my opinion, the highest probability for loudest and longest-lasting noise comes from Arboviruses.  After all, this happened not so long ago with West Nile virus.  The permanent emergence of a pathogen into a new population requires a long-term method of transmission from one potential host to another.  This can be easy, such as the spread from one infected person to another by aerosol as with SARS, or it can be a little more complicated if something like an insect vector is needed.  In the case of WNV, this happened because the virus can be spread by several different species of mosquito.  One of these, Culex pipiens, is extremely common in the Northestern US where WNV was first introduced.  Once some viral particles were ingested by Culex mosquitoes, and those mosquitoes fed on and infected some birds, it was all downhill from there. 

Culex pipiens, one of the mosquitoes that transmits WNV

But that was the past.  What is the wave of the Arbovirus future?  There is a lot of talk about Dengue, since there have been cases in Florida and its favorite mosquito vector, Aedes aegypti, is prevalent in the Southeast.  That said, I'd put my money on his lesser-known (for the moment!) cousin, Chikungunya .  The mortality rate of Chik is comparable to WN and Dengue (notably not DHF), and the clinical presentation including high levels of fever and pain is similar.  Chronic joint damage can and does occur, and so Chik presents a possibility of creating a lot of chronic pain patients.  Chik virus is spread by one of two mosquitoes, either Aedes aegypti or Aedes albopictus (the Asian tiger mosquito).  This is the reason many of us are watching Chik more closely than Dengue.  While A. aegypti lives in the Southeast, the Asian tiger mosquito is found across the US, making Chik's possible distribution similar to WNV. The Asian tiger mosquito is far more aggressive, making it more likely to transmit.  As of now, the strain of Chik that has emerged in the Caribbean seems to prefer A. aegypti.  However, there would be a strong evolutionary advantage for that strain if it adapted to A. albopictus transmission.  Or, of course, another strain that prefers it could be imported!  

Chikunguya: take it to the bank

Image by AJC1