The human and animal health impacts of introduction and spread of an exotic strain of West Nile virus in Australia.

Abstract: Vector-borne diseases can have substantial impacts on human and animal health, including major epidemics. West Nile virus (WNV) is of particular international importance due to its recent emergence and impact in the Western Hemisphere. Despite the presence of a sub-type of WNV (Kunjin virus, KUN) in Australia, a potential ecological niche could be occupied by an exotic strain of WNV of the North American type. This study assesses the probability an exotic strain of WNV enters Australia via an infected mosquito in an aircraft from the United States (U.S.) landing at Sydney airport, the probability it spreads to susceptible species and the impact of the resulting outbreak on human and animal health. A release, exposure and consequence assessment were conducted using expert opinion and scientific literature to parameterise the inputs for the models (OIE, 2009). Following establishment of WNV in Australia, the spatio-temporal spread of WNV was predicted over a six year period based on the Australian human and equine populations at-risk, the known distribution of other mosquito-borne flaviviruses in Australia, climatic factors, and the spread of WNV in the U.S. following it's incursion in New York City in 1999. The impact of this spread was measured as a multiplier of human and equine demographics using the U.S. incidence and case fatality rates as a reference. For an 8 month period from September to April (considering seasonal impact on mosquito activity during the coldest months in Australia and the U.S.), and assuming WNV is endemic in the U.S., the median probability an infected mosquito is introduced is 0.17, and the median number of infected mosquitoes introduced is predicted to be zero, with a 95th percentile range of one. The overall probability of a WNV outbreak (WNV released into Australia, susceptible hosts exposed and the virus spread) occurring in the human and the horse population during this time period is estimated to be 7.0×10(-6) and 3.9×10(-6), respectively. These values are largely influenced by the presence of mosquitoes in aircrafts and whether the introduced infected mosquito contacts wild birds. Results of this study suggest there is a low risk of introduction and spread of an exotic strain of WNV from the U.S via aircraft, and provides an insight into the magnitude and impact of the spread among human and horse populations. The generic framework presented could be applied to assess the potential introduction of other mosquito-borne diseases (which involve a wild bird transmission cycle) via international aircraft movements.