INVITATION Come Fly With Me: Integration of travel medicine and arbovirus surveillance | Natalie Bea Cleton 2016 You are cordially invited to attend the thesis defence Come Fly With Me: Come Fly With Me: Integration of travel medicine and arbovirus surveillance Integration of travel medicine and arbovirus surveillance by Natalie Bea Cleton on Friday 2 September at 13:30 in the Senaatszaal, A-building Erasmus University, Woudestein Campus Burgemeester Oudlaan 50, Rotterdam You are welcome to celebrate with us at the reception following the defense Paranymphs: Ellen Terwindt [email protected] Susan Jagers Viroscience, Erasmus Medical Centre, Erasmus University Rotterdam, [email protected] Rotterdam, The Netherlands Natalie Cleton Centre for Infectious Disease Control, National Institute for Public Health and Dorpsstraat 6 the Environment (RIVM), Bilthoven, The Netherlands 4185NA, Est Natalie Bea Cleton [email protected] 13877_Cleton_Cover.indd 1 20-06-16 13:20 Come Fly With Me Integration of travel medicine and arbovirus surveillance Natalie Bea Cleton Come Fly With Me Integration of travel medicine and arbovirus surveillance Natalie Bea Cleton Come Fly With Me Integration of travel medicine and arbovirus surveillance Vlieg met me mee Integreren van reizigersgeneeskunde met arbovirus surveillance Proefschrift ter verkrijging van de graad van doctor aan de Erasmus Universiteit Rotterdam op gezag van de Rector Magnificus Prof.dr. H.A.P. Pols en volgens besluit van het College voor Promoties. De openbare verdediging zal plaatsvinden op Come Fly With Me: Integration of travel medicine and arbovirus surveillance vrijdag 2 september 2016 om 13:30 uur ISBN: 978‐94‐6299‐376‐1 door Dissertation Erasmus University Rotterdam, Rotterdam, the Netherlands. The research presented was performed at the National Institute for Public Health and the Environment Natalie Bea Cleton (RIVM), Bilthoven, The Netherlands. geboren te Durban, Zuid‐Afrika Cover image: Photograph adapted from Erik F. Bransborg, “Mosquito about to bite”, 2012 Cover design: Vincent Polak‐Hiel Lay‐out: Natalie Cleton & Ridderprint BV Printing: Ridderprint BV, Ridderkerk, the Netherlands ©2016 Natalie Bea Cleton All rights reserved. No part of this publication may be reproduced in any form, by print, photocopying, microfilm, electronic data transmission, or any other means, without prior written permission of the author. Come Fly With Me Integration of travel medicine and arbovirus surveillance Vlieg met me mee Integreren van reizigersgeneeskunde met arbovirus surveillance Proefschrift ter verkrijging van de graad van doctor aan de Erasmus Universiteit Rotterdam op gezag van de Rector Magnificus Prof.dr. H.A.P. Pols en volgens besluit van het College voor Promoties. De openbare verdediging zal plaatsvinden op Come Fly With Me: Integration of travel medicine and arbovirus surveillance vrijdag 2 september 2016 om 13:30 uur ISBN: 978‐94‐6299‐376‐1 door Dissertation Erasmus University Rotterdam, Rotterdam, the Netherlands. The research presented was performed at the National Institute for Public Health and the Environment Natalie Bea Cleton (RIVM), Bilthoven, The Netherlands. geboren te Durban, Zuid‐Afrika Cover image: Photograph adapted from Erik F. Bransborg, “Mosquito about to bite”, 2012 Cover design: Vincent Polak‐Hiel Lay‐out: Natalie Cleton & Ridderprint BV Printing: Ridderprint BV, Ridderkerk, the Netherlands ©2016 Natalie Bea Cleton All rights reserved. No part of this publication may be reproduced in any form, by print, photocopying, microfilm, electronic data transmission, or any other means, without prior written permission of the author. Contents Promotiecommissie: Promotor: Prof.dr. M.P.G. Koopmans Chapter 1 General introduction 1 Overige leden: Prof.dr. E.C.M. van Gorp Chapter 2 Using routine diagnostic data as a method of surveillance of arboviral infection in 11 Prof.dr. D.A.M.P.J. Gommers travellers: a comparative analysis with a focus on dengue. Travel Medicine and Infectious Diseases, 2014 Mar‐Apr;12(2):159‐66. Prof.dr. L.G. Visser Chapter 3 Come fly with me: review of clinically important arboviruses for global travelers. 29 Copromotor: Dr.ir. C.B.E.M. Reusken Journal of Clinical Virology, 2012 Nov;55[1]:191‐203. Chapter 4.1 Syndromic approach to arboviral diagnostics of global travelers as a basis for 53 infectious disease surveillance. PLoS Negl Trop Dis. 2015 Sep 15;9(9):e0004073. Chapter 4.2 Ross River virus disease in two Dutch travellers returning from Australia, February 73 to April 2015. Euro Surveill. 2015 Aug 6;20(31). pii: 21200. Chapter 5.1 Spot the Difference: Development of a syndrome based protein microarray for 83 specific serological detection of multiple flavivirus infections in travelers. PLoS Negl Trop Dis. 2015 Mar 13;9[1]:e0003580. Chapter 5.2 A serological flavivirus protein microarray for detection of multiple cross‐reactive 105 flavivirus infections in horses for veterinary and public health surveillance. (Submitted) Chapter 6 Retrospective study in travellers shows underdiagnosis of flavivirus infections, 127 stressing the need for multiplexing (Submitted) Chapter 7 Summarizing discussion and conclusion 147 Summary 161 Samenvatting 163 Curriculum Vitae 167 PhD Portfolio 169 List of Publications 171 Acknowledgements 173 Contents Promotiecommissie: Promotor: Prof.dr. M.P.G. Koopmans Chapter 1 General introduction 1 Overige leden: Prof.dr. E.C.M. van Gorp Chapter 2 Using routine diagnostic data as a method of surveillance of arboviral infection in 11 Prof.dr. D.A.M.P.J. Gommers travellers: a comparative analysis with a focus on dengue. Travel Medicine and Infectious Diseases, 2014 Mar‐Apr;12(2):159‐66. Prof.dr. L.G. Visser Chapter 3 Come fly with me: review of clinically important arboviruses for global travelers. 29 Copromotor: Dr.ir. C.B.E.M. Reusken Journal of Clinical Virology, 2012 Nov;55[1]:191‐203. Chapter 4.1 Syndromic approach to arboviral diagnostics of global travelers as a basis for 53 infectious disease surveillance. PLoS Negl Trop Dis. 2015 Sep 15;9(9):e0004073. Chapter 4.2 Ross River virus disease in two Dutch travellers returning from Australia, February 73 to April 2015. Euro Surveill. 2015 Aug 6;20(31). pii: 21200. Chapter 5.1 Spot the Difference: Development of a syndrome based protein microarray for 83 specific serological detection of multiple flavivirus infections in travelers. PLoS Negl Trop Dis. 2015 Mar 13;9[1]:e0003580. Chapter 5.2 A serological flavivirus protein microarray for detection of multiple cross‐reactive 105 flavivirus infections in horses for veterinary and public health surveillance. (Submitted) Chapter 6 Retrospective study in travellers shows underdiagnosis of flavivirus infections, 127 stressing the need for multiplexing (Submitted) Chapter 7 Summarizing discussion and conclusion 147 Summary 161 Samenvatting 163 Curriculum Vitae 167 PhD Portfolio 169 List of Publications 171 Acknowledgements 173 MUSKIETE JAG A.D. Keet Jou vabond, wag, ek sal jou kry, Van jou sal net ‘n bloedkol bly Hier teen my kamermure. Deur jou vervloekte gonsery, Deur jou gebyt en plagery, Kon ek nie slaap vir ure. Mag ek my voorstel, eer ons skei, Eer jy die doodslag van my kry – My naam is van der Merwe. Muskiet, wees maar nie treurig nie, Wees ook nie so kieskeurig nie. Jy moet tog ééndag sterwe. Verwekker van malaria, Sing maar jou laaste aria – Nog een minuut vir grasie. Al soebat jy nou nog so lang, Al sê jy ook: ek is nie bang, Nooit sien jy weer jou nasie… Hoe sedig sit hy, o die kreng! Sy kinders kan maar kranse bring, Nòu gaan die vabond sterwe….. Pardoef! Dis mis! daar gaan hy weer! Maar dóód sal hy, sowaar ek sweer – My naam is van der Merwe. MUSKIETE JAG A.D. Keet Jou vabond, wag, ek sal jou kry, Van jou sal net ‘n bloedkol bly Hier teen my kamermure. Deur jou vervloekte gonsery, Deur jou gebyt en plagery, Kon ek nie slaap vir ure. Mag ek my voorstel, eer ons skei, Eer jy die doodslag van my kry – My naam is van der Merwe. Muskiet, wees maar nie treurig nie, Wees ook nie so kieskeurig nie. Jy moet tog ééndag sterwe. Verwekker van malaria, Sing maar jou laaste aria – Nog een minuut vir grasie. Al soebat jy nou nog so lang, Al sê jy ook: ek is nie bang, Nooit sien jy weer jou nasie… Hoe sedig sit hy, o die kreng! Sy kinders kan maar kranse bring, Nòu gaan die vabond sterwe….. Pardoef! Dis mis! daar gaan hy weer! Maar dóód sal hy, sowaar ek sweer – | My naam is van der Merwe. 1 1 | General Introduction Chapter 1 | General introduction General introduction since 1996 has caused outbreaks of encephalitis in horses and humans in France, Greece, Italy, Romania and Hungary.[21‐25] Arboviruses are a group of viruses that use arthropod vectors as their main transmission route and are therefore defined as ARthropod‐BOrne viruses. Known vectors include Figure 1: General cycle arboviruses mosquitoes, ticks, midges, and sandflies. They transmit viruses belonging to various families that are taxonomically unrelated, but grouped by their shared biomechanical characteristic. Of the over 545 suspected arbovirus species, more than 150 cause disease in humans, and most of these are zoonotic.[1‐3] Most pathogenic human arboviruses are sustained in a transmission cycle in which the vectors are arthropods, mainly mosquitoes, and the animal reservoirs are mainly domestic poultry, wild birds, and rodents that serve as the amplifying hosts (figure 1). An amplifying host develops a high level of viremia for sufficient time to infect the vectors that feed on it. Humans are often dead‐end hosts, as they seldom develop the high viremias needed to infect arthropods. A few viruses like yellow fever virus (YFV), chikungunya virus (CHIKV), and dengue virus (DENV) have expanded their host range to include humans as an amplifying host, thereby losing the need for an animal reservoir to sustain virus circulation.[4‐7] Several factors determine the capacity of blood‐feeding (hematophagous) arthropods to serve as vectors in a transmission cycle.