By MARGIE MASON
2 hours ago
TRI NGUYEN ISLAND, Vietnam (AP) — Nguyen Thi Yen rolls up the
sleeves of her white lab coat and delicately slips her arms into a box
covered by a sheath of mesh netting. Immediately, the feeding frenzy
begins.
Hundreds of mosquitoes light on her thin forearms and
swarm her manicured fingers. They spit, bite and suck until becoming
drunk with blood, their bulging bellies glowing red. Yen laughs in
delight while her so-called "pets" enjoy their lunch and prepare to
mate.
The petite, grandmotherly entomologist — nicknamed Dr.
Dracula — knows how crazy she must look to outsiders. But this is
science, and these are very special bloodsuckers.
She smiles and
nods at her red-hot arms, swollen and itchy after 10 minutes of feeding.
She knows those nasty bites could reveal a way to greatly reduce one of
the world's most menacing infectious diseases.
All her mosquitoes
have been intentionally infected with bacteria called Wolbachia, which
essentially blocks them from getting dengue. And if they can't get it,
they can't spread it to people.
New
research suggests some 390 million people are infected with the virus
each year, most of them in Asia. That's about one in every 18 people on
Earth, and more than three times higher than the World Health
Organization's previous estimates.
Known as "breakbone fever"
because of the excruciating joint pain and hammer-pounding headaches it
causes, the disease has no vaccine, cure or specific treatment. Most
patients must simply suffer through days of raging fever, sweats and a
bubbling rash. For those who develop a more serious form of illness,
known as dengue hemorrhagic fever, internal bleeding, shock, organ
failure and death can occur.
And it's all caused by one bite from a female mosquito that's transmitting the virus from another infected person.
So
how can simple bacteria break this cycle? Wolbachia is commonly found
in many insects, including fruit flies. But for reasons not fully
understood, it is not carried naturally by certain mosquitoes, including
the most common one that transmits dengue, the Aedes aegypti.
The
germ has fascinated scientist Scott O'Neill his entire career. He
started working with it about two decades ago at Yale University. But it
wasn't until 2008, after returning to his native Australia, that he had
his eureka moment.
One
of his research students figured out how to implant the bacteria into a
mosquito so it could be passed on to future generations. The initial
hope was that it would shorten the insect's life. But soon, a hidden
benefit was discovered: Wolbachia-infected mosquitoes not only died
quicker but they also blocked dengue partially or entirely, sort of like
a natural vaccine.
"The dengue virus couldn't grow in the
mosquito as well if the Wolbachia was present," says O'Neill, dean of
science at Monash University in Melbourne. "And if it can't grow in the
mosquito, it can't be transmitted."
But proving something in the
lab is just the first step. O'Neill's team needed to test how well the
mosquitoes would perform in the wild. They conducted research in small
communities in Australia, where dengue isn't a problem, and the results
were encouraging enough to create a buzz among scientists who have long
been searching for new ways to fight the disease. After two and a half
years, the Wolbachia-infected mosquitoes had overtaken the native
populations and remained 95 percent dominant.
But how would it
work in dengue-endemic areas of Southeast Asia? The disease swamps
hospitals in the region every rainy season with thousands of sick
patients, including many children, sometimes killing those who seek help
too late.
The Australians tapped 58-year-old Yen at Vietnam's
National Institute of Hygiene and Epidemiology, where she's worked for
the past 35 years. Their plan was to test the Wolbachia mosquitoes on a
small island off the country's central coast this year, with another
release expected next year in Indonesia.
Just
getting the mosquitoes to Tri Nguyen Island was an adventure. Thousands
of tiny black eggs laid on strips of paper inside feeding boxes had to
be hand-carried inside coolers on weekly flights from Hanoi, where Yen
normally works, to Nha Trang, a resort city near the island. The eggs
had to be kept at just the right temperature and moisture. The
mosquitoes were hatched in another lab before finally being transported
by boat.
Yen insisted on medical checks for all volunteer feeders
to ensure they weren't sickening her mosquitoes. She deemed vegetarian
blood too weak and banned anyone recently on antibiotics, which could
kill the Wolbachia.
"When I'm sleeping, I'm always thinking about
them," Yen says, hunkered over a petri dish filled with dozens of
squiggling mosquito pupae. "I'm always worried about temperature and
food. I take care of them same-same like baby. If they are healthy, we
are happy. If they are not, we are sad."
___
Recently, there
have been several promising new attempts to control dengue. A vaccine
trial in Thailand didn't work as well as hoped, proving only 30 percent
effective overall, but it provided higher coverage for three of the four
virus strains. More vaccines are in the pipeline. Other science
involves releasing genetically modified "sterile" male mosquitoes that
produce no offspring, or young that die before reaching maturity, to
decrease populations.
Wolbachia
could end up being used in combination with these and other methods,
including mosquito traps and insecticide-treated materials.
"I've
been working with this disease now for 40-something years, and we have
failed miserably," says Duane Gubler, a dengue expert at the Duke-NUS
Graduate Medical School in Singapore who is not involved with the
Wolbachia research.
"We are now coming into a very exciting period where I think we'll be able to control the disease. I really do."
Wolbachia
also blocks other mosquito-borne diseases such as yellow fever and
chikungunya, O'Neill says. Similar research is being conducted for
malaria, though that's trickier because the disease is carried by
several different types of mosquitoes.
It's unclear why mosquitoes
that transmit dengue do not naturally get Wolbachia, which is found in
up to 70 percent of insects in the wild. But O'Neill doesn't believe
that purposefully infecting mosquitoes will negatively impact
ecosystems. He says the key to overcoming skepticism is to be
transparent with research while providing independent risk analyses and
publishing findings in high-caliber scientific journals.
"I
think, intuitively, it makes sense that it's unlikely to have a major
consequence of introducing Wolbachia into one more species," O'Neill
says, adding that none of his work is for profit. "It's already in
millions already."
Dengue typically comes in cycles, hitting some
areas harder in different years. People remain susceptible to the other
strains after being infected with one, and it is largely an urban
disease with mosquitoes breeding in stagnant water.
Laos and
Singapore have experienced their worst outbreaks in recent history this
season. Thailand has also struggled with a large number of patients.
Cases have also been reported in recent years outside tropical regions,
including in the U.S. and Europe.
Vietnam has logged lower numbers
this year overall, but the country's highest dengue rate is in the
province where Yen is conducting her work.
At the area's main
hospital in Nha Trang, Dr. Nguyen Dong, director of infectious diseases,
says 75 of the 86 patients crammed into the open-air ward are infected
with the virus.
Before
jabbing his fingers into the stomach of one seriously ill patient to
check for pain, he talks about how the dengue season has become much
longer in recent years. And despite the government's increased education
campaigns and resources, the disease continues to overwhelm the
hospital.
If the experiment going on just a short boat ride away
from the hospital is successful, it eventually will be expanded across
the city and the entire province.
____
The 3,500 people on
Tri Nguyen island grew accustomed to what would be a bizarre scene
almost anywhere else: For five months, community workers went
house-to-house in the raging heat, releasing cups of newborn mosquitoes.
And the residents were happy to have them.
"We
do not kill the mosquitoes. We let them bite," says fisherman Tran To.
"The Wolbachia living in the house is like a doctor in the house. They
may bite, but they stop dengue."
Specimens collected from traps
are taken back to the lab for analysis to determine how well Wolbachia
mosquitoes are infiltrating the native population.
The strain of
bacteria used on the island blocks dengue 100 percent, but it's also the
hardest to sustain. At one point, 90 percent of the mosquitoes were
infected, but the rate dropped to about 65 percent after the last batch
was released in early September. A similar decrease occurred in
Australia as well, and scientists switched to other Wolbachia strains
that thrive better in the wild but have lesser dengue-blocking
abilities.
The job is sure to keep Yen busy in her little mosquito lab, complete with doors covered by long overlapping netting.
And
while she professes to adore these pests nurtured by her own blood, she
has a much stronger motivation for working with them: Dengue nearly
claimed her own life many years ago, and her career has been devoted to
sparing others the same fate.
"I love them," she says, "when I need them."
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On the Net: http://www.eliminatedengue.com/