Dengue Risk and Emerging Arboviruses Management in the Pacific (DREAM Pacific): outlines of a future project dedicated to emergi

For more than 50 years the Pacific is regularly experiencing epidemics due to mosquito borne viruses, with dengue being at the top of the list of the most widespread arboviroses in Pacific Island Countries (PICs). Globalization and intensification of human travels have contributed to increase the frequency of introduction of new DENV serotypes into the Pacific and have shortened the time needed for these viruses to be distributed between PICs. With the major DENV vector, Aedes aegypti, being present in the most inhabited islands and, several endemic mosquito species proven to act as secondary vectors in less urbanized settings, DENV is still a major public health concern in PICs awaiting more efficient vector control strategies, a vaccine and anti-viral therapeutics. The threat of the emergence of other mosquito borne viruses has also strongly increased during the last decades. Epidemics due to Ross River Virus have become more and more frequent in Australia, with sometimes a spread to other PICs (several islands in the 1980s and at least Fiji in the early 2000 years). Recently, human cases due to local transmission of chikungunya virus have been reported for the first time in New Caledonia. What about the risk for West Nile virus (WNV) that caused in last September the largest outbreak ever reported in the United States? Do some of the mosquito species present in the PICs might be efficient vectors for WNV? In the expectation to better evaluate the risk of arboviruses emergences in the Pacific and in order to provide local authorities with biological and entomological indicators to better anticipate and manage potential future outbreaks in their country, the knowledge gaps, the weaknesses in the surveillance systems, the difficulties in data production and sharing needed to be identified. To that aim, actors of both public health and research on arboviruses in the Pacific were invited to share their expertise and knowledge within the framework of a workshop organized by the Institut Louis Malardé, Tahiti, French Polynesia, from 3-5 September, 2012. Invited participants were: (1) basic science researchers (entomologists, arbovirologists, climatologists, epidemiologists) mostly from academic research institutions situated in the Pacific (Australia, Fiji, French Polynesia, Hawaii, New Caledonia, New Zealand, Papua New Guinea); (2) representatives of public health organizations involved in the surveillance and support to PICs (WHO, SPC, CDC); (3) representatives of local public health authorities (Directions of Health in French Polynesia and New Caledonia); (4) the staff from public health laboratories in some PICs (Yap - FSM, Majuro-RMI, Tonga). These three days of conferences and workgroup sessions have resulted in designing the outlines of a future scientific project that would address both fundamental and operational aspects of arboviruses emergence in the region: the DREAM Pacific project.