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PLOS Neglected Tropical Diseases logoLink to PLOS Neglected Tropical Diseases
. 2023 Oct 19;17(10):e0011422. doi: 10.1371/journal.pntd.0011422

Mosquito surveillance on U.S military installations as part of a Japanese encephalitis virus detection program: 2016 to 2021

Mark F Olson 1,*, Caroline Brooks 1, Akira Kakazu 1, Ploenphit Promma 2, Wannapa Sornjai 2, Duncan R Smith 2, Timothy J Davis 1
Editor: Mariangela Bonizzoni3
PMCID: PMC10617694  PMID: 37856569

Abstract

Japanese encephalitis virus (JEV) continues to circulate throughout Southeast Asia and the Western Pacific where approximately 3 billion people in 24 countries are at risk of infection. Surveillance targeting the mosquito vectors of JEV was conducted at four military installations on Okinawa, Japan, between 2016 and 2021. Out of a total of 10,426 mosquitoes from 20 different species, zero were positive for JEV. The most abundant mosquito species collected were Aedes albopictus (36.4%) followed by Culex sitiens (24.3%) and Armigeres subalbatus (19%). Statistically significant differences in mosquito species populations according to location were observed. Changes in land use over time appear to be correlated with the species and number of mosquitoes trapped in each location. JEV appears to be absent from mosquito populations on Okinawa, but further research on domestic pigs and ardeid birds is warranted.

Author summary

Japanese encephalitis (JE) is a vector borne disease of significant public health importance for over one third of the earth’s population. While JE was first reported in Japan, the most significant outbreaks today are occurring in China and India. Since 2015, Japanese encephalitis vaccine became mandatory for United States military personnel assigned to Japan or South Korea. In an effort to evaluate the risk of JE infection to service members stationed on Okinawa, mosquito surveillance was conducted at four military installations between 2016 and 2021. Over ten thousand mosquitoes were collected, identified to species, and subjected to PCR testing. None of these samples were positive for Japanese encephalitis virus, but further research is still necessary.

Introduction

Japanese encephalitis (JE) is among the most devastating viral encephalitides found in the Western Pacific and Southeast Asia, where approximately 3 billion people in 24 countries are at risk of infection [1]. Quan et al [2] estimate that in 2015 there were approximately 100,000 cases of JE globally resulting in an estimated 25,000 deaths, with China and India bearing the greatest disease burden.

JE is caused by the Japanese encephalitis virus (JEV), a flavivirus of the family Flaviviridae maintained in an enzootic transmission cycle with wading birds as the reservoir, pigs (both wild and domestic) as the amplification host, and mosquitoes as the vector [3]. Domestic pig farms are especially susceptible for viral amplification due to rapid reproduction, erratic animal vaccination, and direct transmission. Serological evidence of JEV in Singapore in the absence of pig farming suggests that other vertebrates may also act as amplification hosts [4]. Culex tritaeniyorhynchus Giles, 1901, has historically been considered the primary vector [5,6]. However, JEV has also been detected in 13 additional mosquito species: Aedes albopictus, Ae. vexans, Ae. vigilax, Armigeres subalbatus, Cx. annulirostris, Cx. bitaeniorhynchus, Cx. fuscocephala, Cx. gelidus, Cx. pipiens, Cx. pseudovishnui, Cx. quinquefasciatus, Cx. sitiens, and Cx. vishnui, all of which were also confirmed as competent vectors of JEV in the laboratory setting [7].

JE was first reported in 1871 in Japan, in both humans and horses [8] with significant outbreaks occurring in Japan, China, India, Guam, Bangladesh, Malaysia and Nepal among other nations between the early 1900s and now [9]. Since then, aggressive vaccination efforts have reduced transmission, preventing an estimated 45,000 infections in 2015 [2]. In 1991, three US military members stationed on Okinawa developed symptoms consistent with encephalitis and subsequently diagnosed with JE and with one patient developing severe neurologic sequelae [10]. None of the three had been vaccinated, nor had any travel off the island prior to onset [10]. Previous to this outbreak, the last known case of JE in Okinawa occurred in 1974 [10]. Since then, there has been 1 case of JE in 1980, one in 1998 and finally, a one-year-old boy with no travel history contracted JE in Okinawa in 2011. In all of Japan, the incidence of JE has been under 10 cases annually since 2017 and there have been zero cases in Okinawa between 2016 and 2022 (Table 1).

Table 1. Mosquito-borne disease–Japan, (Okinawa).

Year
2016 2017 2018 2019 2020 2021 2022
West Nile Fever 0(0) 0(0) 0(0) 0(0) 0(0) 0(0) 0(0)
Yellow Fever 0(0) 0(0) 0(0) 0(0) 0(0) 0(0) 0(0)
Zika Fever 12(0) 5(0) 0(0) 3(0) 1(0) 0(0) 0(0)
Chikungunya Fever 14(0) 5(0) 4(0) 49(0) 3(1) 0(0) 5(0)
Dengue Fever 342(4) 245(2) 201(0) 461(10) 45(0) 8(0) 91(3)
Japanese Encephalitis 11(0) 3(0) 0(0) 9(0) 5(0) 3(0) 5(0)
Malaria 54(0) 61(1) 50(1) 57(0) 21(0) 29(0) 28(0)

Reference: Official Website of the Okinawa Prefecture (https://www.pref.okinawa.jp/)

The United States Indo-Pacific Command (USINDOPACOM) has approximately 375,000 U.S. military and civilian personnel assigned to this region. Of those, approximately 30,000 are stationed on Okinawa. Since February 1, 2015, Japanese encephalitis vaccine has been mandatory for all active-duty Airmen permanently assigned or temporarily assigned to Japan or South Korea for 30 days or more [11]. The vaccine also became mandatory for members of the US Navy and Marine Corps on November 1, 2016.

In this study, we aim to discover the incidence of JEV among adult mosquitoes in Okinawa between 2016 and 2021. Due to changes in agricultural practices and high rates of vaccination among the Japanese population, we hypothesize JEV circulation to be low.

Materials and methods

Study area

Surveillance for JEV was conducted at four military installations on Okinawa from 13 May 2016 through 21 October 2021 (Fig 1). Okinawa (also referred to as the Ryukyu Archipelago) is the southernmost prefecture of Japan, approximately 400 miles south of mainland and is comprised of 150 islands in the East China Sea, the largest of which being the island of Okinawa itself. The climate is subtropical, warm temperate with an average temperature of 22.9° C, the lowest temperature being 17.3° C in January and highest temperature approximately 28.0° C in August, and annual rainfall of 1,817 mm (climate-data.org). The landscape of the island of Okinawa can roughly be split in half; the northern half more forested and mountainous, comprised mostly of the Yambaru National Forest; and the southern half containing more developed, urban, spaces. Site 1, Okuma Beach Resort (26°44’17.9” N, 128°09’32.3” E), is located on a headland in the northern part of the island, surrounded by fields of various crops. Site 2, Camp Hansen (26°27’22.7” N, 127°55’14.0” E), is near a small, local farm with goats, chickens and geese. A small river and reservoir are also close to this location, and feral hogs inhabit the forested areas. Site 3 is located on Kadena Air Base on the munitions range (26°22’28.8” N, 127°46’13.1” E) which is heavily forested, preserved, and surrounded by various crop fields. Site 4 is at Camp Kinser (26°15’14.1” N, 127°41’29.4” E) located near a coastal port and in a densely populated urban part of the island.

Fig 1. Step map indicating mosquito trapping locations.

Fig 1

(Map created in QGIS version 3.10.11 A Coruña.) Content is the intellectual property of Esri and is used herein with permission. Copyright 2023 Esri and its licensors. All rights reserved. Site 1: Okuma; Site 2: Hansen; Site 3: Kadena; Site 4: Kinser.

Mosquito sampling

Passive box traps (PBT) (BioQuip Products Inc., Rancho Dominguez, CA) were used to collect mosquito samples using carbon dioxide (CO2) tanks and sugar-baited nucleic acid preservation cards that are red in color and affixed to the left and right side of the inner walls of the trap, as described by Hall-Mendelin et al, Ritchie et al and van den Hurk et al [1214]. Traps were collected weekly and placed in a large plastic bag and transported in a large cooler to the lab where the entire trap was placed in a freezer to euthanize the adult mosquitoes. Traps at all four locations were replaced on a weekly basis and CO2 flow was monitored and adjusted as needed, and tanks were replaced when empty. Additional sampling was conducted using Mosquito Magnet (MM) (Woodstream Corporation, Lancaster, PA) baited with MM Octenol and a 20-pound propane tank, Reiter/Cummings gravid trap (BioQuip Products Inc., Rancho Dominguez, CA), and Biogents gravid autocidal traps (BG-GAT1) (Biogents, Martinsburg, WV) in 2016 and 2018. A photo of each trap type is available in the supporting information (S1 Fig).

Identification

Adult mosquitoes were separated by sex and identified morphologically using “The Illustrated Key to Mosquitoes of Okinawa” by the U.S. Army Medical Center Entomology Branch as well as “A revision of the adult and larval mosquitoes of Japan (including the Ryukyu Archipelago and the Ogasawara Islands) and Korea (Diptera: Culicidae)” [15]. Female mosquitoes of the same species were placed into 1.5ml micro centrifuge tubes in pools of no more than 20 mosquitoes per tube. 750 μl of Buffer AVL (Qiagen, Hilden, Germany) was added, and mosquitoes were thoroughly homogenized. Mosquito lysate samples were shipped to Institute of Molecular Biosciences, Mahidol University, Thailand via FedEx for molecular analysis and pathogen detection. Samples were shipped at room temperature with an average transit time of 4 days.

PCR analysis

RNA was extracted from individual or pooled single species mosquito lysates using QIAamp viral RNA mini-kit (Qiagen, Hilden, Germany) according to the manufacturer’s instructions. Complementary DNA was synthesized using RevertAid reverse transcriptase (Thermo Fisher Scientific, Waltham, MA) in a 10 μL reaction containing 4 μL RNA template, 2.5 μM random hexamers (Invitrogen, Carlsbad, CA), 100 units of RevertAid RT, 5 units of RiboLock RNase inhibitor, 1 mM dNTPs and 1X reaction buffer. The thermal cycling conditions were undertaken following manufacturer’s protocol.

Pan-flavivirus screening was undertaken using the SuperScript III one-step RT-PCR system (Invitrogen, Carlsbad, CA). The amplification was carried in a 10 μL reaction containing 1 μL of RNA sample, 0.4 μL of Platinum Taq DNA polymerase, 0.4 mM of each dNTP, 3.2 mM MgSO4 and 200 nM of each pan-flavivirus primers (Flav 100F 5’-AAYTCIACICAIGARATGTAY-3’ and Flav 200R 5’- CCIARCCATRWACCA-3’). The thermal cycling was undertaken according to a previously published protocol [16].

Amplification specifically for JEV was undertaken using DreamTaq DNA polymerase (Thermo Fisher Scientific, Waltham, MA). Reaction was assayed in a 10 μL of PCR mixture containing 1 μL of cDNA, 200 nM dNTPs, 500 μM MgCl2, 0.25 unit of DreamTaq DNA polymerase, 1X DreamTaq buffer and 250 nM of the specific primers (JP1_Fw 5’- GGAAATGAAGGCTCAATC-3’ and JP2_Rv 5’- GAAGTCACGATTGCCCATTCC-3’) according to a previously published protocol [17]. Amplification was undertaken with appropriate negative (no RNA) and positive (stock Beijing-1 JEV RNA) controls. PCR products were separated on 1.0% agarose gels by electrophoresis and products visualized by ethidium bromide staining. Putative positives were rescreened by independent amplification of the lysates and cloning and sequencing of the bands.

We note that the JEV primers used in this study were based on JEV genotype III sequences, and over time this genotype has largely been replaced by genotype I in Asia [18], and as such it is possible that the primers used in the study are less sensitive to detect circulating JEV, although at this point there is no evidence to refute or support this supposition.

Statistical analysis

To compare the mean count of each mosquito species by collection site and trap type, we used the Wilcoxon rank sum test with continuity correction, adjusting P-values (P ≤ 0.05 is considered significant) with the Benjamini-Hochberg procedure.

We standardized the trap counts to reflect a 7-day trapping period for each trap.

All statistical analyses were conducted in R version 4.2.2 [19] using RStudio version 2022.12.0+353 [20].

Results

Over the course of this study, a total of 10,426 mosquitoes were captured using all trap methods (Table 2). The total population was evenly distributed among the 4 sites (site 1: n = 2,613; site 2: n = 2,167; site 3: n = 2,501; site 4: n = 3,145). Of these, the most abundant mosquito species was Ae. albopictus (n = 3,793; 36.4%), followed by Cx. sitiens (n = 2,536; 24.3%), Ar. subalbatus (n = 1,985; 19%), and Cx. quinquefasciatus (13.7%), respectively. Only 369 (3.5%) Cx. tritaeniyorhynchus were trapped over the study period with the highest number being caught in 2019 (n = 59) and zero collected in 2020 and 2021.

Table 2. Species and number of mosquitoes caught by collection site in Okinawa, Japan, 2016–2021.

Species Site Total
1 2 3 4
Aedes albopictus 2373 176 475 769 3793
Aedes dorsalis 2 2
Aedes japonicus 34 25 6 65
Aedes okinawanus 4 4
Aedes pandani 1 1
Aedes togoi 2 2
Aedes vexans 2 124 2 38 166
Aedes vexans nipponi 14 7 21
Anopheles sinensis 2 2 1 5
Armigeres subalbatus 44 223 1680 38 1985
Coquillettidia crassipes 1 4 5
Coquillettidia ochrasea 3 7 10
Culex bitaeniorhynchus 2 1 6 9
Culex quinquefasciatus 91 995 253 90 1429
Culex sitiens 9 450 5 2072 2536
Culex tritaeniorhynchus 51 176 21 121 369
Mansonia crassipes 6 6
Mansonia uniformis 1 1 2 4
Uranotaenia binoculota 7 7
Uranotaenia lateralis 7 7
Grand Total 2613 2167 2501 3145 10,426

Site 1: Okuma; Site 2: Hansen; Site 3: Kadena; Site 4: Kinser. Includes passive box trap, Mosquito Magnet, Biogents Gravid Autocidal Trap, and Reiter/Cummings Gravid Trap for surveillance methods.

Significant differences were noted in trapping method. The MM was only used in 2016 but accounted for 7,215 adult female mosquitoes. The PBT was utilized in all study years and accounted for the next highest number of mosquitoes (n = 3,155), with BG-GAT1 and Reiter/Cummings gravid trap catching a relatively small number (n = 32 and n = 24 respectively). The 7-day mean for the MM was 195.00 (± 43.28 SEM); for the PBT, 30.37 (± 6.48 SEM); for the BG-GAT1, 12.00 (± 6.00 SEM); and for the gravid trap, 44.8 (± 10.52 SEM). The MM and PBT caught significantly higher 7-day mean counts than the gravid trap (P < 0.005) and the MM also had significantly higher mean counts than the PBT (P < 0.0005).

For analyzing population trends according to geographical location, only mosquitoes caught using the PBT were included (Table 3). The most abundant species trapped at Site 1 was Ae. albopictus (n = 1,081; 89.7%). At Site 2, the most abundant species was Cx. sitiens (n = 446; 61.3%) but significant numbers of Ae. albopictus (n = 98; 13.5%) Cx. quinquefasciatus (n = 87;12.0%) and even Cx. tritaeniyorhynchus (n = 62; 8.5%) were identified. Ar. subalbatus was the dominant species at Site 3 (n = 560; 68.1%) with a significant number of Ae. albopictus as well (n = 199;24.2%). Finally, Site 4 is characterized primarily by Cx. sitiens (n = 205; 51.1%) and Ae. albopictus (n = 119; 29.7%), but also with significant numbers of Cx. tritaeniyorhynchus (n = 50; 12.5%).

Table 3. Species and number of mosquitoes caught only with PBT by site in Okinawa, Japan, 2016–2021.

Species Site Total
1 2 3 4
Aedes albopictus 1,081 98 199 119 1,497
Aedes dorsalis 2 2
Aedes japonicus 34 1 6 41
Aedes okinawanus 4 4
Aedes pandani 1 1
Aedes togoi 2 2
Aedes vexans 8 1 9
Armigeres subalbatus 36 20 560 16 632
Coquillettidia crassipes 1 4 5
Coquillettidia ochrasea 3 7 10
Culex bitaeniorhynchus 1 1 2 4
Culex quinquefasciatus 28 87 31 5 151
Culex sitiens 8 446 5 205 664
Culex tritaeniorhynchus 12 62 10 50 134
Mansonia uniformis 1 1 2 4
Grand Total 1,205 727 822 401 3,155

Site 1: Okuma; Site 2: Hansen; Site 3: Kadena; Site 4: Kinser. Includes Passive Box Trap only.

No mosquitoes or nucleic acid preservation cards tested positive for JEV. Furthermore, none of the samples screened for JEV specifically showed any amplification products after screening with pan-flavivirus primers. However, while a number of flaviviruses including members of the JEV, Kokobera and Nataya virus serocomplexes of the genus Flavivirus have the same transmission vectors as JEV [21] to the best of our knowledge none of these viruses have ever been reported in Japan.

A significantly higher mean count per collection of Ae. albopictus was observed at Site 1 in relation to site 2–4 (P < 0.005). Significantly higher mean populations of Ar. subalbatus were found at Site 3 in comparison to Sites 1 (P = 0.0088), 2 (P = 0.0088) and 4 (P = 0.0075). For Cx. sitiens, significantly higher mean counts of mosquitoes were observed in Site 2 compared to Site 1 (P = 0.036) and Site 3 (P = 0.036). The mean count of Cx. sitiens captured at Site 4 was also significantly higher than Site 1 (P = 0.036). No further statistically significant correlations were observed in other species (Ae. japonicus, Cx. quinquefasciatus, and Cx. tritaenioryhnchus).

The six most prolific species (having > 40 total mosquitoes as noted in Table 3) found in this study were also analyzed by each site using the previously mentioned statistical analysis (Table 4 and Fig 2). At Site 1, significantly higher mean counts of Ae. albopictus than any other species were observed (P < 0.005). At Site 2, Cx. sitiens had significantly higher mean counts compared with Cx. quinquefasciatus (P = 0.00083), Ar. subalbatus (P = 0.01644) and Ae. japonicus (P < 0.0005). At Site 3, significantly higher mean counts of Ar. subalbatus were detected compared to Cx. quinquefasciatus, Cx. sitiens and Cx. tritaenioryhnchus. However, Ae. albopictus populations at this site were also significantly higher than Ae. japonicus (P < 0.005), Cx. quinquefasciatus (P < 0.005), and Cx. tritaeniyorhynchus (P < 0.005). Finally, at Site 4 there were significantly higher mean populations of Ae. albopictus compared with Ae. japonicus (P = 0.00058), Ar. subalbatus (P = 0.00129), or Cx. quinquefasciatus (P = 0.00129). Mean counts of Cx. sitiens were significantly higher than Ae. japonicus (P = 0.04622), but not significantly higher than other species.

Table 4. Mean ± SEM number of female mosquitoes caught per collection (7 trap-nights), by site and species.

Species Site
1 2 3 4
Aedes albopictus 20.02 ± 4.52 (1,081) 3.06 ± 0.99 (98) 6.22 ± 1.98 (199) 4.71 ± 1.44 (119)
Aedes japonicus 0.63 ± 0.34 (34) - 0.03 ± 0.03 (1) 0.27 ± 0.27 (6)
Armigeres subalbatus 0.67 ± 0.19 (36) 0.63 ± 0.33 (20) 11.81 ± 8.46 (378) 0.35 ± 0.21 (8)
Culex quinquefasciatus 0.52 ± 0.41 (28) 2.72 ± 2.66 (87) 0.97 ± 0.87 (31) 0.22 ± 0.09 (5)
Culex sitiens 0.15 ± 0.06 (8) 13.94 ± 5.07 (446) 0.16 ± 0.08 (5) 8.91 ± 4.40 (205)
Culex tritaeniorhynchus 0.22 ± 0.09 (12) 1.94 ± 1.14 (62) 0.31 ± 0.18 (10) 2.17 ± 1.16 (50)

Site 1: Okuma; Site 2: Hansen; Site 3: Kadena; Site 4: Kinser. Includes Passive Box Trap only.

Fig 2. Mean (± SEM) count of female mosquitoes per trapping event, by species and site, 2016–2021.

Fig 2

A- Site 1, B- Site 2, C- Site 3, D- Site 4. Aealb = Aedes albopictus; Aejap = Aedes japonicus; Arsub = Armigeres subalbatus; Cxqui = Culex quinquefasciatus; Cxsit = Culex sitiens; Cxtri = Culex tritaeniyorhynchus.

Significant changes in relative abundance of different mosquito taxa over time were also observed (Fig 3). For example, the mean count of Ae. albopictus mosquitoes captured at Site 1 declined from 42.82 (± 17.79 SEM) per trapping event in 2016 to 2.57 (± 0.72 SEM) in 2021. Significantly more Cx. sitiens were caught in 2021 at Site 2 compared to all previous years (P < .05).

Fig 3. Change in population relative abundance over time, by species.

Fig 3

Note: Only PBT data was used since PBT was consistently used each year of the study, at all study locations. A- Site 1, B- Site 2, C- Site 3, D- Site 4. Aealb = Aedes albopictus; Aejap = Aedes japonicus; Arsub = Armigeres subalbatus; Cxqui = Culex quinquefasciatus; Cxsit = Culex sitiens; Cxtri = Culex tritaeniyorhynchus.

Discussion

Our study investigated the incidence of JEV in adult mosquitoes captured in Okinawa, Japan, between 2016 and 2021. While several of the confirmed competent vectors of JEV were captured in our surveillance, no JEV was detected. Interestingly, a review of historical data from the Okinawan Prefectural Government showed zero autochthonous cases of Japanese Encephalitis from 2016–2021 (Table 1), and the last recorded military case of JE was in 1991.

The stark absence of Japanese encephalitis virus from adult mosquitoes in Okinawa is likely due to many factors. Changes in agricultural practices have greatly diminished the number of rice paddies on island, a preferred breeding environment for Cx. tritaeniyorhynchus. Land use analyses from around 2015, 2019 and 2020 appear to indicate a decrease in “Paddy fields” and “Crop lands” and an increase in “Built up” areas. (S2 Fig). Post WWII, rice and wheat farming was replaced with sugarcane and other cash crops [22]. These landscape changes, especially the reduction of rice paddies and increases in “Built up” areas likely resulted in diminished mosquito breeding habitats, especially for Cx. tritaeniyorhynchus which is also supported by the data we collected.

Pigs and ardeid birds are considered reservoirs and amplifying hosts in the JEV transmission cycle [6] but little is known about the status of JEV in these animals on Okinawa. One study by Nidaira et al [23] found a high percentage of JEV-positive serum samples from wild boars in the Northern part of Okinawa yet they suspected these were infected from JEV that was amplified on pig farms where there was a more constant supply of uninfected hosts. As of 2022, there were 219 pig farms on Okinawa with a total population of 211,700 pigs but we were unable to determine what percentage have been immunized against JEV. Additionally, an unknown population of wild boar is also present on island. Komiya et al [24] found a high rate (86.5%, n = 37) of JEV neutralizing antibodies and 21.6% IgM antibodies (suggesting recent infection) collected from wild boars in Ishikawa Prefecture, Japan, even during winter months, therefore more research on the status of JEV among these wild animal hosts is warranted.

In our study, the highest number of mosquitoes were collected in 2016. However, this was influenced by the use of the Mosquito Magnet (MM). In 2016, the MM was deployed along with the passive box trap in the same locations for a total of 22 weeks (154 trap nights). During that period, the MM captured 7,215 female mosquitoes compared to 1,661 in the PBT. We discontinued the use of MM after 2016 due to trap malfunction and inability to obtain repair services.

Total mosquito abundance was evenly distributed among trapping sites when considering all trap types. However, heterogeneity of mosquito species diversity and abundance was observed at each collection site when filtering the data for just Passive Box Trap. Site 1, Okuma Beach, seems to favor populations of the Asian tiger mosquito, Ae. albopictus and had the greatest overall abundance (Table 3) whereas Site 2, Hansen, appears more suitable to both Ae. albopictus and members of the Cx. sitiens complex. Ar. subalbatus mosquitoes were frequently caught at Site 3, Kadena munitions range, but not at the other locations, and a variety of mosquitoes were caught at Site 4, Kinser, but showed less overall abundance. The greater abundance of Ae. albopictus at Site 1 could be a result of its proximity to the evergreen broadleaf forests which comprise the Yambaru National Park. The greatest abundance of Ar. subalbatus were captured at Site 3, Kadena AB. The Walter Reed Biosystematics Unit (https://WRBU.si.edu) describes Ar. subalbatus as “originally forest-associated” and “thrives in rural and sub-urban areas.” The overall paucity of mosquitoes caught at Site 4 seems to correlate well with the densely urbanized or “built up” conditions potentially offering fewer areas for oviposition.

Currently, vaccination coverage is high in Japan. In 1954, Japan added a mouse brain-derived JEV vaccine to the routine childhood immunization program, but discontinued the recommendation in 2005 due to concerns over potential side effects. Understandably, vaccination coverage dropped dramatically until 2009 when a new, Vero cell-derived vaccine was approved for use and Japan reinstated the recommendation in 2010 [25]. The percentage of the target population of 3–4-year-old children receiving JEV vaccine in 2006 dropped to 4.0%, but climbed to 61.2% in 2009 and in 2020, the Japan Ministry of Health, Labor and Welfare reported 119.1% coverage for the first dose. (https://www.mhlw.go.jp/topics/bcg/other/5.html) (i.e. the target population in 2020 was 939,000 children, but 1,118,107 1st doses of JEV vaccine were administered). Consequently, childhood-onset JE was higher between 2005 and 2015 compared to previous years when the inactivated mouse brain-derived vaccine was in use [25] demonstrating the importance of universal childhood vaccination in locations where JE is still endemic.

Our study had several limitations. In 2020, COVID-19 caused travel restrictions and prevented access to our CO2 vendor. Another limitation in our study was a lack of trap diversity. For the sake of comparison, utilizing the Mosquito Magnet and perhaps the Reiter/Cummings Gravid, Biogents Gravid Autocidal Trap consistently throughout the study would have offered additional insight. Also, homogenized mosquito samples were held at room temperature (24° C) in Buffer AVL for up to 7 days for packaging and shipping to Mahidol University. Recognizing the potential for RNA degradation, our team developed a quality assurance process using positive and negative proficiency analyte testing rounds (blinded to lab personnel) to include with field samples. To date, positive controls undergoing the same packaging and shipping protocol indicate sample integrity is maintained. Finally, we were unable to collect serum samples from domestic pig farms to assess JEV-seropositivity.

In conclusion, we did not detect JEV in any of the mosquitoes we collected between 2016 and 2021. Moreover, with the exception of Cx. sitiens, we observed a decrease in the populations of some of the mosquitoes historically known to serve as vectors for JEV. However, based upon this data alone we cannot determine if JEV has been eliminated from Okinawa. For example, Chen et al [26] demonstrated the potential for JEV transmission by Ar. subalbatus in a location without rice farming. Changes in land use (and subsequently mosquito habitat), climate change, and JEV vaccination in humans and animals all play an important role in breaking or facilitating the JEV transmission cycle. Future studies should look at levels of JEV seropositivity in domestic pigs, wild boars as well as herons and other wading birds, and the potential role of Ar. subalbatus in the JEV transmission cycle on the island of Okinawa.

Supporting information

S1 Fig. Traps used in this study.

A–Mosquito Magnet; B–Passive Box Trap; C–Biogents Gravid Autocidal Trap; D–Reiter/Cummings Gravid Trap. All photos were taken by the author, Dr. Mark F. Olson.

(TIF)

S2 Fig. Changes in land use at each trapping location over time.

A = Satellite imagery showing trap locations. Content is the intellectual property of Esri and is used herein with permission. Copyright 2023 Esri and its licensors. All rights reserved. B = Land use around 2015. C = Land use around 2019. D = Land use around 2020 (latest version). (Source: ALOS–Advanced Land Observing Satellite, Research and Application Project; https://www.eorc.jaxa.jp/ALOS/en/dataset/lulc_e.htm; Content is the intellectual property of Japan Aerospace Exploration Agency (JAXA) and is used herein with permission).

(TIF)

S1 Table. CSV file containing data underlying the findings in this study.

(CSV)

Acknowledgments

We would like to thank the Okinawa Prefectural Government and University of the Ryukyus for their expertise and collaboration. Additionally, we are grateful to Dr. Gabriel Hamer, Dr. Craig Stoops, and Capt George Cooksey for their review and valuable recommendations for improving the manuscript. We would also like to thank the 18th Wing Public Affairs office at Kadena Air Base for screening this manuscript for operations security (OPSEC) prior to publication.

Data Availability

A CSV file containing data underlying the findings in this study is available in Supporting information.

Funding Statement

This work was financially supported by the Armed Forces Health Surveillance Division—Global Emerging Infections Surveillance (AFHSD-GEIS) under awards P0091_21_18(TD), P0049_22_18(MO), and P0058_23_18(MO). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. No authors received any salary from the funder of this study.

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PLoS Negl Trop Dis. doi: 10.1371/journal.pntd.0011422.r001

Decision Letter 0

Mariangela Bonizzoni, Abdallah M Samy

7 Jul 2023

Dear Dr. Olson,

Thank you very much for submitting your manuscript "Mosquito surveillance on U.S military installations as part of a Japanese encephalitis virus detection program: 2016 to 2021" for consideration at PLOS Neglected Tropical Diseases. As with all papers reviewed by the journal, your manuscript was reviewed by members of the editorial board and by several independent reviewers. The reviewers appreciated the attention to an important topic. Based on the reviews, we are likely to accept this manuscript for publication, providing that you modify the manuscript according to the review recommendations.

Please prepare and submit your revised manuscript within 30 days. If you anticipate any delay, please let us know the expected resubmission date by replying to this email.

When you are ready to resubmit, please upload the following:

[1] A letter containing a detailed list of your responses to all review comments, and a description of the changes you have made in the manuscript.

Please note while forming your response, if your article is accepted, you may have the opportunity to make the peer review history publicly available. The record will include editor decision letters (with reviews) and your responses to reviewer comments. If eligible, we will contact you to opt in or out

[2] Two versions of the revised manuscript: one with either highlights or tracked changes denoting where the text has been changed; the other a clean version (uploaded as the manuscript file).

Important additional instructions are given below your reviewer comments.

Thank you again for your submission to our journal. We hope that our editorial process has been constructive so far, and we welcome your feedback at any time. Please don't hesitate to contact us if you have any questions or comments.

Sincerely,

Mariangela Bonizzoni

Academic Editor

PLOS Neglected Tropical Diseases

Abdallah Samy

Section Editor

PLOS Neglected Tropical Diseases

***********************

Reviewer's Responses to Questions

Key Review Criteria Required for Acceptance?

As you describe the new analyses required for acceptance, please consider the following:

Methods

-Are the objectives of the study clearly articulated with a clear testable hypothesis stated?

-Is the study design appropriate to address the stated objectives?

-Is the population clearly described and appropriate for the hypothesis being tested?

-Is the sample size sufficient to ensure adequate power to address the hypothesis being tested?

-Were correct statistical analysis used to support conclusions?

-Are there concerns about ethical or regulatory requirements being met?

Reviewer #1: Methods are appropriate to test the hypothesis, although more information in some sections would be beneficial to strengthen the data.

1. Line 95: Are there any mosquito species bias using the passive box traps? Please include the answer/explanation in the text.

2. Line 101-102: Delete "The sugar-baited nucleic acid preservation cards."

3. Line 114: Please include how the homogenized mosquito samples were shipped. Temperature? Duration of travel? At certain temperatures, short storage periods in buffer AVL could have a significant effect on the viral RNA integrity.

4. Line 134: Some JEV PCR primers are more sensitive to certain genotypes. Any data that this PCR based on genotype III works well to identify others, including the now dominant genotype Ib? Please include this information in the manuscript.

--------------------

Results

-Does the analysis presented match the analysis plan?

-Are the results clearly and completely presented?

-Are the figures (Tables, Images) of sufficient quality for clarity?

Reviewer #1: The results are very clear and concise. The supplementary figures are especially very visually pleasing and able to highlight the important information right away.

1. Figure 1: It would be great if sites 1-4 were labeled on the map.

2. Line 175: No positive detection by the pan-flavivirus PCR either? Please include this information.

3. Line 193: Please include the appropriate p-values for the Site 3 statement.

4. Supplementary figures: Any way to include SFigs 2 and 3 in the main manuscript? They are very helpful as a results summary. Maybe even replace Table 3 or 4 and turn either tables as supplementary tables.

--------------------

Conclusions

-Are the conclusions supported by the data presented?

-Are the limitations of analysis clearly described?

-Do the authors discuss how these data can be helpful to advance our understanding of the topic under study?

-Is public health relevance addressed?

Reviewer #1: Please explain on the study limitations (i.e. any mosquito species bias with the selected mosquito traps).

--------------------

Editorial and Data Presentation Modifications?

Use this section for editorial suggestions as well as relatively minor modifications of existing data that would enhance clarity. If the only modifications needed are minor and/or editorial, you may wish to recommend “Minor Revision” or “Accept”.

Reviewer #1: (No Response)

--------------------

Summary and General Comments

Use this section to provide overall comments, discuss strengths/weaknesses of the study, novelty, significance, general execution and scholarship. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. If requesting major revision, please articulate the new experiments that are needed.

Reviewer #1: The authors submitted a well-written manuscript describing their JEV mosquito surveillance in Okinawa, Japan. Adequate background information was provided in both the introduction and conclusion to highlight the importance of the study and to help the readers digest the data collected. It would be great if the requested additional information is included in the manuscript to strengthen their results and the readers' understanding.

--------------------

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Reviewer #1: No

Figure Files:

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References

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PLoS Negl Trop Dis. doi: 10.1371/journal.pntd.0011422.r003

Decision Letter 1

Mariangela Bonizzoni, Abdallah M Samy

5 Oct 2023

Dear Dr. Olson,

We are pleased to inform you that your manuscript 'Mosquito surveillance on U.S military installations as part of a Japanese encephalitis virus detection program: 2016 to 2021' has been provisionally accepted for publication in PLOS Neglected Tropical Diseases.

Before your manuscript can be formally accepted you will need to complete some formatting changes, which you will receive in a follow up email. A member of our team will be in touch with a set of requests.

Please note that your manuscript will not be scheduled for publication until you have made the required changes, so a swift response is appreciated.

IMPORTANT: The editorial review process is now complete. PLOS will only permit corrections to spelling, formatting or significant scientific errors from this point onwards. Requests for major changes, or any which affect the scientific understanding of your work, will cause delays to the publication date of your manuscript.

Should you, your institution's press office or the journal office choose to press release your paper, you will automatically be opted out of early publication. We ask that you notify us now if you or your institution is planning to press release the article. All press must be co-ordinated with PLOS.

Thank you again for supporting Open Access publishing; we are looking forward to publishing your work in PLOS Neglected Tropical Diseases.

Best regards,

Mariangela Bonizzoni

Academic Editor

PLOS Neglected Tropical Diseases

Abdallah Samy

Section Editor

PLOS Neglected Tropical Diseases

***********************************************************

PLoS Negl Trop Dis. doi: 10.1371/journal.pntd.0011422.r004

Acceptance letter

Mariangela Bonizzoni, Abdallah M Samy

16 Oct 2023

Dear Dr. Olson,

We are delighted to inform you that your manuscript, "Mosquito surveillance on U.S military installations as part of a Japanese encephalitis virus detection program: 2016 to 2021," has been formally accepted for publication in PLOS Neglected Tropical Diseases.

We have now passed your article onto the PLOS Production Department who will complete the rest of the publication process. All authors will receive a confirmation email upon publication.

The corresponding author will soon be receiving a typeset proof for review, to ensure errors have not been introduced during production. Please review the PDF proof of your manuscript carefully, as this is the last chance to correct any scientific or type-setting errors. Please note that major changes, or those which affect the scientific understanding of the work, will likely cause delays to the publication date of your manuscript. Note: Proofs for Front Matter articles (Editorial, Viewpoint, Symposium, Review, etc...) are generated on a different schedule and may not be made available as quickly.

Soon after your final files are uploaded, the early version of your manuscript will be published online unless you opted out of this process. The date of the early version will be your article's publication date. The final article will be published to the same URL, and all versions of the paper will be accessible to readers.

Thank you again for supporting open-access publishing; we are looking forward to publishing your work in PLOS Neglected Tropical Diseases.

Best regards,

Shaden Kamhawi

co-Editor-in-Chief

PLOS Neglected Tropical Diseases

Paul Brindley

co-Editor-in-Chief

PLOS Neglected Tropical Diseases

Associated Data

    This section collects any data citations, data availability statements, or supplementary materials included in this article.

    Supplementary Materials

    S1 Fig. Traps used in this study.

    A–Mosquito Magnet; B–Passive Box Trap; C–Biogents Gravid Autocidal Trap; D–Reiter/Cummings Gravid Trap. All photos were taken by the author, Dr. Mark F. Olson.

    (TIF)

    S2 Fig. Changes in land use at each trapping location over time.

    A = Satellite imagery showing trap locations. Content is the intellectual property of Esri and is used herein with permission. Copyright 2023 Esri and its licensors. All rights reserved. B = Land use around 2015. C = Land use around 2019. D = Land use around 2020 (latest version). (Source: ALOS–Advanced Land Observing Satellite, Research and Application Project; https://www.eorc.jaxa.jp/ALOS/en/dataset/lulc_e.htm; Content is the intellectual property of Japan Aerospace Exploration Agency (JAXA) and is used herein with permission).

    (TIF)

    S1 Table. CSV file containing data underlying the findings in this study.

    (CSV)

    Attachment

    Submitted filename: Response to reviewers.docx

    Data Availability Statement

    A CSV file containing data underlying the findings in this study is available in Supporting information.


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