Control of arbovirus diseases: is the vector the weak link?

Arthropod-borne virus (arbovirus) diseases (ABVDs) remain major threats to human health and well-being and, as an epidemiologic group, inflict an unacceptable health and economic burden on humans and animals, including livestock. The developed world has been fortunate to have escaped much of the burden that arboviruses and their arthropod vectors inflict on humans in disease endemic countries, but the introduction and rapid spread of West Nile virus in the Western Hemisphere demonstrated that we can no longer be complacent in the face of these emerging and resurging vector-borne diseases. Unfortunately, as the burdens and threats of ABVDs have increased, the U.S. and international public health capacity to address them has decreased. Vaccines are not available for most of these agents. Previously successful strategies to control ABVDs emphasized vector control, but source reduction and vector control strategies using pesticides have not been sustainable. New insights into vector biology and vector pathogen interactions, and the novel targets that likely will be forthcoming in the vector post-genomics era, provide new targets and opportunities for vector control and disease reduction programs. These findings and approaches must be incorporated into existing strategies if we are to control these important pathogens.