C Roxanne Connelly

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Researchers used ecological niche modeling and county-level collection records to map where Culicoides paraensis — the primary insect vector of Oropouche virus — is likely to exist across the continental United States and its Caribbean territories. High suitability was estimated across the southeastern US, with moderate suitability extending toward the Great Lakes and Atlantic coast. The maps provide the first county-level risk estimate for this vector as Oropouche virus continues to expand its range in the Americas.

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This review compiled newly available field collection data, museum specimens, and published records to produce an updated distribution map for Culicoides paraensis in the United States, expanding its known range to 219 counties across 24 states. New state records were established for Arkansas, Michigan, New Jersey, and Washington DC. The review also synthesizes the biology, surveillance methods, and public health significance of this species as Oropouche virus spreads in the Caribbean and generates travel-associated cases in the US.

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Surveillance data from over 8,800 trap nights across Las Vegas metro area census tracts showed that Aedes aegypti — a major vector for dengue, Zika, and chikungunya — has established a permanent, expanding population in the city since its first detection in 2017. By 2023, more than half of surveyed census tracts tested positive, despite the city's arid climate that models had predicted would disfavor the mosquito. The findings underscore that this species can establish in unexpected environments and that vector control programs must adapt accordingly.

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Following the detection of Cache Valley virus in an aborted lamb in Arkansas in 2023, a One Health investigation was conducted to understand the risk this mosquito-borne virus posed to both animals and people in the region. Cache Valley virus can cause severe neurological disease in humans and reproductive failure in sheep and goats, making it a dual threat to agriculture and public health. The investigation demonstrates how coordinated animal and human surveillance can detect emerging viral threats early.

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A scoping review of 10 studies examined whether pyrethrins and synthetic pyrethroids used for community mosquito control cause harm to people living in treated areas. No studies found a causal link between properly applied pyrethroid mosquito spraying and acute or chronic health effects in the public, and risk assessments consistently showed exposures well below regulatory safety thresholds. The evidence supports continued use of these insecticides for mosquito control when applied according to label directions.

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A scoping review of 10 studies assessed the human health risks associated with organophosphate insecticides used for adult mosquito control in the US and Canada. None of the included studies found a causal link between organophosphate exposure during mosquito control operations and measurable health effects, including increased hospitalizations or toxicity. The evidence base is limited and dated, pointing to a need for more recent research to support evidence-based decision-making by mosquito control agencies.

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This study examined 159 kidney transplant patients to understand the relationship between a common post-transplant parathyroid condition and calcium deposits found in transplanted kidneys on biopsy. Patients with tertiary hyperparathyroidism were six times more likely to have calcium deposits in their allograft, and the main risk factors for developing the parathyroid condition were longer time on dialysis before transplant and prior use of a calcium-lowering drug. Importantly, neither the calcium deposits nor the parathyroid condition were associated with worse kidney function at three years.

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This review assessed the risk of Oropouche virus spreading to the continental United States following major outbreaks in South America and the Caribbean that also included the first documented deaths and vertical transmission cases. The risk of sustained local transmission in the continental US was judged to be low because the primary vector insect interacts with humans differently in North America than in endemic regions. However, the review identified key data gaps and called for prioritizing detection and response capacity given the virus's recent expansion.

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Researchers analyzed 113 kidneys placed on hypothermic machine perfusion pumps and found that the temperature of the perfusate in the first five minutes — before the organ had fully cooled the circuit — independently predicted whether the recipient would develop delayed graft function. Kidneys where the early perfusate exceeded 10 degrees Celsius were 4.5 times more likely to develop this complication. The finding suggests a simple quality improvement target: ensuring perfusion circuits are pre-cooled before organs are placed on pump.

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This article provides practical guidance for mosquito control programs on how to plan, execute, and seek federal reimbursement for emergency mosquito control operations after hurricanes, drawing on experience with Hurricane Florence response in North Carolina. Key lessons include the importance of pre-established FEMA reimbursement documentation, maintaining community trust through ongoing communication, and deploying experienced local operators familiar with treatment areas. The article serves as a preparedness resource for mosquito control programs in hurricane-prone regions.

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Laboratory bioassays tested five commercial mosquito larvicides against susceptible Aedes aegypti larvae and documented both lethal concentrations and sublethal effects on the adults that survived. Adult mosquitoes that developed from larvae exposed to the estimated lethal concentration for 50% of the population were measurably smaller than controls, with females more affected than males. The study provides baseline potency data for these products and documents that sublethal larvicide exposure can alter the physical characteristics of adult mosquitoes.

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This study compared whether mosquitoes incubated under fluctuating daily temperature ranges — which better reflect real-world conditions — transmitted West Nile virus differently than those held at a constant temperature. No significant differences were found in infection, spread, or transmission rates for either of two Culex mosquito species tested. However, viral titers differed between temperature treatments, suggesting that temperature fluctuations affect how much virus is present even when transmission rates appear similar.

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Researchers developed Aedes aegypti strains that were genetically similar but differed in pyrethroid resistance, then infected them with Zika virus to test whether resistance status affected the mosquito's ability to acquire and spread the virus. Pyrethroid-resistant mosquitoes showed different rates of infection and disseminated infection compared to susceptible ones, suggesting that widespread insecticide resistance may be altering how effectively this mosquito spreads arboviruses. The findings add a new dimension to the public health consequences of insecticide resistance.

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Researchers tested three North American mosquito and midge species — Culex quinquefasciatus, Culicoides sonorensis, and another Culex species — to determine whether any could transmit Oropouche virus if it were introduced. Culicoides sonorensis showed high infection and spread of the virus within the insect but appeared to have a barrier preventing efficient transmission, while Culex quinquefasciatus showed low but detectable infection and transmission. The results suggest that North American establishment of Oropouche virus transmission is possible but would likely be limited.

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This comprehensive review synthesized available research on controlling Aedes aegypti in the continental United States, covering chemical control, insecticide resistance, biological control, source reduction, trapping, and emerging techniques. The review identified major gaps in evidence-based control protocols specific to the continental US, where this species receives little attention outside of outbreak periods. As local Ae. aegypti-borne outbreaks have become more frequent — including Zika in 2016 — the review argues that a much stronger evidence base is urgently needed.

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This report compiled 92 new county distribution records for mosquito species in Florida gathered from multiple sources between 1989 and 2019. The records update the known geographic range of numerous species across the state. Accurate, current distribution data are foundational for mosquito surveillance programs and for assessing which areas face the greatest risk from mosquito-borne diseases.

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This article describes how $37.6 million in CDC hurricane relief funding was distributed to seven states and territories to rebuild and strengthen mosquito surveillance and control programs after Hurricanes Harvey, Irma, and Maria. Activities funded included training for applicators, equipment replacement, insecticide resistance testing, and testing of novel control techniques. The article introduces a special journal issue documenting mosquito control response experiences to guide future disaster preparedness.

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The EPA and CDC jointly issued their first combined recommendation stating that mosquito surveillance and control should be maintained to the extent possible during public health emergencies and natural disasters. The guidance addresses the challenge that competing priorities and public fear of pesticides can disrupt mosquito control precisely when disease transmission risk is elevated. It endorses integrated pest management using a combination of physical and chemical methods following EPA label directions.

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During the 2016 Zika outbreak in Miami-Dade County, mosquito control authorities responded to four transmission clusters by combining aerial and ground-based insecticide applications in a way not previously used for Aedes aegypti control. Mosquito populations rapidly declined and local Zika transmission stopped within the treated zones following the combined spray approach. The response demonstrated that coordinated, multi-method insecticide deployment can effectively interrupt urban Aedes aegypti-borne transmission.

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Insecticide susceptibility testing on 37 Aedes aegypti and 42 Aedes albopictus populations collected throughout Florida found that 95% of Ae. aegypti populations were resistant to pyrethroids, while about 30% of Ae. albopictus showed pyrethroid resistance. Organophosphate resistance was found at roughly 31% frequency in both species. The data provide a statewide baseline showing heavy reliance on pyrethroids has produced widespread resistance in Ae. aegypti and point to the need for resistance management strategies.

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Researchers tested a published venous thromboembolism prediction algorithm against current pediatric trauma guidelines at two institutions, applying it retrospectively to more than 8,000 pediatric trauma admissions. The algorithm identified far fewer patients as high- or moderate-risk than current guidelines suggest treating, while achieving better sensitivity and specificity for actual VTE events. Using the algorithm instead of current guidelines would have anticoagulated 80% fewer patients while catching more actual cases.

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A coordinated statewide survey launched in 2016 mapped the presence of Aedes aegypti and Aedes albopictus in all participating Florida counties for the first time. Both species were detected in the 56 participating counties, with Ae. albopictus found predominantly in the northern panhandle and Ae. aegypti more widespread. The results provide a current baseline for disease risk assessment and underscore the ongoing threat of arbovirus outbreaks in a state where dengue, chikungunya, and Zika are all present.

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Researchers reviewed 67 cases of traumatic hip dislocation to determine whether initial attempts at reduction using conscious sedation or general anesthesia were more successful. Conscious sedation succeeded in about half of cases, with general anesthesia used when it failed. Hips dislocated for more than six hours were nearly 20 times more likely to fail conscious sedation, providing a practical clinical decision point for choosing the initial approach.

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Researchers used blood-meal DNA analysis to identify which hosts mosquitoes were feeding on at a facility where invasive Burmese pythons were kept outdoors in Florida. Three Culex mosquito species were found feeding on the pythons, with Culex erraticus taking significantly more blood meals from pythons than from any other available host. The study demonstrates that established invasive pythons in southern Florida could potentially become nodes in mosquito-borne disease transmission networks.

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A 10-year retrospective review of more than 12,000 trauma activations found that tachypnea — an elevated respiratory rate — was the strongest pre-hospital predictor of under-triage, particularly for patients with chest injuries or those requiring emergency intubation. Adding a rule that activates a higher-level trauma response for tachypneic patients with suspected chest injury reduced the under-triage rate by more than 1%. The respiratory rate, often overlooked, should be a more prominent triage decision point.

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A two-year study at seven Florida field sites compared four mosquito sampling methods — two aspirator types, a sweep net, and a standard CO2-baited CDC light trap. The CDC trap collected the most species (29) and the aspirators and sweep net were close behind, with all dominant species captured by every method. The results help surveillance programs choose the most practical sampling tool depending on their specific objectives and site characteristics.

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Four female mosquitoes of the species Aedes japonicus were collected in Okaloosa County, Florida in 2012, representing the first confirmed record of this species in the state. Follow-up collections confirmed its presence in five additional northwestern Florida counties by 2017. The species is a competent vector for several arboviruses including West Nile and Eastern equine encephalitis, and its role in Florida disease transmission requires further investigation.

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A review of more than 2,900 pediatric trauma patients showed that thoracic CT use had not decreased over time the way other regional CT scans had, even as evidence grew that most thoracic CTs do not change patient management. Every clinically meaningful intervention prompted by a thoracic CT in the study could have been predicted by two factors alone: a vehicle-related injury mechanism and an abnormal chest X-ray. The authors propose reserving thoracic CT for patients with both of these features to reduce radiation exposure.

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Three point-of-care platelet function tests were prospectively compared in 64 trauma patients, including 25 who were on antiplatelet medications. All three tests — Multiplate, TEG Platelet Mapping, and VerifyNow — reliably detected antiplatelet medication use and platelet dysfunction, performing comparably to the laboratory standard. None of the tests reliably predicted progression of intracranial hemorrhage, identifying a gap in current bedside diagnostic capability.

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A national trauma database analysis of nearly 93,000 trauma laparotomies found that splenectomy was not associated with higher rates of major complications or blood clots during the hospitalization. However, splenectomy was independently linked to a higher rate of pneumonia — a finding that held up in multivariable analysis and was the most pronounced infectious complication. The study highlights pneumonia as the primary early infectious risk following spleen removal.

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Researchers tested a four-component assessment tool for medical students — covering case presentation, problem definition, question response, and use of literature — and found that most components correlated moderately with final exam performance. The tool had acceptable interrater reliability across nearly five assessors per student on average. As medical education evolves toward competency-based models, validated assessment instruments of this kind are increasingly needed.

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A simulation-based training course for laparoscopic common bile duct exploration enrolled both surgical residents and practicing surgeons and measured skills before and after completion. All participants improved their written test scores and significantly reduced their time to complete the simulated procedure. Practicing surgeons also reported greater comfort with the technique and all of them performed the procedure in actual patients within a year of completing the course.

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Researchers analyzed coagulation data from severely injured trauma patients enrolled in the PROPPR trial and found that those who developed venous thromboembolism actually recovered from their post-trauma coagulopathy more slowly than those who did not. Rather than a hypercoagulable state driving clot formation, the data suggest that delayed recovery of normal coagulation — not rapid normalization — characterizes the trajectory toward VTE. The paradox of prolonged coagulopathy preceding clot formation requires further mechanistic study.

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Using data from the 12-center PROPPR trial, researchers found that damage control laparotomy rates varied dramatically between institutions — from 33% to 83% of emergency laparotomies — but there was no difference in 30-day mortality between high- and low-utilization centers. Standard damage control criteria captured only 80% of the patients who actually received the procedure, suggesting clinician judgment drives a significant portion of decisions. The findings challenge whether higher rates of damage control are necessary or beneficial.

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A three-center randomized trial tested whether adjusting enoxaparin doses upward based on thromboelastography results would reduce venous thromboembolism in trauma and surgical patients compared to standard dosing. VTE rates were low and identical in both groups at around 6%, and the adjusted dose group did not achieve higher drug levels until day six. Antithrombin deficiency and hypercoagulable TEG parameters were common in both groups, suggesting more nuanced approaches to VTE prevention are needed.

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After implementing a protocol-driven approach to cervical spine imaging in pediatric trauma patients, CT scan rates for cervical spine fell from 30% to 13% while plain X-ray rates increased, with no change in missed injuries. Overall CT use across all body regions also fell, reducing estimated lifetime cancer risk from radiation by 22% in males and 38% in females. A simple institutional protocol can dramatically cut radiation exposure in children without compromising diagnostic accuracy.

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Implementing a one-week night float rotation for third-year medical students on the trauma surgery clerkship significantly improved students' perception of team cohesion compared to traditional call structures. Standardized exam scores also increased significantly after the change, and the improvement persisted into the following academic year. The findings suggest that restructuring the student schedule to mirror resident workflows can enhance both educational outcomes and team integration.

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Using national trauma registry data from more than 536,000 pediatric patients, researchers built and internally validated a clinical prediction tool for venous thromboembolism in injured children. The model achieved an AUROC of 0.93 and incorporated eight clinical variables — including Glasgow Coma Scale score, age, central venous catheter placement, and major surgery — to assign individual risk scores. The tool provides an initial foundation for developing evidence-based VTE prevention protocols in pediatric trauma, where no national guidelines currently exist.

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This review describes the range of endpoints used to assess resuscitation adequacy in trauma and shock, including serum lactate, base deficit, central venous oxygen, and thromboelastography-guided transfusion. No single endpoint reliably indicates when resuscitation is complete, but serial trends in metabolic markers and early normalization of central venous oxygen correlate with better survival. The authors propose damage control resuscitation — achieving hemorrhage control and hemostatic balance — as an additional, underrecognized endpoint.

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Laboratory studies tested Culex coronator — a mosquito that spread rapidly throughout Florida after its first detection in 2005 — for its ability to acquire and transmit West Nile virus. The mosquito had high infection rates of 80-100% and dissemination rates of 65-85%, but transmission rates were lower and temperature-dependent, ranging from 0-17% at 25 degrees and 28-67% at 28 degrees. The rapid statewide spread of a competent but temperature-limited West Nile vector has important public health implications for Florida.

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This conceptual paper argues that mosquito-borne disease research too often focuses on a single biological scale — such as the cell, the individual mosquito, or the mosquito population — without integrating across levels. Using West Nile virus transmission and mosquito mortality as examples, the authors show how processes at one scale (individual variation in virus susceptibility) can fundamentally alter dynamics at another (population transmission potential). The paper calls for more integrative, multi-scale modeling to improve disease control strategies.

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This review examines the ecological importance of wetlands and the complex challenges of managing mosquitoes within them, arguing that effective integrated mosquito abatement must be scientifically rigorous, ecologically sound, and publicly defensible. It surveys available control methods — chemical, biological, and physical — and emphasizes that strategies must be tailored to the specific wetland type and mosquito species involved. Education and transparent communication with the public are highlighted as essential for sustaining effective and politically supported wetland mosquito management.

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A workshop on responding to arboterrorism — the deliberate release of infected mosquitoes or other arthropods as a biological weapon — produced recommendations for strengthening US mosquito control readiness. Key gaps identified included a lack of training for first responders in entomological threat response and the absence of coordinated state-level emergency plans. The workshop recommended establishing a Council for Emergency Mosquito Control in every state to coordinate training and resources for rapid deployment.

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Researchers designed a simple larval holding chamber to test whether a new larvicide formulation could travel through standing water to reach confined mosquito larvae. After 30 hours, all larvae in chambers containing the larvicide died, while control chambers showed no mortality. The device provides a practical tool for evaluating how effectively new larvicide formulations disperse and work in a contained aquatic environment.