I think that misinformation – at least in our corner of the Northeastern United States, often distorts the perception of certain mosquito-borne diseases to emphasize rare and dangerous outcomes while often ignoring the fact that risk can be highly localized (so answering the second half of this question is generally difficult if not impossible), and that we do have reasonably good ability to detect and respond to severe threats. A classic example would be Florida’s mosquito control efforts in Miami-Dade during the 2016 Zika outbreak that were quite effective in reducing mosquitoes and controlling the spread of the viruses in hot zones. Nearly everyone interacts with mosquitoes at some point or another and due to that, I think that people are hyper-sensitized to sensationalistic headlines.

West Nile virus has been part of the “mainstream” lexicon since it arrived in 1999, and because it has been endemic for such a long period, I do not think that the headlines hold as much weight as they used to. Headlines tend to stay focused on whether it is going to be a “bad mosquito year” for much of the Spring, which leads to public mosquito fatigue by the late summer, when epizootic disease tends to be at its peak. You could use EEE as a case for disproportionate reaction in both directions; it is largely restricted to a specific habitat and geography, and has a very low probability of infection, yet can result in severe disease for those that are present in that habitat. The “one size fits all” messaging is often too extreme for those that are not at risk, yet often too vague for those that are.

I really don’t have much experience with this. I would say that for me, this comes in the form of social media; particularly things like residential Facebook groups where folks very often complain of nuisance mosquitoes (that are unlikely to spread disease) and share recommendations for residential pest control companies that are unlikely to have any short- or long-term effect (on mosquito-borne disease risk)despite significant insecticide use.

First, detection of a pathogen before human cases appear should be framed and reported as a good thing. That means that surveillance works and is doing its job. Second, people need to know, and feel, like they can do something to protect themselves rather than face some inevitable or unavoidable disease threat. Exactly what that “something” is depends on the pathogen and environment, but it needs to be front and center in public messaging.

Epidemiology is a bit like climatology in that hindsight is always 20/20 and I think that prefacing any public statements about mosquito-borne diseases should sound a bit more like weather forecasting, with the lead-in being the actual evidence used to build the statements. After that, pointed statements that address the real and current risk perception, rather than a blanket statement, create a dynamic messaging system. The public needs to understand that vector-borne disease risk can change very quickly and that the messaging can and will change with it.

The answer to this depends heavily on the when and where – really, I think, the answer is “all of them”.

West Nile virus is endemic nationwide and responsible for the greatest disease burden, and transmission seasons are starting earlier and lasting longer. Late-season prevention will likely come to dominate messaging here.

EEE is rare but serious. The public should understand the ecological drivers and whether (or not) they are at risk.

Dengue carries a bit of a different message because it is shifting from imported to locally acquired. Given the Aedes vectors, the public would do well to understand the local propensities for day biting and local prevention. The same goes for Chikungunya, while Zika dictates constant messaging to pregnant and at-risk populations, with the addendum that we have successfully controlled the vectors in the past.

There are many other emerging mosquito-borne diseases (Jamestown, Cache Valley, St. Louis encephalitis) that I think would be excellent case studies to communicate the fact that we still don’t know all there is to know about mosquito-borne disease, and that continued funding and research are necessary.

As far as messaging reflecting evolving risk, I would refer to my answer to question 5 above.