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Background  Mosquito-borne viruses threaten public health worldwide. When the ratio of competent vectors to susceptible humans is low enough, the virus’s basic reproductive number ( R  0 ) falls below 1.0 (each case generating, on average, <1.0 additional case) and the infection fades out from the population. Conventional mosquito control tactics, however, seldom yield  R  0  < 1.0. A promising alternative uses mosquitoes to disseminate a potent growth-regulator larvicide, pyriproxyfen (PPF), to aquatic larval habitats; this kills most mosquito juveniles and substantially reduces adult mosquito emergence. We tested mosquito-disseminated PPF in Manacapuru, a 60,000-inhabitant city (~650 ha) in Amazonian Brazil.    Methods and Findings  We sampled juvenile mosquitoes monthly in 100 dwellings over four periods in February 2014–January 2016: 12 baseline months, 5 mo of citywide PPF dissemination, 3 mo of focal PPF dissemination around  Aedes -infested dwellings, and 3 mo after dissemination ended. We caught 19,434 juvenile mosquitoes (66%  Aedes albopictus , 28%  Ae .  aegypti ) in 8,271 trap-months. Using generalized linear mixed models, we estimated intervention effects on juvenile catch and adult emergence while adjusting for dwelling-level clustering, unequal sampling effort, and weather-related confounders. Following PPF dissemination,  Aedes  juvenile catch decreased by 79%–92% and juvenile mortality increased from 2%–7% to 80%–90%. Mean adult  Aedes  emergence fell from 1,077 per month (range 653–1,635) at baseline to 50.4 per month during PPF dissemination (range 2–117). Female  Aedes  emergence dropped by 96%–98%, such that the number of females emerging per person decreased to 0.06 females per person-month (range 0.002–0.129). Deterministic models predict, under plausible biological-epidemiological scenarios, that the  R  0  of typical  Aedes -borne viruses would fall from 3–45 at baseline to 0.004–0.06 during PPF dissemination. The main limitations of our study were that it was a before–after trial lacking truly independent replicates and that we did not measure mosquito-borne virus transmission empirically.    Conclusions  Mosquito-disseminated PPF has potential to block mosquito-borne virus transmission citywide, even under adverse scenarios. Our results signal new avenues for mosquito-borne disease prevention, likely including the effective control of  Aedes -borne dengue, Zika, and chikungunya epidemics. Cluster-randomized controlled trials will help determine whether mosquito-disseminated PPF can, as our findings suggest, develop into a major tool for improving global public health.

plos medicine

Mosquito-Disseminated Insecticide for Citywide Vector Control and Its Potential to Block Arbovirus Epidemics: Entomological Observations and Modeling Results from Amazonian Brazil