
Treating Wastewater To Store Ocean Carbon
Press Release – Science Media Centre
The proof-of-concept results show that, if scalable, the approach could help reduce ocean carbon oversaturation, especially in the Northern Hemisphere where the most wastewater treatment plants are located.
Treating wastewater with alkaline minerals could soak up over 18 million tonnes of carbon dioxide a year, new research suggests.
Oceans are absorbing increasing amounts of CO from the atmosphere, which is making them more acidic. In theory, increasing the alkalinity of treated wastewater that's discharged into the sea would expand the ocean's capacity to store CO. Chinese research published in Science Advances uses lab experiments to test how effective this could be. The proof-of-concept results show that, if scalable, the approach could help reduce ocean carbon oversaturation, especially in the Northern Hemisphere where the most wastewater treatment plants are located.
The SMC asked local, third-party experts to comment on the research.
Dr Lokesh Padhye, Associate Director of the New York State Center for Clean Water Technology; and Honorary Academic at the University of Auckland, comments:
'This study takes the idea of using wastewater treatment plants as 'alkalinity factories' a step further. By adding olivine during the aerobic treatment stage, the researchers sped up the rock weathering process by about 20 times compared to just dumping the same mineral straight into the ocean. This helped boost the wastewater's alkalinity and, at least in theory, the authors claim, could lock away around 19 million tonnes of CO each year. Still, lower than what we emit from burning fossil fuels each year.
'The lab results are impressive, but scaling this up to the real world comes with challenges. Mining, crushing, and shipping huge amounts of olivine would use a lot of energy and create emissions of their own. Plus, dumping highly alkaline water through effluent plumes could cause calcium carbonate to precipitate, and how much CO actually gets captured would depend a lot on local ocean conditions like temperature and water chemistry. There's also a tradeoff for regulators to consider: adding olivine seems to help remove phosphate from wastewater, which is beneficial, but it might complicate sludge management.
'In short, turning wastewater plants into carbon-capturing hubs is a clever idea with real potential, but it needs more real-world testing, and it should be seen as one piece for solving this complex puzzle, not a replacement for cutting emissions from fossil fuels and industry.'
No conflicts of interest.
Professor Matthew Watson, Member of the Product Accelerator Network, Professor of Chemical and Process Engineering, Director – Biomolecular Interaction Centre (BIC), University of Canterbury, comments:
'A potential carbon sequestration of 0.018 billion tonnes of CO per year sounds big, but it is important to put it in perspective.
'Man-made CO emissions are approximately 36.8 billion tonnes of CO per year. That's approximately 2,000 times the 0.018 billion tonnes of CO figure listed in the article. About 3% of this is associated with wastewater treatment plants, or 1.1 billion tonnes of CO per year (approximately 60 times the 0.018 billion tonnes of CO figure listed in the article). Forests sequester 16 billion tonnes of CO per year.
'The mass efficiency (I estimate to be 0.04 tonnes of CO removed per tonne of olivine) seems to be very low (details of approximate calculations below). And the authors don't mention anything about the unintended consequences of adding large quantities of finely ground olivine (which may contain asbestos, chrome, and nickel) into rivers and waterways.
'The idea of the article is certainly a step in the right direction and the results are interesting in that the activated sludge seems to catalyse (speed up) the CO removal with olivine.'
'Mass efficiency estimate:
'Globally we discharge about 150 billion tonnes/yr of wastewater and authors have identified about 1 in 6 of the WWTPs as being suitable, so ~25 billion tonnes/yr. At 2 wt. % olivine = 0.5 billion tonnes of olivine to remove 0.018 billion tonnes/yr of CO2. The mass efficiency seems to be very low.'
Conflict of interest statement: Watson is a founder of and has a beneficial ownership stake in Aspiring Materials.
Dr Ricardo Bello-Mendoza, Associate Professor, Department of Civil and Natural Resources Engineering, University of Canterbury, comments:
'New research estimates that adding alkaline minerals to wastewater treatment could help capture and store about 18 million tonnes of greenhouse gas carbon dioxide (CO), when biologically treated and alkalinity-enhanced wastewater is discharged into the ocean. The researchers used olivine rock, a magnesium-iron silicate mineral abundant globally, to increase wastewater alkalinity. That is, to improve its capacity to neutralise acids such as carbonic acid produced when CO dissolves in seawater. In New Zealand, olivine is used as an aggregate to make roads, and it has previously been studied for carbon sequestration in industrial applications. This study proposes using olivine in wastewater treatment plants (WWTP) as a more effective way to maintain alkalinity in the treated water and disperse it into the aquatic environment. This would make a WWTP an alkalinity factory for ocean alkalinity enhancement (OAE) and CO sequestration. Alkalinity enhancement was studied before the activated sludge (AS) process, which is widely used in wastewater treatment, including New Zealand. While the results are promising, further research is needed to assess their potential in practical engineering applications. The addition of alkalinity to the wastewater should be customised according to the specific hydrochemical conditions at each discharge site. Furthermore, a life cycle analysis of the technology is still necessary.'

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Press Release – Science Media Centre The SMC asked experts about the current situation in the Pacific. The Cook Islands declared a dengue outbreak in Rarotonga last week. Other Pacific nations including Sāmoa, Tonga, and Fiji are also experiencing outbreaks. The SMC asked experts about the current situation in the Pacific. Dr Gregor Devine, Senior Director, Field Entomology at the World Mosquito Program, comments: What is the immediate threat posed by dengue in the wider Pacific region, and how is this changing? 'Dengue fever is the world's most prevalent disease spread by mosquitoes. Cases are increasing across the Western Pacific (e.g., Pacific Island Countries and Territories, Laos, Cambodia, Vietnam) and South East Asia (e.g., Bangladesh, Indonesia, Thailand, and Timor-Leste). All of these countries experienced significant dengue outbreaks in 2024 and 2025, and the general trend in cases globally is relentlessly upwards. 'These increases are fuelled by 1) climate change (increased temperatures encourage mosquito proliferation and shorten the time needed for viruses to replicate in their mosquito hosts), 2) increasing globalisation (and the increased movement of humans carrying the virus), 3) immunological naïveté, where human populations are being exposed to new dengue serotypes, and 4) the limited impact of existing control measures. 'According to the Pacific Syndromic Surveillance System, as of May 27th 2025, dengue cases are increasing or peaking in Fiji, Samoa, Tonga, Kiribati, and Cook Islands. There have been deaths reported from Fiji, Tonga and Samoa.' What hopes are currently on the horizon for new technologies or programmes to combat the disease? 'Current responses to dengue outbreaks largely involve the application of insecticides and the implementation of environmental 'clean-up' campaigns, but these have limited impacts. Moreover, resistance to insecticides is increasingly documented in the Pacific, and this further reduces the impact of conventional vector control. 'A safe, effective and sustainable solution exists. The Wolbachia method, developed by the non-profit World Mosquito Program, involves releasing mosquitoes infected with a bacteria that reduces their ability to transmit dengue. It has been proven to have a tremendous impact on dengue transmission around the world. Wolbachia releases have been piloted in Fiji, Vanuatu, Kiribati, and New Caledonia. Following six years of Wolbachia mosquito releases in New Caledonia, the project has been hailed a monumental success, and the French territory hasn't had a dengue epidemic since 2019. This year, releases will continue in Kiribati, and be adopted in Timor-Leste.' What is your biggest concern and/or is there anything you wish people understood better about the situation? 'The upward trend in dengue case numbers regionally will inevitably stress public health systems and impact family well-being (through both the health and economic costs of hospitalisation and the lost earnings of the sick). Sustainable ways to combat dengue, such as the Wolbachia method, are desperately needed. Vaccines are still years away from being universally affordable and applicable.' Conflict of interest statement: Greg Devine is the Senior Director of Field Entomology for the World Mosquito Program Dr Joan Ingram, Medical Advisor, Immunisation Advisory Centre, comments: What is the immediate threat posed by dengue in the Pacific region, and how is this changing? 'Dengue outbreaks are currently affecting Kiribati, Samoa, Fiji, Tonga and French Polynesia with the most cases being reported from Fiji, according to The Pacific Community (SPC). Case numbers are increasing in all of those areas, apart from in French Polynesia. There are four dengue serotypes – and both serotype 1 and serotype 2 are currently circulating. 'The Pacific Islands are vulnerable to dengue outbreaks as they have high levels of mosquitoes and dengue viruses can be introduced by infected people. 'Between 2012 and 2021, there were 69 outbreaks of dengue fever among the Pacific Islands. However, they are not unique in having dengue fever – dengue is common in many other regions including the Americas, Africa, the Middle East and Asia. 'Globally, dengue cases were at a very high level in 2024, particularly in South America. Cases increased almost 30-fold there between 2000 and 2024. Urbanisation, globalisation and climate change have contributed to this increase.' What is your biggest concern and is there anything you wish people understood better about the situation? 'Dengue is often a leading cause of fever in risk countries. Estimates are that around 6 in 1000 travellers spending a month in a risk area become unwell with dengue, with up to 30% of them being hospitalised. 'Dengue is spread by common biting mosquitoes (various Aedes species), which thrive where humans live. The main way to avoid dengue is mosquito bite avoidance. Aedes mosquitoes (unlike the malaria-transmitting Anopheles) are daytime feeders, with two peak times of biting activity in the day – 2 to 3 hours after dawn, and mid-to-late afternoon. However, they may feed all day indoors or on overcast days. 'People should regularly apply effective repellent as well as using light-coloured clothing to cover up. In addition, they should take steps to reduce mosquitoes indoors (such as screens on windows and doors), and in the environment by emptying any water-holding containers.' What hopes are currently on the horizon for new technologies or programmes to combat the disease? 'Qdenga, a dengue vaccine, is available in 30 countries overseas but not in New Zealand. It protects against dengue serotype 1 and 2 very well, especially in people who have had previous dengue. Protection against serotypes 3 and 4 is still being evaluated. 'An earlier dengue vaccine increased the risk of severe dengue in people who had not had dengue previously. It does not seem as though Qdenga does that, but it is still being monitored and most authorities prefer to administer it to people with past dengue infection although the guidelines differ. 'A new hope for the future is the use of Wolbachia-infected Aedes aegypti. Wolbachia infection blocks the transmission of the dengue virus from mosquitoes. Trials are ongoing with promising results.' No conflicts of interest. Dr Berlin Kafoa, Director, Public Health Division at The Pacific Community (SPC), comments: What is the immediate threat posed by dengue in the Pacific region, and how is this changing? ' 1. Increasing morbidity due to escalating dengue outbreaks reported across the Pacific region with circulation of multiple serotypes. 'Dengue is actively circulating in at least six Pacific Island Countries and Territories (PICTs), including Fiji (>8,000 cases, 4 deaths), Tonga (793 cases, 3 deaths), French Polynesia (>2,000 cases), Samoa (110 cases, 1 death), Cook Islands, and Kiribati. Multiple serotypes (DENV-1, DENV-2, DENV-3) are co-circulating, increasing the risk of severe dengue due to secondary infections in populations with partial immunity. ' 2. Changing epidemiology and vulnerable populations 'There is a growing incidence of severe dengue amongst children and youth with no prior dengue exposure. There are older adults coming from areas historically free of dengue. This suggests immunity gaps, but the lack of updated seroprevalence data limits precise risk profiling. ' 3. Climate and mobility as amplifiers 'Climate change and variability (e.g., rainfall, temperature) is expanding mosquito habitats and altering transmission regional and international travel and trade from endemic areas (e.g., Southeast Asia, South America) raises the risk of virus introduction.' What hopes are currently on the horizon for new technologies or programmes to combat the disease? ' 1. A need for collaboration across sectors, agencies, and countries. 'Through the Pacific Public Health Surveillance Network (PPHSN), we are working with WHO and allied members to support countries with preparedness, detection and response to dengue and other arboviral diseases. This includes: Rapid risk assessments and technical guidance Laboratory supplies and testing algorithms and Strengthening PCR testing capabilities in countries. Subtyping and WGS/Whole-Genome Sequencing via reference labs (e.g., VIDRL in Australia). Dissemination of risk communication messages through multiple channels and sharing of best practices in risk communication and community engagement ' 2. A need for predictive analytics and early warning 'We are exploring predictive algorithms that integrate climate data (e.g., rainfall, temperature), flight and mobility data, and historical outbreak and seroprevalence data. These tools aim to forecast outbreak risks and optimize vector control timing.' ' 3. Vector control capacity building to promote a One Health approach. 'The Pacific Vector Network (PVN) launched in 2023, a service arm of PPHSN, supports a coordinated response to control of vector-borne disease in the region; practical entomology training for PICTs; mosquito surveys, mapping, and surveillance; and provision of vector control equipment and insecticides.' ' 4. New tools being tested 'Other new tools being tested in the region include pilot testing of new technologies such as Sterile Insect Technique (SIT) in French Polynesia, and trials of Wolbachia introduction in Fiji, Vanuatu, New Caledonia, and Kiribati. For possible consideration, there is the introduction of dengue vaccines-contingent on availability of sero-prevalence data.' What is your biggest concern and/or is there anything you wish people understood better? 'The real risk of severe dengue is rising. Severe cases and fatalities are being reported, especially among youth. Dengue should not be dismissed as a mild illness, it can be life-threatening. 'There are gaps in immunity and surveillance. Many populations remain immunologically naive due to limited past exposure. Inadequate seroprevalence data and diagnostic capacity hinder targeted responses. 'There are changes in vector behaviours with possible increase in behaviours resistance to insecticides. 'Dengue is not the only arboviral threat which further complicates surveillance, diagnosis, and response efforts. Other threats include: Zika: Imported cases have been reported in the Pacific Rim (e.g., New Zealand from Fiji). Chikungunya: A major outbreak in La Réunion (339,000+ cases) and an imported case in Wallis and Futuna. Yellow fever: While not yet reported in the Pacific, the presence of Aedes vectors makes introduction a real risk 'There is a need to support the Pacific to acquire new technology for genomic surveillance. Genetic sequencing of dengue strains is essential to track virus movement and mutations across the region, but capacity remains limited. 'Dengue is no longer a seasonal or isolated threat in the Pacific; it is a regional health emergency shaped by climate, mobility, and historical vulnerabilities. Through a One Health multisector, multiagency and multi-country collaborative efforts with WHO, PIHOA and PPHSN partners, we are responding and building the tools and intelligence to predict, prepare and hopefully prevent the next wave.'


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Press Release – Science Media Centre The SMC asked experts about the current situation in the Pacific. The Cook Islands declared a dengue outbreak in Rarotonga last week. Other Pacific nations including Sāmoa, Tonga, and Fiji are also experiencing outbreaks. The SMC asked experts about the current situation in the Pacific. Dr Gregor Devine, Senior Director, Field Entomology at the World Mosquito Program, comments: What is the immediate threat posed by dengue in the wider Pacific region, and how is this changing? 'Dengue fever is the world's most prevalent disease spread by mosquitoes. Cases are increasing across the Western Pacific (e.g., Pacific Island Countries and Territories, Laos, Cambodia, Vietnam) and South East Asia (e.g., Bangladesh, Indonesia, Thailand, and Timor-Leste). All of these countries experienced significant dengue outbreaks in 2024 and 2025, and the general trend in cases globally is relentlessly upwards. 'These increases are fuelled by 1) climate change (increased temperatures encourage mosquito proliferation and shorten the time needed for viruses to replicate in their mosquito hosts), 2) increasing globalisation (and the increased movement of humans carrying the virus), 3) immunological naïveté, where human populations are being exposed to new dengue serotypes, and 4) the limited impact of existing control measures. 'According to the Pacific Syndromic Surveillance System, as of May 27th 2025, dengue cases are increasing or peaking in Fiji, Samoa, Tonga, Kiribati, and Cook Islands. There have been deaths reported from Fiji, Tonga and Samoa.' What hopes are currently on the horizon for new technologies or programmes to combat the disease? 'Current responses to dengue outbreaks largely involve the application of insecticides and the implementation of environmental 'clean-up' campaigns, but these have limited impacts. Moreover, resistance to insecticides is increasingly documented in the Pacific, and this further reduces the impact of conventional vector control. 'A safe, effective and sustainable solution exists. The Wolbachia method, developed by the non-profit World Mosquito Program, involves releasing mosquitoes infected with a bacteria that reduces their ability to transmit dengue. It has been proven to have a tremendous impact on dengue transmission around the world. Wolbachia releases have been piloted in Fiji, Vanuatu, Kiribati, and New Caledonia. Following six years of Wolbachia mosquito releases in New Caledonia, the project has been hailed a monumental success, and the French territory hasn't had a dengue epidemic since 2019. This year, releases will continue in Kiribati, and be adopted in Timor-Leste.' What is your biggest concern and/or is there anything you wish people understood better about the situation? 'The upward trend in dengue case numbers regionally will inevitably stress public health systems and impact family well-being (through both the health and economic costs of hospitalisation and the lost earnings of the sick). Sustainable ways to combat dengue, such as the Wolbachia method, are desperately needed. Vaccines are still years away from being universally affordable and applicable.' Conflict of interest statement: Greg Devine is the Senior Director of Field Entomology for the World Mosquito Program Dr Joan Ingram, Medical Advisor, Immunisation Advisory Centre, comments: What is the immediate threat posed by dengue in the Pacific region, and how is this changing? 'Dengue outbreaks are currently affecting Kiribati, Samoa, Fiji, Tonga and French Polynesia with the most cases being reported from Fiji, according to The Pacific Community (SPC). Case numbers are increasing in all of those areas, apart from in French Polynesia. There are four dengue serotypes – and both serotype 1 and serotype 2 are currently circulating. 'The Pacific Islands are vulnerable to dengue outbreaks as they have high levels of mosquitoes and dengue viruses can be introduced by infected people. 'Between 2012 and 2021, there were 69 outbreaks of dengue fever among the Pacific Islands. However, they are not unique in having dengue fever – dengue is common in many other regions including the Americas, Africa, the Middle East and Asia. 'Globally, dengue cases were at a very high level in 2024, particularly in South America. Cases increased almost 30-fold there between 2000 and 2024. Urbanisation, globalisation and climate change have contributed to this increase.' What is your biggest concern and is there anything you wish people understood better about the situation? 'Dengue is often a leading cause of fever in risk countries. Estimates are that around 6 in 1000 travellers spending a month in a risk area become unwell with dengue, with up to 30% of them being hospitalised. 'Dengue is spread by common biting mosquitoes (various Aedes species), which thrive where humans live. The main way to avoid dengue is mosquito bite avoidance. Aedes mosquitoes (unlike the malaria-transmitting Anopheles) are daytime feeders, with two peak times of biting activity in the day – 2 to 3 hours after dawn, and mid-to-late afternoon. However, they may feed all day indoors or on overcast days. 'People should regularly apply effective repellent as well as using light-coloured clothing to cover up. In addition, they should take steps to reduce mosquitoes indoors (such as screens on windows and doors), and in the environment by emptying any water-holding containers.' What hopes are currently on the horizon for new technologies or programmes to combat the disease? 'Qdenga, a dengue vaccine, is available in 30 countries overseas but not in New Zealand. It protects against dengue serotype 1 and 2 very well, especially in people who have had previous dengue. Protection against serotypes 3 and 4 is still being evaluated. 'An earlier dengue vaccine increased the risk of severe dengue in people who had not had dengue previously. It does not seem as though Qdenga does that, but it is still being monitored and most authorities prefer to administer it to people with past dengue infection although the guidelines differ. 'A new hope for the future is the use of Wolbachia-infected Aedes aegypti. Wolbachia infection blocks the transmission of the dengue virus from mosquitoes. Trials are ongoing with promising results.' No conflicts of interest. Dr Berlin Kafoa, Director, Public Health Division at The Pacific Community (SPC), comments: What is the immediate threat posed by dengue in the Pacific region, and how is this changing? ' 1. Increasing morbidity due to escalating dengue outbreaks reported across the Pacific region with circulation of multiple serotypes. 'Dengue is actively circulating in at least six Pacific Island Countries and Territories (PICTs), including Fiji (>8,000 cases, 4 deaths), Tonga (793 cases, 3 deaths), French Polynesia (>2,000 cases), Samoa (110 cases, 1 death), Cook Islands, and Kiribati. Multiple serotypes (DENV-1, DENV-2, DENV-3) are co-circulating, increasing the risk of severe dengue due to secondary infections in populations with partial immunity. ' 2. Changing epidemiology and vulnerable populations 'There is a growing incidence of severe dengue amongst children and youth with no prior dengue exposure. There are older adults coming from areas historically free of dengue. This suggests immunity gaps, but the lack of updated seroprevalence data limits precise risk profiling. ' 3. Climate and mobility as amplifiers 'Climate change and variability (e.g., rainfall, temperature) is expanding mosquito habitats and altering transmission regional and international travel and trade from endemic areas (e.g., Southeast Asia, South America) raises the risk of virus introduction.' What hopes are currently on the horizon for new technologies or programmes to combat the disease? ' 1. A need for collaboration across sectors, agencies, and countries. 'Through the Pacific Public Health Surveillance Network (PPHSN), we are working with WHO and allied members to support countries with preparedness, detection and response to dengue and other arboviral diseases. This includes: Rapid risk assessments and technical guidance Laboratory supplies and testing algorithms and Strengthening PCR testing capabilities in countries. Subtyping and WGS/Whole-Genome Sequencing via reference labs (e.g., VIDRL in Australia). Dissemination of risk communication messages through multiple channels and sharing of best practices in risk communication and community engagement ' 2. A need for predictive analytics and early warning 'We are exploring predictive algorithms that integrate climate data (e.g., rainfall, temperature), flight and mobility data, and historical outbreak and seroprevalence data. These tools aim to forecast outbreak risks and optimize vector control timing.' ' 3. Vector control capacity building to promote a One Health approach. 'The Pacific Vector Network (PVN) launched in 2023, a service arm of PPHSN, supports a coordinated response to control of vector-borne disease in the region; practical entomology training for PICTs; mosquito surveys, mapping, and surveillance; and provision of vector control equipment and insecticides.' ' 4. New tools being tested 'Other new tools being tested in the region include pilot testing of new technologies such as Sterile Insect Technique (SIT) in French Polynesia, and trials of Wolbachia introduction in Fiji, Vanuatu, New Caledonia, and Kiribati. For possible consideration, there is the introduction of dengue vaccines-contingent on availability of sero-prevalence data.' What is your biggest concern and/or is there anything you wish people understood better? 'The real risk of severe dengue is rising. Severe cases and fatalities are being reported, especially among youth. Dengue should not be dismissed as a mild illness, it can be life-threatening. 'There are gaps in immunity and surveillance. Many populations remain immunologically naive due to limited past exposure. Inadequate seroprevalence data and diagnostic capacity hinder targeted responses. 'There are changes in vector behaviours with possible increase in behaviours resistance to insecticides. 'Dengue is not the only arboviral threat which further complicates surveillance, diagnosis, and response efforts. Other threats include: Zika: Imported cases have been reported in the Pacific Rim (e.g., New Zealand from Fiji). Chikungunya: A major outbreak in La Réunion (339,000+ cases) and an imported case in Wallis and Futuna. Yellow fever: While not yet reported in the Pacific, the presence of Aedes vectors makes introduction a real risk 'There is a need to support the Pacific to acquire new technology for genomic surveillance. Genetic sequencing of dengue strains is essential to track virus movement and mutations across the region, but capacity remains limited. 'Dengue is no longer a seasonal or isolated threat in the Pacific; it is a regional health emergency shaped by climate, mobility, and historical vulnerabilities. Through a One Health multisector, multiagency and multi-country collaborative efforts with WHO, PIHOA and PPHSN partners, we are responding and building the tools and intelligence to predict, prepare and hopefully prevent the next wave.'


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Dengue In The Pacific Region – Expert Q&A
The Cook Islands declared a dengue outbreak in Rarotonga last week. Other Pacific nations including Sāmoa, Tonga, and Fiji are also experiencing outbreaks. The SMC asked experts about the current situation in the Pacific. Dr Gregor Devine, Senior Director, Field Entomology at the World Mosquito Program, comments: What is the immediate threat posed by dengue in the wider Pacific region, and how is this changing? 'Dengue fever is the world's most prevalent disease spread by mosquitoes. Cases are increasing across the Western Pacific (e.g., Pacific Island Countries and Territories, Laos, Cambodia, Vietnam) and South East Asia (e.g., Bangladesh, Indonesia, Thailand, and Timor-Leste). All of these countries experienced significant dengue outbreaks in 2024 and 2025, and the general trend in cases globally is relentlessly upwards. 'These increases are fuelled by 1) climate change (increased temperatures encourage mosquito proliferation and shorten the time needed for viruses to replicate in their mosquito hosts), 2) increasing globalisation (and the increased movement of humans carrying the virus), 3) immunological naïveté, where human populations are being exposed to new dengue serotypes, and 4) the limited impact of existing control measures. 'According to the Pacific Syndromic Surveillance System, as of May 27th 2025, dengue cases are increasing or peaking in Fiji, Samoa, Tonga, Kiribati, and Cook Islands. There have been deaths reported from Fiji, Tonga and Samoa.' What hopes are currently on the horizon for new technologies or programmes to combat the disease? 'Current responses to dengue outbreaks largely involve the application of insecticides and the implementation of environmental 'clean-up' campaigns, but these have limited impacts. Moreover, resistance to insecticides is increasingly documented in the Pacific, and this further reduces the impact of conventional vector control. 'A safe, effective and sustainable solution exists. The Wolbachia method, developed by the non-profit World Mosquito Program, involves releasing mosquitoes infected with a bacteria that reduces their ability to transmit dengue. It has been proven to have a tremendous impact on dengue transmission around the world. Wolbachia releases have been piloted in Fiji, Vanuatu, Kiribati, and New Caledonia. Following six years of Wolbachia mosquito releases in New Caledonia, the project has been hailed a monumental success, and the French territory hasn't had a dengue epidemic since 2019. This year, releases will continue in Kiribati, and be adopted in Timor-Leste.' What is your biggest concern and/or is there anything you wish people understood better about the situation? 'The upward trend in dengue case numbers regionally will inevitably stress public health systems and impact family well-being (through both the health and economic costs of hospitalisation and the lost earnings of the sick). Sustainable ways to combat dengue, such as the Wolbachia method, are desperately needed. Vaccines are still years away from being universally affordable and applicable.' Dr Joan Ingram, Medical Advisor, Immunisation Advisory Centre, comments: What is the immediate threat posed by dengue in the Pacific region, and how is this changing? 'Dengue outbreaks are currently affecting Kiribati, Samoa, Fiji, Tonga and French Polynesia with the most cases being reported from Fiji, according to The Pacific Community (SPC). Case numbers are increasing in all of those areas, apart from in French Polynesia. There are four dengue serotypes – and both serotype 1 and serotype 2 are currently circulating. 'The Pacific Islands are vulnerable to dengue outbreaks as they have high levels of mosquitoes and dengue viruses can be introduced by infected people. 'Between 2012 and 2021, there were 69 outbreaks of dengue fever among the Pacific Islands. However, they are not unique in having dengue fever – dengue is common in many other regions including the Americas, Africa, the Middle East and Asia. 'Globally, dengue cases were at a very high level in 2024, particularly in South America. Cases increased almost 30-fold there between 2000 and 2024. Urbanisation, globalisation and climate change have contributed to this increase.' What is your biggest concern and is there anything you wish people understood better about the situation? 'Dengue is often a leading cause of fever in risk countries. Estimates are that around 6 in 1000 travellers spending a month in a risk area become unwell with dengue, with up to 30% of them being hospitalised. 'Dengue is spread by common biting mosquitoes (various Aedes species), which thrive where humans live. The main way to avoid dengue is mosquito bite avoidance. Aedes mosquitoes (unlike the malaria-transmitting Anopheles) are daytime feeders, with two peak times of biting activity in the day – 2 to 3 hours after dawn, and mid-to-late afternoon. However, they may feed all day indoors or on overcast days. 'People should regularly apply effective repellent as well as using light-coloured clothing to cover up. In addition, they should take steps to reduce mosquitoes indoors (such as screens on windows and doors), and in the environment by emptying any water-holding containers.' What hopes are currently on the horizon for new technologies or programmes to combat the disease? 'Qdenga, a dengue vaccine, is available in 30 countries overseas but not in New Zealand. It protects against dengue serotype 1 and 2 very well, especially in people who have had previous dengue. Protection against serotypes 3 and 4 is still being evaluated. 'An earlier dengue vaccine increased the risk of severe dengue in people who had not had dengue previously. It does not seem as though Qdenga does that, but it is still being monitored and most authorities prefer to administer it to people with past dengue infection although the guidelines differ. 'A new hope for the future is the use of Wolbachia-infected Aedes aegypti. Wolbachia infection blocks the transmission of the dengue virus from mosquitoes. Trials are ongoing with promising results.' No conflicts of interest. Dr Berlin Kafoa, Director, Public Health Division at The Pacific Community (SPC), comments: What is the immediate threat posed by dengue in the Pacific region, and how is this changing? ' 1. Increasing morbidity due to escalating dengue outbreaks reported across the Pacific region with circulation of multiple serotypes. 'Dengue is actively circulating in at least six Pacific Island Countries and Territories (PICTs), including Fiji (>8,000 cases, 4 deaths), Tonga (793 cases, 3 deaths), French Polynesia (>2,000 cases), Samoa (110 cases, 1 death), Cook Islands, and Kiribati. Multiple serotypes (DENV-1, DENV-2, DENV-3) are co-circulating, increasing the risk of severe dengue due to secondary infections in populations with partial immunity. ' 2. Changing epidemiology and vulnerable populations 'There is a growing incidence of severe dengue amongst children and youth with no prior dengue exposure. There are older adults coming from areas historically free of dengue. This suggests immunity gaps, but the lack of updated seroprevalence data limits precise risk profiling. ' 3. Climate and mobility as amplifiers 'Climate change and variability (e.g., rainfall, temperature) is expanding mosquito habitats and altering transmission regional and international travel and trade from endemic areas (e.g., Southeast Asia, South America) raises the risk of virus introduction.' What hopes are currently on the horizon for new technologies or programmes to combat the disease? ' 1. A need for collaboration across sectors, agencies, and countries. 'Through the Pacific Public Health Surveillance Network (PPHSN), we are working with WHO and allied members to support countries with preparedness, detection and response to dengue and other arboviral diseases. This includes: Rapid risk assessments and technical guidance Laboratory supplies and testing algorithms and Strengthening PCR testing capabilities in countries. Subtyping and WGS/Whole-Genome Sequencing via reference labs (e.g., VIDRL in Australia). Dissemination of risk communication messages through multiple channels and sharing of best practices in risk communication and community engagement ' 2. A need for predictive analytics and early warning 'We are exploring predictive algorithms that integrate climate data (e.g., rainfall, temperature), flight and mobility data, and historical outbreak and seroprevalence data. These tools aim to forecast outbreak risks and optimize vector control timing.' ' 3. Vector control capacity building to promote a One Health approach. 'The Pacific Vector Network (PVN) launched in 2023, a service arm of PPHSN, supports a coordinated response to control of vector-borne disease in the region; practical entomology training for PICTs; mosquito surveys, mapping, and surveillance; and provision of vector control equipment and insecticides.' ' 4. New tools being tested 'Other new tools being tested in the region include pilot testing of new technologies such as Sterile Insect Technique (SIT) in French Polynesia, and trials of Wolbachia introduction in Fiji, Vanuatu, New Caledonia, and Kiribati. For possible consideration, there is the introduction of dengue vaccines-contingent on availability of sero-prevalence data.' What is your biggest concern and/or is there anything you wish people understood better? 'The real risk of severe dengue is rising. Severe cases and fatalities are being reported, especially among youth. Dengue should not be dismissed as a mild illness, it can be life-threatening. 'There are gaps in immunity and surveillance. Many populations remain immunologically naive due to limited past exposure. Inadequate seroprevalence data and diagnostic capacity hinder targeted responses. 'There are changes in vector behaviours with possible increase in behaviours resistance to insecticides. 'Dengue is not the only arboviral threat which further complicates surveillance, diagnosis, and response efforts. Other threats include: Zika: Imported cases have been reported in the Pacific Rim (e.g., New Zealand from Fiji). Chikungunya: A major outbreak in La Réunion (339,000+ cases) and an imported case in Wallis and Futuna. Yellow fever: While not yet reported in the Pacific, the presence of Aedes vectors makes introduction a real risk 'There is a need to support the Pacific to acquire new technology for genomic surveillance. Genetic sequencing of dengue strains is essential to track virus movement and mutations across the region, but capacity remains limited. 'Dengue is no longer a seasonal or isolated threat in the Pacific; it is a regional health emergency shaped by climate, mobility, and historical vulnerabilities. Through a One Health multisector, multiagency and multi-country collaborative efforts with WHO, PIHOA and PPHSN partners, we are responding and building the tools and intelligence to predict, prepare and hopefully prevent the next wave.'