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West Nile Virus West Nile Virus The 2004 Picture Washington State Department of Health 1 WNV Background First isolated from in the West Nile District of Uganda, 1937 Recognized as a cause of inflammation of the spinal cord and brain with outbreak in elderly patients, Israel, 1957 Equine disease noted in Egypt and France in the early 1960s 1999 “Old World” virus arrives in the “New World” Washington State Department of Health 2 Transmission Cycle Mosquito vector Bird reservoir hosts Washington State Department of Health Incidental infections Incidental infections 3 WNV in the US Some Speculated Pathways of Introduction Human-transported bird Human-transported mosquitoes Storm-transported bird Intentional introduction (terrorist event) - not likely Infected human traveler - not likely Washington State Department of Health 4 Human infection with WNV 1/150 of all infections cause West Nile neuroinvasive disease (WNND) <1% WNND ~20% West Nile fever Fatal WNV infection: <0.1% of all infections 10% of WNND Very rough estimates ~80% No symptoms Washington State Department of Health 5 Washington State Department of Health 6 Washington &WNV 2002 Washington goes positive... Raven Crow Horse Horse Pend Oreille County Snohomish County Island County Whatcom County Washington State Department of Health 7 A Tale of Two Years As of November 16 2003 2004 US Total 9,862 2,313 “The West” 3,773 1,562 Washington State Department of Health 8 A Tale of Two Years 2003 Arizona California Colorado Idaho Montana Nevada New Mexico Oregon Utah Washington Wyoming Washington State Department of Health 2004* 13 389 3 2,947 1 737 276 2 222 2 209 6 44 86 0 1 0 3 11 0 375 9 *As of Nov 23, 2004 9 2004 WNV Cases as of November 23 Washington State Department of Health 10 West Nile Virus The Northwest Experience Washington State Department of Health 11 Idaho 2003 2004 Humans 1 2 Horses 0 23 Birds 0 6 Washington State Department of Health 12 Idaho Human Case Locations 2004 Washington State Department of Health 13 Idaho Horse Case Locations 2004 Washington State Department of Health 14 Idaho Bird Case Locations 2004 Washington State Department of Health 15 Oregon 2003 2004 Humans 0 3 Horses 0 31 Birds 0 19 Washington State Department of Health 16 Oregon Human Case Locations 2004 Washington State Department of Health 17 Oregon Horse Case Locations 2004 Washington State Department of Health 18 Oregon Bird Case Locations 2004 Washington State Department of Health 19 Washington Bird Locations 2004 536 birds tested Washington State Department of Health 20 Washington Surveillance Testing 2004 Humans 23 Horses 53 Birds 551 Mosquito Pools 829 Washington State Department of Health 21 Lasting Effects 47% required physical therapy after hospitalization Only 37% fully recovered after 1 year Cognitive loss reported = 41.2% Functional loss reported = 42.9% Physical loss reported = 45.7% Source: Emerging Infectious Diseases, Vol. 10, No. 8, August 2004 (http://www.cdc.gov/ncidod/EID/vol10no8/03-0879.htm) Washington State Department of Health 22 West Nile Virus Surveillance Thanks to Our Partners • • • • • • Mosquito Control Districts Local Health Jurisdictions USACHPPM-West Veterinarians Health Care Providers State agencies and others Washington State Department of Health 23 West Nile Virus Only Time Will Tell Washington State Update 2004 Washington State Department of Health 24
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