West Nile Virus
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- Nasci, R.S. 2001. Field Biology Presentation given at the Second National Planning Meeting for Surveillance, Prevention, and Control of West Nile Virus in the United States. January 31–February 4, 2001. http://www.cdc.gov/ncidod/dvbid/westnile/misc/slides/nasci/slide01.htm
- Nasci, R. S. and J. D. Edman. 1981 Blood-feeding Patterns of Culiseta melanura (Diptera: Culicidae) and Associated Sylvan Mosquitoes in Southeastern Massachusetts Eastern Equine Encephalitis Enzootic Foci. Journal of Medical Entomology 6: 493-500.
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Nasci, Roger S., Dennis J. White, Helen Stirling, JoAnne Oliver, Thomas J. Daniels, Richard C. Falco, Scott Campbell, Wayne J. Crans, Harry M. Savage, Robert S. Lanciotti, Chester G. Moore, Marvin S. Godsey, Kristy L. Gottfried, and Carl J. Mitchell. 2001. West Nile Virus Isolates from Mosquitoes in New York and New Jersey, 1999. Emerging Infectious Diseases 7(4): 626-630. http://www.cdc.gov/ncidod/EID/vol7no4/nasci.htm
Abstract: An outbreak of encephalitis due to West Nile virus (WNV) occurred in New York City and the surrounding areas during 1999. Mosquitoes were collected as part of a comprehensive surveillance program implemented to monitor the outbreak. More than 32,000 mosquitoes representing 24 species were tested, and 15 WNV isolates were obtained. Molecular techniques were used to identify the species represented in the WNV-positive mosquito pools. Most isolates were from pools containing Culex pipiens mosquitoes, but several pools contained two or more Culex species.
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Nash, Denis, Farzad Mostashari, Annie Fine, James Miller, Daniel O’Leary, Kristy Murray, Ada Huang, Amy Rosenberg, Abby Greenberg, Margaret Sherman, Susan Wong, Grant L. Campbell, John T. Roehrig, Duane J. Gubler, Wun-Ju Shieh, Sherif Zaki, Perry Smith, Marcelle Layton. 2001. The Outbreak of West Nile Virus Infection in the New York City Area in 1999. The New England Journal of Medicine 343 (24): 1807-1814.
Abstract: Background: In late August 1999, an unusual cluster of cases of meningoencephalitis associated with muscle weakness was reported to the New York City Department of Health. The initial epidemiologic and environmental investigations suggested an arboviral cause.
Methods: Active surveillance was implemented to identify patients hospitalized with viral encephalitis and meningitis. Cerebrospinal fluid, serum, and tissue specimens from patients with suspected cases underwent serologic and viral testing for evidence of arboviral infection.
Results: Outbreak surveillance identified 59 patients who were hospitalized with West Nile virus infection in the New York City area during August and September of 1999. The median age of these patients was 71 years (range, 5 to 90). The overall attack rate of clinical West Nile virus infection was at least 6.5 cases per million population, and it increased sharply with age. Most of the patients (63 percent) had clinical signs of encephalitis; seven patients died (12 percent). Muscle weakness was documented in 27 percent of the patients and flaccid paralysis in 10 percent; in all of the latter, nerve conduction studies indicated an axonal polyneuropathy. An age of 75 years or older was an independent risk factor for death (relative risk adjusted for the presence or absence of diabetes mellitus, 8.5; 95 percent confidence interval, 1.2 to 59.1), as was the presence of diabetes mellitus (age-adjusted relative risk, 5.1; 95 percent confidence interval, 1.5 to 17.3).
Conclusions: This outbreak of West Nile meningoencephalitis in the New York City metropolitan area represents the first time this virus has been detected in the Western Hemisphere. Given the subsequent rapid spread of the virus, physicians along the eastern seaboard of the United States should consider West Nile virus infection in the differential diagnosis of encephalitis and viral meningitis during the summer months, especially in older patients and in those with muscle weakness.
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National Intelligence Council. 2000. The Global Infectious Disease Threat and its Implications for the United States. NIE 99-17D, January 2000. http://www.odci.gov/cia/publications/nie/report/nie99-17d.html. Produced under the auspices of David F. Gordon, National Intelligence Officer for Economics and Global Issues. and drafted primarily by Lt. Col. (Dr.) Don Noah of the Armed Forces Medical Intelligence Center and George Fidas of the NIC, with input and review by several prominent epidemiologists and other health experts.
Excerpts from Preface and Key Judgments: This report represents an important initiative on the part of the Intelligence Community to consider the national security dimension of a nontraditional threat. It responds to a growing concern by senior US leaders about the implications — in terms of health, economics, and national security--of the growing global infectious disease threat. The dramatic increase in drug-resistant microbes, combined with the lag in development of new antibiotics, the rise of megacities with severe health care deficiencies, environmental degradation, and the growing ease and frequency of cross-border movements of people and produce have greatly facilitated the spread of infectious diseases.
In June 1996, President Clinton issued a Presidential Decision Directive calling for a more focused US policy on infectious diseases. The State Department's Strategic Plan for International Affairs lists protecting human health and reducing the spread of infectious diseases as US strategic goals, and Secretary Albright in December 1999 announced the second of two major U.S. initiatives to combat HIV/AIDS. The unprecedented UN Security Council session devoted exclusively to the threat to Africa from HIV/AIDS in January 2000 is a measure of the international community's concern about the infectious disease threat.
As part of this new US Government effort, the National Intelligence Council produced this National Intelligence Estimate. It examines the most lethal diseases globally and by region; develops alternative scenarios about their future course; examines national and international capacities to deal with them; and assesses their national and global social, economic, political, and security impact. It then assesses the infectious disease threat from international sources to the United States; to US military personnel overseas; and to regions in which the United States has or may develop significant equities.
Key Judgments: New and reemerging infectious diseases will pose a rising global health threat and will complicate US and global security over the next 20 years. These diseases will endanger US citizens at home and abroad, threaten US armed forces deployed overseas, and exacerbate social and political instability in key countries and regions in which the United States has significant interests.
Infectious diseases are a leading cause of death, accounting for a quarter to a third of the estimated 54 million deaths worldwide in 1998. The spread of infectious diseases results as much from changes in human behavior—including lifestyles and land use patterns, increased trade and travel, and inappropriate use of antibiotic drugs—as from mutations in pathogens.
- New York City Department of Health. Adult Mosquito Control Programs Draft Environmental Impact Statement. May 2001. http://www.ci.nyc.ny.us/html/doh/html/wnv/deis.html
- New York State Department of Health. New York State West Nile Virus Response Plan. May 2001. [407 Kb pdf].
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News Focus: Infectious Diseases. West Nile Researchers Get Ready for Round Three. Science 292 (18 May 2001): 1289-1291. http://www.sciencemag.org/cgi/content/full/292/5520/1289
Summary: "Virologist Laura Kramer, who has spent much of life studying a West Nile cousin called St. Louis encephalitis, [is in the process of assembling a research team at] Wadsworth Center, the laboratory of the NYS DOH. Its main task is to test thousands of bird and mosquito samples from all over the state for traces of the WNV Kramer's lab is one of the most prominent examples of how federal and state agencies have rallied to the threat of West Nile. In New York, Governor George Patakis administration is spending mores than $20 million on surveillance, control, and research this year, while the US CDC is giving the state another $3.9 million to deal with the outbreak.
This year, experts think the virus will once more rage through bird populations along the East Coast. They also expect the virus to keep spreading, perhaps into Canada, the Midwest, and the Deep South. ..[Predicting whether humans will get sick is most difficult.] Researchers think that the transmission level in birds must be very high for the epidemic to spill into humans. Recently, NYS DOH epidemiologist Millicent Eidson found what may be a simple way to predict human risk: the "dead crow density" factor. Examining data from the 2000 outbreak, Eidson discovered that the number of birds reported per square mile--whether they were subsequently tested or not--was as high as 5.9 in Staten Island, where most human cases occurred. In nearby counties and boroughs, some of which had human cases in 1999 and 2000, the density was between 0.1 and 1.5, and it was below 0.1 in all other counties where no human cases occurred.
[Kramer's group will study issues including] how the virus survives the harsh Northeastern winters, exactly what roles different mosquito and bird species play in its transmission, why it kills crows en masse, how it will evolve as it spends more time in North America [ and] possible drugs that could battle the infection in humans."
- News this Week: Epidemiology. Groups Race to Sequence and Identify New York Virus. Science 286 (8 October 1999): 206-7.
- News this Week: Epidemiology. New York's Lethal Virus Came from Middle East, DNA Suggests. Science 286 (19 November 1999): 1450-1451.
- News of the Week: Infectious Diseases. New York's Deadly Virus May Stage a Comeback.Science 287 (24 March 2000): 2129-2130.
- Nir Y, Avivi A, Lasovski Y, Margalit J, Goldwasser R. 1972. Arbovirus activity in Israel. Israel Journal of Medical Sciences 8:1695-701.
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Nir Y, Lasowski Y, Avivi A, Goldwasser R. 1969. Survey for antibodies to arboviruses in the serum of various animals in Israel during 1965-1966. American Journal of Tropical Medicine and Hygiene 18:416-22.
From Emerging Infectious Diseases 9(7) Steinman et al: "To our knowledge, WNV in a reptile was reported only once before in a serosurvey conducted in Israel from 1965 to 1966, in which 22 reptiles and 96 amphibians were tested for hemagglutination-inhibiting antibodies against several viruses, including WNV; one turtle (Clemmys caspica) was seropositive."
- Nir Y., R. Goldwasser, T. Lasowski and A. Avivi. 1967. Isolation of Arboviruses from Wild Birds in Israel. American Journal of Epidemiology 86:372-378.
