[1] United States: CDC MMWR: WNV Activity, Sept 8-14, 2004 + Cumulative
[2] US: Oregon, 1st human case
[3] US: Pennsylvania, Sharp decline in case numbers
[4] US: California Outbreak may be peaking
[5] Canada: Health Canada Surveillance Data (as of Sept 15 2004)
[6] Mexico: WNV surveillance data (as of Sept 9 2004)
[7] Israel: Human cases
----------------------------
[1]
US: CDC MMWR: WNV ACTIVITY, SEPT 8-14, 2004 + CUMULATIVE
Source: CDC MMWR Weekly September 17, 2004 / 53(36);850-851 [edited]
<http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5336a7.htm>
HUMAN: 195 cases of WNV illness were reported from 26 states during
week Sept 8-14 (Alabama, Arizona, Arkansas, California, Colorado,
Florida, Georgia, Idaho, Illinois, Iowa, Kansas, Maryland, Minnesota,
Missouri, Nebraska, Nevada, New Mexico, New York, North Dakota,
Oklahoma, Oregon, Pennsylvania, South Dakota, Tennessee, Texas, and
Wisconsin).
CUMULATIVE HUMAN: During 2004, 39 states have reported 1,386 cases (35
fatalities) of human WNV illness to CDC through ArboNET. Of these, 392
(28%) cases are from California, 345 (25%) from Arizona, and 225 (16%)
from Colorado. Neuroinvasive illness: 489 cases; West Nile fever: 553;
in the other 344 cases symptoms are unspecified. A total of 764 (57%)
of the 1,347 cases for which all data were available occurred in males;
the median age of patients was 51 years (range: 1 month--99 years).
Illness onset ranged from April 23 to September 8.
BLOOD DONORS: 124 presumptive WN viremic blood donors (PVDs) have been
reported to ArboNET in 2004. Of these, 37 (30%) were reported from
Arizona; 35 from California; 15 from Texas; 11 from New Mexico; five
from Colorado; four from Georgia; three each from Florida and South
Dakota; two each from Missouri, Oklahoma, and Wisconsin; and one each
from Iowa, Louisiana, Minnesota, Nebraska, and North Dakota. Of the 124
PVDs, five persons aged 35, 50, 66, 69, and 77 years subsequently had
neuroinvasive illness, and 27 persons (median age: 54 years; range:
17--73 years) subsequently had West Nile fever.
BIRDS & MAMMALS: 3,946 dead corvids and 868 other dead birds with WNV
infection have been reported from 44 states and New York City. WNV
infections have been reported in HORSES from 34 states (Alabama,
Arizona, Arkansas, California, Colorado, Florida, Georgia, Idaho,
Illinois, Indiana, Iowa, Kansas, Kentucky, Michigan, Minnesota,
Mississippi, Missouri, Montana, Nevada, New Jersey, New Mexico, North
Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, South Dakota,
Tennessee, Texas, Utah, Virginia, Wisconsin, West Virginia, and
Wyoming) and in five DOGS from Nevada and New Mexico. Three SQUIRRELS
with WNV infection were reported from Arizona. Four unidentified animal
species with WNV infection were reported from Idaho, Illinois, Iowa,
and Nevada. WNV seroconversions have been reported in 690 SENTINEL
CHICKEN flocks from 13 states (Alabama, Arizona, Arkansas, California,
Delaware, Florida, Iowa, Louisiana, Nebraska, Nevada, Pennsylvania,
South Dakota, and Utah) and in seven WILD HATCHLING BIRDS from Missouri
and Ohio. Three seropositive sentinel horses were reported from Puerto
Rico.
[see also note from ProMED moderator re: horse cases, item 6 below]
MOSQUITOES: A total of 5,248 WNV-positive mosquito pools have been
reported from 32 states and New York City.
Additional information about national WNV activity is available from
CDC at http://www.cdc.gov/ncidod/dvbid/westnile/index.htm and at
http://westnilemaps.usgs.gov.
----------------------
[2]
OREGON: 1st HUMAN CASE
Source: ProMED Id 20040910.2523, posted Sept 10, 2004 [edited]
Since 2002, Oregon physicians have diagnosed several persons with WNV
infection. However, none had acquired the infection in Oregon until the
Malheur County case reported by the Oregon Department of Human Services
in a news release on Fri Sept 10, 2004. The ProMED moderator comments:
[This report records a significant westward extension of human WNV
infection in the USA. Oregon was the last of the contiguous states
(i.e. all states excluding Alaska and Hawaii) to confirm isolation of
WNV. A dead crow found in Vale (also in Malheur County) was confirmed
positive for WNV less
than a month ago (on 15 Aug 2004). Subsequently, other birds, and 4
equines, have been confirmed WNV-positive. This report of a human case
in Oregon confirms that West Nile virus is now endemic throughout the
lower 48 United States of America. - Mod.CP]
--------------------
[3]
PENNSYLVANIA: SHARP DECLINE IN CASE NUMBERS
Source: ProMED-mail <promed@promedmail.org> Id 20040916.2574, from
NYTimes, AP report, Sun Sept 12 2004 [edited]
<http://www.nytimes.com/aponline/health/AP-West-Nile-Virus.html>
A year after Pennsylvania experienced a surge in West Nile cases (240
human cases with 8 fatalities), the number of people infected with the
mosquito-borne virus appear to be headed back down. State agencies
have received reports of only 4 Pennsylvanians contracting the virus so
far in 2004, compared to 63 at this time a year ago. Current year
firgures are more like 2002, when the state had 62 cases of the
disease. Officials say cooler weather, more rain, a more careful
public, and better mosquito control efforts are probably responsible
for the decline.
"The fact that we've had a lot of rain makes you think mosquitoes
would be breeding more," Department of Health spokeswoman Jessica
Seiders told The Morning Call of Allentown. "But we think the continual
rainfall actually helped flush out stagnant water." Frequent rains can
flush out pools of standing water that serve as breeding grounds for
mosquitoes, which are also less active in the
cool than in the heat. The state has also used chemical sprays to kill
mosquitoes in areas where they were a problem in 2003.
It's unclear whether this year's numbers will remain low. Mosquito
season generally ends with the 1st frost, but last year [2003], the
state continued to receive reports of cases through December.
---------------------
[4]
CALIFORNIA OUTBREAK MAY BE PEAKING
Source: ProMED Id 20040916.2574, from SingOnSanDiego.com, AP, Sep 10,
2004, submitted by Pablo Nart <p.nart@ntlworld.com> [edited]
<http://www.signonsandiego.com/news/state/20040910-2245-ca-
westnile.html>
In Los Angeles, 186 county residents have been reported infected with
WNV in 2004. This is an 11 percent increase since previous week, first
week of September, but far from the 69 percent increase reported in
late August 2004. Statewide, 486 people have been infected, up 10
percent from 1st week of September 2004.
--------------------
[5]
CANADA: HEALTH CANADA SURVEILLANCE DATA AS OF SEPT 15, 2004
Source: ProMED-mail <promed@promedmail.org> from Health Canada,
Surveillance Data 2004 Program
<http://www.hc-sc.gc.ca/pphb-dgspsp/wnv-vwn/mon_e.html>
HUMAN: number of human cases in Canada has been revised, and the total
is now 20 confirmed cases, an increase of 3
cases overall since Thu 2 Sep 2004. There have been 3 confirmed cases
in Manitoba (up one - one neuroinvasive, one fever, and one
unspecified), 8 in Ontario (up one - 6 neuroinvasive, one fever, and
one unspecified), and 9 in Saskatchewan (up 2 - all fever). The
single case in Quebec has been removed from the current list.
BIRDS: 375 birds from 4 provinces have been found WNV-positive of 5886
tested across the country.
[Promed moderator comments: An additional 134 dead birds have been
tested since the figures released 7 days ago on Wed 8 Sep 2004 and
posted in the preceding update. The number of confirmed WNV-positive
birds has increased from 361 to 375 (plus 9 classified as presumed
positives).
Alberta, Manitoba, Ontario, Quebec, and Saskatchewan remain the only
provinces to report West Nile virus-positive birds so far in 2004.
The total of 14 West Nile virus-positive birds confirmed during the
past week [2nd week of September 2004] compares with 35 in the
preceding week, and, represents the 1st decline in virus-affected
birds. - Mod.CP]
EQUINE: The total number of equine cases in Canada is now given as 7: 2
presumed positive cases in Alberta, 4 confirmed cases in Ontario, and
one presumed-positive case in Quebec.
MOSQUITO POOLS: 137 mosquito pools (an increase of 11) have tested
WNV-positive: one in Alberta, 54 in Manitoba, 49
in Ontario, 6 in Quebec and 27 in Saskatchewan. These 5 are the only
provinces to report WNV-positive mosquito pools in 2004 so far.
-------------------------
[6]
MEXICO: WNVSURVEILLANCE DATA (AS OF SEPT 9, 2004)
Excerpted from ProMED Mail Id 20040910.2523, extracted from National
Center for Epidemiologic Surveillance of Mexico web-site, Resumen
Epidemiologico [edited]
<http://www.cenave.gob.mx/von/archivos/ResumenCASOSVON.xls>
HUMAN, CUMULATIVE: 210 individuals, resident in 25 of the 32 states,
have been tested for evidence of WNV; 209 were seronegative and
asymptomatic, and one individual in the state of Sonora exhibited signs
of disease.
HORSES, CUMULATIVE: 2284 horses, from 29 of the 32 states, have been
tested for evidence of WNV. 1761 were seronegative and 523
seropositive. All
were asymptomatic.
BIRDS, CUMULATIVE: 737 birds, from 6 of the 32 states, have been tested
for evidence of WNV; 685 were seronegative and 51 were seropositive
(and considered to be asymptomatic), and one in the state of Sonora
exhibited signs of disease.
[Sonora state, where the single human and avian cases were confirmed,
shares its northern border with the state of Arizona in the USA.
The majority (43 percent) of the seropositive equines were reported
from Sonora state. - Mod.CP]
[WNV causes overt clinical disease in horses, and has produced up to 33
percent mortality in them. The equine WNV infection season is only
just beginning in the USA -- see chart
<http://www.aphis.usda.gov/vs/nahps/equine/wnv/chart_2002- 2004.html>,
so it is unlikely that a quarter of all horses tested are already
infected in 2004. Therefore, to have so many asymptomatic seropositive
horses in the survey suggests that either the test used is
non-specific, or, they had a lot of unrecorded horse deaths from WNV
last year [2003] and these are the survivors. - Mod.JW]
--------------------------
[7]
ISRAEL: WEST NILE FEVER, HUMAN
Excerpted from ProMED-mail, from Haaretz, 21 Sep 2004, byline: Ran
Reznick [edited]
<http://www.haaretz.com/hasen/spages/479579.html>
The Health Ministry has reported the first 2 cases in 2004 of patients
with WNF.
According to the ministry's assessments, the appearance of the disease
at the end of the summer denotes that there will not be a renewed and
widespread outbreak of the disease this year. Israel experienced a
severe outbreak of WNF in 2000, with some 400 individuals falling ill
and 29 fatalities recorded. Since then, there has been a significant
fall-off in the extent of the disease, with 2001 seeing 14 people fall
ill and 2 fatalities, and 2002 seeing 7 people contract the disease and
1 death.
[According to a Ministry of Health (MOH) press release dated 21 Sep
2004, (<http://www.health.gov.il/news/news.asp?ID=242>, in Hebrew), one
of the
patients, a woman in her 30s, was infected in July in Jericho and
admitted to hospital in August in Jerusalem, where lab diagnosis was
obtained (no
further details provided); released following recovery. The other
patient, a man of 63, was bitten by mosquitoes on 5 Sep 2004 in Eilat,
admitted to
hospital due to encephalitis; still in hospital, condition "good".
According to the MOH statistical data, the cumulative total number of
WNF cases for 2003 was 21; the same figure appears for 2002: see
<http://www.health.gov.il/download/docs/units/epi/week03/IWER52.xls>.
Most cases of WNF occur in Israel during August-October. In 2003, the
1st case was diagnosed in May. - Mod.AS]
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