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Published on October 21, 2007

Author: Kestrel

Source: authorstream.com

Slide1:  1 Mosquito-borne Diseases:  Mosquito-borne Diseases Western equine encephalitis and St. Louis encephalitis Both have occurred in Washington but no reported cases since early 1980’s West Nile virus Detected in 1999 in New York City Detected in Washington and 43 other states in 2003 Continued surveillance effort in Washington 2 Mosquito-borne Disease Surveillance:  Mosquito-borne Disease Surveillance Pre-1960’s No record of state activity 1960’s First statewide mosquito survey published in 1966 1960’s Mosquito Control Districts formed in Eastern Washington 1970’s Sentinel flocks used in Benton County and Grant County 3 Mosquito-borne Disease Surveillance:  Mosquito-borne Disease Surveillance 1980’s Last confirmed human and horse cases of mosquito-borne encephalitis 1990’s Zoonotic Disease program established in DOH 2001 DOH initiates WNV surveillance 4 Yakima Valley Encephalitis Outbreaks:  Yakima Valley Encephalitis Outbreaks 1939 31 cases 1940 58 cases 13 fatal 1941 26 cases 3 fatal 1942 28 cases 2 fatal (Reported in August 1945 Journal of American Medical Association) 5 Slide6:  Spokane San Juan Island Pierce King Snohomish Skagit Whatcom Clallam Jefferson Grays Harbor Thurston Kitsap Clark Cowlitz Lewis Skamania Wahkiakum Mason Yakima 7 Cases ( 6 WEE, 1 SLE) Chelan Okanogan Ferry Stevens Pend Oreille Lincoln Kittitas Whitman Klickitat Benton Walla Walla Columbia Garfield Asotin Franklin Adams Grant Douglas Pacific Reported Human Cases of Mosquito-borne Disease (1970-1982) Western Equine Encephalitis St. Louis Encephalitis Total cases = 12 6 Slide7:  Spokane San Juan Island Pierce King Snohomish Skagit Whatcom Clallam Jefferson Grays Harbor Thurston Kitsap Clark Cowlitz Lewis Skamania Wahkiakum Mason Yakima Chelan Okanogan Ferry Stevens Pend Oreille Lincoln Kittitas Whitman Klickitat Benton Walla Walla Columbia Garfield Asotin Franklin Adams Grant Douglas Pacific Western Equine Encephalitis Horse Cases (1953-1983) Suspect cases Confirmed cases 7 West Nile Virus In the United States:  West Nile Virus In the United States 8 WNV Background:  WNV Background First isolated 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” 9 West Nile Outbreaks:  West Nile Outbreaks Israel 1951-1954, 1957, 2000-2002 France 1962, 2000 South Africa 1974 Romania 1996-1997 Italy 1997 Czech Republic 1998 Republic of the Congo 1998 Russia 1999 United States 1999-2002 10 Outbreak Timeline:  Outbreak Timeline Israel 1957 Uganda 1937 Israel 1951-54 France 1962 South Africa 1974 Romania 1996 Italy 1997 Czech Rep. 1998 Congo 1998 Russia 1999 US 1999-2002 Israel 2000-2002 France 2000 Encephalitis Condition Identified Equine Disease Identified 11 West Nile Virus Transmission Cycle:  Incidental infections Bird reservoir hosts Incidental infections West Nile Virus Transmission Cycle Mosquito vector 12 Slide13:  13 WNV in the US Speculated Pathways of Introduction:  WNV in the US Speculated Pathways of Introduction Human-transported bird Legal Illegal Human-transported mosquitoes Storm-transported bird Intentional introduction (terrorist event)-not likely Infected human traveler-not likely 14 WNV Symptoms:  The incubation period for West Nile Virus is generally 3-14 days following a bite from an infected mosquito. WNV Symptoms High Fever Headache and body aches Skin rash Swollen lymph glands Neck stiffness Disorientation Convulsions 15 Distribution of WNV Before 1999:  States with WNV (0) Distribution of WNV Before 1999 16 Distribution of WNV as of November 1999:  States with WNV (4) Distribution of WNV as of November 1999 17 Distribution of WNV as of November 2000:  States with WNV (12 + DC) Distribution of WNV as of November 2000 18 Distribution of WNV as of November 2001:  States with WNV (27 + DC) Distribution of WNV as of November 2001 19 Distribution of WNV as of November 2002:  States with WNV (44 + DC) Distribution of WNV as of November 2002 20 Slide21:  WNV 1999-2002 by County 21 Distribution by County December 7, 2002:  Distribution by County December 7, 2002 Source: Dr. Henry Huang, Washington U. School of Medicine 22 Slide23:  San Juan Island Clallam Jefferson Grays Harbor Kitsap Lewis Skamania Pacific Mason Ferry Stevens Lincoln Kittitas Klickitat Columbia Garfield Asotin Okanogan Snohomish Douglas Chelan Spokane Yakima Whatcom Pierce Franklin Benton Whitman Walla Walla Clark Cowlitz Thurston Wahkiakum Pend Oreille Grant Adams King Counties Detecting West Nile Virus 2002 Skagit 23 Slide24:  24 Slide25:  25 Slide26:  26 Case Summary 1999-2002:  Case Summary 1999-2002 27 WNV Case-Patient Demographics & Mortality United States, 1999-2002*:  *As of Dec 19 WNV Case-Patient Demographics & Mortality United States, 1999-2002* 28 Date of Symptom Onset, West Nile Virus United States, 1999-2001:  Date of Symptom Onset, West Nile Virus United States, 1999-2001 29 Protecting Public Health:  Protecting Public Health Surveillance Personal Protection and Education Mosquito Control 30 WNV Surveillance:  WNV Surveillance Mosquitoes Dead birds (especially crows, jays, ravens and magpies) Veterinary surveillance Human surveillance 31 Mosquito Surveillance:  Mosquito Surveillance Review information on species in your jurisdiction Establish system for recording “mosquito complaints” Identify and map breeding locations Conduct larval/adult surveillance (May-Sep) 32 Dead Bird Surveillance:  Dead Bird Surveillance Establish system for recording dead bird reports Message to public on reporting sightings Submit corvids for analysis (May-Oct) Response protocol for positive birds 33 Horse Case Surveillance:  Horse Case Surveillance Encourage reporting by local veterinarians Identify major stables, training facilities and establish contact Track cases as they occur Response protocol for sick, dead horses 34 Human Case Surveillance:  Human Case Surveillance Enhanced passive surveillance May-Sep Active surveillance when cases result Case investigation to help define probable exposure Response protocol for illness or death in humans 35 Mosquito Control:  Mosquito Control Assessment of local capability Designation of lead agency, person (where, when, how) Develop local action plan Training and licensing of personnel to use mosquito control compounds Keep community involved and informed in the decision process, especially if adulticiding is considered 36 WNV Mosquito Species in Washington:  WNV Mosquito Species in Washington Aedes cinereus Aedes vexans Culex pipiens Culex restuans Culex tarsalis Anopheles punctipennis Coquilletidia perturbans Ochlerotatus canadensis Ochlerotatus japonicus Counties (39) 22 27 28 1 35 26 10 5 1 37 Estimated Sensitivity of WNV Surveillance Methods:  Human cases Veterinary cases Mosquitoes Dead birds Time Disease Activity Sentinel hosts Estimated Sensitivity of WNV Surveillance Methods 38 Personal Protection:  Personal Protection Wear long sleeves & pants in mosquito-infested areas Use repellant containing DEET (N,N-diethyl-3-methylbenzamide) and follow directions carefully Limit outdoor activities at dawn and early evening Repair holes in door & window screens 39 Habitat Reduction:  Habitat Reduction Eliminate standing water (flower pots; tires; wheelbarrows; wading pools) Change the water in birdbaths at least weekly Aerate and chlorinate swimming pools and hot tubs; cover if possible Consider mosquito-eating fish for your pond Keep gutters clean to prevent standing water Spread the word: educate your friends and neighbors 40 Slide41:  41 Want More?:  Want More? www.doh.wa.gov/wnv www.cdc.gov www.cfe.cornell.edu/erap/WNV/ www.mrsc.org/subjects/governance/spd/mosquito.aspx Your local health department 42

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