1 west nile virus washington state department of health the 2004 picture west nile virus
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West Nile Virus
Washington State Department of Health
The 2004 Picture
WestNileVirus
Washington State Department of Health 2
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”
WNV Background
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Incidental infections
Bird reservoir hosts
Incidental infections
Mosquito vector
Transmission Cycle
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Some Speculated Pathways of Introduction Human-transported birdHuman-transported mosquitoesStorm-transported birdIntentional introduction (terrorist event)
- not likelyInfected human traveler - not likely
WNV in the US
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Human Human infectioninfection with WNV with WNV
~80%No symptoms
~20%West Nile fever
<1%WNND
Fatal WNV infection: <0.1% of all infections10% of WNND
1/150 of all infectionscause West Nileneuroinvasive
disease (WNND) Very rough estimates
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Washington &WNV
2002 Washington goes positive...
Raven Pend Oreille CountyCrowSnohomish CountyHorse Island CountyHorse Whatcom County
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A Tale of Two Years
2003 2004
US Total 9,862 2,313
“The West” 3,773 1,562
As of November 16
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2003 2004*
Arizona 13 389
California 3 737
Colorado 2,947 276
Idaho 1 2
Montana 222 6
Nevada 2 44
New Mexico 209 86
Oregon 0 3
Utah 1 11
Washington 0 0
Wyoming 375 9*As of Nov 23, 2004
A Tale of Two Years
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2004 WNV Cases as of November 23
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The Northwest Experience
Washington State Department of Health
WestNileVirus
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Idaho
2003 2004
Humans 1 2
Horses 0 23
Birds 0 6
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Idaho Human Case Locations 2004
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Idaho Horse Case Locations 2004
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Idaho Bird Case Locations 2004
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Oregon
2003 2004
Humans 0 3
Horses 0 31
Birds 0 19
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Oregon Human Case Locations 2004
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Oregon Horse Case Locations 2004
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Oregon Bird Case Locations 2004
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Washington Bird Locations 2004
536 birds tested
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Washington Surveillance Testing 2004
Humans 23
Horses 53
Birds 551
Mosquito Pools 829
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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)
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Thanks to Our Partners
• Mosquito Control Districts• Local Health Jurisdictions• USACHPPM-West• Veterinarians• Health Care Providers• State agencies and others
West Nile Virus Surveillance
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Only Time Will Tell
Washington State Department of Health
Washington State Update 2004
WestNileVirus