Theresa L. Smith, MD, MPH Division of Vector-Borne Infectious Diseases Centers for Disease Control...
-
Upload
martina-randall -
Category
Documents
-
view
220 -
download
5
Transcript of Theresa L. Smith, MD, MPH Division of Vector-Borne Infectious Diseases Centers for Disease Control...
![Page 1: Theresa L. Smith, MD, MPH Division of Vector-Borne Infectious Diseases Centers for Disease Control and Prevention Fort Collins, CO West Nile Virus Epidemiology.](https://reader036.fdocuments.net/reader036/viewer/2022081603/56649e915503460f94b962b8/html5/thumbnails/1.jpg)
Theresa L. Smith, MD, MPHDivision of Vector-Borne Infectious DiseasesCenters for Disease Control and PreventionFort Collins, CO
West Nile Virus
Epidemiology & Surveillance Update 2005
Blood Product Advisory CommitteeGaithersburg, MDNovember 3, 2005
![Page 2: Theresa L. Smith, MD, MPH Division of Vector-Borne Infectious Diseases Centers for Disease Control and Prevention Fort Collins, CO West Nile Virus Epidemiology.](https://reader036.fdocuments.net/reader036/viewer/2022081603/56649e915503460f94b962b8/html5/thumbnails/2.jpg)
West Nile Virus (WNV) Update*West Nile Virus (WNV) Update*
• VirologyVirology
• Epidemiology of WNV in US 1999 – 2005 Epidemiology of WNV in US 1999 – 2005
• 2005 surveillance update2005 surveillance update
• Blood donation surveillance eventsBlood donation surveillance events
*Unless marked, all data including 2005 was in ArboNET as of 11/1/05*Unless marked, all data including 2005 was in ArboNET as of 11/1/05
![Page 3: Theresa L. Smith, MD, MPH Division of Vector-Borne Infectious Diseases Centers for Disease Control and Prevention Fort Collins, CO West Nile Virus Epidemiology.](https://reader036.fdocuments.net/reader036/viewer/2022081603/56649e915503460f94b962b8/html5/thumbnails/3.jpg)
WNV: Virology
• Flavivirus in the Japanese encephalitis serogroup• WNV & St. Louis encephalitis in the US
• Primarily bird pathogen• Bird – mosquito – bird transmission cycle
• Mammals are dead-end hosts in natural cycle• Low-level viremia before illness onset
![Page 4: Theresa L. Smith, MD, MPH Division of Vector-Borne Infectious Diseases Centers for Disease Control and Prevention Fort Collins, CO West Nile Virus Epidemiology.](https://reader036.fdocuments.net/reader036/viewer/2022081603/56649e915503460f94b962b8/html5/thumbnails/4.jpg)
WNV UpdateWNV Update
• VirologyVirology
• Epidemiology of WNV in US 1999 – 2005 Epidemiology of WNV in US 1999 – 2005
• 2005 surveillance update2005 surveillance update
• Blood donation surveillance eventsBlood donation surveillance events
![Page 5: Theresa L. Smith, MD, MPH Division of Vector-Borne Infectious Diseases Centers for Disease Control and Prevention Fort Collins, CO West Nile Virus Epidemiology.](https://reader036.fdocuments.net/reader036/viewer/2022081603/56649e915503460f94b962b8/html5/thumbnails/5.jpg)
ArboNET: A National Arbovirus Surveillance System
• Web-based passive system begun in 2000• 57 area health departments to DVBID
• Mosquito, bird, horse, other animal surveillance• Year, state, county, date of collection
• Human cases• Age, sex, race/ethnicity• Residence• Clinical illness, onset date and outcome• Blood or organ donation/receipt
![Page 6: Theresa L. Smith, MD, MPH Division of Vector-Borne Infectious Diseases Centers for Disease Control and Prevention Fort Collins, CO West Nile Virus Epidemiology.](https://reader036.fdocuments.net/reader036/viewer/2022081603/56649e915503460f94b962b8/html5/thumbnails/6.jpg)
First Reported WNV Activity, by State, 1999-2005
Human200120001999 2002
20032004
![Page 7: Theresa L. Smith, MD, MPH Division of Vector-Borne Infectious Diseases Centers for Disease Control and Prevention Fort Collins, CO West Nile Virus Epidemiology.](https://reader036.fdocuments.net/reader036/viewer/2022081603/56649e915503460f94b962b8/html5/thumbnails/7.jpg)
2004
2,539 human cases1,142 WNND100 deaths
40 states + DC523 counties
![Page 8: Theresa L. Smith, MD, MPH Division of Vector-Borne Infectious Diseases Centers for Disease Control and Prevention Fort Collins, CO West Nile Virus Epidemiology.](https://reader036.fdocuments.net/reader036/viewer/2022081603/56649e915503460f94b962b8/html5/thumbnails/8.jpg)
2005
2,581 human cases1,053 WNND83 deaths
40 states 563 counties
![Page 9: Theresa L. Smith, MD, MPH Division of Vector-Borne Infectious Diseases Centers for Disease Control and Prevention Fort Collins, CO West Nile Virus Epidemiology.](https://reader036.fdocuments.net/reader036/viewer/2022081603/56649e915503460f94b962b8/html5/thumbnails/9.jpg)
WNV UpdateWNV Update
• VirologyVirology
• Epidemiology of WNV in US 1999 – 2005 Epidemiology of WNV in US 1999 – 2005
• 2005 surveillance update2005 surveillance update
• Blood donation surveillance eventsBlood donation surveillance events
![Page 10: Theresa L. Smith, MD, MPH Division of Vector-Borne Infectious Diseases Centers for Disease Control and Prevention Fort Collins, CO West Nile Virus Epidemiology.](https://reader036.fdocuments.net/reader036/viewer/2022081603/56649e915503460f94b962b8/html5/thumbnails/10.jpg)
0
50
100
150
200
250
300
Week Ending
Nu
mb
er
of
ca
se
s Onset Report
Human WNV Disease Casesby week of illness onset and date reported to ArboNET
United States, 2004
![Page 11: Theresa L. Smith, MD, MPH Division of Vector-Borne Infectious Diseases Centers for Disease Control and Prevention Fort Collins, CO West Nile Virus Epidemiology.](https://reader036.fdocuments.net/reader036/viewer/2022081603/56649e915503460f94b962b8/html5/thumbnails/11.jpg)
Reported Human WNV disease cases,United States, 1999-2005
Year Cases States/District
1999 62 1
2000 21 3
2001 66 10
2002 4,156 39 + DC
2003 9,862 45 + DC
2004 2,539 40 + DC
2005 2,581 42
![Page 12: Theresa L. Smith, MD, MPH Division of Vector-Borne Infectious Diseases Centers for Disease Control and Prevention Fort Collins, CO West Nile Virus Epidemiology.](https://reader036.fdocuments.net/reader036/viewer/2022081603/56649e915503460f94b962b8/html5/thumbnails/12.jpg)
Human WNV Disease, ArboNET 2005
2,581 case reports
• 42 states• Neuroinvasive – 1,053 • Fever – 1,363 • Deaths – 83*
• Median age: 78 yrs• Age range: 36 – 98 yrs
States with > 100 case reports
• California 824• Illinois 241• South Dakota 235• Texas 139 • Louisiana 111• Arizona 102
• 64% of all reports
* 78 fatalities had age available
![Page 13: Theresa L. Smith, MD, MPH Division of Vector-Borne Infectious Diseases Centers for Disease Control and Prevention Fort Collins, CO West Nile Virus Epidemiology.](https://reader036.fdocuments.net/reader036/viewer/2022081603/56649e915503460f94b962b8/html5/thumbnails/13.jpg)
WNV UpdateWNV Update
• VirologyVirology
• Epidemiology of WNV in US 1999 – 2005 Epidemiology of WNV in US 1999 – 2005
• 2005 surveillance update2005 surveillance update
• Blood donation surveillance eventsBlood donation surveillance events
![Page 14: Theresa L. Smith, MD, MPH Division of Vector-Borne Infectious Diseases Centers for Disease Control and Prevention Fort Collins, CO West Nile Virus Epidemiology.](https://reader036.fdocuments.net/reader036/viewer/2022081603/56649e915503460f94b962b8/html5/thumbnails/14.jpg)
WNV Blood Screening, US, 2003-2005
Year Screened* PVDs WNND WNF TAT
2003 6.2 818 6 137 6
2004 8.2 224 4 66 1
2005 NA 374 3 82 1
*In millions
![Page 15: Theresa L. Smith, MD, MPH Division of Vector-Borne Infectious Diseases Centers for Disease Control and Prevention Fort Collins, CO West Nile Virus Epidemiology.](https://reader036.fdocuments.net/reader036/viewer/2022081603/56649e915503460f94b962b8/html5/thumbnails/15.jpg)
![Page 16: Theresa L. Smith, MD, MPH Division of Vector-Borne Infectious Diseases Centers for Disease Control and Prevention Fort Collins, CO West Nile Virus Epidemiology.](https://reader036.fdocuments.net/reader036/viewer/2022081603/56649e915503460f94b962b8/html5/thumbnails/16.jpg)
![Page 17: Theresa L. Smith, MD, MPH Division of Vector-Borne Infectious Diseases Centers for Disease Control and Prevention Fort Collins, CO West Nile Virus Epidemiology.](https://reader036.fdocuments.net/reader036/viewer/2022081603/56649e915503460f94b962b8/html5/thumbnails/17.jpg)
Data
unavailable
![Page 18: Theresa L. Smith, MD, MPH Division of Vector-Borne Infectious Diseases Centers for Disease Control and Prevention Fort Collins, CO West Nile Virus Epidemiology.](https://reader036.fdocuments.net/reader036/viewer/2022081603/56649e915503460f94b962b8/html5/thumbnails/18.jpg)
Reported PVDs to ArboNET, 2004 vs. 2005
2004• 224 in 29 states
• Top four states:• California 66• Arizona
36• Colorado 24• Texas 16
2005• 374 in 30 states
• Top four states:• California 87• Texas 57• Nebraska 53• Louisiana 22
![Page 19: Theresa L. Smith, MD, MPH Division of Vector-Borne Infectious Diseases Centers for Disease Control and Prevention Fort Collins, CO West Nile Virus Epidemiology.](https://reader036.fdocuments.net/reader036/viewer/2022081603/56649e915503460f94b962b8/html5/thumbnails/19.jpg)
Implicated Donation Viral Concentrations
• 2002• 16 implicated donations had virus titers ranging from
0.8 to 75.1 pfu/mL with a of median of 10.5 pfu/mL
• 2003• Four implicated donations had virus titers ranging from
0.06 to 0.5 pfu/mL with a median of 0.11 pfu/mL
• 2004• One implicated donation had a viral titer of 0.12 pfu/mL
![Page 20: Theresa L. Smith, MD, MPH Division of Vector-Borne Infectious Diseases Centers for Disease Control and Prevention Fort Collins, CO West Nile Virus Epidemiology.](https://reader036.fdocuments.net/reader036/viewer/2022081603/56649e915503460f94b962b8/html5/thumbnails/20.jpg)
2005 Investigations
• Blood Transmission
• 6 investigations
• 3 negative
• 3 pending plasma return from Switzerland
• Organ Transplantation Transmission
• Likely mosquito-borne infection in donor
• Possible febrile illness
• IgM positive, PCR negative before donation
• Three of four organ recipients PCR positive
• Two became ill
![Page 21: Theresa L. Smith, MD, MPH Division of Vector-Borne Infectious Diseases Centers for Disease Control and Prevention Fort Collins, CO West Nile Virus Epidemiology.](https://reader036.fdocuments.net/reader036/viewer/2022081603/56649e915503460f94b962b8/html5/thumbnails/21.jpg)
Organ Donor TimelineAugust 2005
Serum, PlasmaPCR (-)
IgM, IgG (+)
28
WNV +MosquitoesIn Nearby
ParkInjury andSurgery
Organ Recovery
BrainDeath
262316
Febrile Illness?
27
![Page 22: Theresa L. Smith, MD, MPH Division of Vector-Borne Infectious Diseases Centers for Disease Control and Prevention Fort Collins, CO West Nile Virus Epidemiology.](https://reader036.fdocuments.net/reader036/viewer/2022081603/56649e915503460f94b962b8/html5/thumbnails/22.jpg)
2005 Summary
• WNV activity over most of the continental US• Continued westward expansion
• Full season of transmission in CA• Human cases reported from all states except
Alaska, Hawaii, Maine, & Washington• Risk of WNV TAT unknown• Continue to investigate possible TAT• TAT less likely to cause organ transplant related
WNV transmission