West Nile virus outbreak among horses in New York State, 1999 and 2000

Integrating Spatiotemporal Epidemiology, Eco-Phylogenetics, and Distributional Ecology to Assess West Nile Disease Risk in Horses

Mosquito-borne West Nile virus (WNV) is the causative agent of West Nile disease in humans, horses, and some bird species. Since the initial introduction of WNV to the United States (US), approximately 30,000 horses have been impacted by West Nile neurologic disease and hundreds of additional horses are infected each year. Research describing the drivers of West Nile disease in horses is greatly needed to better anticipate the spatial and temporal extent of disease risk, improve disease surveillance, and alleviate future economic impacts to the equine industry and private horse owners. To help meet this need, we integrated techniques from spatiotemporal epidemiology, eco-phylogenetics, and distributional ecology to assess West Nile disease risk in horses throughout the contiguous US. Our integrated approach considered horse abundance and virus exposure, vector and host distributions, and a variety of extrinsic climatic, socio-economic, and environmental risk factors. Birds are WNV reservoir hosts, and therefore we quantified avian host community dynamics across the continental US to show intra-annual variability in host phylogenetic structure and demonstrate host phylodiversity as a mechanism for virus amplification in time and virus dilution in space. We identified drought as a potential amplifier of virus transmission and demonstrated the importance of accounting for spatial non-stationarity when quantifying interaction between disease risk and meteorological influences such as temperature and precipitation. Our results delineated the timing and location of several areas at high risk of West Nile disease and can be used to prioritize vaccination programs and optimize virus surveillance and monitoring.

West Nile Virus: An Update on Pathobiology, Epidemiology, Diagnostics, Control and "One Health" Implications

West Nile virus (WNV) is an important zoonotic flavivirus responsible for mild fever to severe, lethal neuroinvasive disease in humans, horses, birds, and other wildlife species. Since its discovery, WNV has caused multiple human and animal disease outbreaks in all continents, except Antarctica. Infections are associated with economic losses, mainly due to the cost of treatment of infected patients, control programmes, and loss of animals and animal products. The pathogenesis of WNV has been extensively investigated in natural hosts as well as in several animal models, including rodents, lagomorphs, birds, and reptiles. However, most of the proposed pathogenesis hypotheses remain contentious, and much remains to be elucidated. At the same time, the unavailability of specific antiviral treatment or effective and safe vaccines contribute to the perpetuation of the disease and regular occurrence of outbreaks in both endemic and non-endemic areas. Moreover, globalisation and climate change are also important drivers of the emergence and re-emergence of the virus and disease. Here, we give an update of the pathobiology, epidemiology, diagnostics, control, and “One Health” implications of WNV infection and disease.

Protective Efficacy of a Chimeric Insect-Specific Flavivirus Vaccine against West Nile Virus

Virulent strains of West Nile virus (WNV) are highly neuro-invasive and human infection is potentially lethal. However, no vaccine is currently available for human use. Here, we report the immunogenicity and protective efficacy of a vaccine derived from a chimeric virus, which was constructed using the structural proteins (prM and E) of the Kunjin strain of WNV (WNV_KUN) and the genome backbone of the insect-specific flavivirus Binjari virus (BinJV). This chimeric virus (BinJ/WNV_KUN-prME) exhibits an insect-specific phenotype and does not replicate in vertebrate cells. Importantly, it authentically presents the prM-E proteins of WNV_KUN, which is antigenically very similar to other WNV strains and lineages. Therefore BinJ/WNV_KUN-prME represents an excellent candidate to assess as a vaccine against virulent WNV strains, including the highly pathogenic WNV_NY99. When CD1 mice were immunized with purified BinJ/WNV_KUN-prME, they developed robust neutralizing antibody responses after a single unadjuvanted dose of 1 to 5 μg. We further demonstrated complete protection against viremia and mortality after lethal challenge with WNV_NY99, with no clinical or subclinical pathology observed in vaccinated animals. These data suggest that BinJ/WNV_KUN-prME represents a safe and effective WNV vaccine candidate that warrants further investigation for use in humans or in veterinary applications.

Zoonotic Viral Diseases of Equines and Their Impact on Human and Animal Health

INTRODUCTION

Zoonotic diseases are the infectious diseases that can be transmitted to human beings and vice versa from animals either directly or indirectly. These diseases can be caused by a range of organisms including bacteria, parasites, viruses and fungi. Viral diseases are highly infectious and capable of causing pandemics as evidenced by outbreaks of diseases like Ebola, Middle East Respiratory Syndrome, West Nile, SARS-Corona, Nipah, Hendra, Avian influenza and Swine influenza.

EXPALANTION

Many viruses affecting equines are also important human pathogens. Diseases like Eastern equine encephalitis (EEE), Western equine encephalitis (WEE), and Venezuelan-equine encephalitis (VEE) are highly infectious and can be disseminated as aerosols. A large number of horses and human cases of VEE with fatal encephalitis have continuously occurred in Venezuela and Colombia. Vesicular stomatitis (VS) is prevalent in horses in North America and has zoonotic potential causing encephalitis in children. Hendra virus (HeV) causes respiratory and neurological disease and death in man and horses. Since its first outbreak in 1994, 53 disease incidents have been reported in Australia. West Nile fever has spread to many newer territories across continents during recent years.It has been described in Africa, Europe, South Asia, Oceania and North America. Japanese encephalitis has expanded horizons from Asia to western Pacific region including the eastern Indonesian archipelago, Papua New Guinea and Australia. Rabies is rare in horses but still a public health concern being a fatal disease. Equine influenza is historically not known to affect humans but many scientists have mixed opinions. Equine viral diseases of zoonotic importance and their impact on animal and human health have been elaborated in this article.

CONCLUSION

Equine viral diseases though restricted to certain geographical areas have huge impact on equine and human health. Diseases like West Nile fever, Hendra, VS, VEE, EEE, JE, Rabies have the potential for spread and ability to cause disease in human. Equine influenza is historically not known to affect humans but some experimental and observational evidence show that H3N8 influenza virus has infected man. Despite our pursuit of understanding the complexity of the vector-host-pathogen mediating disease transmission, it is not possible to make generalized predictions concerning the degree of impact of disease emergence. A targeted, multidisciplinary effort is required to understand the risk factors for zoonosis and apply the interventions necessary to control it.

West Nile virus host-vector-pathogen interactions in a colonial raptor

Background

Avian host species have different roles in the amplification and maintenance of West Nile virus (WNV), therefore identifying key taxa is vital in understanding WNV epidemics. Here, we present a comprehensive case study conducted on red-footed falcons, where host-vector, vector-virus and host-virus interactions were simultaneously studied to evaluate host species contribution to WNV circulation qualitatively.

Results

Mosquitoes were trapped inside red-footed falcon nest-boxes by a method originally developed for the capture of blackflies and midges. We showed that this approach is also efficient for trapping mosquitoes and that the number of trapped vectors is a function of host attraction. Brood size and nestling age had a positive effect on the number of attracted Culex pipiens individuals while the blood-feeding success rate of both dominant Culex species (Culex pipiens and Culex modestus) markedly decreased after the nestlings reached 14 days of age. Using RT-PCR, we showed that WNV was present in these mosquitoes with 4.2% (CI: 0.9–7.5%) prevalence. We did not detect WNV in any of the nestling blood samples. However, a relatively high seroprevalence (25.4% CI: 18.8–33.2%) was detected with an enzyme-linked immunoabsorbent assay (ELISA). Using the ELISA OD ratios as a proxy to antibody titers, we showed that older seropositive nestlings have lower antibody levels than their younger conspecifics and that hatching order negatively influences antibody levels in broods with seropositive nestlings.

Conclusions

Red-footed falcons in the studied system are exposed to a local sylvatic WNV circulation, and the risk of infection is higher for younger nestlings. However, the lack of individuals with viremia and the high WNV seroprevalence, indicate that either host has a very short viremic period or that a large percentage of nestlings in the population receive maternal antibodies. This latter assumption is supported by the age and hatching order dependence of antibody levels found for seropositive nestlings. Considering the temporal pattern in mosquito feeding success, maternal immunity may be effective in protecting progeny against WNV infection despite the short antibody half-life measured in various other species. We conclude that red-footed falcons seem to have low WNV host competence and are unlikely to be effective virus reservoirs in the studied region.

Evaluation of a Multivariate Syndromic Surveillance System for West Nile Virus

BACKGROUND

Various methods are currently used for the early detection of West Nile virus (WNV) but their outputs are not quantitative and/or do not take into account all available information. Our study aimed to test a multivariate syndromic surveillance system to evaluate if the sensitivity and the specificity of detection of WNV could be improved.

METHODS

Weekly time series data on nervous syndromes in horses and mortality in both horses and wild birds were used. Baselines were fitted to the three time series and used to simulate 100 years of surveillance data. WNV outbreaks were simulated and inserted into the baselines based on historical data and expert opinion. Univariate and multivariate syndromic surveillance systems were tested to gauge how well they detected the outbreaks; detection was based on an empirical Bayesian approach. The systems' performances were compared using measures of sensitivity, specificity, and area under receiver operating characteristic curve (AUC).

RESULTS

When data sources were considered separately (i.e., univariate systems), the best detection performance was obtained using the data set of nervous symptoms in horses compared to those of bird and horse mortality (AUCs equal to 0.80, 0.75, and 0.50, respectively). A multivariate outbreak detection system that used nervous symptoms in horses and bird mortality generated the best performance (AUC = 0.87).

CONCLUSIONS

The proposed approach is suitable for performing multivariate syndromic surveillance of WNV outbreaks. This is particularly relevant, given that a multivariate surveillance system performed better than a univariate approach. Such a surveillance system could be especially useful in serving as an alert for the possibility of human viral infections. This approach can be also used for other diseases for which multiple sources of evidence are available.

Risk factors for West Nile virus infection and disease in populations and individuals

West Nile virus (WNV) is a mosquito-borne enveloped positive-strand RNA virus that emerged in North America in 1999 in New York City. Over the past 15 years, WNV has become established throughout the USA and has spread into Canada, Mexico and the Caribbean. CDC reports indicate >41,000 clinical cases, including more than 1700 fatalities. An estimated 3 million people in the USA may have been infected to date. Infection with WNV is dependent on many factors including climate, mosquito habitats and immunologically naïve bird populations. In addition, variations within individuals contribute to the risk of severe disease, in particular, advanced age, hypertension, immunosuppression and critical elements of the immune response. Recent advances in technology now allow detailed analysis of complex immune interactions relevant to disease susceptibility.

Infection control and biosecurity in equine disease control

Infectious diseases are an important cause of morbidity and mortality in horses, along with economic costs and broader impacts associated with the loss of members of a species that generates income, acts as a working animal and is a companion. Endemic diseases continue to challenge, emerging diseases are an ever‐present threat and outbreaks can be both destructive and disruptive. While infectious diseases can never be completely prevented, measures can be introduced to restrict the entry of pathogens into a population or limit the implications of the presence of a pathogen. Objective research regarding infection control and biosecurity in horses is limited, yet a variety of practical infection prevention and control measures can be used. Unfortunately, infection control can be challenging, because of the nature of the equine industry (e.g. frequent horse movement) and endemic pathogens, but also because of lack of understanding or motivation to try to improve practices. Recognition of the basic concepts of infection control and biosecurity, and indeed the need for measures to control infectious diseases, is the foundation for successful infection prevention and control.

A review of vaccine approaches for West Nile virus

The West Nile virus (WNC) first appeared in North America in 1999. The North American lineages of WNV were characterized by the presence of neuroinvasive and neurovirulent strains causing disease and death in humans, birds and horses. The 2012 WNV season in the United States saw a massive spike in the number of neuroinvasive cases and deaths similar to what was seen in the 2002–2003 season, according to the West Nile virus disease cases and deaths reported to the CDC by year and clinical presentation, 1999–2012, by ArboNET (Arboviral Diseases Branch, Centers for Disease Control and Prevention). In addition, the establishment and recent spread of lineage II WNV virus strains into Western Europe and the presence of neurovirulent and neuroinvasive strains among them is a cause of major concern. This review discusses the advances in the development of vaccines and biologicals to combat human and veterinary West Nile disease.

West Nile viral infection of equids

West Nile virus (WNV) is a flavivirus transmitted between certain species of birds and mosquito vectors. Tangential infections of equids and subsequent equine epizootics have occurred historically. Although the attack rate has been estimated to be below 10%, mortality rates can approach 50% in horses that present clinical disease. Symptoms are most commonly presenting in the form of encephalitis with ataxia as well as limb weakness, recumbency and muscle fasciculation. The most effective strategy for prevention of equine disease is proper vaccination with one of the numerous commercially available vaccines available in North America or the European Union. Recently, WNV has been increasingly associated with equine epizootics resulting from novel non-lineage-1a viruses in expanding geographic areas. However, specific experimental data on the virulence of these novel virus strains is lacking and questions remain as to the etiology of the expanded epizootics: whether it be a function of inherent virulence or ecological and/or climactic factors that could precipitate the altered epidemiological patterns observed.

Vectors and vector-borne diseases of horses

Most diseases of horses with zoonotic importance are transmitted by arthropods. The vectors belong to two very distantly related groups, the chelicerate Ixodidae (Acari = ticks) and the hexapod Diptera (true flies). Almost all relevant species are predestined for transmitting pathogens by their blood-sucking habits. Especially species of Diptera, one of the megadiverse orders of holometabolan insects (ca. 150.000 spp.), affect the health status and performance of horses during the grazing period in summer. The severity of pathological effect depends on the pathogen, but also on the group of vectors and the intensity of the infection or infestation. Dipteran species but also blood-sucking representatives of Acari (Ixodidae) can damage their hosts by sucking blood, causing myiasis, allergy, paralysis and intoxication, and also transmit various bacterial, viral, parasitic, spirochetal and rickettsial diseases to animals and also humans. The aim of this review was to provide extensive information on the infectious diseases transmitted by members of the two arthropod lineages (Ixodidae, Diptera) and a systematic overview of the vectors. For each taxon, usually on the ordinal, family, and genus level a short characterisation is given, allowing non-entomologists easy identification. Additionally, the biology of the relevant species (or genera) is outlined briefly.

Transcellular transport of West Nile virus-like particles across human endothelial cells depends on residues 156 and 159 of envelope protein

Background

West Nile virus (WNV) causes viremia after invasion to the hosts by mosquito bite. Endothelial cells could play an important role in WNV spread from the blood stream into the central nervous system and peripheral tissues. Here, we analyzed the capacity of virus-like particles (VLPs) of the highly virulent NY99 6-LP strain (6-LP VLPs) and the low virulence Eg101 strain (Eg VLPs) to cross cultured human endothelial cells.

Results

6-LP VLPs were transported from the apical to basolateral side of endothelial cells, whereas Eg VLPs were hardly transported. The localization of tight junction marker ZO-1 and the integrity of tight junctions were not impaired during the transport of 6-LP VLPs. The transport of 6-LP VLPs was inhibited by treatment with filipin, which prevents the formation of cholesterol-dependent membrane rafts, suggesting the involvement of raft-associated membrane transport. To determine the amino acid residues responsible for the transport of VLPs, we produced mutant VLPs, in which residues of E protein were exchanged between the 6-LP and Eg strains. Double amino acid substitution of the residues 156 and 159 greatly impaired the transport of VLPs.

Conclusion

Our results suggest that a transcellular pathway is associated with 6-LP VLPs transport. We also showed that the combination of the residues 156 and 159 plays an important role in the transport of VLPs across endothelial cells.

Diversification of West Nile virus in a subtropical region

Background

West Nile virus (WNV) has spread across North, Central, and South America since its introduction in 1999. At the start of this spread, Florida was considered a potentially important area with regards to transmission due to its geographic, climatological, and demographic conditions. Curiously, the anticipated high levels of transmission or disease outbreaks have not been observed. As other studies have predicted that the lack of intense WNV transmission is not due to vector incompetence, we sought to evaluate the role of viral strain diversity in WNV transmission in Florida. Therefore, a phylogentic analysis was carried out on several isolates collected from three distinct locations in Florida.

Results

Contrasting with a positive control collected in Indian River County, Florida during 2003 that contains the original NY99 genotype with valanine at amino acid 159 of the envelope region, all of the isolates collected in 2005 contain the WN02 genotype composed of a substation with alanine at that position indicating the window of introduction of the WN02 genotype occurred between 2003 and 2005. From the eight isolates collected in Duval, Indian River, and Manatee Counties; there is also a silent nucleotide substitution that differentiates the isolates collected on the Atlantic side of the state compared to the isolate collected on the Gulf side, which groups closer to isolates from other locations near the Gulf.

Conclusion

As a whole, the Florida isolates contained numerous variable nucleotide and amino acid sites from the reference sequences, as well as each other; indicating greater nucleotide diversity within the Florida 2005 isolates than within other regions. Finally, a series of three amino acid substitutions surrounding a set of histidines located in the envelope coding region that hypothesized to play a role in conformational changes was found in the isolate collected in Indian River County, perhaps changing the antigenicity of the homodimer. Taken together, these findings expand our understanding of the temporal and spatial compartmentalization of West Nile virus subtypes within North America.

Equine West Nile virus disease occurrence and the Normalized Difference Vegetation Index

The association between the Normalized Difference Vegetation Index (NDVI) and periods of above- or below-average reported cases of equine West Nile virus encephalomyelitis, reported in Texas between 2002 and 2004, was investigated. A time-series of case reports, using a biweekly window, was constructed. Because of the disparity in number of cases reported (1698, 672 and 101 in 2002, 2003 and 2004, respectively), data were standardized by calculating the number of cases reported during each biweekly period as a ratio of the annual average number of cases reported. The mean NDVI (0.439) in Texas in biweekly periods in which cases were reported was significantly higher (P<0.001) than the mean NDVI (0.396) in periods in which cases were not reported. The best-fitting model of standardized case ratios included the mean NDVI in the preceding 4-week period. This association was further investigated in the two ecological regions of Texas in which most cases were reported during the study period--Prairies and Lakes, and the Panhandle Plains. Standardized case ratios in the Prairies and Lakes ecoregion were best predicted by NDVI estimated 19-20 weeks previously, whereas standardized case ratios in the Panhandle Plains region were most strongly associated with NDVI estimated 1-4 weeks previously, indicating that the temporal lag between appropriate environmental conditions and resulting increased risk of WNV transmission can vary in different regions. The associations identified could be useful in an early-warning system of increased disease risk.

Use of a surrogate chimeric virus to detect West Nile virus-neutralizing antibodies in avian and equine sera

A chimeric yellow fever virus/West Nile virus (WNV) was compared to WNV alone as a biosafety level 2 reagent in the plaque reduction neutralization test for determining WNV infection histories. Concordance was 96.3% among 188 avian and equine serum samples. Neutralizing antibody titers were frequently more than twofold lower with the chimera.

Cutaneous myiasis

Cutaneous myiasis is a unique disease, endemic in tropical areas, and uncommon in the Western world, making its diagnosis difficult for physicians that are unfamiliar with the disease process. Larvae of a two-winged fly are inoculated through normal skin by a mosquito bite. The larvae grow in the subcutaneous tissues, feed off the surrounding tissues and develop into a fly. A patient with a seemingly commonplace cutaneous lesion which was a harbinger of a much more sinister, unique disease process, is presented. Salient features that characterise these lesions, the difficulty in accurate (and timely) diagnosis, treatment and a review of the literature are discussed with the aim of overcoming limitations of diagnosis and management.

Using geographic information systems and spatial and space-time scan statistics for a population-based risk analysis of the 2002 equine West Nile epidemic in six contiguous regions of Texas

BACKGROUND

In 2002, West Nile virus (WNV) first appeared in Texas. Surveillance data were retrospectively examined to explore the temporal and spatial characteristics of the Texas equine WNV epidemic in 2002. Using Geographic Information Systems (GIS) and the Spatial and Space-Time Scan (SaTScan) statistics, we analyzed 1421 of the reported equine WNV cases from six contiguous state Health Service Regions (HSRs), comprising 158 counties, in western, northern, central and eastern Texas.

RESULTS

Two primary epidemic peaks occurred in Epidemiological (Epi) week 35 (August 25 to 31) and Epi week 42 (October 13 to 19) of 2002 in the western and eastern part of the study area, respectively. The SaTScan statistics detected nine non-random spatio-temporal equine case aggregations (mini-outbreaks) and five unique high-risk areas imbedded within the overall epidemic.

CONCLUSION

The 2002 Texas equine WNV epidemic occurred in a bi-modal pattern. Some "local hot spots" of the WNV epidemic developed in Texas. The use of GIS and SaTScan can be valuable tools in analyzing on-going surveillance data to identify high-risk areas and shifts in disease clustering within a large geographic area. Such techniques should become increasingly useful and important in future epidemics, as decisions must be made to effectively allocate limited resources.

West Nile Virus Outbreak Detection Using Syndromic Monitoring in Horses

Recent outbreaks of West Nile virus-associated (WNV) diseases, both in the old World and Americas, underline the importance for early warning systems that rapidly identify emerging and re-emerging diseases and thus help in their control. Traditional approaches of disease monitoring become less reliable and increasingly costly when used for rare health-related events, such as WNV outbreaks in southern France. The objective of this work was to discuss methodological issues related to syndromic monitoring of WNV-associated disease in Camargue horses by veterinary practitioners. Tracking cases of equine encephalitis by veterinarians is an example of such syndromic monitoring of an emerging disease. Signs of illness, observed prior diagnostic confirmation, can be of interest because they may provide an early warning for WNV circulation in a given area and allow authorities to take appropriate preventive measures for public health.

High prevalence of West Nile virus: a continuing risk in acquiring infection from a mosquito bite

The prevalence of West Nile Virus (WNV) was evaluated by diplex real-time RT-PCR assay for the years 2001-2005 in Culex species of mosquitoes, several species of dead birds, and clinically suspected mammals collected in Kansas. The analysis was performed using a TaqMan-based diplex real-time RT-PCR assay targeted against two regions of the WNV genome, envelope glycoprotein gene and 3' untranslated region. The assay aided in the accurate detection of WNV in mosquitoes at high prevalence for the years 2002-2005. Similarly, high incidence of birds that tested positive for WNV was detected in 2002-2004. WNV positives in mammals by the diplex real time RT-PCR assay included horses, squirrels, mules, sheep and a mountain goat. Majority of the equine WNV positives were detected only in the year 2002. Sequence analysis of a segment of the envelope glycoprotein gene from 31 randomly selected WNV positive samples revealed variations in six samples at one or two nucleotide positions. The identity of high levels of WNV positives in Kansas parallels the recent reports on the widespread distribution of the virus in the United States. The continued detection of WNV in the mosquitoes is of significant public health concern and calls for continued surveillance and public health activities.

Characteristics of an outbreak of West Nile virus encephalomyelitis in a previously uninfected population of horses

Equine West Nile virus (WNV) encephalomyelitis cases - based on clinical signs and ELISA serology test results - reported to Texas disease control authorities during 2002 were analyzed to provide insights into the epidemiology of the disease within a previously disease-free population. The epidemic occurred between June 27 and December 17 (peaking in early October) and 1,698 cases were reported. Three distinct epidemic phases were identified, occurring mostly in southeast, northwest and then central Texas. Significant (P<0.05) disease clusters were identified in northwest and northern Texas. Most (91.1%) cases had no recent travel history, and most (68.9%) cases had not been vaccinated within the previous 12 months. One-third of cases did not survive, 71.2% of which were euthanatized. The most commonly reported presenting signs included ataxia (69%), abnormal gait (52%), muscle fasciculations (49%), depression (32%) and recumbency (28%). Vaccination status, ataxia, falling down, recumbency and lip droop best explained the risk of not surviving WNV disease. Results suggest that the peak risk period for encephalomyelitis caused by WNV may vary substantially among regions within Texas. Recumbent horses have a poor prognosis for survival. Vaccines, even if not administered sufficiently in advance of WNV infection within a district, may reduce the risk of death by at least 44%.

Rural cases of equine West Nile virus encephalomyelitis and the normalized difference vegetation index

Data from an outbreak (August to October, 2002) of West Nile virus (WNV) encephalomyelitis in a population of horses located in northern Indiana was scanned for clusters in time and space. One significant (p = 0.04) cluster of case premises was detected, occurring between September 4 and 10 in the south-west part of the study area (85.70 degrees N, 45.50 degrees W). It included 10 case premises (3.67 case premises expected) within a radius of 2264 m. Image data were acquired by the Advanced Very High Resolution Radiometer (AVHRR) sensor onboard a National Oceanic and Atmospheric Administration polar-orbiting satellite. The Normalized Difference Vegetation Index (NDVI) was calculated from visible and near-infrared data of daily observations, which were composited to produce a weekly-1km(2) resolution raster image product. During the epidemic, a significant (p < 0.01) decrease (0.025 per week) in estimated NDVI was observed at all case and control premise sites. The median estimated NDVI (0.659) for case premises within the cluster identified was significantly (p < 0.01) greater than the median estimated NDVI for other case (0.571) and control (0.596) premises during the same period. The difference in median estimated NDVI for case premises within this cluster, compared to cases not included in this cluster, was greatest (5.3% and 5.1%, respectively) at 1 and 5 weeks preceding occurrence of the cluster. The NDVI may be useful for identifying foci of WNV transmission.

Epidemic West Nile virus encephalomyelitis: a temperature-dependent, spatial model of disease dynamics

Since first being detected in New York in 1999, West Nile virus (WNV) has spread throughout the United States and more than 20,000 cases of equine WNV encephalomyelitis have been reported. A spatial model of disease occurrence was developed, using data from an outbreak of serologically confirmed disease in an unvaccinated population of horses at 108 locations in northern Indiana between 3 August and 17 October 2002. Daily maximum temperature data were recorded at meteorological stations surrounding the study area. The distribution of the total number of degree-days elapsing between July 4 and the date of diagnosis of each case was best described by a normal distribution (mean=5243 degrees F, S.D.=1047). The days on which the average risk was >25, >50 and >75% were predicted (versus observed) to occur on August 23 (August 9), August 31 (September 2) and September 9 (September 9). The epidemic was predicted to occur 3 days earlier, or 4 days later, than observed if temperatures in the study area were uniformly increased, or decreased, by 5 degrees F, respectively. Maps indicated that WNV encephalomyelitis risk always remained greater in the northwest quadrant of the study area. Since WNV might exist at a hypoendemic level of infection, and occasionally re-emerge as a cause of epidemics in equine populations, by identifying factors that contributed to this epidemic, the potential impact of future epidemics can be reduced. Such studies rely on a GIS framework, availability of meteorological and possibly remotely sensed data and information on host and landscape factors. An early-warning system for WNV transmission in equine populations could be developed.

Envelope protein glycosylation status influences mouse neuroinvasion phenotype of genetic lineage 1 West Nile virus strains

The introduction of West Nile virus (WNV) into North America has been associated with relatively high rates of neurological disease and death in humans, birds, horses, and some other animals. Previous studies identified strains in both genetic lineage 1 and genetic lineage 2, including North American isolates of lineage 1, that were highly virulent in a mouse neuroinvasion model, while other strains were avirulent or significantly attenuated (D. W. C. Beasley, L. Li, M. T. Suderman, and A. D. T. Barrett, Virology 296:17-23, 2002). To begin to elucidate the basis for these differences, we compared a highly virulent New York 1999 (NY99) isolate with a related Old World lineage 1 strain, An4766 (ETH76a), which is attenuated for mouse neuroinvasion. Genomic sequencing of ETH76a revealed a relatively small number of nucleotide (5.1%) and amino acid (0.6%) differences compared with NY99. These differences were located throughout the genome and included five amino acid differences in the envelope protein gene. Substitution of premembrane and envelope genes of ETH76a into a NY99 infectious clone backbone yielded a virus with altered in vitro growth characteristics and a mouse virulence phenotype comparable to ETH76a. Further site-specific mutagenesis studies revealed that the altered phenotype was primarily mediated via loss of envelope protein glycosylation and that this was associated with altered stability of the virion at mildly acidic pH. Therefore, the enhanced virulence of North American WNV strains compared with other Old World lineage 1 strains is at least partly mediated by envelope protein glycosylation.

Le virus West Nile : généralités et implications en transfusion sanguine

West Nile virus (WNV) is an arbovirus (genus Flavivirus, Family Flaviviridae, transmitted to humans by mosquito bite. In most cases (80%), human infection remains asymptomatic. Severe central nervous system complications (encephalitis and meningoencephalitis) are rare. In the Old World, the virus circulation has been demonstrated in Asia, Australia, Africa, Middle East and Europe. Several outbreaks in humans have been described. Following its introduction into North America in 1999, WN virus has been responsible of a large number of human cases in USA and Canada. For the first time, viral transmission by blood products was clearly demonstrated in USA in 2002. In France, the presence of virus has been reported in the Southeastern departments since 1962. In 2003, the occurrence of humans cases at specific geographical foci urged the French National Blood Agency (etablissement francais du sang) to take preventive measures for evaluating the virus transmission risks.

West Nile virus outbreak in North American owls, Ontario, 2002

From July to September 2002, an outbreak of West Nile virus (WNV) caused a high number of deaths in captive owls at the Owl Foundation, Vineland, Ontario, Canada. Peak death rates occurred in mid-August, and the epidemiologic curve resembled that of corvids in the surrounding Niagara region. The outbreak occurred in the midst of a louse fly (Icosta americana, family Hippoboscidae) infestation. Of the flies tested, 16 (88.9 %) of 18 contained WNV RNA. Species with northern native breeding range and birds >1 year of age were at significantly higher risk for WNV-related deaths. Species with northern native breeding range and of medium-to-large body size were at significantly higher risk for exposure to WNV. Taxonomic relations (at the subfamily level) did not significantly affect exposure to WNV or WNV-related deaths. Northern native breeding range and medium-to-large body size were associated with earlier death within the outbreak period. Of the survivors, 69 (75.8 %) of 91 were seropositive for WNV.

Detection of West Nile virus using formalin fixed paraffin embedded tissues in crows and horses: quantification of viral transcripts by real-time RT-PCR

West Nile virus (WNV) RNA was quantified in WNV infected crows and horses with the help of a real-time reverse transcriptase-PCR assay. A 5' nuclease assay, based on NS5 gene detection with a fluorescent probe was used for quantifying WNV RNA using formalin fixed paraffin embedded tissue specimens. Quantitative detection of WNV RNA showed the presence of a higher amount of the viral RNA in crow tissues compared to equine tissues and these results correlated well with the detection of WNV antigen by immunostaining. In crows, the highest amount of virus was seen in the intestine and in horses in the brain.

DNA vaccine for West Nile virus infection in fish crows (Corvus ossifragus)

A DNA vaccine for West Nile virus (WNV) was evaluated to determine whether its use could protect fish crows (Corvus ossifragus) from fatal WNV infection. Captured adult crows were given 0.5 mg of the DNA vaccine either orally or by intramuscular (IM) inoculation; control crows were inoculated or orally exposed to a placebo. After 6 weeks, crows were challenged subcutaneously with 105 plaque-forming units of WNV (New York 1999 strain). None of the placebo inoculated-placebo challenged birds died. While none of the 9 IM vaccine-inoculated birds died, 5 of 10 placebo-inoculated and 4 of 8 orally vaccinated birds died within 15 days after challenge. Peak viremia titers in birds with fatal WNV infection were substantially higher than those in birds that survived infection. Although oral administration of a single DNA vaccine dose failed to elicit an immune response or protect crows from WNV infection, IM administration of a single dose prevented death and was associated with reduced viremia.

West Nile virus: epidemiology, clinical presentation, diagnosis, and prevention

West Nile virus was recognized in the United States for the first time in 1999, when it caused an epidemic of encephalitis and meningitis in New York City, NY. Since then, the disease has been steadily moving westward, and human cases were recognized in 39 states and the District of Columbia in 2002. The infection is caused by a flavivirus that is transmitted from birds to humans through the bite of culicine mosquitoes. Most infections are mild, with symptoms primarily being fever, headache, and myalgias. People older than 50 years are at highest risk of severe disease, which may include encephalomyelitis. In 2002, 5 new modes of transmission were recognized: blood product transfusion, organ transplantation, breast-feeding, transplacental transmission, and occupational exposure in laboratory workers. The transmission season was long, with cases occurring into December in some parts of the United States. Currently, there is no specific drug treatment or vaccine against the infection, and avoiding mosquito bites is the best way to protect against the disease.

Experimental infection of North American birds with the New York 1999 strain of West Nile virus

To evaluate transmission dynamics, we exposed 25 bird species to West Nile virus (WNV) by infectious mosquito bite. We monitored viremia titers, clinical outcome, WNV shedding (cloacal and oral), seroconversion, virus persistence in organs, and susceptibility to oral and contact transmission. Passeriform and charadriiform birds were more reservoir competent (a derivation of viremia data) than other species tested. The five most competent species were passerines: Blue Jay (Cyanocitta cristata), Common Grackle (Quiscalus quiscula), House Finch (Carpodacus mexicanus), American Crow (Corvus brachyrhynchos), and House Sparrow (Passer domesticus). Death occurred in eight species. Cloacal shedding of WNV was observed in 17 of 24 species, and oral shedding in 12 of 14 species. We observed contact transmission among four species and oral in five species. Persistent WNV infections were found in tissues of 16 surviving birds. Our observations shed light on transmission ecology of WNV and will benefit surveillance and control programs.

Mosquito surveillance for West Nile virus in southeastern Wisconsin--2002

In 2001, West Nile virus (WNV) was identified among dead American crows and bluejays in five counties in southeastern Wisconsin. In response to the introduction of WNV, a pilot mosquito surveillance program was initiated in these five southeastern Wisconsin counties during the summer of 2002. Forty sites were selected for surveillance one night each week during a 17-week period. Mosquitoes were collected in carbon dioxide-baited light traps and gravid traps. During the study period 31,419 mosquitoes were collected, identified to species level and pooled into groups of up to 50 mosquitoes of like species from each collection site. Twenty-five different mosquito species were identified with the common pest mosquitoes, Aedes vexans and Ochlerotatus trivittatus, being the most abundant. Seventeen of the 25 mosquito species found in southeastern Wisconsin have previously been shown to be carriers of WNV in other parts of the U.S. Only 2/1,592 (0.126%) mosquito pools from Wisconsin were positive for WNV by cell culture and reverse transcription polymerase chain reaction (RT-PCR). Active mosquito surveillance is useful for identifying potential mosquito vectors of arboviruses in defined geographic areas, and to monitor population densities of those vectors. This information coupled with infection rate data can help guide public health policies related to vector control, and may help reduce the impact on human, veterinary and bird mortality.

West Nile virus activity in the United States, 2001

West Nile virus (WNV) first appeared in the naive environment of the Western Hemisphere in 1999 in New York. Genetic analysis determined that the virus was introduced into the United States from the Mediterranean Basin. This review discusses the spread of the virus in 2001 from the initial focus in Queens, New York, to widespread activity in the eastern and midwestern United States. It concentrates on viral ecology, epizootiology, pathology, prediction, and prevention. Research questions to further our understanding of the transmission cycle of WNV are discussed, including host-preference studies, molecular confirmation of implicated mosquito vectors, and survival of WNV in the temperate environment of the United States. Comparisons are drawn with two other arboviruses enzootic in the United States, eastern equine encephalitis, and St. Louis encephalitis viruses. Although not recently introduced, these two viruses also demonstrated increased activity in the United States in 2001.

West Nile virus in livestock and wildlife

WN virus is one of the most ubiquitous arboviruses occurring over a broad geographical range and in a wide diversity of vertebrate host and vector species. The virus appears to be maintained in endemic foci on the African continent and is transported annually to temperate climates to the north in Europe and to the south in South Africa. Reports of clinical disease due to natural WN virus infection in wild or domestic animals were much less common than reports of infection (virus isolation or antibody detection). Until recently, records of morbidity and mortality in wild birds were confined to a small number of cases and infections causing encephalitis, sometimes fatal, in horses were reported infrequently. In the period 1996-2001, there was an increase in outbreaks of illness due to WN virus in animals as well as humans. Within the traditional range of WN virus, encephalitis was reported in horses in Italy in 1998 and in France in 2000. The first report of disease and deaths caused by WN virus infection in domestic birds was reported in Israel in 1997-1999, involving hundreds of young geese. In 1999 WN virus reached North America and caused an outbreak of encephalitis in humans in the New York area at the same time as a number of cases of equine encephalitis and deaths in American crows and a variety of other bird species, both North American natives and exotics. Multi-state surveillance for WN virus has been in place since April 2000 and has resulted in the detection of WN virus in thousands of dead birds from an increasing number of species in North America, and also in several species of mammals. The surveillance system that has developed in North America because of the utility of testing dead birds for the rapid detection of WN virus presence has been a unique integration of public health and wildlife health agencies. It has been suggested that the recent upsurge in clinical WN virus infection in wild and domestic animals as well as in humans may be related to the emergence of one or more new strains of WN virus. Virus isolated in New York in 1999 was found to be identical to that from Israel. It was alarming for WN virus to so easily invade the United States and surprising that it became established so quickly in the temperature climate of New York. Its persistence and rapid expansion in the United States leave a number of unanswered questions. New disease characteristics and patterns have occurred and more are evolving as WN virus further invades the western hemisphere. Additional animal research is needed to answer these questions. Some of the research needs include bird migration as a mechanism of virus dispersal, vector and vertebrate host relationships, virus persistence mechanisms, laboratory diagnosis, viral pathogenesis, risk factor studies, vaccine development, and WN virus impact on wildlife (CDC 2001a). Determination of the primary reservoir host species that are involved in the epidemiology of WN virus and the suitable sentinel species for active surveillance are also important research areas.

West Nile virus in the western hemisphere

West Nile virus first appeared in the western hemisphere in 1999 in New York. Genetic analysis determined that the virus was introduced from the Mediterranean Basin. This review discusses the establishment of West Nile virus in the naïve environment of the northeastern USA, its ecology, epizootiology, pathology, prevention and prediction, as well as laboratory studies that have been conducted to elucidate the transmission cycle.

West Nile virus infection in mosquitoes, birds, horses, and humans, Staten Island, New York, 2000

West Nile (WN) virus transmission in the United States during 2000 was most intense on Staten Island, New York, where 10 neurologic illnesses among humans and 2 among horses occurred. WN virus was isolated from Aedes vexans, Culex pipiens, Cx. salinarius, Ochlerotatus triseriatus, and Psorophora ferox, and WN viral RNA was detected in Anopheles punctipennis. An elevated weekly minimum infection rate (MIR) for Cx. pipiens and increased dead bird density were present for 2 weeks before the first human illness occurred. Increasing mosquito MIRs and dead bird densities in an area may be indicators of an increasing risk for human infections. A transmission model is proposed involving Cx. pipiens and Cx. restuans as the primary enzootic and epizootic vectors among birds, Cx. salinarius as the primary bridge vector for humans, and Aedes/Ochlerotatus spp. as bridge vectors for equine infection.