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Ladzinski AT, Tai A, Rumschlag MT, Smith CS, Mehta A, Boapimp P, Edewaard EJ, Douce RW, Morgan LF, Wang MS, Fisher-Hubbard AO, Cummings MJ, Jagger BW. Clinical Characteristics of the 2019 Eastern Equine Encephalitis Outbreak in Michigan. Open Forum Infect Dis 2023; 10:ofad206. [PMID: 37180595 PMCID: PMC10173547 DOI: 10.1093/ofid/ofad206] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 04/17/2023] [Indexed: 05/16/2023] Open
Abstract
Background Eastern equine encephalitis virus is a mosquito-borne alphavirus responsible for unpredictable outbreaks of severe neurologic disease in animals and humans. While most human infections are asymptomatic or clinically nonspecific, a minority of patients develops encephalitic disease, a devastating illness with a mortality rate of ≥30%. No treatments are known to be effective. Eastern equine encephalitis virus infection is rare in the United States, with an annual average nationwide incidence of 7 cases between 2009 and 2018. However, in 2019, 38 cases were confirmed nationwide, including 10 in Michigan. Methods Data from 8 cases identified by a regional network of physicians in southwest Michigan were abstracted from clinical records. Clinical imaging and histopathology were aggregated and reviewed. Results Patients were predominantly older adults (median age, 64 years), and all were male. Results of initial arboviral cerebrospinal fluid serology were frequently negative, and diagnosis was not made until a median of 24.5 days (range, 13-38 days) after presentation, despite prompt lumbar punctures in all patients. Imaging findings were dynamic and heterogeneous, with abnormalities of the thalamus and/or basal ganglia, and prominent pons and midbrain abnormalities were displayed in 1 patient. Six patients died, 1 survived the acute illness with severe neurologic sequelae, and 1 recovered with mild sequelae. A limited postmortem examination revealed diffuse meningoencephalitis, neuronophagia, and focal vascular necrosis. Conclusions Eastern equine encephalitis is a frequently fatal condition whose diagnosis is often delayed, and for which no effective treatments are known. Improved diagnostics are needed to facilitate patient care and encourage the development of treatments.
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Affiliation(s)
- Adam T Ladzinski
- Department of Medicine, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MichiganUSA
| | - Aisha Tai
- Department of Internal Medicine, Corewell Health Lakeland, St Joseph, Michigan, USA
| | - Matthew T Rumschlag
- Department of Medicine, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MichiganUSA
| | - Christopher S Smith
- Department of Medicine, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MichiganUSA
| | - Aditya Mehta
- Department of Medicine, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MichiganUSA
| | - Pimpawan Boapimp
- Department of Medicine, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MichiganUSA
| | - Eric J Edewaard
- Department of Medicine, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MichiganUSA
| | - Richard W Douce
- Department of Internal Medicine, Corewell Health Lakeland, St Joseph, Michigan, USA
| | - Larry F Morgan
- Department of Medicine, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MichiganUSA
- Neuroscience Center, Bronson Methodist Hospital, Kalamazoo, MichiganUSA
| | - Michael S Wang
- Department of Internal Medicine, Corewell Health Lakeland, St Joseph, Michigan, USA
| | - Amanda O Fisher-Hubbard
- Department of Pathology, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MichiganUSA
| | - Matthew J Cummings
- Department of Neuroradiology, Premier Radiology, Kalamazoo, Michigan, USA
- Department of Radiology, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MichiganUSA
| | - Brett W Jagger
- Correspondence: Brett W. Jagger, MD, PhD, Division of Infectious Diseases, Allergy and Immunology, Edward A. Doisy Research Center, 8th Floor, 1100 S Grand Blvd, St Louis, MO 63104 (); Current affiliation: Department of Internal Medicine, Saint Louis University, St Louis, Missouri
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Kunkel MR, Casalena MJ, Mead DG, Blake M, Berghaus RD, Adcock KG, Martin JA, Ruder MG, Nemeth NM. Susceptibility of wild turkeys ( Meleagris gallopavo) to experimental West Nile virus infection. Avian Pathol 2022; 51:601-612. [DOI: 10.1080/03079457.2022.2123732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Melanie R. Kunkel
- Southeastern Cooperative Wildlife Disease Study, University of Georgia, Athens, GA 30602, USA
| | | | - Daniel G. Mead
- Southeastern Cooperative Wildlife Disease Study, University of Georgia, Athens, GA 30602, USA
| | - Mitchell Blake
- National Wild Turkey Federation, Edgefield, SC 29824, USA
| | - Roy D. Berghaus
- Department of Population Health, University of Georgia, Athens, GA 30602, USA
| | - Kayla G. Adcock
- Southeastern Cooperative Wildlife Disease Study, University of Georgia, Athens, GA 30602, USA
| | - James A. Martin
- Warnell School of Forestry and Natural Resources and Savannah River Ecology Laboratory, University of Georgia, Athens, GA, 30602, USA
| | - Mark G. Ruder
- Southeastern Cooperative Wildlife Disease Study, University of Georgia, Athens, GA 30602, USA
| | - Nicole M. Nemeth
- Southeastern Cooperative Wildlife Disease Study, University of Georgia, Athens, GA 30602, USA
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Kunkel MR, Mead DG, Ruder MG, Nemeth NM. Our current understanding of West Nile virus in upland game birds. WILDLIFE SOC B 2022. [DOI: 10.1002/wsb.1269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Melanie R. Kunkel
- Southeastern Cooperative Wildlife Disease Study University of Georgia 589 D.W. Brooks Drive Athens 30602 GA USA
| | - Daniel G. Mead
- Southeastern Cooperative Wildlife Disease Study University of Georgia 589 D.W. Brooks Drive Athens 30602 GA USA
| | - Mark G. Ruder
- Southeastern Cooperative Wildlife Disease Study University of Georgia 589 D.W. Brooks Drive Athens 30602 GA USA
| | - Nicole M. Nemeth
- Southeastern Cooperative Wildlife Disease Study University of Georgia 589 D.W. Brooks Drive Athens 30602 GA USA
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Ridenour CL, Cocking J, Poidmore S, Erickson D, Brock B, Valentine M, Roe CC, Young SJ, Henke JA, Hung KY, Wittie J, Stefanakos E, Sumner C, Ruedas M, Raman V, Seaton N, Bendik W, Hornstra O’Neill HM, Sheridan K, Centner H, Lemmer D, Fofanov V, Smith K, Will J, Townsend J, Foster JT, Keim PS, Engelthaler DM, Hepp CM. St. Louis Encephalitis Virus in the Southwestern United States: A Phylogeographic Case for a Multi-Variant Introduction Event. Front Genet 2021; 12:667895. [PMID: 34168675 PMCID: PMC8217752 DOI: 10.3389/fgene.2021.667895] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 04/28/2021] [Indexed: 11/14/2022] Open
Abstract
Since the reemergence of St. Louis Encephalitis (SLE) Virus (SLEV) in the Southwest United States, identified during the 2015 outbreak in Arizona, SLEV has been seasonally detected within Culex spp. populations throughout the Southwest United States. Previous work revealed the 2015 outbreak was caused by an importation of SLEV genotype III, which had only been detected previously in Argentina. However, little is known about when the importation occurred or the transmission and genetic dynamics since its arrival into the Southwest. In this study, we sought to determine whether the annual detection of SLEV in the Southwest is due to enzootic cycling or new importations. To address this question, we analyzed 174 SLEV genomes (142 sequenced as part of this study) using Bayesian phylogenetic analyses to estimate the date of arrival into the American Southwest and characterize the underlying population structure of SLEV. Phylogenetic clustering showed that SLEV variants circulating in Maricopa and Riverside counties form two distinct populations with little evidence of inter-county transmission since the onset of the outbreak. Alternatively, it appears that in 2019, Yuma and Clark counties experienced annual importations of SLEV that originated in Riverside and Maricopa counties. Finally, the earliest representatives of SLEV genotype III in the Southwest form a polytomy that includes both California and Arizona samples. We propose that the initial outbreak most likely resulted from the importation of a population of SLEV genotype III variants, perhaps in multiple birds, possibly multiple species, migrating north in 2013, rather than a single variant introduced by one bird.
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Affiliation(s)
- Chase L. Ridenour
- School of Informatics, Computing, and Cyber Systems, Northern Arizona University, Flagstaff, AZ, United States
- The Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, AZ, United States
| | - Jill Cocking
- School of Informatics, Computing, and Cyber Systems, Northern Arizona University, Flagstaff, AZ, United States
- The Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, AZ, United States
| | - Samuel Poidmore
- The Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, AZ, United States
| | - Daryn Erickson
- The Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, AZ, United States
| | - Breezy Brock
- The Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, AZ, United States
| | - Michael Valentine
- Translational Genomics Research Institute, Flagstaff, AZ, United States
| | - Chandler C. Roe
- School of Informatics, Computing, and Cyber Systems, Northern Arizona University, Flagstaff, AZ, United States
- The Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, AZ, United States
| | - Steven J. Young
- Vector Control Division, Maricopa County Environmental Services Department, Phoenix, AZ, United States
| | - Jennifer A. Henke
- Coachella Valley Mosquito and Vector Control District, Indio, CA, United States
| | - Kim Y. Hung
- Coachella Valley Mosquito and Vector Control District, Indio, CA, United States
| | - Jeremy Wittie
- Coachella Valley Mosquito and Vector Control District, Indio, CA, United States
| | | | - Chris Sumner
- Yuma County Pest Abatement District, Yuma, AZ, United States
| | - Martha Ruedas
- Yuma County Pest Abatement District, Yuma, AZ, United States
| | - Vivek Raman
- Southern Nevada Health District, Las Vegas, NV, United States
| | - Nicole Seaton
- Southern Nevada Health District, Las Vegas, NV, United States
| | - William Bendik
- Southern Nevada Health District, Las Vegas, NV, United States
| | | | - Krystal Sheridan
- The Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, AZ, United States
- Translational Genomics Research Institute, Flagstaff, AZ, United States
| | - Heather Centner
- Translational Genomics Research Institute, Flagstaff, AZ, United States
| | - Darrin Lemmer
- Translational Genomics Research Institute, Flagstaff, AZ, United States
| | - Viacheslav Fofanov
- School of Informatics, Computing, and Cyber Systems, Northern Arizona University, Flagstaff, AZ, United States
- The Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, AZ, United States
| | - Kirk Smith
- Vector Control Division, Maricopa County Environmental Services Department, Phoenix, AZ, United States
| | - James Will
- Vector Control Division, Maricopa County Environmental Services Department, Phoenix, AZ, United States
| | - John Townsend
- Vector Control Division, Maricopa County Environmental Services Department, Phoenix, AZ, United States
| | - Jeffrey T. Foster
- The Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, AZ, United States
| | - Paul S. Keim
- The Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, AZ, United States
- Translational Genomics Research Institute, Flagstaff, AZ, United States
| | | | - Crystal M. Hepp
- School of Informatics, Computing, and Cyber Systems, Northern Arizona University, Flagstaff, AZ, United States
- The Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, AZ, United States
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Hannon ER, Jackson KC, Biggerstaff BJ, Raman V, Komar N. Bloodmeal Host Selection of Culex quinquefasciatus (Diptera: Culicidae) in Las Vegas, Nevada, United States. JOURNAL OF MEDICAL ENTOMOLOGY 2019; 56:603-608. [PMID: 30668743 DOI: 10.1093/jme/tjy237] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Indexed: 06/09/2023]
Abstract
St. Louis encephalitis virus (SLEV) and West Nile virus (WNV) have recently emerged in the southwestern United States. Surveillance for arboviruses in Las Vegas, NV, detected a surge of SLEV activity in the southern house mosquito (Culex quinquefasciatus Say) during 2016. To identify candidate avian amplifiers, we assessed the identification, viral infection, and immune status of vertebrate hosts for 195 blood-engorged Cx. quinquefasciatus mosquitoes collected in August and September 2016. Bloodmeals were identified from 164 engorged abdomens, representing 19 species of birds and three species of mammals. No SLEV or WNV viremia was detected, but one mosquito tested positive for Culex flavivirus. House finch (Haemorhous mexicanus) (Muller) was the most common bloodmeal, followed by domestic chicken (Gallus gallus) (Linnaeus), American robin (Turdus migratorius) L., house sparrow (Passer domesticus) (L.), great-tailed grackle (Quiscalus mexicanus) (Gmelin), northern mockingbird (Mimus polyglottos) (L.) and mourning dove (Zenaida macroura) (L.). SLEV-reactive antibodies were detected in six identified bloodmeals and WNV-reactive antibodies were detected in 33. House sparrow and house finch were the most likely hosts to show previous exposure to SLEV and WNV, respectively. Over-utilization by Cx. quinquefasciatus for bloodmeal hosts was observed primarily among robin, finch and sparrow, all species that roost communally. House finch stands out as a candidate important amplifier for both SLEV and WNV because of its preference by mosquito vectors, and high competence for closely related virus strains. While implicated in previous outbreaks as an important mosquito vector, Cx. quinquefasciatus feeds infrequently on mammals in Las Vegas, indicating a low risk for bridge transmission to humans.
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Affiliation(s)
- Emily R Hannon
- Arbovirus Diseases Branch, Division of Vector Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO
| | - Katelin C Jackson
- Arbovirus Diseases Branch, Division of Vector Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO
| | - Brad J Biggerstaff
- Arbovirus Diseases Branch, Division of Vector Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO
| | - Vivek Raman
- Southern Nevada Health District, Las Vegas, NV
| | - Nicholas Komar
- Arbovirus Diseases Branch, Division of Vector Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO
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No indication of arthropod-vectored viruses in mosquitoes (Diptera: Culicidae) collected on Greenland and Svalbard. Polar Biol 2018. [DOI: 10.1007/s00300-017-2242-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Yukich JO, Briët OJT, Ahorlu CK, Nardini P, Keating J. Willingness to pay for small solar powered bed net fans: results of a Becker-DeGroot-Marschak auction in Ghana. Malar J 2017; 16:316. [PMID: 28784127 PMCID: PMC5547488 DOI: 10.1186/s12936-017-1965-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 07/31/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND AND METHODS Long-lasting insecticidal nets (LLINs) are one of the main interventions recommended by the World Health Organization for malaria vector control. LLINs are ineffective if they are not being used. Subsequent to the completion of a cluster randomized cross over trial conducted in rural Greater Accra where participants were provided with the 'Bɔkɔɔ System'-a set of solar powered net fan and light consoles with a solar panel and battery-or alternative household water filters, all trial participants were invited to participate in a Becker-DeGroot-Marschak auction to determine the mean willingness to pay (WTP) for the fan and light consoles and to estimate the demand curve for the units. RESULTS, DISCUSSION AND CONCLUSIONS Results demonstraed a mean WTP of approximately 55 Cedis (~13 USD). Demand results suggested that at a price which would support full manufacturing cost recovery, a majority of households in the area would be willing to purchase at least one such unit.
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Affiliation(s)
- Joshua O. Yukich
- Center for Applied Malaria Research and Evaluation, Tulane University School of Public Health and Tropical Medicine, 1440 Canal St. #8317, New Orleans, LA 70112 USA
| | - Olivier J. T. Briët
- Swiss Tropical and Public Health Institute, Socinstrasse 57, P.O. Box CH-4002 Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Collins K. Ahorlu
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | | | - Joseph Keating
- Center for Applied Malaria Research and Evaluation, Tulane University School of Public Health and Tropical Medicine, 1440 Canal St. #8317, New Orleans, LA 70112 USA
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Briët OJT, Yukich JO, Pfeiffer C, Miller W, Jaeger MS, Khanna N, Oppong S, Nardini P, Ahorlu CK, Keating J. The effect of small solar powered 'Bͻkͻͻ' net fans on mosquito net use: results from a randomized controlled cross-over trial in southern Ghana. Malar J 2017; 16:12. [PMID: 28049477 PMCID: PMC5209841 DOI: 10.1186/s12936-016-1654-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Accepted: 12/15/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Long-lasting insecticidal nets (LLINs) are ineffective malaria transmission prevention tools if they are unused. Discomfort due to heat is the most commonly reported reason for not using nets, but this problem is largely unaddressed. With increasing rural electrification and the dropping price of solar power, fans could improve comfort inside nets and be affordable to populations in malaria endemic areas. Here, results are presented from a pilot randomized controlled cross-over study testing the effect of fans on LLIN use. METHODS Eighty-three households from two rural communities in Greater Accra, Ghana, randomized into three groups, participated in a 10-month cross-over trial. After a screening survey to identify eligible households, all households received new LLINs. Bͻkͻͻ net fan systems (one fan per member) were given to households in Group 1 and water filters were given to households in Group 2. At mid-point, Group 1 and 2 crossed over interventions. Households in Group 1 and 2 participated in fortnightly surveys on households' practices related to nets, fans and water filters, while households in Group 3 were surveyed only at screening, mid-point and study end. Entomological and weather data were collected throughout the study. Analysis took both 'per protocol' (PP) and 'intention to treat' (ITT) approaches. The mid- and end-point survey data from Group 1 and 2 were analysed using Firth logistic regressions. Fortnightly survey data from all groups were analysed using logistic regressions with random effects. RESULTS Provision of fans to households appeared to increase net use in this study. Although the increase in net use explained by fans was not significant in the primary analyses (ITT odds ratio 3.24, p > 0.01; PP odds ratio = 1.17, p > 0.01), it was significant in secondary PP analysis (odds ratio = 1.95, p < 0.01). Net use was high at screening and even higher after provision of new LLINs and with follow up. Fan use was 90-100% depending on the fortnightly visit. CONCLUSIONS This pilot study could not provide definitive evidence that fans increase net use. A larger study with additional statistical power is needed to assess this association across communities with diverse environmental and socio-demographic characteristics.
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Affiliation(s)
- Olivier J. T. Briët
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Joshua O. Yukich
- Department of Tropical Medicine, Tulane University School of Public Health and Tropical Medicine, New Orleans, USA
- Center for Applied Malaria Research and Evaluation, Tulane University, New Orleans, USA
| | - Constanze Pfeiffer
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | | | - Mulako S. Jaeger
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Nitin Khanna
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | | | | | - Collins K. Ahorlu
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Joseph Keating
- Department of Tropical Medicine, Tulane University School of Public Health and Tropical Medicine, New Orleans, USA
- Center for Applied Malaria Research and Evaluation, Tulane University, New Orleans, USA
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