Arboviral Disease Surveillance in Tennessee

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Arboviral Disease Surveillance in Tennessee

• Abelardo Moncayo, Ph.D
• Tennessee Department of Health

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Major arboviruses 1964-2006
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Arboviral surveillance in Tennessee
Regions Mosquitoes
Vets Horses
Public Birds
Physicians
Commercial labs
TUES
TDH
TDH
TDA
TDH
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TN Emerging Infections Program Tennessee
Department of Health Vanderbilt University
Campy/GBS
Emerging Infections Program PIs Allen Craig,
Bill Schaffner
ABCs
Foodnet
TN Unexplained Encephalitis (TUES)
Epidemiology Diane Levine Delia Woods
Diagnostic Lab Yi-Wei Tang Haijing Li Shufang
Mengs
HD LabJerry Hindman, serology Lynn Hillstrom,
virology Bill Reimels
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Case Residency (TUES)
CA, CO (5), FL (2), TX, NM, CT, LA
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Viral Causes of Encephalitis (TUES)

• Pathogen Conf Prob Possible Total
• EBV 13 4 2 19
• HSV 15 0 2 17
• VZV 13 0 2 15
• La Crosse Virus 12 3 0 15
• West Nile Virus 9 0 0 9
• Rabies 1 0 0 1
• HIV (acute) 1 0 0 1
• Parvovirus B19 0 1 3 4
• Rotavirus 0 1 1 2
• Influenza 0 0 11 11
• Adenovirus 0 0 3 3
• Parainfluenza 1 0 0 1 1
• Total 64 9 25 98 (32)

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WNV 2002- Human Cases
1
1
3
1
1
1
1
1
1
3
1
40
Human Cases (WNF Encephalitis)-55
TUES Case
Non-TUES Case
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WNV 2003- Human Cases
3
1
1
1
1
1
1
1
2
10
1
2
Human Cases (WNF Encephalitis)-25
TUES Case
Non-TUES Case
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La Crosse Virus 1996-2003
1
12
1
5
1
1
1
5
1
7
1
3
2
12
2
6
2
1
1
1
2

• TUES Cases (2000-2003) n16
• Age 0-9 63
• Age 10-20 19
• Age gt20 19
• Fatal cases 13

• TDH Cases (1996-2003) n95
• Age 0-9 70
• Age 10-20 24
• Age gt20 6
• Fatal cases 0

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Cases Referred Into TUES Study, Summer Months,
2002-2005
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If Not WNV, Then What Is It?

• HSV
• VZV
• RMSF
• Ehrlichia
• La Crosse Virus
• Rabies
• Mycoplasma (?)

WNV 10
Unknown 44
Alt infect 43
Noninfect 3
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Tennessee Vector-Borne Diseases Program

• Affiliation TDH Communicable and Environmental
  Disease Services
• Location TDH Laboratory Services
• Mission
• Service - to enhance disease surveillance and
  outbreak investigation arbovirus reference lab
  policy design.
• Research - to better understand disease
  epidemiology and ecology make recommendations on
  prevention and control measures.
• Teaching - serve as a resource for universities
  to mentor new generations of public health
  workers.

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Current Projects

• Culex genetics and West Nile virus epidemiology
• EEE virus epidemiology
• Tick-borne diseases epidemiology
• Expanded arboviral surveillance

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Collaborators

• Vanderbilt University
• Harvard University
• Ohio University
• University of Georgia
• Union University
• University of Tennessee
• University of Pittsburgh
• University of Texas
• Rutgers University

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Expanded Surveillance (SECEBT)

• Build regional partnerships that combine
  broad-based academic medical research, diverse
  clinical and laboratory expertise, and experience
  in disease control and prevention.
• Develop and enhance new and existing county,
  state, federal and global collaborations with
  university partners in order to combat emerging
  infectious diseases by leveraging academic and
  public health expertise and unique research
  facilities.
• Promote new means of detecting, treating and
  preventing biologic threats, whether purposefully
  caused, as from terrorism, or from naturally
  occurring causes.
• Differential diagnosis for physicians and
  veterinarians.

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Potential arboviruses

• Bunyaviridae
• La Crosse
• South River
• Potosi
• Lokern
• Tensaw
• Trivittatus
• Cache Valley
• Keystone
• Jamestown Canyon
• San Angelo
• Main Drain
• Flaviviridae
• St. Louis encephalitis
• Cowbone ridge
• Dengue
• Yellow fever

Togaviridae Eastern equine encephalitis Western
equine encephalitis Venezuelan equine
encephalitis Highlands J virus Fort
Morgan Chickungunya Rift Valley
Fever Rhabdoviridae Flanders Farmington Rhode
Island