West Nile Virus Surveillance and Public Health Response

1
West Nile Virus Surveillance and Public Health
Response

• Florida 2001

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The Plan

• Building on existing system for arboviral control
  

3
Florida Interagency Partnerships/Acknowledgements

• Florida Mosquito Control Association
• University of Florida Medical Entomology
  Laboratory
• Florida AM Public Health Entomology Resource and
  Education Center
• Centers for Disease Control and Prevention

• Department of Health
• Department of Agriculture and Consumer Services
• Florida Conservation and Wildlife Commission
• Department of Environmental Protection

4
Florida Ecology Supports Arbovirus

• Warm Climate
• Regular Rainfall
• Vectors Identified
• Suitable Hosts for Amplification
• Historical Data

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Surveillance for West Nile Virus

• Animal surveillance
• Dead birds
• Sentinel chickens
• Horses
• Other vertebrates (minor)
• Mosquito surveillance
• Human surveillance

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Dead Crow Reports and WN Positive Tests, by week,
Florida, 2001
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WN Virus Activity, Selected Florida Counties, 2001
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Bird-based Surveillance

• Avian mortality surveillance
• 1) dead bird sightings
• 2) virus testing
• Sensitive early detection system
• Almost all of the positive birds were found
  singly
• WEBBOARD

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Dead Bird Surveillance Results 2001

• 16,838 reports received
• All 67 counties
• 23,000 individual birds
• gt60 species
• 2,595 Crows
• 2,282 Jays

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Avian Mortality Surveillance

• Positive birds provided the first confirmation of
  viral activity in 54 of 67 counties
• Dead bird reports correlated with human
  population
• Dead crow reports correlated better with WN
• Weekly dead crows/sq. mile predicted risk in NY
  did not seem to in Florida.

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WN virus positive birds by identified species
N tested 7,773 N pos. 1,127 Rate pos 14
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Bird-based Surveillance

• Live bird surveillance
• Captive birds
• Chickens preceded other cases in 3 counties
• Free-ranging birds
• Used in selected counties to help determine
  extent of virus transmission thank you CDC

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Number of Sentinel Chicken Seroconversions to SLE
virus, July-December, 1997-2001, Florida
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Mosquito Surveillance

• 27 mosquito pools w/ WN virus
• Culex
• quinquefasciatus
• nigripalpus
• salinarius
• Culiseta
• melanura
• Ochlerotatus
• taeniorhynchus
• atlanticus
• Anopheles
• crucians
• atropos
• Deinocerites
• cancer

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Equine Surveillance

• 469 cases
• 40 counties
• 56 of cases from Marion, Jefferson, Clay,
  Alachua, Leon and Duval Counties
• Sensitive surveillance method

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Confirmed West Nile Virus Equine Cases,Florida,
2001
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Jefferson, Leon,Madison, Taylor,Suwannee
WEST NILE VIRUS
June
July
Aug
Sept
Oct
Nov
Dec
JeffersonLeonMadisonTaylorSuwannee 1
58
31
19
31
4
23
Duval, Clay, Nassau,St. Johns
WEST NILE VIRUS
June
July
Aug
Sept
Oct
Nov
Dec
JeffersonLeonMadisonTaylorSuwannee 1
58
31
19
31
4
Duval ClayNassauSt. Johns
5
2
1
17
61
9
24
WEST NILE VIRUS
June
July
Aug
Sept
Oct
Nov
Dec
JeffersonLeonMadisonTaylorSuwannee 1
58
19
31
31
4
Duval ClayNassauSt. Johns
5
17
2
1
61
9
Gadsden,Jackson,Walton,Washington,
Okaloosa,Wakulla
25
WEST NILE VIRUS
June
July
Aug
Sept
Oct
Nov
Dec
JeffersonLeonMadisonTaylorSuwannee 1
58
19
31
31
4
Duval ClayNassauSt. Johns
5
17
2
1
61
9
Gadsden,Jackson,Walton,Washington,
Okaloosa,Wakulla
43
69
25
4
AlachuaLevyMarionPutnam
2
18
7
26
WEST NILE VIRUS
June
July
Aug
Sept
Oct
Nov
Dec
JeffersonLeonMadisonTaylorSuwannee 1
144
58
19
31
31
4
Duval ClayNassauSt. Johns
95
5
17
2
1
61
9
Gadsden,Jackson,Walton,Washington,
Okaloosa,Wakulla
33
43
69
25
4
AlachuaLevyMarionPutnam
2
145
18
7
LakeSumterCitrusPascoPolk
19
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Human Surveillance

• Younger than expected (range 19-73, mean 53.5)
• Serosurveillance study in Madison County
  (population lt20,000)
• Geographically northern and extreme southern part
  of the state

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Human West Nile Encephalitis by week of onset,
Florida, 2001
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Did virus detection by sentinel surveillance
precede human cases?

• Yes (Jefferson, Clay, Leon, Putnam, Washington,
  Marion and Palm Beach (7))
• No (Madison, Monroe (5))

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The Response

• Massive media campaign
• Internal communication
• Conference calls
• Electronic mailings
• External communication
• Press releases
• Hotline
• Web information
• Enhanced mosquito control

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Medical Alert Issued October 31, 2001 (53
counties)
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Medical Alert Lifted December 31, 2001
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2001 A hypothesis-generating season