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West Nile Virus in the U.S.: Epidemiology and Surveillance
|Thursday, January 31, 2013|
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West Nile virus (WNV) expanded from a small transmission focus in the New York City area in 1999 and is now found across much of the western hemisphere from central Canada to southern Argentina. WNV successfully adapted to the diverse ecosystems of the North America and enzootic transmission foci (as well as human cases) have been detected in all 48 of the continental United States. During the period from 1999-2012, over 36,000 cases of human disease in have been reported to CDC, which includes approximately 16,000 cases of neuroinvasive disease and 1,500 deaths. Some models estimate that as many as 4 million people have been infected with WNV, and approximately a quarter of those may have experienced some degree of illness from the virus.
CDC tracks WNV human cases and reports of WNV in mosquitoes, birds, sentinel chickens and horses through the ArboNET system. This nationwide surveillance platform was developed in 2000 in conjunction with state health departments to monitor the spread of WNV and track disease trends. During the active WNV transmission season, the ArboNET system provides weekly updates of WNV activity by county. The multi-year historical database acquired by the ArboNET system has been used in identifying areas of recurring high transmission levels, quantifying disease burden and identifying populations segments at risk of serious disease.
Despite the valuable information ArboNET has provided about national and regional WNV trends, and the considerable information discovered about the mosquitoes, birds and environmental components of the WNV transmission cycles over the past 14 years, predicting when and where WNV outbreaks occur remains a significant challenge. Long-term predictions have not proven useful, largely because the interplay among the many biotic and abiotic elements that drive WNV amplification is a complex process that is difficult to model. Short-term surveillance programs based on measuring the amount of WNV circulating in the environment before human cases occur have been more successful; however, WNV environmental surveillance programs can be costly to maintain. The best WNV indicators currently available are based on measuring WNV activity in mosquitoes, birds, and sentinel chickens. With adequate effort, these can provide 2-4 weeks lead time in advance of human cases. This is often sufficient time to implement the adult mosquito control efforts that have demonstrated success in reducing human risk, resulting in fewer human cases.
Roger S. Nasci
Chief, Arboviral Diseases Branch
Division of Vector-Borne Diseases
Centers for Disease Control and Prevention
As Chief of the Arboviral Diseases Branch in the Division of Vector-Borne Diseases, Roger Nasci coordinates CDC's activities involving arthropod-transmitted viruses such as West Nile, yellow fever, La Crosse, eastern equine encephalitis, and Chikungunya. The Arboviral Diseases Branch maintains a multi-faceted program that includes epidemiology and diagnostic testing; basic research into virology, transmission ecology and mosquito control; and provides outbreak and emergency response assistance to domestic and international health agencies.
Dr. Nasci began his career at CDC as a research entomologist in 1991. He served as Chief of the Ecology and Entomology Section before becoming Arboviral Diseases Branch Chief in 2006. Prior to joining CDC, Dr. Nasci was an Associate Professor in the Department of Biological and Environmental Sciences at McNeese State University in Lake Charles, Louisiana.
Dr. Nasci received his Bachelor of Science and Master of Science degrees in zoology and microbiology at Ohio University and his Ph.D. in entomology from the University of Massachusetts and was an NIH post-doctoral research associate in the Vector Biology Laboratory at the University of Notre Dame.
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