arbovirus

Information about arbovirus

Published on October 24, 2007

Author: Javier

Source: authorstream.com

Content

Arboviral Diseases:  Arboviral Diseases Presented by : Kathi Rose Malloy, RN, BSN Slide2:  Information courtesy of: Department of Health and Human Service Centers for Disease Control and Prevention Background: Arthropod-borne Viruses (Arbovirus):  Background: Arthropod-borne Viruses (Arbovirus) Viruses spread via the bite of an arthropod, most commonly a tick or mosquito Approximately 80 arboviruses known to cause human disease In the Eastern region of the United States the two most important types of arboviruses include Eastern Equine Encephalitis (EEE) West Nile Virus (WNV) Background : Eastern Equine Encephalitis:  Background : Eastern Equine Encephalitis EEE first isolated in the US in 1933 Most commonly found in North America, Central and South America, and the Carribean In the US, most cases reported from the eastern seaboard states, the Gulf Coast, and some inland midwestern states Background: West Nile Virus:  Background: West Nile Virus West Nile virus was first recognized in the US in 1999 in metropolitan New York City More commonly found in Africa, West and Central Asia, and the Middle East It is unknown how the virus arrived in the US EEE in the United States:  EEE in the United States Spread of West Nile virus by state, 1999-2002. :  Spread of West Nile virus by state, 1999-2002. West Nile Virus Activity in the U.S. in Birds, Horses, Mosquitoes, Animals, or Humans. West Nile Virus in the United States as of October 15, 2003:  West Nile Virus in the United States as of October 15, 2003 Maryland's Arbovirus Surveillance Testing Results 2003 (Updated 01/08/04) :  Maryland's Arbovirus Surveillance Testing Results 2003 (Updated 01/08/04) Avian West Nile virus was established as endemic in Maryland in 2002. Therefore, the Maryland Department of Health and Mental Hygiene (DHMH) discontinued pickup and testing of dead birds in 2003. Maryland's Arbovirus Surveillance Testing Results 2003 (Updated 01/08/04) :  Maryland's Arbovirus Surveillance Testing Results 2003 (Updated 01/08/04) Equine: One-hundred and eighty (180) Maryland horses tested positive for West Nile Virus (WNV) infection in 20 jurisdictions in 2003. Sixty-six (66) of the 180 horse cases were fatal. Maryland Jurisdictions with WNV in horses - 2003:  Maryland Jurisdictions with WNV in horses - 2003 Anne Arundel 16 Baltimore 6 Calvert 3 Caroline 10 Carroll 40 Cecil 2 Charles 8 Dorchester 2 Frederick 24 Harford 5 Howard 8 Kent 4 Montgomery 14 Prince George’s 9 Queen Anne’s 10 St. Mary’s 7 Somerset 1 Talbot 7 Washington 3 Worcester 1 Maryland's Arbovirus Surveillance Testing Results 2003 (Updated 01/08/04):  Maryland's Arbovirus Surveillance Testing Results 2003 (Updated 01/08/04) Mosquitoes: Over 195,000 mosquitoes were tested in Maryland between June 1 and October 31, 2003. A total of 62 mosquito pools in 13 jurisdictions tested positive for West Nile Virus during that time. One pool of Culiseta melanura mosquitoes collected in Worcester County tested positive for both WNV and EEE. Maryland Jurisdictions with WNV in mosquitoes - 2003:  Maryland Jurisdictions with WNV in mosquitoes - 2003 Alleghany 1 Anne Arundel 10 Baltimore Co 15 Caroline 1 Carroll 3 Charles 1 Dorchester 5 Frederick 3 Prince Georges 3 Somerset 3 Talbot 1 Wicomico 2 Worcester 11 Baltimore City 3 Maryland's Arbovirus Surveillance Testing Results 2003 (Updated 01/08/04) :  Maryland's Arbovirus Surveillance Testing Results 2003 (Updated 01/08/04) Humans Seventy-three (73) human WNV cases (63 confirmed, 10 probable) have been reported this year in 13 jurisdictions. Five (5) WNV – related fatalities have been reported to date. Maryland Jurisdictions with WNV in humans- 2003:  Maryland Jurisdictions with WNV in humans- 2003 Anne Arundel 7 Baltimore City 14 Baltimore Co 17 Caroline 1 Carroll 2 Charles 1 Frederick 3 Harford 2 Howard 3 Montgomery 10 Prince George’s 4 Queen Anne’s 5 Washington 4 Total 73 Eastern Equine Encephalitis Surveillance in MD, 2003 :  Eastern Equine Encephalitis Surveillance in MD, 2003 Mosquitoes - Ten (10) pools of Culiseta melanura mosquitoes in two jurisdictions (Wicomico and Worcester Counties) have tested positive for EEE in Maryland. A single pool of C. melanura mosquitoes collected in Worcester County tested positive for both WNV and EEE. Horses - Three horses in Worcester County have tested positive for EEE. All three were fatal cases. None of the horses had received the EEE vaccine. Ratites (Flightless birds) - One (1) emu in Wicomico County has tested positive for EEE. Transmitting WNV infection:  Transmitting WNV infection Additional Transmission:  Additional Transmission Blood Transfusions Additional evidence shows WNV can be spread via blood transfusions CDC, FDA, HRSA, State and local Health Departments have ongoing investigations A blood screening test has been developed Breast milk Health benefits of breastfeeding are well established Risk of WNV transmission via breast milk unknown No suggested changes in breast feeding recommendations Symptoms : EEE:  Symptoms : EEE Most people have no symptoms Central Nervous system symptoms develop 4-10 days after being bitten Sudden onset of fever, muscle aches, headache May progress to more severe symptoms such as seizure and coma (encephalitis) 30 to 50% of patients with encephalitis die of the disease Symptoms : West Nile virus:  Symptoms : West Nile virus Most people do not develop symptoms An estimated 20% become ill 3-15 days after being bitten Mild illness: fever, headache, body aches, and sometimes skin rash and swollen glands An estimated 1 in 150 persons infected develop a more severe form of the disease West Nile encephalitis: inflammation of the brain, high fever, stiff neck, stupor, disorientation, coma, tremors, convulsions, muscle weakness, and paralysis; few cases have been fatal Geographic Risks:  Geographic Risks People are only at risk when EEE and West Nile Viruses are circulating in nature Northern states at risk during summer Southern states at risk year round Maryland’s Eastern Shore is in a moderate climate and therefore at risk until the first “killing frost” Killing frost is defined as 27-28° Fahrenheit for at least 4 hours High Risk Persons:  High Risk Persons Risk of arboviral encephalitis is higher for the youngest and oldest (50+) segments of the population People living in an area where the disease is common People who work outside or participate in outdoor activities in areas where disease is common Human Illness:  Human Illness EEE – fewer than 5 cases are reported in most years. Last human death in Maryland was in 1989 (Dorchester County) WNV – in the most affected areas of New York City only 2.6% population infected Treatment:  Treatment No specific therapy for infection of EEE or West Nile viruses Arboviral encephalitis treated by hospitalization, intravenous fluids, respiratory support, prevention of secondary infections, and good nursing care Vaccine:  Vaccine Not available for humans Horse vaccine is available – generally recommended annually in March, may booster mid-late summer in years where disease activity present Prevention and Control FIGHT THE BITE !:  Prevention and Control FIGHT THE BITE ! AVOID MOSQUITO BITES Apply insect repellent to exposed skin when outdoors. The most effective contain DEET. Higher concentrations equals longer protection. Over 50% does not increase length of protection. Use care in applying repellent to children: don’t put repellent on their hands and avoid their mouths and eyes. Products containing 10% DEET or less recommended for children 2-12. When possible, wear protective clothing while outdoors Slide27:  Spray clothing with repellents Consider staying indoors between dusk and dawn to avoid peak mosquito biting time Avoid areas where mosquitoes are prevalent Fix or install window or door screens to keep mosquitoes out of buildings Slide28:  AVOID CREATING MOSQUITO BREEDING AREAS; DRAIN STANDING WATER WHERE POSSIBLE MOSQUITO SPRAYING Community based Public Health Emergency Summary:  Summary EEE and West Nile encephalitis are NOT transmitted person to person There is no evidence that a person can get the virus from handling live or dead infected birds. However, persons should avoid bare-handed contact when handling any dead animals and use gloves or double plastic bags to place the carcass in a garbage can. There is no evidence that the virus can be transmitted to humans through consuming infected birds or animals, but procedures for fully cooking meat should always be used. Although the vast majority of infections have been in birds; horses, and other mammals may be infected If you think you are infected and display any of the symptoms, contact your health care provider or doctor immediately. Additional Info:  Additional Info Websites: Worcester County Health Department www.worcesterhealth.org Department of Health and Mental Hygiene – Disease control www.edcp.org Centers for Disease Control www.cdc.gov Maryland Department of Agriculture www.mda.state.md.us Reporting concerns:  Reporting concerns Standing Water Reports – Worcester County Dept of Development @ 410-632-1200 Mosquito Spraying – Worcester County Mosquito Control @ 410-632-3767 Dead bird Disposal – State Health Topics Hotline @ 1-866-866-2769

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