Hale Nashed, MPHWalden University

PUBH 6165-1Instructor Name: Dr. Rebecca Heick

2010 term 3

Nursing staff Community members living in the endemic areas.

To increase knowledge about West Nile virus To learn about prevention To learn about care of the hospitalized West Nile

Virus patient

History of West Nile virus Geographic distribution of the virus West Nile virus in California Symptoms of West Nile virus Risk of getting West Nile virus Mode of transmission Infection control measures in hospital Preventive measures Agencies’ efforts to prevent West Nile virus

West Nile virus is an emerging infectious disease that was first discovered in the African country of Uganda in 1937.

In recent years the disease has spread beyond its traditional boundaries, causing illness in birds, horses, and humans in Europe and now the United States.

The disease was first discovered in the U.S. in 1999 in New York City. Since that time, WNV has been detected in humans, animals, and mosquitoes in 47 states from coast to coast.

Source: Emerging Disease Issues, Michigan state from http://www.michigan.gov/emergingdiseases-

From January 2009 to December 2009 , there were 663 case of West Nile virus reported , 51% were reported as severe cases (meningitis), 46% were reported as mild cases, 4% were asymptomatic.

There were more severe cases reported than mild cases. Data from a population-based survey indicated that among

people who become ill, less than 1% will develop severe illness (Mostashari F…et al, 1999)

Source: Center for Disease Control and Prevention http://www.cdc.gov/ncidod/dvbid/westnile/Mapsactivity/surv&control09Maps.htm

Mostashari, Bunning , Kitsutani , et al. Epidemic West Nile Encephalitis, New York, 1999: Results of a household-based seroepidemiological survey. Lancet 2001;358:261-264.

HUMAN CASES YTD: 110 cases Counties: 19Four fatalities have been reported in Fresno (1), Los Angeles (1),

Merced (1) and Stanislaus (1) counties.  HORSES YTD: 18 cases Counties: 12 12-18 horses from 12 counties have tested positive for WNV in 2009.  DEAD BIRDS YTD: 515 Counties: 36515 dead birds from 36 counties have tested positive for WNV in

2009.   Source: California Department of public Health from

http://www.westnile.ca.gov

MOSQUITO SAMPLES

YTD: 1,068 Counties: 27

1,068 mosquito samples from 27 counties have

SENTINEL CHICKENS

YTD: 442 Counties: 23

442 sentinel chickens from 23 counties have tested positive for WNV in 2009.

 

SQUIRRELS

YTD: 10 Counties: 7

10 squirrels from 7 counties have tested positive for WNV in 2009

Source: California Department of public Health http://www.westnile.ca.gov

Infected Mosquitoes. Mosquitoes become infected when they feed on infected birds. Infected mosquitoes can then spread WNV to humans and other animals when they bite.

Transfusions, Transplants, and Mother-to-Child. WNV also has been spread through blood transfusions, organ transplants, breastfeeding and even during pregnancy from mother to baby.

Not through touching. WNV is not spread through casual contact such as touching or kissing a person with the virus

Source: Center for Disease Control and Prevention http://www.cdc.gov/ncidod/dvbid/westnile/wnv_factsheet.htm

Serious Symptoms in a Few People

About one in 150 people infected with WNV will develop severe illness. The severe symptoms can include high fever, headache, neck stiffness, stupor, disorientation, coma, tremors, convulsions, muscle weakness, vision loss, numbness and paralysis. These symptoms may last several weeks, and neurological effects may be permanent.

Source: Center for Disease Control and Prevention http://www.cdc.gov/ncidod/dvbid/westnile/wnv_factsheet.htm

Milder Symptoms in Some People. Up to 20 percent of the people who become infected have symptoms such as fever, headache, and body aches, nausea, vomiting, and sometimes swollen lymph glands or a skin rash on the chest, stomach and back. Symptoms can last for for just a few days, though even healthy people have become sick for several weeks.

No Symptoms in Most People. Approximately 80 percent of people (about 4 out of 5) who are infected with WNV will not show any symptoms at all.

Source : Center for Disease Control and Prevention http://www.cdc.gov/ncidod/dvbid/westnile/wnv_factsheet.htm

People over 50 are at higher risk of getting a severe illness.

People whose jobs require them to be outdoors.

Risk through blood transfusion or organ transplant is minimal.

Source: Center for Disease Control and Prevention http://www.cdc.gov/ncidod/dvbid/westnile/wnv_factsheet.htm

West Nile virus is transmitted by a vector-borne route.

This means that:There is no person to person transmission,

sostandard precautions should beimplemented for all patients admitted to thehospital with a diagnosis of West Nile Virus

disease.

When you are outdoors, use insect repellent.

Many mosquitoes are most active at dusk and dawn. Be sure to use insect repellent and wear long sleeves and pants at these times or consider staying indoors during these hours.

Make sure you have good screens on your windows and doors to keep mosquitoes out.

Get rid of mosquito breeding sites by emptying standing water from flower pots, buckets and barrels. Change the water in pet dishes and replace the water in bird baths weekly. Drill holes in tire swings so water drains out..

Source: Center for Disease Control and Prevention http://www.cdc.gov/ncidod/dvbid/westnile/wnv_factsheet.htm

CDC: Helping states carry-out program to prevent WNV, co-ordinate an electronic nation-wide data base for surveillance, develop a better lab diagnostic test. Phone no # 1-800-CDC-INFO

NIOSH: the National institute of Occupational Safety and Health, instituted a brochure for workers who spend their time outdoors. 1-800-CDC-INFO

California Department of Public Health: Develop policies, surveillance, and educational brochures regarding prevention. (916)- 558-1784

LA County Department of Public Health: Developed methods of reporting mosquito breed areas, method of reporting a dead bird and provide surveillance. (213) 240-7941

For more information:

Los Angeles County Department of public Health http://publichealth.lacounty.gov/acd/VectorWestNile.htm

California Department of Public health http://www.cdph.ca.gov/HealthInfo/discond/Pages/WestNileVirus.aspx

Center for Disease Control and Prevention http://www.cdc.gov/ncidod/dvbid/westnile/wnv_factsheet.htm

Mostashari , Bunning , Kitsutani . Epidemic West Nile Encephalitis, New York, 1999: Results of a household-based seroepidemiological survey. Lancet 2001;358:261-264