Epidemic/epizootic West Nile virus in the United States : guidelines for surveillance, prevention, and control. 3rd revision
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Epidemic/epizootic West Nile virus in the United States : guidelines for surveillance, prevention, and control. 3rd revision

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    In late summer 1999, the first domestically acquired human cases of West Nile (WN) encephalitis were documented in the U.S. The discovery of virus-infected, overwintering mosquitoes during the winter of 1999-2000 presaged renewed virus activity for the following spring and precipitated early season vector control and disease surveillance in New York City (NYC) and the surrounding areas. These surveillance efforts were focused on identifying and documenting WN virus (WNV) infections in birds, mosquitoes and equines as sentinel animals that could alert health officials to the occurrence of human disease. Surveillance tracked the spread of WNV throughout much of the U.S. between 2000 and 2002. By the end of 2002, WNV activity had been identified in 44 states and the District of Columbia. The 2002 WNV epidemic and epizootic resulted in reports of 4,156 reported human cases of WN disease (including 2,942 meningoencephalitis cases and 284 deaths), 16,741 dead birds, 6,604 infected mosquito pools, and 14,571 equine cases. The 2002 WNV epidemic was the largest recognized arboviral meningoencephalitis epidemic in the Western Hemisphere and the largest WN meningoencephalitis epidemic ever recorded. Significant human disease activity was recorded in Canada for the first time, and WNV activity was also documented in the Caribbean basin and Mexico. In 2002, 4 novel routes of WNV transmission to humans were documented for the first time: 1) blood transfusion, 2) organ transplantation, 3) transplacental transfer, and 4) breast-feeding.

    Since 1999, the Centers for Disease Control and Prevention (CDC) and a variety of other U.S. governmental agencies and partners have sponsored yearly national meetings of arbovirologists, epidemiologists, laboratorians, ecologists, vector-control specialists, wildlife biologists, communication experts, and state and local health and agriculture officials to assess the implications of the WNV introduction into the U.S. and to refine the comprehensive national response plan. Recommendations from these meetings have been used to develop and to update these guidelines.

    The following CDC, Division of Vector-Borne Infectious Diseases staff members prepared this report: Duane J. Gubler, Lyle R. Petersen, John T. Roehrig, Grant L. Campbell, Nicholas Komar, Roger S. Nasci, Emily Zielinski-Gutierrez, Anthony A. Marfin, Robert S. Lanciotti, Michel L. Bunning, Daniel R. O’Leary, Mel Fernandez, Lauren Dieterich, Barbara B. Tuttle, Rebecca L. Deavours.

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