Epidemiologic aspects of a St. Louis encephalitis epidemic in Jefferson County Arkansas, 1991

Distribution of pyrethroid insecticides in urban storm drain structures: Catch basins, open channels, and outfalls

Surface water runoff can transport contaminants offsite to downstream aquatic ecosystems. The prevalence of impervious surfaces in urban areas enhances surface runoff and contributes to contamination of urban surface streams. Urban areas have complex drainage systems for the conveyance of drainage water, however, there is a dearth of information on the distribution of contaminants within storm drain system structures. Pyrethroid insecticides are among the most used insecticides in urban areas, and trace levels of pyrethroids are known to exert toxicity to aquatic invertebrates. To investigate pyrethroid occurrence and distribution throughout an urban drainage system, samples of water, sediment, algae, and biofilm were collected from catch basins, open channels, and outfalls in Los Angeles County, California, during the dry season. From 3 catch basins, 7 open channels, and 7 outfalls, a total of 28 water samples, 4 sediment samples, 8 algae samples, and 4 biofilm samples were collected and analyzed. Pyrethroid concentrations above the reporting limit were detected in 89% of water samples and all sediment, algae, and biofilm samples, with bifenthrin and cyfluthrin being the most frequently detected compounds. The median total pyrethroid concentrations in water, sediments, algae, and biofilms were 27 ng/L, 88 ng/g, 356 ng/g, and 3556 ng/g, respectively. Bifenthrin concentrations in catch basins were found to be significantly higher than those in open channels or outfalls. Significant correlations were found for various metrics, including between pyrethroid partitioning in water samples and total suspended solids. These findings highlight the role of underground catch basins as a sink as well as a secondary source for contaminants such as pyrethroid insecticides. Prevention of the input of these urban originated contaminants to catch basins is crucial for protecting the water quality of urban surface waters.

Seroepidemiological survey on chikungunya in endemic zones for arboviruses in Brazil, 2019

This study aimed to identify the seroprevalence of chikungunya and its associated factors in the city of Quixadá, Ceará, Brazil. We also aimed to identify the spatial distribution patterns of positive cases. A cross-sectional survey was conducted with a questionnaire about clinical symptoms, socioeconomic and demographic factors, and a 10 ml blood sample was collected and analysed by ELISA. For the bivariate analysis, we use the chi-square test, a prevalence ratio and its 95% confidence interval. A robust Poisson hierarchical regression was used to adjust for confounders. The Kernel density was performed for the spatial analysis. A total of 409 samples were analysed; of them, 70.7% were seropositive for previous exposure to chikungunya virus (CHIKV). High seropositivity for CHIKV was higher in female participants (75.5%; PR = 1.23; 95% CI: 1.06-1.43), those aged 31 years or more (74.3%; PR = 1.62; 95% CI: 1.04-2.52), and those with elementary education level (75.0%; PR = 1.30; 95% CI: 1.06-1.60). There were also high seroprevalence in those with less than a minimum wage per month (89.5%; PR = 1.59; 95% CI: 1.11-2.30), housewives (87.5%; PR = 1.64; 95% CI: 1.24-2.18) and unemployed (80.0%; PR = 1.50; 95% CI: 1.10-2.06). After adjusting for age, morning stiffness was the only chikungunya symptom that remained associated (PR = 1.20; 95% CI: 1.06-1.37; p < .001). There was an area of high density of cases in the downtown and two areas of medium density in nearby regions. Otherwise, the higher seroprevalence rates were in the peripherical neighbourhoods. There is a hyperendemicity of CHIKV in Quixadá, and most cases are spatially contiguous. The main associated clinical sign is morning stiffness, but other factors such as low income and spending a longer time at home were significantly associated with higher seroprevalence.

Seroprevalence and Symptomatic Attack Rate of Chikungunya Virus Infection, United States Virgin Islands, 2014-2015

When introduced into a naïve population, chikungunya virus generally spreads rapidly, causing large outbreaks of fever and severe polyarthralgia. We randomly selected households in the U.S. Virgin Islands (USVI) to estimate seroprevalence and symptomatic attack rate for chikungunya virus infection at approximately 1 year following the introduction of the virus. Eligible household members were administered a questionnaire and tested for chikungunya virus antibodies. Estimated proportions were calibrated to age and gender of the population. We enrolled 509 participants. The weighted infection rate was 31% (95% confidence interval [CI]: 26-36%). Among those with evidence of chikungunya virus infection, 72% (95% CI: 65-80%) reported symptomatic illness and 31% (95% CI: 23-38%) reported joint pain at least once per week approximately 1 year following the introduction of the virus to USVI. Comparing rates from infected and noninfected study participants, 70% (95% CI: 62-79%) of fever and polyarthralgia and 23% (95% CI: 9-37%) of continuing joint pain in patients infected with chikungunya virus were due to their infection. Overall, an estimated 43% (95% CI: 33-52%) of the febrile illness and polyarthralgia in the USVI population during the outbreak was attributable to chikungunya virus and only 12% (95% CI: 7-17%) of longer term joint pains were attributed to chikungunya virus. Although the rates of infection, symptomatic disease, and longer term joint symptoms identified in USVI are similar to other outbreaks of the disease, a lower proportion of acute fever and joint pain was found to be attributable to chikungunya virus.

St. Louis Encephalitis Virus Disease in the United States, 2003-2017

St. Louis encephalitis virus (SLEV), an arthropod-borne flavivirus, can cause disease presentations ranging from mild febrile illness through severe encephalitis. We reviewed U.S. national SLEV surveillance data for 2003 through 2017, including human disease cases and nonhuman infections. Over the 15-year period, 198 counties from 33 states and the District of Columbia reported SLEV activity; 94 (47%) of those counties reported SLEV activity only in nonhuman species. A total of 193 human cases of SLEV disease were reported, including 148 cases of neuroinvasive disease. A median of 10 cases were reported per year. The national average annual incidence of reported neuroinvasive disease cases was 0.03 per million. States with the highest average annual incidence of reported neuroinvasive disease cases were Arkansas, Arizona, and Mississippi. No large outbreaks occurred during the reporting period. The most commonly reported clinical syndromes were encephalitis (N = 116, 60%), febrile illness (N = 35, 18%), and meningitis (N = 25, 13%). Median age of cases was 57 years (range 2-89 years). The case fatality rate was 6% (11/193) and all deaths were among patients aged > 45 years with neuroinvasive disease. Nonhuman surveillance data indicated wider SLEV activity in California, Nevada, and Florida than the human data alone suggested. Prevention depends on community efforts to reduce mosquito populations and personal protective measures to decrease exposure to mosquitoes.

Assessment of productivity of Culex spp. larvae (Diptera: Culicidae) in urban storm water catch basin system in Wrocław (SW Poland)

In urban environments, catch basins serve as major developmental and resting sites for anthropophilic and zoophilic mosquitoes. However, the use of this habitat is inconsistent, with abundance of larvae varying significantly across catch basins at a fine spatial scale. During seasonal summer investigations on mosquito species composition, their spatial and temporal distribution and the environmental characteristic of the breeding sites in the underground storm drain systems of the Wrocław urban area (SW Poland) were assessed from May to September in 2012-2013. The study was conducted in order to develop a rational strategy to control mosquito populations and prevent the potential human exposure to mosquito-transmitted pathogens. Mosquito larvae and pupae were collected and identified weekly from 100 regularly inspected street catch basins located in the town center. All existing and potential breeding habitats in the study area were recorded using a GPS receiver (Magellan MobileMapper CX) and transferred to the computer database. Collected data on the geographical location of inspected breeding places, water quality parameters in inspected catch basins, daily temperature, and precipitation were imposed on orthophotomap in ArcGIS (ESRI, USA). Water quality parameters including pH, electrical conductivity, and water temperature were measured by standard methods. Chemical water analysis of cations (Na(+), NH4 (+), K(+), Mg(2+), Ca(2+)) and anions (Cl(-), NO2 (-), NO3 (-), SO4 (2-)) were carried out using Waters Alliance high-performance liquid chromatograph (HPLC) 2695 with 432 Conductivity Detector and 2998 Photodiode Array Detector, an IC-Pak Anion HR column (glauconate/borate eluent) and IC-Pak Cation M/D column (EDTA/HNO3 eluent). Over two seasonal studies and 3739 samplings in total, 3669 mosquito larvae and 274 pupae/1 dip (from 0 to 110 individuals/dip) were collected by dipper. Culex pipiens s.l. (L.) and Cx. torrentium (Martini) prevailed at all catch basins of the study area as the predominant species. In all examined catch basins, autogenous individuals dominated by far. Breeding activity was first detected in early May. Peak abundance of Culex spp. population in many catch basins was observed in June 2012 and August 2013 when average daily temperatures were increasing and rainfall had declined. Dry periods between rainfalls varied during 2 years of the study period and were noted on June 2012 as well as on July and August 2013. Organically enriched catch basins with significant higher concentrations of Na(+) and NO3 (-) were found to be more productive breeding habitats. Differences in the Culex immature stage density based on the variables of habitat type, temperature, and precipitation support the need for ongoing surveillance in communities to guide public health officials in planning for and prioritizing mosquito control efforts.

Implications for operational control of adult mosquito production in cisterns and wells in St. Augustine, FL using attractive sugar baits

The aim of this study was to further investigate the use of attractive sugar baits as an effective, inexpensive, and environmentally friendly tool for integrated mosquito management programs. Mosquitoes were offered dyed sugar bait in wells and cisterns in an urban tourist area in St. Augustine, FL. Exit traps were constructed to cover the well and cistern openings so the number of resting and emerging mosquitoes stained by feeding on the sugar bait could be monitored. Four mosquito species were collected from these structures: Aedes albopictus (Skuse), Anopheles crucians (Wiedemann), Culex quinquefasciatus Say, and Toxorhynchites rutilus rutilus (Coquillett). Overall, 90% (1482/1644) of the mosquitoes trapped were stained. In general, the number of mosquitoes stained was significantly greater in wells (P<0.0001) and cisterns (P<0.0001) than the numbers that were not stained by the colored bait. Based on the number of mosquitoes stained, we would have expected considerable mosquito mortality had the sugar bait contained an oral toxin. The results of this study support the concept of using attractive toxic sugar baits as an effective tool for integrated mosquito management.

Modifiable risk factors for West Nile virus infection during an outbreak--Arizona, 2010

West Nile virus (WNV) is the leading cause of mosquito-borne disease in the United States; however, risk factors for infection are poorly defined. We performed a case-control study to identify modifiable risk factors for WNV infection. Case-patients (N = 49) had laboratory evidence of recent WNV infection, whereas control-subjects (N = 74) had negative WNV serology. We interviewed participants, surveyed households, and assessed environmental data. WNV infection was associated with living in or near Water District X within Gilbert Township (adjusted odds ratio [aOR] 5.2; 95% confidence interval [95% CI] = 1.5-18.1), having water-holding containers in their yard (aOR 5.0; 95% CI = 1.5-17.3), and not working or attending school outside the home (aOR 2.4; 95% CI = 1.1-5.5). During this outbreak, WNV infection was likely primarily acquired peri-domestically with increased risk associated with potential mosquito larval habitats around the home and neighborhood.

STAT1-independent control of a neurotropic measles virus challenge in primary neurons and infected mice

Neurons are chiefly nonrenewable; thus, cytolytic immune strategies to clear or control neurotropic viral infections could have lasting neurologic consequences. IFN-γ is a potent antiviral cytokine that is critical for noncytolytic clearance of multiple neurotropic viral infections, including measles virus (MV); however, the downstream pathways through which IFN-γ functions in neurons have not been defined. Unlike most cell types studied to date in which IFN-γ affects gene expression via rapid and robust activation of STAT1, basal STAT1 levels in primary hippocampal neurons are constitutively low, resulting in attenuated STAT1 activation and consequently slower kinetics of IFN-γ-driven STAT1-dependent gene expression. Given this altered expression and activation of STAT1 in neurons, we sought to determine whether STAT1 was required for IFN-γ-mediated protection from infection in neurons. To do so, we evaluated the consequences of MV challenge of STAT1-deficient mice and primary hippocampal neurons explanted from these mice. Surprisingly, the absence of STAT1 did not restrict the ability of IFN-γ to control viral infection either in vivo or ex vivo. Moreover, the canonical IFN-γ-triggered STAT1 gene expression profile was not induced in STAT1-deficient neurons, suggesting that IFN-γ regulates neuronal STAT1-independent pathways to control viral replication.

West Nile virus and its emergence in the United States of America

Zoonotic West Nile virus (WNV) circulates in natural transmission cycles involving certain mosquitoes and birds, horses, humans, and a range of other vertebrates are incidental hosts. Clinical infections in humans can range in severity from uncomplicated WNV fever to fatal meningoencephalitis. Since its introduction to the Western Hemisphere in 1999, WNV had spread across North America, Central and South America and the Caribbean, although the vast majority of severe human cases have occurred in the United States of America (USA) and Canada. By 2002-2003, the WNV outbreaks have involved thousands of patients causing severe neurologic disease (meningoencephalitis and poliomyelitis-like syndrome) and hundreds of associated fatalities in USA. The purpose of this review is to present recent information on the epidemiology and pathogenicity of WNV since its emergence in North America.

Control of Culex quinquefasciatus in a storm drain system in Florida using attractive toxic sugar baits

Attractive toxic sugar baits (ATSBs) were used to control mosquitoes in the storm drains of a residential area on the outskirts of St Augustine, Florida. The drainage system was newly constructed and no mosquitoes were breeding inside it. The area covered by the storm drains was divided in half; 10 drains served as control drains and 16 drains served as experimental drains. The baits, which consisted of a mixture of brown sugar, fruit juice, green dye marker and boric acid, were presented at the entrances of the treated drains and exit traps were positioned over the drain openings and the connecting tubes leading to retention ponds. Similar baits with orange dye and without toxin were presented at the entrances of control drains. A total of 220 pupae of Culex quinquefasciatus (Diptera: Culicidae) were released in each control and toxin-treated drain, and the numbers of recovered mosquitoes were examined to determine the effectiveness of ATSBs in the storm drain system. An average of 178.2 mosquitoes exited each drain in the control area; 87.0% of these had fed on the baits and were stained orange, whereas 13.0% were unstained. In the toxin-treated drains, 83.7% of hatched females and 86.6% of hatched males were controlled by the baits.

Efficacy of toxic sugar baits against adult cistern-dwelling Anopheles claviger

Sugar baits were used for mosquito control in cisterns at the building complex of Mar Saba Monastery in the Judean Hills, Israel. These cisterns provide fresh water for the monastery and are breeding and resting sites for Anopheles claviger (Meigen). The baits, including sucrose, fruit juice, dye marker and oral insecticide, were presented at the entrance of the cisterns and caused a drastic decline of A. claviger numbers in the neighbourhood. Pre-treatment catches of 16.8+/-4.0 to 33+/-8.1 females per trap decreased to between 2.5+/-1.3 and 0.3+/-0.6 females per trap six nights after treatment. Numbers of males were initially 9.2+/-1.7 to 21.0+/-4.8 specimens per trap and decreased to between 1.0+/-0.4 and 0.5+/-0.2 per trap post treatment. In the control area, where baits without toxin were presented in cisterns, there were only small fluctuations in the mosquito population. Non-poisonous bait marked >95% of the mosquitoes exiting from a cistern in the control area. Following treatment, the number of human-landing mosquitoes decreased by more than ten-fold in the experimental area, whilst in the control area there was no significant decrease.

Risk factors associated with St. Louis encephalitis seroprevalence in two populations from Córdoba, Argentina

St. Louis encephalitis virus (SLEV) is endemic in Argentina. The first outbreak was recorded in Córdoba during the late summer of 2005. This study analyzes the association between social and demographic factors and other variables related to exposure to mosquitoes with SLEV infection in 264 individuals who attended two health centers in the city of Córdoba during the period December 2004-January 2005. Multiple logistic regression models were used to estimate the risk coefficients. The seroprevalence was 12.9%, similar to that in previous reports. Risks of infection were associated with the presence of garbage dumps near dwellings, the practice of outdoor activities at night and place of residence. Risk for older people (60-80 years old) was moderate. The identification of risk factors related to SLEV infection would be useful to improve programs for vector control and community health.

Geographic dynamics of viral encephalitis in Thailand

Viral encephalitis (VE) continues to be a major disease in Asia, causing serious illness which may result in death or have neurological sequelae. This study involves an ecological analysis of the climatic, geographic and seasonal patterns of clinically reported VE in Thailand from 1993 to 1998 to investigate regional and seasonal differences in disease incidence. Three thousand eight hundred and twenty nine cases of VE were clinically diagnosed nationwide during the study period by the Thai Ministry of Public Health. Spearman rank correlations of temporal, spatial and geographic variables with disease incidence were performed. The monthly incidence of VE correlated significantly with seasonal changes in temperature, relative humidity and rainfall in the north-northeast region of Thailand (P < 0.001), whereas incidence in the south-central region correlated only with relative humidity (P = 0.003). Spatial analysis revealed a positive correlation of disease with elevation (P < 0.001), and negative correlations with rice-field cover (P < 0.001), agricultural land-use (P < 0.001) and temperature (P = 0.004) in the north-northeast region. No significant spatial correlation was identified in the south-central region. The spatial distribution of VE suggests that etiologic variations may be responsible, in part, for the geographic patterns of disease. Active etiologic surveillance is necessary in a variety of geographic settings in order to provide physicians with information necessary for disease prevention and clinical management.

Initiating arbovirus surveillance in Arkansas, 2001

Migratory birds could introduce West Nile (WN) virus to Arkansas. The purpose of this study was to establish a cooperative arbovirus surveillance program to monitor mosquitoes and birds in Arkansas for arboviruses. Our objectives were to: 1) perform routine, multicounty collections of mosquitoes and test them for eastern equine encephalitis, St. Louis encephalitis, and WN viruses; and 2) conduct passive surveillance by testing dead wild birds for WN virus. Arbovirus surveillance was organized by the Arkansas Department of Health, University of Arkansas, and Vector Disease Control Incorporated. None of the 14,560 mosquitoes (425 pools) tested were virus positive. Two hundred forty-two dead birds from 62 counties were tested for WN virus. Four blue jays in three counties were positive. These infections are the first reported incidences of WN virus in Arkansas. Sera from five horses with suspected encephalitis all tested negative for WN, eastern equine encephalitis, and western equine encephalitis viruses.

West Nile virus activity in the United States, 2001

West Nile virus (WNV) first appeared in the naive environment of the Western Hemisphere in 1999 in New York. Genetic analysis determined that the virus was introduced into the United States from the Mediterranean Basin. This review discusses the spread of the virus in 2001 from the initial focus in Queens, New York, to widespread activity in the eastern and midwestern United States. It concentrates on viral ecology, epizootiology, pathology, prediction, and prevention. Research questions to further our understanding of the transmission cycle of WNV are discussed, including host-preference studies, molecular confirmation of implicated mosquito vectors, and survival of WNV in the temperate environment of the United States. Comparisons are drawn with two other arboviruses enzootic in the United States, eastern equine encephalitis, and St. Louis encephalitis viruses. Although not recently introduced, these two viruses also demonstrated increased activity in the United States in 2001.

The emergence of West Nile virus in North America: ecology, epidemiology, and surveillance

In late summer 1999, the first domestically acquired human cases of WN encephalitis were documented in the USA. Aggressive vector-control and public education efforts by state and local public health officials limited the extent of human involvement. The discovery of virus-infected, overwintering mosquitoes during the winter of 1999-2000, predicted renewed virus activity for the following spring, and prompted early season vector-control activities and disease surveillance efforts in NYC and the surrounding areas. These surveillance efforts were focused on identifying WN virus infections in birds and mosquitoes as predictors of the potential risk of transmission to humans. By the end of the 2000 mosquito-borne disease transmission season, WN virus activity had been documented as far north as the states of Vermont and New Hampshire, and as far south as the state of North Carolina. The ongoing impacts that WN virus will have on wildlife, domestic animal and human populations of the western hemisphere are not yet known. Plans are in place for public health officials and scientists to monitor the further expansion of WN virus with the establishment or enhancement of vector-borne disease surveillance and control programs throughout the eastern seaboard. The valuable lessons learned from the detection and response to the introduction of WN virus into NYC should prove useful if and when subsequent intrusions of new disease agents occur.

The outbreak of West Nile virus infection in the New York City area in 1999

BACKGROUND

In late August 1999, an unusual cluster of cases of meningoencephalitis associated with muscle weakness was reported to the New York City Department of Health. The initial epidemiologic and environmental investigations suggested an arboviral cause.

METHODS

Active surveillance was implemented to identify patients hospitalized with viral encephalitis and meningitis. Cerebrospinal fluid, serum, and tissue specimens from patients with suspected cases underwent serologic and viral testing for evidence of arboviral infection.

RESULTS

Outbreak surveillance identified 59 patients who were hospitalized with West Nile virus infection in the New York City area during August and September of 1999. The median age of these patients was 71 years (range, 5 to 95). The overall attack rate of clinical West Nile virus infection was at least 6.5 cases per million population, and it increased sharply with age. Most of the patients (63 percent) had clinical signs of encephalitis; seven patients died (12 percent). Muscle weakness was documented in 27 percent of the patients and flaccid paralysis in 10 percent; in all of the latter, nerve conduction studies indicated an axonal polyneuropathy in 14 percent. An age of 75 years or older was an independent risk factor for death (relative risk adjusted for the presence or absence of diabetes mellitus, 8.5; 95 percent confidence interval, 1.2 to 59.1), as was the presence of diabetes mellitus (age-adjusted relative risk, 5.1; 95 percent confidence interval, 1.5 to 17.3).

CONCLUSIONS

This outbreak of West Nile meningoencephalitis in the New York City metropolitan area represents the first time this virus has been detected in the Western Hemisphere. Given the subsequent rapid spread of the virus, physicians along the eastern seaboard of the United States should consider West Nile virus infection in the differential diagnosis of encephalitis and viral meningitis during the summer months, especially in older patients and in those with muscle weakness.

Clinical findings of West Nile virus infection in hospitalized patients, New York and New Jersey, 2000

Outbreaks of West Nile (WN) virus occurred in the New York metropolitan area in 1999 and 2000. Nineteen patients diagnosed with WN infection were hospitalized in New York and New Jersey in 2000 and were included in this review. Eleven patients had encephalitis or meningoencephalitis, and eight had meningitis alone. Ages of patients ranged from 36 to 87 years (median 63 years). Fever and neurologic and gastrointestinal symptoms predominated. Severe muscle weakness on neurologic examination was found in three patients. Age was associated with disease severity. Hospitalized cases and deaths were lower in 2000 than in 1999, although the case-fatality rate was unchanged. Clinicians in the Northeast should maintain a high level of suspicion during the summer when evaluating older patients with febrile illnesses and neurologic symptoms, especially if associated with gastrointestinal complaints or muscle weakness.