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Book 2 Part 4 Serological Studies Suffolk County Vector Control and Wetlands Management Long-Term Plan Literature Review Task Three Serosurveys for West Nile Virus January 2005 SUFFOLK COUNTY VECTOR CONTROL AND WETLANDS MANAGEMENT LONG - TERM PLAN AND ENVIRONMENTAL IMPACT STATEMENT PROJECT SPONSOR Steve Levy Suffolk County Executive Department of Public Works Department of Health Services Charles J. Bartha, P.E. Brian L. Harper, M.D., M.P.H. Commissioner Commissioner Richard LaValle, P.E. Vito Minei, P.E. Chief Deputy Commissioner Director, Division of Environmental Quality Leslie A. Mitchel Deputy Commissioner PROJECT MANAGEMENT Project Manager: Walter Dawydiak, P.E., J.D. Chief Engineer, Division of Environmental Quality, Suffolk County Department of Health Services Suffolk County Department of Public Suffolk County Department of Works, Division of Vector Control Health Services, Office of Ecology Dominick V. Ninivaggi Martin Trent Superintendent Acting Chief Tom Iwanejko Kim Shaw Entomologist Bureau Supervisor Mary E. Dempsey Robert M. Waters Biologist Bureau Supervisor Laura Bavaro Senior Environmental Analyst Erin Duffy Environmental Analyst Phil DeBlasi Environmental Analyst Jeanine Schlosser Principal Clerk Cashin Associates, P.C. i Suffolk County Vector Control and Wetlands Management Long-Term Plan Literature Review Task Three Serosurveys for West Nile Virus January 2005 SUFFOLK COUNTY LONG TERM PLAN CONSULTANT TEAM Cashin Associates, P.C. Hauppauge, NY Subconsultants Cameron Engineering, L.L.P. Syosset, NY Integral Consulting Annapolis, MD Bowne Management Systems, Inc. Mineola, NY Kamazima Lwiza, PhD Stony Brook University, Stony Brook, NY Ducks Unlimited Stony Brook, NY Steven Goodbred, PhD & Laboratory Stony Brook University, Stony Brook, NY RTP Environmental Westbury, NY Sinnreich, Safar & Kosakoff Central Islip, NY Bruce Brownawell, PhD & Laboratory Stony Brook University, Stony Brook, NY Anne McElroy, PhD & Laboratory Stony Brook University, Stony Brook, NY Andrew Spielman, PhD Harvard School of Public Health, Boston, MA Richard Pollack, PhD Harvard School of Public Health, Boston, MA Wayne Crans, PhD Rutgers University, New Brunswick, NJ Susan Teitelbaum, PhD Mount Sinai School of Medicine, NY Zawicki Vector Management Consultants Freehold, NJ Michael Bottini, Turtle Researcher East Hampton, NY Robert Turner, PhD & Laboratory Southampton College, NY Christopher Gobler, PhD & Laboratory Southampton College, NY Jerome Goddard, PhD Mississippi Department of Health, Jackson, MS Sergio Sanudo, PhD & Laboratory Stony Brook University, Stony Brook, NY Suffolk County Department of Health Hauppauge, NY Services, Division of Environmental Quality Cashin Associates, P.C. ii Suffolk County Vector Control and Wetlands Management Long-Term Plan Literature Review Task Three Serosurveys for West Nile Virus January 2005 Primary research for this report was conducted by Cashin Associates (personnel including David J. Tonjes, PhD, and Michael Tumbarello). It was edited and revised in response to comments by Cashin Associates (personnel including David Tonjes, PhD). Review was provided by Suffolk County Department of Public Works, Division of Vector Control, and Suffolk County Department of Health Services (personnel including Phil DeBlasi and Erin Duffy). Additional comments have been received from _____. Cashin Associates, P.C. iii Suffolk County Vector Control and Wetlands Management Long-Term Plan Literature Review Task Three Serosurveys for West Nile Virus January 2005 TABLE OF CONTENTS EXECUTIVE SUMMARY...............................................................................................1 1. INTRODUCTION .................................................................................................2 2. WEST NILE VIRUS..............................................................................................3 2.1 History in the United States..............................................................................3 2.2 Standard Medical Reporting.............................................................................4 3. WNV SEROLOGICAL SURVEYS .....................................................................7 3.1 Douglaston, NY, 1999 ......................................................................................7 3.2 Staten Island, NY, 2001....................................................................................8 3.3 Suffolk County, NY, 2001................................................................................8 3.4 Fairfield County, CT, 2001...............................................................................9 3.5 Cuyahoga County, OH, 2002............................................................................9 3.6 South Oakville, Ontario, Canada, 2003 ..........................................................10 3.7 unidentified location, Wisconsin, 2002 ..........................................................10 3.8 Bucharest, Romania, 1996...............................................................................11 3.9 Hashimiah, Jordan, 1998 .................................................................................11 3.10 WNV in the Blood Supply............................................................................11 REFERENCES ................................................................................................................13 List of Tables Table 2-1. Human Cases of WNV in the US, 1999-2003 ..................................................6 Cashin Associates, P.C. iv Suffolk County Vector Control and Wetlands Management Long-Term Plan Literature Review Task Three Serosurveys for West Nile Virus January 2005 List of Abreviations and Acronyms CDC Centers for Disease Control and Prevention ELISA enzyme-linked immunoabsorbent assay IgM immunoglobulin M km2 square kilometer mi2 square mile NYCDOH New York City Department of Health NYSDOH New York State Department of Health PRNT plaque reduction neutralization SCDHS Suffolk County Department of Health Services SLE St. Louis encephalitis WHO World Health Organization WNV West Nile virus Cashin Associates, P.C. v Suffolk County Vector Control and Wetlands Management Long-Term Plan Literature Review Task Three Serosurveys for West Nile Virus January 2005 EXECUTIVE SUMMARY West Nile virus (WNV) infections can range from asymptomatic to fatal illnesses. Human serologic surveys have been conducted to determine the rate of infections in humans. Most of the surveys found approximately two percent of humans in highly exposed areas may seroconvert. The highest infection rate, found in Jordan, was eight percent; however, this was apparently from a strain of the virus that does not cause virulent disease. In areas with the more virulent form of WNV, infection rates ranged from zero in Connecticut in 2000 to four percent in Romania in 1996. Data on symptomatic illness appeared to show that approximately 20 percent of those infected might experience measurable impacts. However, in approximately one out of every 150 cases, serious disease, such as encephalitis or meningitis requiring hospitalization, can occur. Nationwide fatality rates of those with the most severe symtoms have ranged from six percent in 2000 to 14 percent in 2001. The most recent data suggests the fatality rate for these individuals is slightly less than ten percent. This suggests that one out of every 1500 cases may result in a fatality in any given year. These data can be used to make a very simplistic estimate of the annual risks for a population exposed to WNV infection. An infection rate of two percent would imply that 2,000 out of 100,000 exposed people would become infected. Approximately 20 percent of those infected exhibit fever or other flu-like symptoms. Thus, approximately 400 people out of 100,000 might have such symptoms. Estimates also show that one out of 150 infected people have severe neurological effects requiring hospitalization. This suggests that 10 to 15 people out of the hypothetically-exposed population of 100,000 might require hospitalization. Furthermore, data on fatalities from the disease suggests that one or two those hospitalized people will die from the disease. Thus, the serological data on West Nile virus infections and associated illnesses suggests that, through a very simplistic and generalized estimation, out of 100,000 exposed individuals in any year, one or two people might be expected to die from the effects of the disease. Cashin Associates, P.C. 1 Suffolk County Vector Control and Wetlands Management Long-Term Plan Literature Review Task Three Serosurveys for West Nile Virus January 2005 1.0 INTRODUCTION Serology is the study of analyzing blood to detect the presence of antibodies against a microorganism. A serological survey is when samples are taken from a population to determine exposure to a microorganism. To perform a serological test, blood is drawn and then analyzed in a laboratory. Certain microorganisms, known as antigens, stimulate the body to produce antibodies during an active infection. In the laboratory, the antibodies react with antigens in specific ways that can be used to confirm the identity of the specific microorganism (WHO, 2003). There are several serology techniques that can be used depending on the suspected antibodies. Commonly used serology techniques include: · agglutination · precipitation · complement-fixation · fluorescent antibodies (WHO, 2003) Cashin Associates, P.C. 2 Suffolk County Vector Control and Wetlands Management Long-Term Plan Literature Review Task Three Serosurveys
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