Comparison of Characteristics of Patients with West Nile Virus or St. Louis Encephalitis Virus Neuroinvasive Disease During Concurrent Outbreaks, Maricopa County, Arizona, 2015.

Autor: Venkat H; Arizona Department of Health Services, Phoenix, Arizona, USA.; Maricopa County Department of Public Health, Phoenix, Arizona, USA.; Epidemic Intelligence Service, Division of Scientific Education and Professional Development, Centers for Disease Control and Prevention, Atlanta, Georgia, USA., Krow-Lucal E; Epidemic Intelligence Service, Division of Scientific Education and Professional Development, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.; Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA., Kretschmer M; Maricopa County Department of Public Health, Phoenix, Arizona, USA., Sylvester T; Maricopa County Department of Public Health, Phoenix, Arizona, USA., Levy C; Maricopa County Department of Public Health, Phoenix, Arizona, USA., Adams L; Arizona Department of Health Services, Phoenix, Arizona, USA.; Career Epidemiology Field Officer Program, Center for Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA., Fitzpatrick K; Arizona State Public Health Laboratory, Arizona Department of Health Services, Phoenix, Arizona, USA., Laven J; Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA., Kosoy O; Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA., Sunenshine R; Maricopa County Department of Public Health, Phoenix, Arizona, USA.; Career Epidemiology Field Officer Program, Center for Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA., Smith K; Vector Control Division, Maricopa County Environmental Services Department, Phoenix, Arizona, USA., Townsend J; Vector Control Division, Maricopa County Environmental Services Department, Phoenix, Arizona, USA., Chevinsky J; Epidemiology Elective Program, Centers for Disease Control and Prevention, Atlanta, Georgia, USA., Hennessey M; Epidemic Intelligence Service, Division of Scientific Education and Professional Development, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.; Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA., Jones J; Arizona Department of Health Services, Phoenix, Arizona, USA.; Maricopa County Department of Public Health, Phoenix, Arizona, USA.; Epidemic Intelligence Service, Division of Scientific Education and Professional Development, Centers for Disease Control and Prevention, Atlanta, Georgia, USA., Komatsu K; Arizona Department of Health Services, Phoenix, Arizona, USA., Fischer M; Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA., Hills S; Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA.
Jazyk: angličtina
Zdroj: Vector borne and zoonotic diseases (Larchmont, N.Y.) [Vector Borne Zoonotic Dis] 2020 Aug; Vol. 20 (8), pp. 624-629. Date of Electronic Publication: 2020 Apr 06.
DOI: 10.1089/vbz.2019.2572
Abstrakt: West Nile virus (WNV) and St. Louis encephalitis virus (SLEV) are closely related mosquito-borne flaviviruses that can cause neuroinvasive disease. No concurrent WNV and SLEV disease outbreaks have previously been identified. When concurrent outbreaks occurred in 2015 in Maricopa County, Arizona, we collected data to describe the epidemiology, and to compare features of patients with WNV and SLEV neuroinvasive disease. We performed enhanced case finding, and gathered information from medical records and patient interviews. A case was defined as a clinically compatible illness and laboratory evidence of WNV, SLEV, or unspecified flavivirus infection in a person residing in Maricopa County in 2015. We compared demographic and clinical features of WNV and SLEV neuroinvasive cases; for this analysis, a case was defined as physician-documented encephalitis or meningitis and a white blood cell count >5 cells/mm 3 in cerebrospinal fluid. In total, we identified 82 cases, including 39 WNV, 21 SLEV, and 22 unspecified flavivirus cases. The comparative analysis included 21 WNV and 14 SLEV neuroinvasive cases. Among neuroinvasive cases, the median age of patients with SLEV (63 years) was higher than WNV (52 years). Patients had similar symptoms; rash was identified more frequently in WNV (33%) neuroinvasive cases than in SLEV (7%) cases, but this difference was not statistically significant ( p  = 0.11). In summary, during the first known concurrent WNV and SLEV disease outbreaks, no specific clinical features were identified that could differentiate between WNV and SLEV neuroinvasive cases. Health care providers should consider both infections in patients with aseptic meningitis or encephalitis.
Databáze: MEDLINE