Skip to main content Accessibility help
×
Home

Hospital-based enhanced surveillance for West Nile virus neuroinvasive disease

  • N. P. LINDSEY (a1), M. FISCHER (a1), D. NEITZEL (a2), E. SCHIFFMAN (a2), M. L. SALAS (a3), C. A. GLASER (a3), T. SYLVESTER (a4), M. KRETSCHMER (a4), A. BUNKO (a4) and J. E. STAPLES (a1)...

Summary

Accurate data on the incidence of West Nile virus (WNV) disease are important for directing public health education and control activities. The objective of this project was to assess the underdiagnosis of WNV neuroinvasive disease through laboratory testing of patients with suspected viral meningitis or encephalitis at selected hospitals serving WNV-endemic regions in three states. Of the 279 patients with cerebrospinal fluid (CSF) specimens tested for WNV immunoglobulin M (IgM) antibodies, 258 (92%) were negative, 19 (7%) were positive, and two (1%) had equivocal results. Overall, 63% (12/19) of patients with WNV IgM-positive CSF had WNV IgM testing ordered by their attending physician. Seven (37%) cases would not have been identified as probable WNV infections without the further testing conducted through this project. These findings indicate that over a third of WNV infections in patients with clinically compatible neurological illness might be undiagnosed due to either lack of testing or inappropriate testing, leading to substantial underestimates of WNV neuroinvasive disease burden. Efforts should be made to educate healthcare providers and laboratorians about the local epidemiology of arboviral diseases and the optimal tests to be used in different clinical situations.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Hospital-based enhanced surveillance for West Nile virus neuroinvasive disease
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Hospital-based enhanced surveillance for West Nile virus neuroinvasive disease
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Hospital-based enhanced surveillance for West Nile virus neuroinvasive disease
      Available formats
      ×

Copyright

Corresponding author

*Author for correspondence: N. P. Lindsey, Arboviral Diseases Branch, CDC, 3156 Rampart Road, Fort Collins, CO 80521, USA. (Email: nplindsey@cdc.gov)

References

Hide All
1. Reimann, CA, et al. Epidemiology of neuroinvasive arboviral disease in the United States, 1999–2007. American Journal of Tropical Medicine and Hygiene 2008; 79: 974979.
2. Mostashari, F, et al. Epidemic West Nile encephalitis, New York, 1999: Results of a household-based seroepidemiological survey. Lancet 2001; 358: 261264.
3. Sejvar, JJ, Marfin, AA. Manifestations of West Nile neuroinvasive disease. Reviews in Medical Virology 2006; 16: 209224.
4. Lindsey, NP, et al. Surveillance for human West Nile virus disease – United States, 1999–2008. Morbidity and Mortality Weekly Report. Surveillance Summaries 2010; 59(SS-2): 117.
5. Boehmer, TK, et al. Use of hospital discharge data to evaluate notifiable disease reporting to Colorado's Electronic Disease Reporting System. Public Health Reports 2011; 126: 100106.
6. Silk, BJ, et al. Differential West Nile fever ascertainment in the United States: a multilevel analysis. American Journal of Tropical Medicine and Hygiene 2010; 83: 795802.
7. Weber, IB, et al. Completeness of West Nile virus testing in patients with meningitis and encephalitis during an outbreak in Arizona, USA. Epidemiology and Infection 2012; 140: 16321636.
8. CDC. West Nile Virus in the United States: Guidelines for Surveillance, Prevention, and Control, 2013 (http://www.cdc.gov/westnile/resources/pdfs/wnvguidelines.pdf).
9. Gable, MS, et al. The frequency of autoimmune N-methyl-d-aspartate receptor encephalitis surpasses that of individual viral etiologies in young individuals enrolled in the California Encephalitis Project. Clinical Infectious Diseases 2012; 54: 899904.
10. Tyler, KL, et al. CSF findings in 250 patients with serologically confirmed West Nile virus meningitis and encephalitis. Neurology 2006; 66: 361365.
11. Pierro, A, et al. A model of laboratory surveillance for neuro-arbovirosis applied during 2012 in the Emilia-Romagna region, Italy. Clinical Microbiology and Infection 2014; 20: 672677.
12. Lanciotti, RS, et al. Rapid detection of West Nile virus from human clinical specimens, field-collected mosquitoes, and avian samples by a TaqMan reverse transcriptase-PCR assay. Journal of Clinical Microbiology 2000; 38: 40664071.
13. Hayes, EB, et al. Virology, pathology, and clinical manifestations of West Nile virus disease. Emerging Infectious Diseases 2005; 11: 11741179.
14. Penn, RG, et al. Persistent neuroinvasive West Nile virus infection in an immunocompromised patient. Clinical Infectious Diseases 2006; 42: 680683.

Keywords

Hospital-based enhanced surveillance for West Nile virus neuroinvasive disease

  • N. P. LINDSEY (a1), M. FISCHER (a1), D. NEITZEL (a2), E. SCHIFFMAN (a2), M. L. SALAS (a3), C. A. GLASER (a3), T. SYLVESTER (a4), M. KRETSCHMER (a4), A. BUNKO (a4) and J. E. STAPLES (a1)...

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed