West Nile Virus Activity in California...
Transcript of West Nile Virus Activity in California...
West Nile Virus West Nile Virus Activity in Activity in California California
20052005
Division of Communicable Disease ControlCalifornia Department of Health Services
WNV in California, 2003WNV in California, 2003
Equine Case (1)
Human Case (3)
32 10,111
70 31,227
96 1,769
POS N
20042004
58 counties
WNV activity (no human cases)
WNV activity (number of human infections)
Humans 830 / 28 Horses 540 / 230Dead birds 3232Mosquito pools 1136Sentinel chickens 805
15
1
197
116
331
60
7
1
6
3
64
2
2
1
1
10
1 1
33
1
1
3
0
20
40
60
80
100
120
140
1 2 3 4 5 6 7 8 9 1 0 1 1 1 2 1 3 1 4 1 5 1 6 1 7 1 8 1 9 2 0 2 1 2 2 2 3 2 4 2 5 2 6 2 7 2 8 2 9 3 0 3 1 3 2 3 3 3 4 3 5 3 6 3 7 3 8 3 9 4 0 4 1 4 2 4 3 4 4 4 5 4 6 4 7
Sequence of WNV detection events in California Sequence of WNV detection events in California relative to human caserelative to human case onset, 2005 onset, 2005
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov
Num
ber o
f cas
es
1/3
1/25
2/15
3/15*5/1
Week of onset• Onset dates not available for all patients• Birds, mosquitoes: date of collection• Chickens: date of probable seroconversion * Estimated date of onset
March 2005March 20051 / 005711
Humans, onset / reportedHorses, onset / reportedDead birdsMosquito poolsSentinel chickens
N = 1 county with human infection
WNV activity (number of human cases with known onset date)
WNV activity (no human cases)
1
April 2005April 20052 / 006311
Humans, onset / reportedHorses, onset / reportedDead birdsMosquito poolsSentinel chickens
N = 2 counties with human infection
WNV activity (number of human cases with known onset date)
WNV activity (no human cases)
1
1
May 2005May 20054 / 01 / 110163
Humans, onset / reportedHorses, onset / reportedDead birdsMosquito poolsSentinel chickens
N = 4 counties with human infection
WNV activity (number of human cases with known onset date)
WNV activity (no human cases)
1
1
1
1
June 30, 2005June 30, 2005
N = 8 counties with human infection
WNV activity (number of human cases with known onset date)
WNV activity (no human cases)
2
5
3
8
1
1
11
22/ 28 / 343713714
Humans, onset / reportedHorses, onset / reportedDead birdsMosquito poolsSentinel chickens
July 31, 2005July 31, 2005
N = 24 counties with human infection
WNV activity (number of human cases with known onset date)
WNV activity (no human cases)
30
41
44
24
15
8
1418
5
4
8
21
22
6
11
31
21
254 / 56116 / 481,216588179
Humans, onset / reportedHorses, onset / reportedDead birdsMosquito poolsSentinel chickens
12
1
August 31, 2005August 31, 2005
N = 37 counties with human infection
WNV activity (number of human cases with known onset date)
WNV activity (no human cases)
49
79
140
44
26
21
3426
22
12
28
274
64
9
16128
83
8
1
2
1
2
1
2
11
1
656 / 416343 / 2772,3061,040557
Humans, onset / reportedHorses, onset / reportedDead birdsMosquito poolsSentinel chickens
7
1
1
5
WNV Activity in California WNV Activity in California 20052005
WNV activity (number of human infections)
WNV activity (no human cases)
67
104
177
60
35
25
6332
47
17
35
365
92
9
281
211
195
12
1
4
1
2
1
4
12
1
19294563,0461,242790
Humans infectionsHorse casesDead birdsMosquito poolsSentinel chickens
N = 40 counties with human infection
4
13
1
1
2
1
1
6
2005 2005 Reported WNV Reported WNV
cases per cases per 100,000 people100,000 people
CA Total 2.6
Glenn 49.1Kings 24.7Stanislaus 19.6 > 15Tulare 15.2
Sacramento 14.2Placer 14.0Merced 13.3Butte 11.8 > 10 Sutter 11.4Amador 11.4Colusa 10.6 Yuba 10.0
Madera 9.8Kern 9.5Fresno 7.6Yolo 7.1 > 5San Joaquin 6.4Riverside 6.4Tehama 7.1
Calaveras 4.9Plumas 4.8Nevada 4.3San Bernardino 1.9 > 1Tuolumne 1.8Solano 1.3Contra Costa 1.2
Others > 0
Human infections 929
Top Ten Counties with Human WNV InfectionsTop Ten Counties with Human WNV Infections
2004 2005Sacramento 177
Riverside 104Stanislaus 92
Kern 67Fresno 63Tulare 60
Los Angeles 47San Joaquin 36
Placer 35San Bernardino 35
Los Angeles 323San Bernardino 191
Riverside 112Orange 64
Kern 60Fresno 15Tehama 10
Butte 7Shasta 6Glenn 3
Human WNV Infections Human WNV Infections 2004 2004 -- 20052005
Human infections 830 929
Counties 23 40
Positive blood donors 66 93
Symptomatic donors 15 (23%) 42 (45%)
2004 2005
Human WNV Clinical Presentation Human WNV Clinical Presentation 2004 2004 -- 20052005
Number of symptomatic cases 779 874
Clinical presentation
Neuroinvasive 289 (42%) 303 (36%)
Fever 395 (58%) 530 (64%)
Unknown 95 41
Median age 52 yrs 51 yrs
Fatal cases 28 18
Median age of fatalities 76 yrs 79 yrs
2004 2005
Incidence of WNV illness by age and clinical presentationIncidence of WNV illness by age and clinical presentationCalifornia 2005California 2005
(n=818)
0.0
0.5
1.0
1.5
2.0
2.5
3.0
3.5
4.0
0-9 10-19 20-29 30-39 40-49 50-59 60-69 70+Age group (years)
Rep
orte
d in
cide
nce
per 1
00,0
00 p
op.
WNNDWNF
0
20
40
60
80
100
120
140
9 1 0 1 1 1 2 1 3 1 4 1 5 1 6 1 7 1 8 1 9 2 0 2 1 2 2 2 3 2 4 2 5 2 6 2 7 2 8 2 9 3 0 3 1 3 2 3 3 3 4 3 5 3 6 3 7 3 8 3 9 4 0 4 1 4 2 4 3 4 4 4 5 4 6 4 7
WNNDWNFUnk
Mar Apr May Jun Jul Aug Sep Oct Nov
• Onset dates not available for all patientsWeek of onset
Num
ber o
f cas
es
* Estimated date of onset
Human WNV Cases in California, 2005Human WNV Cases in California, 2005
5-M
ar
19-M
ar
2-A
pr
16-A
pr
30-A
pr
14-M
ay
28-M
ay
11-J
un
25-J
un
9-Ju
l
23-J
ul
6-A
ug
20-A
ug
3-Se
p
17-S
ep
1-O
ct
15-O
ct
29-O
ct
12-N
ov
26-N
ov
Mar 15 Nov 11
0
20
40
60
80
100
120
140
160
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39
2005
2004
Onset of Human Illness 2004 Onset of Human Illness 2004 -- 200520055-
Mar
19-M
ar
2-A
pr
16-A
pr
30-A
pr
14-M
ay
28-M
ay
11-J
un
25-J
un
9-Ju
l
23-J
ul
6-A
ug
20-A
ug
3-Se
p
17-S
ep
1-O
ct
15-O
ct
29-O
ct
12-N
ov
26-N
ov
Week of onset
Num
ber o
f cas
es
Dead Bird SurveillanceDead Bird Surveillance
Dead Bird Surveillance Program Dead Bird Surveillance Program 2000 2000 -- 20052005
Year Reported Tested Positive
2000 40 20 0
2001 68 18 0
2002 3,666 653 0
2003 8,650 1,765 96
2004 93,057 5,728 3,2322005 109,375 9,263 3,046
Prevalence of WNV in Tested Prevalence of WNV in Tested Dead Birds*, 2005Dead Birds*, 2005
No positive birds
1 – 19 %
20 –39 %
40 – 59 %
60 – 79 %
* Prevalence = (# pos birds / # tested birds) x 100
2005: 92 species of WNV positive dead birds2005: 92 species of WNV positive dead birds
Other Corvids (4 species) 1%
Non-Corvids (85 species)16%
American Crow 44%
Western Scrub Jay 27%
Yellow-billed Magpie 12%
Number reported = 109,375Number tested = 9,263 Number WNV pos = 3,046
50
0
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Feb Mar April May June July Aug Sep Oct Nov
House FinchHouse SparrowAmerican RobinRed-Tailed HawkLesser GoldfinchNorthern Mockingbird
Top 6 WNV Positive NonTop 6 WNV Positive Non--Corvids, 2005Corvids, 2005
WNV Positive Corvids and NonWNV Positive Corvids and Non--Corvids Corvids JanuaryJanuary--AprilApril
2004 2005
Non-corvids 7%
Corvids 93% Non-Corvids 73%
Corvids 27%
Dead Birds Reported Dead Birds Reported 20052005
n = 109,375
DYCAST* Human WNV Risk Modeling SystemDYCAST* Human WNV Risk Modeling System
DYCAST in 200583% accuracy in predictinghuman cases with quarter-square mile resolution (cells)
50% of cases occurred in cells identified as high risk approximately one monthprior to case onset
Used to evaluate efficacy of aerial adulticiding in Sacramento County
* Dynamic Continuous-Area Space-Time
WNV in California WNV in California Tree Squirrels Tree Squirrels -- 20052005
First positive squirrel: June 10, 2005• Placer County
Prevalence (PCR) was 27% (48 / 180)
Similar prevalence in dead birds (35%)
WNV Activity in Mosquitoes in 2005 WNV Activity in Mosquitoes in 2005
WNV Activity in Mosquitoes WNV Activity in Mosquitoes number positive poolsnumber positive pools
0
20
40
60
80
100
120
140
160
5/5
5/1
9
6/2
6/1
6
6/3
0
7/1
4
7/2
8
8/1
1
8/2
5
9/8
9/2
2
10/6
10/2
0
11/3
11/1
7
12/1
Date
Posi
tive
Pools 2004
2005
2004 1,136 pos (14,602)2005 1,242 pos (21,402)
WNV Positive Mosquito SpeciesWNV Positive Mosquito Species1,242 pos. pools / 21,402 mosquitoes tested
Culexquinquefasciatus 476 (38%)tarsalis 460 (37%)pipiens 240 (19%)stigmatosoma 33 (2.7%)erythrothorax 26 (2.1%)thriambus 7 (<1%)
Plus Anopheles freeborni (1)
0.42
3.23
4.05
4.61
4.83
5.82
0 1 2 3 4 5 6 7
Cx. erythrothorax
Cx. tarsalis
Cx. thriambus
Cx. pipiens
Cx.quinquefasciatus
Cx. stigmatosoma 596 pools tested
6054 pools tested
2519 pools tested
98 pools tested
7688 pools tested
2088 pools tested
Minimum Infection Rate (MIR)** MIR = (# positive mosquito pools / total number of mosquitoes tested) X 1,000
Minimum Infection Rates (per 1,000) by Species Minimum Infection Rates (per 1,000) by Species July July -- September 2005September 2005
> 4.0
> 2.0
> 1.0
> 0.1
SacramentoPlacerFresnoTulareYubaMaderaYoloStanislausButteSutterLakeGlennKernSan BernardinoLos AngelesVenturaKingsSan Luis ObispoSanta ClaraMercedOrangeImperialRiversideSan JoaquinSolanoAlamedaInyoContra CostaNo positive poolsNo mosquitoes tested
7.35.94.94.54.44.33.73.62.82.72.42.42.01.91.71.71.51.51.41.21.00.80.80.80.60.50.30.10
Minimum Minimum Infection Rate Infection Rate
(MIR)* (MIR)* Counties Counties
Submitting Submitting Mosquitoes Mosquitoes
20052005
* MIR = (# positive mosquito pools/total number of mosquitoes tested) X 1,000
Includes all species of mosquitoes
WNV Activity in Sentinel WNV Activity in Sentinel Chickens in 2005Chickens in 2005
Sentinel Chicken Sentinel Chicken Surveillance Program Surveillance Program
20052005WNV positive flock Negative flock
• 790 seroconversions• 31 counties• 141 / 271 flocks
WNV Activity in Sentinel Chickens WNV Activity in Sentinel Chickens
2004: 811+ (32,616) 2005: 790+ (34,011)
0
20
40
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140
160
5/5
5/1
9
6/2
6/1
6
6/3
0
7/1
4
7/2
8
8/1
1
8/2
5
9/8
9/2
2
10/6
10/2
0
11/3
11/1
7
12/1
12/1
5
12/2
9
Date
Posi
tive
Chic
kens
2004
2005
2004 811 pos (143 / 231 flocks) 2005 790 pos (141 / 253 flocks)
Equine WNV Equine WNV SurveillanceSurveillance
20052005
456 cases 1,295 tested
(40 positive counties)
2004: 540 cases
2005 Equine WNV Data2005 Equine WNV Data456 WNV infected horses (40 counties)200 (44%) died / euthanizedVaccination status
20 properly vaccinated78 improperly vaccinated342 non-vaccinated
Median age: 13 years (4 mos – 40 years)
0
10
20
30
40
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60
70
22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48
Week of Onset for Equine WNV CasesWeek of Onset for Equine WNV CasesCalifornia, 2005California, 2005
Week of onset
Num
ber o
f cas
es
4-Ju
n
18-J
un
2-Ju
l
16-J
ul
30-J
ul
13-A
ug
27-A
ug
10-S
ep
24-S
ep
8-O
ct
22-O
ct
5-N
ov
19-N
ov
3-D
ec
May 1 Nov 25
WNV Team at DHSWNV Team at DHSDIS
Jon RosenbergVPHS
Ben SunJames GloverClaudia Erickson
VRDLCarol GlaserCynthia JeanCindi CossenLiz BaylisShilpa Gavali
OPALea Brooks
VBDSVicki KramerStan HustedAl HomRyan CarneyKerry PadgettLauren MarcusColleen BarclayAnne KjemtrupMark NovakRenjie HuHotline staffRegional biologists
CollaboratorsCollaborators
Local Health DepartmentsLocal Public Health Laboratories
Environmental Health Departments