Neuroinvasive Disease and West Nile Virus Infection, North Dakota, USA, 1999–2008

Carson, Paul J.; Borchardt, Stephanie M.; Custer, Brian; Prince, Harry E.; Dunn-Williams, Joan; Winkelman, Valerie; Tobler, Leslie H.; Biggerstaff, Brad J.; Lanciotti, Robert S.; Petersen, Lyle R.; Busch, Michael P.

doi:10.3201/eid1804.111313

Cited by 92 publications

(108 citation statements)

References 13 publications

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“…The lack of IgM in any of the recalled donors would go somewhat against the hypothesis of reexposure or reinfection to West Nile virus, although it is unclear if IgM is induced upon reexposure to virus in someone previously infected, and it is not known how long this would persist. Furthermore, the cumulative seroprevalence of WNV in a highly endemic state was estimated to be only 8.2% of the population over the entire epidemic (2). It is highly unlikely that the majority of the recalled donors faced repeat exposures or infections in the years following their initial infection.…”

Section: Discussionmentioning

confidence: 99%

“…Blood donors who were seropositive for WNV IgG antibodies were identified from a previously reported serosurvey of Ͼ4,500 North Dakota blood donors (2). In that study, 370 donors (8.2%) were IgG positive, and 28 of those (7.5%) were also IgM positive.…”

Section: Methodsmentioning

confidence: 99%

“…Since the start of the epidemic in 1999 through 2012, Ͼ15,000 persons have developed neuroinvasive disease, characterized by meningoencephalitis or acute flaccid paralysis, and Ͼ1,500 deaths have occurred (CDC ArboNET). Advanced age, male sex, and immunosuppression significantly increase the risk for neuroinvasive disease (2,3).…”

mentioning

confidence: 99%

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Characteristics of Antibody Responses in West Nile Virus-Seropositive Blood Donors

Carson

Prince²,

Biggerstaff

et al. 2014

J Clin Microbiol

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The production of WNV-specific IgM and IgG antibodies is important for both the diagnosis and the clearance of WNV infection (4). The persistence of IgG antibodies is thought to confer protection from subsequent reinfection (4-6). In a study of 245 viremic blood donors, IgM antibodies persisted for a mean of 156 days, and IgG antibodies persisted at the same titer for at least 1 year postinfection (7). IgM antibodies persisted in up to 17% of subjects at 400 days postinfection, whereas IgG antibodies were maintained at high levels based on enzyme immunoassay (EIA) signal-to-cutoff levels among all subjects. It is unclear if antibodies persist beyond that time, if those antibodies are specific for and neutralize WNV, and if antibody responses and persistence vary depending on age or sex.We studied the characteristics of WNV antibody responses in two different groups of blood donors, one identified by a crosssectional serosurvey and the second by a longitudinal follow-up of donors detected during acute viremia by blood donor screening for WNV RNA. We compared the antibody levels in donors with recent versus more remote infections and looked at differences according to age and sex. We also assessed the specificity and neutralizing capacities of the antibody responses. MATERIALS AND METHODSThis study was approved by the institutional review boards of the participating institutions, and all subjects agreed to participate and signed informed consents. Blood donors who were seropositive for WNV IgG antibodies were identified from a previously reported serosurvey of Ͼ4,500 North Dakota blood donors (2). In that study, 370 donors (8.2%) were IgG positive, and 28 of those (7.5%) were also IgM positive. The durability of the antibody responses was assessed by comparing IgG antibody levels among recently infected donors (those who were IgM seropositive) versus donors presumed to be infected Ͼ1 year prior (i.e., were IgM negative). The specificity and neutralizing capacity of the antibody response were assessed by assaying a subset (54 samples across the range of IgG response) of samples from seropositive donors using a WNV plaque reduction neutralization assay to quantify plaque reduction neutralization titers. These samples were selected by choosing every 6th sample from the lowest to highest titers across the IgG response spectrum from 324 samples with adequate volume remaining for plaque reduction neutralization testing (PRNT).We also studied a group of 18 donors who were originally identified with acute WNV infection by screening for blood plasma RNA with nucleic acid amplification technology (NAT) in 2005 and who were enrolled in a 1-year longitudinal follow-up study (7). Their WNV IgG, IgM, and PRNT levels were assessed at 6 months and 5 years postinfection. These samples were tested in parallel and under code to minimize interrun variability and biases in assay performance and interpretation.Blood plasma specimens were tested for WNV IgM and IgG by using Food and Drug Administration-approved enzyme-linked immunosorb...

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Characteristics of Antibody Responses in West Nile Virus-Seropositive Blood Donors

Carson

Prince²,

Biggerstaff

et al. 2014

J Clin Microbiol

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“…1 An estimated 70-80% of people infected with the virus are asymptomatic; 20-30% develop an acute systemic febrile illness, and 1% experience neuroinvasive disease (e.g., meningitis, encephalitis, or myelitis). [2][3][4][5] WNV was first documented in the United States in New York City in 1999 and subsequently spread westward, reaching the Pacific coast in 2003. 6,7 Since then, WNV has caused seasonal summer outbreaks that vary in size and scope.…”

Section: Introductionmentioning

confidence: 99%

Meteorological Conditions Associated with Increased Incidence of West Nile Virus Disease in the United States, 2004–2012

Hahn¹,

Monaghan²,

Hayden³

et al. 2015

The American Society of Tropical Medicine and Hygiene

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Abstract. West Nile virus (WNV) is a leading cause of mosquito-borne disease in the United States. Annual seasonal outbreaks vary in size and location. Predicting where and when higher than normal WNV transmission will occur can help direct limited public health resources. We developed models for the contiguous United States to identify meteorological anomalies associated with above average incidence of WNV neuroinvasive disease from 2004 to 2012. We used county-level WNV data reported to ArboNET and meteorological data from the North American Land Data Assimilation System. As a result of geographic differences in WNV transmission, we divided the United States into East and West, and 10 climate regions. Above average annual temperature was associated with increased likelihood of higher than normal WNV disease incidence, nationally and in most regions. Lower than average annual total precipitation was associated with higher disease incidence in the eastern United States, but the opposite was true in most western regions. Although multiple factors influence WNV transmission, these findings show that anomalies in temperature and precipitation are associated with above average WNV disease incidence. Readily accessible meteorological data may be used to develop predictive models to forecast geographic areas with elevated WNV disease risk before the coming season.

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“…Data from previous studies suggest there are an estimated 30 to 70 nonneuroinvasive disease cases for every reported case of West Nile virus. [51][52][53] However, most of these data were derived from adult blood donors and there are not similar estimates for non-neuroinvasive West Nile virus disease in children or for non-neuroinvasive disease caused by other arboviruses. In addition, preconceptions about arboviral disease epidemiology may impact diagnostic practices, with La Crosse virus testing more likely to be performed on children in selected states and West Nile virus testing considered more in older adults.…”

Section: Discussionmentioning

confidence: 99%

Neuroinvasive Arboviral Disease in the United States: 2003 to 2012

2014

PEDIATRICS

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METHODS-We reviewed data reported by state health departments to ArboNET, the national arboviral surveillance system, for 2003 through 2012. Children (<18 years) with neuroinvasive arboviral infections (eg, meningitis, encephalitis, or acute flaccid paralysis) were included. Demographic, clinical syndrome, outcome, geographic, and temporal data were analyzed for all cases.RESULTS-During the study period, 1217 cases and 22 deaths due to pediatric neuroinvasive arboviral infection were reported from the 48 contiguous states. La Crosse virus (665 cases; 55%) and West Nile virus (505 cases; 41%) were the most common etiologies identified. Although less common, Eastern equine encephalitis virus (30 cases; 2%) resulted in 10 pediatric deaths. La Crosse virus primarily affected younger children, whereas West Nile virus was more common in older children and adolescents. West Nile virus disease cases occurred throughout the country, whereas La Crosse and the other arboviruses were more focally distributed.CONCLUSIONS-Neuroinvasive arboviral infections were an important cause of pediatric disease from 2003 through 2012. Differences in the epidemiology and clinical disease result from complex interactions among virus, vector, host, and the environment. Decreasing the morbidity and mortality from these agents depends on vector control, personal protection to reduce mosquito and tick bites, and blood donor screening. Effective surveillance is critical to inform clinicians and

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Neuroinvasive Disease and West Nile Virus Infection, North Dakota, USA, 1999–2008

Cited by 92 publications

References 13 publications

Characteristics of Antibody Responses in West Nile Virus-Seropositive Blood Donors

Characteristics of Antibody Responses in West Nile Virus-Seropositive Blood Donors

Meteorological Conditions Associated with Increased Incidence of West Nile Virus Disease in the United States, 2004–2012

Neuroinvasive Arboviral Disease in the United States: 2003 to 2012

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