Information For Missouri Health Professionals
Experts believe West Nile virus (WNV) is now an established seasonal epidemic in North America. In Missouri, human WNV cases generally occur in late summer and early fall. Rapid identification and reporting of active human West Nile virus infections provides state and local public health agencies with timely information on the location and prevalence of the virus.
Free WNV diagnostic testing for patients with encephalitis, meningitis, uncomplicated fever, or other illness with central nervous system involvement can be obtained through the Missouri State Public Health Laboratory (SPHL) in Jefferson City (phone 573/751-3334 or 751-0633). Specimen shipment instructions and the Virus Serology Test Request form can be downloaded from the SPHL website.
Reporting Human Cases of WNV
Domestic Arboviral Diseases, both neuroinvasive and non-neuroinvasive, are reportable by statute in Missouri under public health rule 19 CSR 20-20.020, Reporting Communicable, Environmental, and Occupational Diseases. Reporting should be etiology-specific: St. Louis encephalitis virus disease, West Nile virus disease, Powassan virus disease, Eastern equine encephalitis virus disease, Western equine virus disease, California serogroup virus disease (includes infections with the following viruses: La Crosse, Jamestown Canyon, snowshoe hare, trivittatus, Keystone, and California encephalitis viruses). Missouri Department of Health and Senior Services Disease Case Report – CD-1 (and instructions).
The Missouri Department of Health and Senior Services (DHSS) has built a WNV surveillance system that includes mosquito trapping, testing dead birds for infection, and assessing human case activity. Tracking the virus’ activity in birds and mosquitoes gives communities a "heads-up" that people are at greater risk of becoming ill with these infections. The WNV Data & Statistical Reports page is updated weekly from April through October.
Recent Scientific Literature:
- West Nile virus blood transfusion-related infection despite nucleic acid testing (Volume 44, December 2004 Transfusion 1695)
- Annals of Internal Medicine Summaries for Patients taken from “Clinical Characteristics and Functional Outcomes of West Nile Fever.”
(Annals of Internal Medicine7 September 2004 Volume 141, pages 360-365).
- West Nile Virus Encephalomyelitis in Transplant Recipients – Commentary by Roger N. Rosenberg, MD (Journal of the American Medical Association; August 18, 2004—Vol 292, No. 7)
- West Nile virus: a primer for infection control professionals (Am J Infect Control. 2004 Apr;32(2):101-5)
- West Nile Virus (Journal of the American Medical Association, Vol. 209, No. 4, July 23/30, 2003)
- Acute Flaccid Paralysis and West Nile Virus Infection (Emerging Infectious Diseases; Vol. 9, No. 7, July 2003)
http://www.cdc.gov/ncidod/eid/vol9no7/03-0129.htm or pdf
- Neurologic Manifestations and Outcome of West Nile Virus Infection (Journal of the American Medical Association, Vol. 209, No. 4, July 23/30, 2003)
- Persistence of Virus-Reactive Serum Immunoglobulin M Antibody in Confirmed West Nile Virus Encephalitis Cases (Emerging Infectious Diseases, Vol. 9, No. 3, March 2003)
http://www.cdc.gov/ncidod/eid/vol9no3/02-0531.htm or pdf
- West Nile Virus: A Primer for the Clinicians (Annals of Internal Medicine; 6 August 2002, Vol. 137, No. 3)
- Clinical Findings of West Nile Virus Infection in Hospitalized Patients, New York & New Jersey, 2000 (Emerging Infectious Diseases; Vol. 7, No. 4, July-August 2001)
- The Outbreak of West Nile Virus Infection in the New York City Area in 1999 New England Journal of Medicine (2001 Jun 14;344(24):1858-9)
- Guillain–Barre´ syndrome: An unusual presentation of West Nile virus infection (Abstract) (Neurology 2000;55:144–146)
Public Health Response
- US Centers for Disease Control’s Guidelines for Surveillance, Prevention, and Control of West Nile Virus (3rd Revision-August 2003)
- Public Health Confronts the Mosquito: Developing Sustainable State and Local Mosquito Control Programs (Recommendations of the Mosquito Control Collaborative)
Other Links for Health Professionals