Assessment of methods for prediction of human West Nile virus (WNV) disease from WNV-infected dead birds

<p>Abstract</p> <p>Background</p> <p>West Nile virus (WNV) is currently the leading cause of arboviral-associated encephalitis in the U.S., and can lead to long-term neurologic sequelae. Improvements in dead bird specimen processing time, including the availability of rapid field laboratory tests, allows reassessment of the effectiveness of using WNV-positive birds in forecasting human WNV disease.</p> <p>Methods</p> <p>Using New York State integrated WNV surveillance data from transmissions seasons in 2001–2003, this study determined which factors associated with WNV-positive dead birds are most closely associated with human disease. The study also addressed the 'delay' period between the distribution of the dead bird variable and the distribution of the human cases. In the last step, the study assessed the relative risk of contracting WNV disease for people who lived in counties with a 'signal' value of the predictor variable versus people who lived in counties with no 'signal' value of the predictor variable.</p> <p>Results</p> <p>The variable based on WNV-positive dead birds [(Positive/Tested)*(Population/Area)] was identified as the optimum variable for predicting WNV human disease at a county level. The delay period between distribution of the variable and human cases was determined to be approximately two weeks. For all 3 years combined, the risk of becoming a WNV case for people who lived in 'exposed' counties (those with levels of the positive dead bird variable above the signal value) was about 2 times higher than the risk for people who lived in 'unexposed' counties, but risk varied by year.</p> <p>Conclusion</p> <p>This analysis develops a new variable based on WNV-positive dead birds, [(Positive/Tested)*(Population/Area)] to be assessed in future real-time studies for forecasting the number of human cases in a county. A delay period of approximately two weeks between increases in this variable and the human case onset was identified. Several threshold 'signal' values were assessed and found effective at indicating human case risk, although specific thresholds are likely to vary by region and surveillance system differences.</p

Potential cost savings with terrestrial rabies control

Background: The cost-benefit of raccoon rabies control strategies such as oral rabies vaccination (ORV) are under evaluation. As an initial quantification of the potential cost savings for a control program, the collection of selected rabies cost data was pilot tested for five counties in New York State (NYS) in a three-year period. Methods: Rabies costs reported to NYS from the study counties were computerized and linked to a human rabies exposure database. Consolidated costs by county and year were averaged and compared. Results: Reported rabies-associated costs for all rabies variants totalled $2.1 million, for human rabies postexposure prophylaxes (PEP) (90.9$784,529). Average costs associated with the raccoon variant varied across counties from $440 to$1,885 per PEP, $14 to$44 per specimen, and $0.33 to$15 per pet vaccinated. Conclusion: Rabies costs vary widely by county in New York State, and were associated with human population size and methods used by counties to estimate costs. Rabies cost variability must be considered in developing estimates of possible ORV-related cost savings. Costs of PEPs and specimen preparation/shipments, as well as the costs of pet vaccination provided by this study may be valuable for development of more realistic scenarios in economic modeling of ORV costs versus benefits

Spatial and temporal patterns of enzootic raccoon rabies adjusted for multiple covariates

BACKGROUND: With the objective of identifying spatial and temporal patterns of enzootic raccoon variant rabies, a spatial scan statistic was utilized to search for significant terrestrial rabies clusters by year in New York State in 1997–2003. Cluster analyses were unadjusted for other factors, adjusted for covariates, and adjusted for covariates and large scale geographic variation (LSGV). Adjustments were intended to identify the unusual aggregations of cases given the expected distribution based on the observed locations. RESULTS: Statistically significant clusters were identified particularly in the Albany, Finger Lakes, and South Hudson areas. The clusters were generally persistent in the Albany area, but demonstrated cyclical changes in rabies activity every few years in the other areas. Cluster adjustments allowed the discussion of possible causes for the high risk raccoon rabies areas identified. CONCLUSION: This study analyzed raccoon variant rabies spatial and temporal patterns in New York that have not been previously described at a focal (census tract) level. Comparisons across the type of spatial analysis performed with various degrees of adjustment allow consideration of the potential influence of geographical factors for raccoon rabies and possible reasons for the highest risk areas (statistically significant clusters)

Terrestrial Rabies and Human Postexposure Prophylaxis, New York, USA

During 1993–2002, cats accounted for 2.7% of rabid terrestrial animals in New York but for one third of human exposure incidents and treatments. Nonbite exposures and animals of undetermined rabies status accounted for 54% and 56%, respectively, of persons receiving rabies treatments

VecTest as Diagnostic and Surveillance Tool for West Nile Virus in Dead Birds

The VecTest WNV assay is adequate for diagnostic and surveillance purposes in American Crows, Blue Jays, and House Sparrows

Crow Deaths Caused by West Nile Virus during Winter

In New York, an epizootic of American crow (Corvus brachyrhynchos) deaths from West Nile virus (WNV) infection occurred during winter 2004–2005, a cold season when mosquitoes are not active. Detection of WNV in feces collected at the roost suggests lateral transmission through contact or fecal contamination

Public Health Impact of Reemergence of Rabies, New York

This report summarizes the spread of a raccoon rabies epizootic into New York in the 1990s, the species of animals affected, and human postexposure treatments (PET). A total of 57,008 specimens were submitted to the state laboratory from 1993 to 1998; 8,858 (16%) animals were confirmed rabid, with raccoons the most common species (75%). After exposure to 11,769 animals, 18,238 (45%) persons received PET, mostly because of contact with saliva or nervous tissue. We analyzed expenditure reports to estimate the cost of rabies prevention activities. An estimated $13.9 million was spent in New York State to prevent rabies from 1993 to 1998. Traditional prevention methods such as vaccinating pets, avoiding wildlife, and verifying an animal’s rabies status must be continued to reduce costly PET. To reduce rabid animals, exposures, and costs, oral vaccination of wildlife should also be considered

Potential cost savings with terrestrial rabies control

BACKGROUND: The cost-benefit of raccoon rabies control strategies such as oral rabies vaccination (ORV) are under evaluation. As an initial quantification of the potential cost savings for a control program, the collection of selected rabies cost data was pilot tested for five counties in New York State (NYS) in a three-year period. METHODS: Rabies costs reported to NYS from the study counties were computerized and linked to a human rabies exposure database. Consolidated costs by county and year were averaged and compared. RESULTS: Reported rabies-associated costs for all rabies variants totalled $2.1 million, for human rabies postexposure prophylaxes (PEP) (90.9$784,529). Average costs associated with the raccoon variant varied across counties from $440 to$1,885 per PEP, $14 to$44 per specimen, and $0.33 to$15 per pet vaccinated. CONCLUSION: Rabies costs vary widely by county in New York State, and were associated with human population size and methods used by counties to estimate costs. Rabies cost variability must be considered in developing estimates of possible ORV-related cost savings. Costs of PEPs and specimen preparation/shipments, as well as the costs of pet vaccination provided by this study may be valuable for development of more realistic scenarios in economic modelling of ORV costs versus benefits