229:, 1,868 cases were reported. Male patients, persons >65 years of age, and minorities were at highest risk for neuroinvasive disease. At total of 1,868 cases including 844 (45%) WNND (West Nile neuroinvasive disease) cases and 89 deaths (case-fatality rate 5%). Dates of onset ranged from May 1, 2012, through December 6, 2012. The outbreak peaked during week 33 (mid-August) with 225 reported cases, which is historically the same peak for all reported WNV cases in Texas during 2002–2011. The median time from date of symptom onset to date of official report to TxDSHS was 27 days (range 6–274 days). Of the 254 counties in Texas, 135 (53%) reported a WNV case. The overall incidence rate for the state was 7.8 cases per 100,000 population. Almost half of the cases were reported from the northeastern quadrant of the state, including the Dallas/Fort Worth metroplex (902 cases): Dallas (396 ), Tarrant (259 ), Collin (64 ), and Denton (183 ) counties. These 4 counties had a combined incidence rate of 16 cases per 100,000 population.
69:
infected the same year was 54,000. The true mortality rate is thought to be much lower because most cases are so mild they go undiagnosed. Some estimates put severe cases at only 1% of all cases. It is believed that the elderly or people with weak immune systems are most vulnerable to serious illness or death if bitten by a mosquito infected by West Nile. Most mild cases go undiagnosed. In addition, some more severe but non-neuroinvasive cases are not reported to the CDC. Some mild cases are discovered during blood donation screening. 1,039 West Nile-tainted blood donations were discovered between 2003 and mid-2005. 30 cases of West Nile from blood transfusion were known, the majority from 2002 before blood screening was instituted.
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202:, authors Elinor Levy and Mark Fischetti praised Dr. Asnis' response to the symptoms, writing that, "Asnis did something other doctors might not have bothered to do." They elaborated that, "One of the worst problems with our disease-detection system is that many doctors never report cases of strange symptoms, either because they are unsure of the disease they are facing, they're ignorant of the reporting requirement, or they simply never get around to it. Deborah Asnis was highly conscientious."
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other bird species in the zoos (avian influenza and
Newcastle disease would have killed chickens in the petting zoo and eastern equine encephalitis would have killed emus on exhibit). Since only corvids appeared to be dying, she suggested the possibility of a novel pathogen. The C.D.C. disagreed that the epidemiologic pattern was inconsistent and declined to test tissue samples from animal species. Instead, Dr. McNamara sent tissue samples to the
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The following maps show the progress of human cases of West Nile across the United States. States are colored according to the percentage of all U.S. West Nile cases they represented in that year. Zero percent (no cases) is colored white; less than 1% is blue; between 1% and 5% is green; between 5%
68:
Differences in surveillance and reporting between health departments and generally increased surveillance as the disease spread cause some problems in direct comparison of the number of cases and the mortality rate. The reported number of infected in 2009 was 720, but the estimated total number of
174:
On
September 9, Dr. McNamara contacted the C.D.C. with concerns that the epidemiologic pattern of this outbreak were not consistent with St. Louis encephalitis, which does not cause bird die-offs. Additionally, she reported that other known avian viral diseases would have resulted in the deaths of
159:
for further analysis. Around the same time, Dr. McNamara identified a potential viral encephalitis in brain tissue from the dead crows and sent samples off for further testing. Meanwhile, by Friday, August 27, just four days after Asnis had contacted Layton, two additional patients had been
60:
spread the disease to mammals. It was mainly noted in horses but also appeared in a number of other species. The first human cases usually followed within three months of the first appearance of infected birds in the area except where cold weather interrupted the mosquito
116:, noticed two male patients who were suffering from similar, unusual symptoms. The two patients, aged 60 and 75 respectively, were exhibiting sudden paralysis in their arms and legs, as well as disorientation and high fevers. Lab testing also showed elevated numbers of
160:
identified in Queens. The number rose to eight by Sunday, August 29, at
Flushing Hospital Medical Center and other hospitals in Queens. All of the early patients resided within a few miles of one another. They were also frequent gardeners in the evenings.
197:
Both Dr. McNamara and Dr. Asnis have been credited by health experts with the early identification of West Nile virus in the United States. Their actions likely prevented a more widespread outbreak. In their 2003 book,
88:.) In 2012, there was a widespread outbreak with the highest death toll and second-highest total case numbers. Maine and Puerto Rico reported one case each, the first time the disease was reported in those places.
100:(NYSDEC) began receiving reports of large die-offs of crows in parks across New York City. On August 9, dead wild crows were discovered outside both the Queens Zoo and the Bronx Zoo, prompting head pathologist
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210:
During the years between 1999 and 2010, an estimate of 3 million people have been infected in the United States. Highest incidence rates are observed in states of the central great plains, with
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on
September 3, 1999. The city of New York began widespread spraying for mosquitos later that same day. However, laboratory testing continued to determine a definitive cause of the symptoms.
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56:, in 1999. The virus is believed to have entered in an infected bird or mosquito, although there is no clear evidence. The disease spread quickly through infected birds.
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136:, but none of these illnesses exactly matched the symptoms. Asnis decided to pursue a more concrete diagnosis by contacting authorities and other colleagues.
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151:, on Monday, August 23, 1999, to report her patients' symptoms. Layton advised Asnis to send samples of the patients' blood and spinal fluid to the
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In the first ten years since the virus arrived in the U.S., over 1,100 deaths occurred with human cases reported from every U.S. state except
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within the spinal fluid of both males. Neither of the patients were responding to antiviral drugs. Possible early hypotheses included
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65:. Since the virus has become widely established in the U.S., an average of 130 deaths a year have occurred.
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by county in 2012. Cumulative total of the entire country: 1,590 cases. (Current as of Aug 28, 2012).
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The U.S. federal government eventually revised its diagnosis from St. Louis encephalitis to
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Peterson LR, Carson PJ, Biggerstaff BJ, Custer B, Borchardt SM, Busch MP (March 2013).
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1168:"Estimated cumulative incidence of West Nile virus infection in US adults, 1999-2010"
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on
September 27, 1999, based on research by Dr. Duane J. Gubler, a C.D.C. expert on
183:, marking the first time a virus in this genus was implicated in an animal disease.
179:. On September 11, they reported that the samples she submitted were positive for a
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1229:(11). Emerging Infectious Diseases. Volume 19, Number 11, 2013 November: 1836–8.
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612:** as of December 15, 2020, also 127 presumptive cases observed in blood donors
85:
1217:
Murray, KO; Ruktanonchai, D; Hesalroad, D; Fonken, E; Nolan, MS (2013-10-31).
1184:
1110:"Dr. Deborah Asnis, Who Sounded Alert on West Nile Virus Outbreak, Dies at 59"
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133:
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200:
The New Killer
Diseases: How the Alarming Evolution of Germs Threatens Us All
40:
U.S. West Nile virus (WNV) neuroinvasive disease incidence as of Sep 4, 2012
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CDC Information Page For
Current Cases and Deaths For West Nile Virus
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and 10% is yellow, and greater than 10% of cases in a year is red.
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This article incorporates text from this source, which is in the
1142:"Deborah Asnis dies at 59; helped detect West Nile virus in U.S."
104:
to begin investigating what was going on. At the same time, Dr.
609:*2019 also had 104 presumptive cases observed in blood donors
194:, and their own testing on samples submitted by Dr. McNamara.
84:. (Animal cases have been occasionally found in Maine and in
1279:
CDC West Nile Virus
Statistics, Surveillance, and Control
968:"Why West Nile Virus is More Dangerous for Older People"
98:
New York State
Department of Environmental Conservation
1304:
History of science and technology in the United States
1284:
West Nile Cases Drop as
Immunities Emerge, Experts Say
167:(C.D.C.) initially identified the mystery illness as
1032:"The 1999 West Nile virus warning signal revisited"
25:map of the United States showing reported cases of
1030:Wilson, James M.; McNamara, Tracey (2020-06-06).
955:"West Nile Virus Activity – United States, 2009"
596:Final Cumulative Maps & Data for 1999–2018
606:, Centers for Disease Control and Prevention
8:
225:During the 2012 West Nile virus outbreak in
1309:Diseases and disorders in the United States
604:West Nile Virus Disease Cases by State 2020
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177:National Veterinary Services Laboratory
108:, an infectious disease specialist at
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600:Preliminary Maps & Data for 2019
1219:"West Nile Virus, Texas, USA, 2012"
907:Spread of West Nile Fever in Europe
153:New York State Department of Health
1036:Intelligence and National Security
711:Counties of reported cases by year
145:New York City Department of Health
52:after the first reported cases in
14:
902:List of West Nile virus outbreaks
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110:Flushing Hospital Medical Center
92:Discovery in the United States
1:
1048:10.1080/02684527.2020.1750144
1223:Emerging Infectious Diseases
1140:Colker, David (2015-09-21).
1108:Roberts, Sam (2015-09-15).
957:(MMWR 59(25), July 2, 2010)
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48:quickly spread across the
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139:Dr. Asnis contacted Dr.
981:West Nile activity maps
130:Guillain–Barré syndrome
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222:leading in incidence.
169:St. Louis encephalitis
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96:In August 1999, the
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616:Maps of progression
126:viral encephalitis
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998:"West Nile Virus"
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252:reported cases
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188:West Nile virus
141:Marcelle Layton
102:Tracey McNamara
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46:West Nile virus
27:West Nile virus
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1150:. Retrieved
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1119:. Retrieved
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1002:. Retrieved
992:
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939:. Retrieved
935:the original
925:
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220:North Dakota
212:South Dakota
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206:Recent cases
199:
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192:arborviruses
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987:(CDC), 2009
86:Puerto Rico
1298:Categories
1152:2015-10-08
1121:2015-10-08
941:2017-06-08
918:References
181:flavivirus
134:meningitis
58:Mosquitoes
1064:219092438
1056:0268-4527
594:Sources:
147:'s chief
30:infection
1253:24210089
1204:22640592
886:See also
122:botulism
1244:3837649
1195:9151873
551:2020**
245:Deaths
216:Wyoming
63:vectors
1251:
1241:
1202:
1192:
1062:
1054:
1004:21 May
602:, and
582:1,126
568:2,911
537:2019*
526:2,647
512:2,097
498:2,149
484:2,175
470:2,205
456:2,469
442:5,674
414:1,021
386:1,356
372:3,623
358:4,269
344:3,000
330:2,539
316:9,862
302:4,156
242:Cases
157:Albany
143:, the
114:Queens
82:Hawaii
78:Alaska
1060:S2CID
1000:. CDC
579:2022
565:2021
523:2018
509:2017
495:2016
481:2015
467:2014
453:2013
439:2012
425:2011
411:2010
397:2009
383:2008
369:2007
355:2006
341:2005
327:2004
313:2003
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285:2001
271:2000
257:1999
233:Cases
227:Texas
132:, or
74:Maine
1249:PMID
1200:PMID
1052:ISSN
1006:2013
880:2016
868:2015
856:2014
844:2013
832:2012
820:2011
808:2010
796:2009
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681:2003
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633:1999
571:227
554:731
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487:146
459:119
445:286
428:712
400:720
375:124
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347:119
333:100
319:264
305:284
294:15%
280:10%
266:11%
218:and
163:The
80:and
44:The
23:USGS
1239:PMC
1231:doi
1190:PMC
1180:doi
1176:141
1044:doi
588:8%
585:90
574:8%
560:9%
557:66
546:6%
543:60
532:6%
518:7%
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490:7%
476:4%
473:97
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448:5%
434:6%
431:43
420:6%
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403:32
392:3%
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