Minnesota Department of Health (MDH) Bug Bytes
August 8, 2003
Vol. 4: No. 9
1. West Nile Virus Update
We are entering the high-risk time for West Nile Virus (WNV) activity in Minnesota. At the time we are going to press, seven confirmed or probable human cases have been reported including an 80-year old male from Faribault County, a 75-year old female from Stearns County, a 60-year old male from Cottonwood County, a 36-year old female from Renville County, a 41-year old male from Redwood County, a 72-year old male from Lincoln County, and a 77-year old from Rock County. Three case-patients had encephalitis and four had WNV fever only. Onset dates ranged from June 18 to July 30. Three persons were hospitalized and all survived. In addition to the human cases, there have been three equine cases (in Crow Wing, Sherburne and Washington Counties). Also, 75 birds from 21 counties, and one mosquito pool (of several hundred tested; i.e pools of mosquitoes that have been trapped for WNV surveillance purposes) from Hennepin County have tested positive for WNV. In the U.S. as of August 7, 164 human cases including four deaths have been reported from 16 states. Forty-three percent of the cases have been from Colorado. We maintain an updated Minnesota map of human, equine, and bird cases at: www.health.state.mn.us/divs/idepc/
We would like to remind clinicians and laboratories our priority
for WNV testing at the MDH Public Health Laboratory:
We are encouraging the submission of serum and/or CSF for arbovirus testing, but are concentrating testing efforts and resources on patients who meet any of the following criteria:
- presumptive viral encephalitis or aseptic meningitis
- fever and headache that warrants a lumbar puncture and/or hospitalization
- presumed Guillain-Barre syndrome or acute flaccid paralysis
We do not have the resources to test potential mild cases,
those that have headache, fever, chills, or rash, but do NOT require
a lumbar puncture and/or hospitalization; commercial laboratories
may offer such testing services. Please see the CDC website
for further Clinical Guidance:
Physicians should call us at 651-201-5414 or 1-877-676-5414, to report suspect cases of WNV.
The MDH Laboratory conducts serology (IgM and IgG EIA, and/or IFA) and real-time PCR for WNV, LaCrosse encephalitis (LAC), Eastern equine encephalitis (EEE), Western equine encephalitis (WEE), and St. Louis encephalitis (SLE). In addition, Vero cell culture is also performed which can detect these agents and other viral agents of encephalitis. Regarding specimens for WNV testing, it is important to note that acute and convalescent sera are needed, and a volume of 1.5-2.0 ml of CSF.
2. Emerging Infections Program Highlighted
A recent article (at: http://www.cdc.gov/ncidod/
EID/vol9no7/03-0083.htm) highlights the accomplishments of the U.S. Emerging Infections Program EIP), of which we are a member. The EIP began in 1995 when we were one of four sites nationally, and it now includes 10 states. The article highlights how this network has successfully provided valuable information to the country to shape public health policy and affect medical practice. For example, the EIP has documented the decline in invasive pneumococcal disease as a result of the use of the pediatric conjugate vaccine. Data gathered by the EIP has lead to a revision in the recommendations for preventing perinatal group B streptococcal disease. The FoodNet component of EIP has documented a decrease in bacterial foodborne disease between 1996 to 2001. Once again, we thank you ICPs, infectious disease clinicians, and microbiologists for being our partners and making our EIP and the EIP national network a success.
3. Save the Date - 2003 Emerging
We are pleased to announce that once again we will be co-sponsoring, along with the University of Minnesota Division of Infectious Diseases and International Medicine, and the Center for Infectious Disease Research and Policy, the 9th Annual Emerging Infections in Clinical Practice and Emerging Health Threats. The conference will be held Friday November 21, 2003 in Minneapolis. Timely topics this year will include SARS, monkeypox and other zoonotic diseases, foodborne disease, immigrant health issues, AIDS in the global village, and more. Additional information and registration forms will be available shortly.
Bug Bytes is a combined effort of the Infectious Disease Epidemiology, Prevention and Control Division and the Public Health Laboratory Division of MDH. We provide Bug Bytes as a way to say THANK YOU to the infection control professionals, laboratorians, local public health professionals, and health care providers who assist us.
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