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NLM Director’s Comments Transcript
What Preceded Dallas’ 2012 West Nile Virus Outbreak?: 08/26/2013

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Greetings from the National Library of Medicine and MedlinePlus.gov

Regards to all our listeners!

I'm Rob Logan, Ph.D. senior staff National Library of Medicine for Donald Lindberg, M.D, the Director of the U.S. National Library of Medicine.

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The 2012 West Nile virus outbreak in Dallas followed a mild winter, a period of excessive rain, an early season virus detection in mosquitos, and occurred in neighborhoods where the illness flared previously, finds a multidimensional analysis with an accompanying editorial recently published in the Journal of the American Medical Association.

The post-outbreak study assessed records from Dallas residents diagnosed with the West Nile virus between May 30-December 12, 2012, as well as epidemiological data from the city’s public health agencies, analyses from neighborhood mosquito traps, and area weather patterns.

The study’s seven authors note the previously unexplored combinations of data assessed in the study (such as the types of weather patterns, and neighborhood hot spots where the West Nile virus was likely to flare) provide fresh and unprecedented insights to assist public health agencies in the future. Although the authors note the findings are from the Dallas area, they imply similar environmental and epidemiological conditions may forecast a high risk of West Nile virus within other communities.

 An editorial that accompanies the study notes anticipating a possible outbreak of West Nile virus is important because (and we quote): ‘reports of human illness will always be a lagging indicator of current risk’ (end of quote). The editorial continues this lag occurs (and we quote): ‘because of the long incubation period for West Nile virus coupled with delays in considering the diagnosis, ordering diagnostic tests, obtaining test results, and reporting cases to public health authorities’ (end of quote).

Stephen Ostroff M.D., the editorial’s author and a former official at the Centers for Disease Controls and Prevention, notes the delay in diagnosing and responding to the 2012 spread of West Nile virus to Dallas residents was from one to four weeks. As a result, Ostroff notes the ability to anticipate a high risk of an outbreak could curb future delays, accelerate public health interventions, and perhaps prevent illnesses and deaths.  

The study’s authors report 19 persons died in Dallas in 2012 from West Nile virus and there were almost 400 cases of illnesses associated with the West Nile virus. The authors add 17 Dallas residents who were blood donors tested positive for West Nile virus.

MedlinePlus.gov’s West Nile virus health topic page explains West Nile virus is an infectious disease that is spread by infected mosquitos (which means the illness flares in warmer months). West Nile virus’ symptoms include: fever, headache, body aches, a skin rash, and swollen lymph glands. MedlinePlus.gov’s West Nile virus health topic page adds the infection is most serious when it enters the brain and causes swelling (called encephalitis), or the infection inflames tissues that surround the brain and spinal cord (called meningitis).

MedlinePlus.gov’s West Nile virus health topic page notes the best way to avoid infection is to prevent mosquito bites. From a public health perspective, Ostroff explains the prevention of West Nile virus occurs by careful monitoring of mosquitos, and a series of interventions (such as neighborhood spraying, traps, removal of standing water) that deter mosquito breeding.

Ostroff concludes the cost to prevent West Nile virus is far less expensive than its clinical treatment. Ostroff writes (and we quote) ‘the cost of surveillance and preventive efforts are likely to be less than the costs associated with responding to major West Nile virus outbreaks’ (end of quote).

Meanwhile, MedlinePlus.gov’s West Nile virus health topic page provides comprehensive information about West Nile virus’ prevention/screening and diagnosis/symptoms.

The U.S. Environmental Protection Agency provides a detailed guide to mosquito control that is accessible within the ‘prevention/screening’ section of MedlinePlus.gov’s West Nile virus health topic page.

A helpful website to help prevent West Nile virus in children (provided by the American Academy of Pediatrics) is available in the ‘children’ section of MedlinePlus.gov’s West Nile virus health topic page.

MedlinePlus.gov’s West Nile virus health topic page also contains research summaries, which are available in the ‘research’ section. Links to the latest pertinent journal research articles are available in the ‘journal articles’ section. You can sign up to receive updates about West Nile virus as they become available on MedlinePlus.gov.

To find MedlinePlus.gov’s West Nile virus health topic page, type ‘West Nile virus’ in the search box on MedlinePlus.gov’s home page. Then, click on ‘West Nile virus (National Library of Medicine).’ MedlinePlus.gov additionally features health topic pages on encephalitis, insect bites and stings, and infections.   

Let’s hope the insights from the current study spark efforts to control the West Nile virus. As Dr. Ostroff succinctly states in the title of his JAMA editorial, West Nile virus is (and we quote) ‘too important to forget’ (end of quote).

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