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Rebekah Doyle, Ph.D student
West Nile Virus Rebekah Doyle, Ph.D student Walden University PUBH 6165 Dr. David Anderson Spring, 2012 This educational presentation on West Nile Virus is being presented to Creek County Health Department: Nursing Department. Reference Microsoft Corporation. (2012). PowerPoint templates. Retrieved from Microsoft Corporation. (2012). PowerPoint templates.
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Agenda Welcome Introductions Presentation Discussion Questions
Hello, my name is Rebekah Doyle and I am a Ph.D of Public Health student from Walden University. I would like to welcome and to thank Creek County health department’s nursing staff for attending this presentation. Please, everyone take a seat. Reference Microsoft Corporation. (2012). PowerPoint templates. Retrieved from Microsoft Corporation. (2012). PowerPoint templates.
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Presentation Overview
The Organism History Epidemiology Transmission The information to be presented today will be of importance Creek County nurses because summer is coming up and mosquitoes will be out in force. As public health nurses, you will need to know what West Nile Virus (WNV) is, the epidemiology of WNV, how it is transmitted, the clinical features of WNV, recommendations for nursing care, and suggestions for the prevention and control of WNV. Reference Microsoft Corporation. (2012). PowerPoint templates. Retrieved from Microsoft Corporation. (2012). PowerPoint templates.
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Presentation Overview
Clinical Features Prevention and Control Questions The information to be presented today will be of importance Creek County nurses because summer is coming up and mosquitoes will be out in force. As public health nurses, you will need to know what West Nile Virus (WNV) is, the epidemiology of WNV, how it is transmitted, the clinical features of WNV, recommendations for nursing care, and suggestions for the prevention and control of WNV. Reference Microsoft Corporation. (2012). PowerPoint templates. Retrieved from Microsoft Corporation. (2012). PowerPoint templates.
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Learning Objectives After attending this presentation, Creek County nursing staff will be able to: Verbalize the name of the organism that can infect a person with WNV. Verbalize the peak season for WNV infections to occur. The learning objectives for this presentation are: 1. The nurses will be able to verbalize the name of the organism that can infect a person with WNV. 2. Can verbalize the peak season for WNV infections to occur. 3. Can verbalize clinical signs of WNV. 3. Can identify methods of prevention of WNV. 4. Locate additional resources for further information on WNV.
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Learning Objectives Verbalize clinical signs of WNV.
Can identify methods of prevention of WNV. Locate additional resources for further information on WNV. The learning objectives for this presentation are: 1. The nurses will be able to verbalize the name of the organism that can infect a person with WNV. 2. Can verbalize the peak season for WNV infections to occur. 3. Can verbalize clinical signs of WNV. 3. Can identify methods of prevention of WNV. 4. Locate additional resources for further information on WNV.
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History WNV first identified in 1937 in Uganda.
Prior to 1999 the virus was only found in the Eastern Hemisphere (mainly in): Africa Asia Middle East Europe In 1937 WNV was first identified in Uganda. Prior to 1999, the WNV was typically only found in the Eastern Hemisphere, mainly in Africa, Asia, the Middle East, and in Europe. Later in the mid-1990’s, there were documented outbreaks in Romania, Russia, and Israel (CDC, 2004). Reference Center for Disease Control. (2004). West Nile Virus: Background information for clinicians, Retrieved from
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History Outbreaks in: Romania 1996 Russia 1999 Israel 2000
WNV is a public health problem in North America. In 1937 WNV was first identified in Uganda. Prior to 1999, the WNV was typically only found in the Eastern Hemisphere, mainly in Africa, Asia, the Middle East, and in Europe. Later in the mid-1990’s, there were documented outbreaks in Romania, Russia, and Israel (CDC, 2004). Reference Center for Disease Control. (2004). West Nile Virus: Background information for clinicians, Retrieved from
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History In 2002 Center for Disease Control (CDC) documented:
4, 156 cases of WNV in humans Located in 44 states As of January 2012 for year 2011, CDC documented: 690 WNV infections in humans Total of 43 deaths occurred Center for Disease Control. (2004). West Nile Virus: Background information for clinicians. Center for Disease Control. (2012). Statistics, surveillance, and control. Since 1999, WNV has been a public health problem in North America. In 2002, the Center for Disease Control (CDC) had documented 4, 156 cases of WNV in humans that covered 44 states in the U.S (CDC, 2004). As of January of 2012, there are 690 documented cases of WNV in humans that have been identified in 44 states. There have been 43 deaths in humans that have occurred during 2011 due to WNV (CDC, 2012). References Center for Disease Control. (2004). West Nile Virus: Background information for clinicians, Retrieved from Center for Disease Control. (2012). Statistics, surveillance, and control. Retrieved from
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The Organism WNV is a single-strand RNA virus
WNV is of the family Flaviviridae Genus Flaviviru A member of the Japanese encephalitis virus antigenic complex WNV is a single-stranded RNA virus of the family Flaviviridae, genus Flavivirus. WNV is maintained in nature in a transmission cycle that involves primarily birds and mosquitoes. WNV is a member of the Japanese encephalitis virus antigenic complex, which includes several medically important viruses associated with human encephalitis: Japanese encephalitis, St. Louis encephalitis, Murray Valley encephalitis, and Kunjin, an Australian subtype of WNV(CDC, 2004). Reference Center for Disease Control. (2004). West Nile Virus: Epidemiologic information for clinicians. Retrieved from
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Epidemiology Including these viruses associated with human encephalities Japanese encephalitis St. Louis encephalitis Murray Valley encephalitis Kunjin WNV is responsible for causing three main diseases: There are several diseases that are caused by the WNV that a human can experience. They are West Nile encephalitis, West Nile meningitis, and West Nile fever. The neuroinvasive disease is most severe because it affects a person’s central nervous system. It presents as West Nile encephalitis and West Nile meningitis. Encephalitis is an inflammation of the brain and meningitis is an inflammation of the membrane around the brain and spinal cord. West Nile fever is an illness that is caused by the WNV and presents with fever, fatigue, headache, aches and sometimes a rash(CDC, 2010). Reference Center for Disease Control. (2010). West Nile Virus: Questions and answers. Retrieved from
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Epidemiology West Nile fever Neuroinvasive disease
-West Nile encephalitis -West Nile meningitis Neuroinvasive disease is the most severe of WNV infections There are several diseases that are caused by the WNV that a human can experience. They are West Nile encephalitis, West Nile meningitis, and West Nile fever. The neuroinvasive disease is most severe because it affects a person’s central nervous system. It presents as West Nile encephalitis and West Nile meningitis. Encephalitis is an inflammation of the brain and meningitis is an inflammation of the membrane around the brain and spinal cord. West Nile fever is an illness that is caused by the WNV and presents with fever, fatigue, headache, aches and sometimes a rash(CDC, 2010). Reference Center for Disease Control. (2010). West Nile Virus: Questions and answers. Retrieved from
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Transmission How the transmission occurs is that a mosquito bites a bird that is infected with WNV and the mosquito then becomes infected with WNV. The mosquito carries the WNV in it’s blood for a few days. If during this time, the infected mosquito then bites a human, then the human can become infected with WNV. References Center for Disease Control. (2005). West Nile Virus: Flowchart: West Nile Virus Transmission Cycle. Retrieved from (CDC, 2005) Retrieved from
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Clinical Features Main route of infection is via a bite from an infected mosquito Most common age group infected is the elderly population Not transmitted person-to-person Example: Kissing Holding hands Or from a health care worker who has cared for an infected person Although anyone can become infected with WNV if they are bitten by an infected mosquito, the most common age group to be infected with WNV is the elderly population. WNV can not be acquired by any other means other than by a person being bitten by a mosquito infected with the WNV. However, there is one documented case of transplacental (mother-to-child) transmission of WNV (CDC, 2010). Reference Center for Disease Control. (2010). West Nile Virus: Questions and answers-transmission. Retrieved from .
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Clinical Features One documented case of transplacental (mother-to-child) transmission of WNV Mild infection Most common Often clinically unapparent Incubation of 3-14 days Symptoms typically last 3-6 days Public health nurses need to know and understand what are the clinical signs and symptoms of WNV in case a client calls or comes into the health department seeking information or care for an illness that they may be experiencing. Some of the most common symptoms of a mild WNV infection are: malaise, headache, nausea, vomiting, rash, myalgia, and eye pain. Some of the most common symptoms of a severe WNV infection are: Fever, gastrointestinal symptoms, ataxia and extrapyramidal signs, seizures, changes in mental status, and myelitis. WNV is diagnosed based on a high index of clinical suspicion and from obtaining specific laboratory test that can be performed per the state Department of Health’s guidelines. Treatment is supportive, sometimes requiring hospitalization with fluid therapy and prevention of secondary infections. WNV is on the list of designated nationally notifiable arboviral encephalitides(CDC, 2006). Reference Center for Disease Control. (2016). West Nile Virus (WNV) infection: Information for clinicians. Retrieved from
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Clinical Features Severe infection
Approximately 1 in 150 result in severe neurological disease Encephalitis is more common than meningitis Myocarditis, pancreatitis, and fulminant hepatitis have occurred. Diagnosis Reporting Public health nurses need to know and understand what are the clinical signs and symptoms of WNV in case a client calls or comes into the health department seeking information or care for an illness that they may be experiencing. Some of the most common symptoms of a mild WNV infection are: malaise, headache, nausea, vomiting, rash, myalgia, and eye pain. Some of the most common symptoms of a severe WNV infection are: Fever, gastrointestinal symptoms, ataxia and extrapyramidal signs, seizures, changes in mental status, and myelitis. WNV is diagnosed based on a high index of clinical suspicion and from obtaining specific laboratory test that can be performed per the state Department of Health’s guidelines. Treatment is supportive, sometimes requiring hospitalization with fluid therapy and prevention of secondary infections. WNV is on the list of designated nationally notifiable arboviral encephalitides(CDC, 2006). Reference Center for Disease Control. (2016). West Nile Virus (WNV) infection: Information for clinicians. Retrieved from
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Prevention and Control
Limit time spent outside between the hours of dawn and dusk. When outside, wear long sleeves and long pants for protection. Insect repellent containing DEET should be used. As you can see, prevention is a very important step to take to prevent WNV infections from occurring. Some methods of prevention are: Limit your time spent outside between the hours of dawn and dusk. When your outside, wear long sleeves and long pants for protections from mosquito bites. Use insect repellent that contains DEET, it is most effective (CDC, 2010). Empty any containers, pools, old tires, and any other items that may have standing water in them. Mosquitoes breed where there is standing water and it stays wet. Put some sort of screens on your windows and patios in order to keep mosquitoes outside. Safely spray areas with insecticide that is specific for mosquitoes if needed. Reference Center for Disease Control. (2010). West Nile Virus: Questions and answers-prevention. Retrieved from
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Prevention and Control
Empty any containers or pools that have standing water in them. Clean yards of old tires and other items that water can stand in. Keep screens on windows and patios to keep mosquitoes outside. Safely spray areas with insecticide that is specific for mosquitoes. As you can see, prevention is a very important step to take to prevent WNV infections from occurring. Some methods of prevention are: Limit your time spent outside between the hours of dawn and dusk. When your outside, wear long sleeves and long pants for protections from mosquito bites. Use insect repellent that contains DEET, it is most effective (CDC, 2010). Empty any containers, pools, old tires, and any other items that may have standing water in them. Mosquitoes breed where there is standing water and it stays wet. Put some sort of screens on your windows and patios in order to keep mosquitoes outside. Safely spray areas with insecticide that is specific for mosquitoes if needed. Reference Center for Disease Control. (2010). West Nile Virus: Questions and answers-prevention. Retrieved from
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Additional Resources WNV Prevention: Training and Health Education Materials (CDC). Located at Mosquito Control and West Nile Virus (EPA). Located at Above is a list of additional resources of where you can find more information on WNV and preventive measures. WNV Prevention: Training and Health Education Materials (CDC). Located at Mosquito Control and West Nile Virus (EPA). Located at
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Questions Okay, that concludes our presentation on WNV, does anyone have any questions that I may answer for them, I’d be happy too. Thank you so much for attending and please feel free to or to call me if you have any questions at a later time.
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References Center for Disease Control. (2004). West Nile Virus: Background information for clinicians. Retrieved from Center for Disease Control. (2005). West Nile Virus: Flowchart: West Nile Virus Transmission Cycle. Retrieved from References Center for Disease Control. (2004). West Nile Virus: Background information for clinicians. Retrieved from Center for Disease Control. (2005). West Nile Virus: Flowchart: West Nile Virus Transmission Cycle. Retrieved from
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References Center for Disease Control. (2004). West Nile Virus: Epidemiologic information for clinicians. Retrieved from Center for Disease Control. (2010). West Nile Virus: Questions and answers-overview. Retrieved from References Center for Disease Control. (2004). West Nile Virus: Epidemiologic information for clinicians. Retrieved from Center for Disease Control. (2010). West Nile Virus: Questions and answers-overview. Retrieved from .
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References Center for Disease Control. (2010). West Nile Virus: Questions and answers-prevention. Retrieved from Center for Disease Control. (2010). West Nile Virus: Questions and answers-transmission. Retrieved from References Center for Disease Control. (2010). West Nile Virus: Questions and answers-prevention. Retrieved from Center for Disease Control. (2010). West Nile Virus: Questions and answers-transmission. Retrieved from
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References Center for Disease Control. (2016). West Nile Virus (WNV) infection: Information for clinicians. Retrieved from Center for Disease Control. (2011). WNV prevention: Training and health education materials. Retrieved from References Center for Disease Control. (2016). West Nile Virus (WNV) infection: Information for clinicians. Retrieved from Center for Disease Control. (2011). WNV prevention: Training and health education materials. Retrieved from
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Reference Center for Disease Control. (2012). Statistics, surveillance, and control. Retrieved from Reference Center for Disease Control. (2012). Statistics, surveillance, and control. Retrieved from
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