1. EDWARD IROBI, MPH STUDENT WALDEN UNIVERSITY 6165-1
INSTRUCTOR: DR. SHANA MORRELL
FALL, 2009
CREATION OF AWARENESS OF THE WEST NILE VIRUS IN THE STATE OF ILLINOIS.

2. LEARNING OBJECTIVES To identify the cause of West Nile Virus (WNV)
To identify symptoms associated with WNV
To explain current and ongoing action in the state of Illinois
To create awareness of the reality of the WNV threat and adherence to prevention measures.
This presentation is intended to educate citizens of Illinois about West Nile Virus. West Nile Virus outbreaks are a problem in Illinois. The Illinois Department of Public Health informs citizens and work together with other state agencies to provide a strong response to West Nile Virus.

3. WHAT IS WEST NILE VIRUS? A mosquito-borne virus (WebMD, 2009)
WNV can cause inflammation of the brain, spinal cord and surrounding tissues
West Nile Virus (WNV) is a mosquito-borne virus.
WNV is a serious disease associated with inflammation of the brain (encephalitis), the spinal cord (myelitis), or its surrounding tissues and the spinal cord (meningitis).
WebMD. (2009). West Nile Virus. Retrieved from
United States Geological Survey (USGS, 2002). Wild Birds Help
Scientists Understand West Nile Virus. Retrieved from
nwhc.usgs.gov/publications/fact_sheets/pdfs/fact_westnile_res.pdf

4. HOW DOES WEST NILE VIRUS INFECT PEOPLE?
Through infected mosquito bite (CDC, 2006)
Mosquitoes get infected after feeding on infected birds (Chicago Tribune, 2009)
The mosquitoes that carry the infection spread WNV to human beings and to other animals when they are bitten (CDC, 2009)
According to the Center for Disease Control (CDC, 2006), West Nile Virus (WNV) is spread when a person is bitten by an infected mosquito. Mosquitoes get infected after feeding on infected birds. The mosquitoes that carry the infection can then spread WNV to human beings and to other animals when they are bitten. Dead birds can be tested in a laboratory for the presence of West Nile Virus.
Chicago Tribune. (2009). West Nile Virus researchers focus on
Neighborhood birds. Retrieved from
com/news/local/chi-west-nile-virus-aug10,0, story
Center for Disease Control. (CDC, 2006). West Nile Virus.
Retrieved from
factsheet.htm

5. SYMPTOMS ASSOCIATED WITH WNV
Serious symptoms are associated with WNV (CDC, 2006)
Milder symptoms are seen in some
infected persons (CDC, 2006)
Some infected individuals show no noticeable symptoms (UPI.com, 2009)
Serious Symptoms: Critical symptoms may involve high fever, headache, neck stiffness, stupor, disorientation, coma, muscle weakness and paralysis. These symptoms may stay for couple of weeks but the neurological involvement may be permanent.
Milder Symptoms: They include, fever, headache, nausea, vomiting and at times swollen lymph glands or skin rash on the back, stomach or chest. The symptoms can persist for few days.
No Symptoms: About 80% of infected individuals (example; 4 out of 5) with WNV will not show any symptoms at all
UPI.com (2009). Science News: Cells Predict West Nile Virus
Infection. Retrieved from
Center for Disease Control. (CDC, 2006). West Nile Virus.
Retrieved from
factsheet.htm

6. WNV AWARENESS IN ILLINOIS
West Nile Virus has a “seasonal epidemic pattern” in North America (CDC, 2006).
About 2,000 cases of WNV and deaths have been identified in Illinois since September, 2001 (IDPH, 2009).
During summer and fall seasons in North America, WNV cases usually increase greatly in a seasonal epidemic pattern. Due to this epidemic pattern, the Illinois department of public health alerts the public to be cautious. As there have been approximately 2,000 cases of WNV identified since fall of 2001, the dissemination of information on the spread and severity of the disease is an important public health service. Affected counties of Illinois work with the state department of health to reduce casualties as a result of the disease.
Center for Disease Control. (CDC, 2006). West Nile Virus.
Retrieved from
Illinois Department of Public Health. (IDPH, 2009). West Nile Virus.
Retrieved from

7. HISTORY OF WNV IN ILLINOIS
In 2001, laboratory analysis confirmed WNV in two dead crows found in Chicago southwestern suburb of Oat Lawn (Watson, 2004, IDPH, 2009; & Devitt, 2009)
In 2002, Illinois recorded, positive birds, mosquitoes, horses and first human cases and deaths from WNV IDPH, 2009)
In late 2002, Illinois reported more than 884 human cases, and 67 deaths (IDPH, 2009)
The history of WNV is made available by the Centers for Disease Control and Prevention. In 2001, laboratory analysis confirmed WNV in two dead crows found around Chicago (Watson, 2004; Devitt, 2009; & IDPH, 2009). In 2002, Illinois recorded, positive birds, mosquitoes, horses and the first human cases and deaths from WNV in about 100 out of 102 counties. The year 2002 was the peak incidence (IDPH, 2009) with close to 1,000 recorded cases in the state. At the later part of 2002, Illinois had already reported more than 884 human cases, and 67 deaths, more than any other state in the United States.
Dewitt, T.(2009). University of Wisconsin News. Do Chicago’s Suburbs hold the key to understanding West Nile Virus? Retrieved from
Watson, J. T; Jones, R. C; Gibbs, K; & Paul, W. (2004) Dead Crows Reports and locations of Human West Nile Cases, Chicago, (2004) Emerging Infectious Diseases,10, ( 5), Retrieved from
Illinois Department of Public Health. (IDPH, 2009). West Nile Virus. Retrieved from

8. HISTORY OF WNV IN ILLINOIS
In 2003, the attention-created by West Nile disease shifted westward.
Colorado recorded the highest infected cases of 2,947, passing the caseload number set the previous year by Illinois.
In 2004, Illinois infection rate went up a little
In 2005 and 2006, IDPH number of reported cases was at 252.
In 2003, the attention-created by West Nile disease shifted westward. Colorado recorded the highest incidence of 2,947, passing the caseload number set the previous year by Illinois. Illinois had a significant fall with recorded number of only 54 cases and one death. In the year 2004, Illinois incidence rate went up a little with 60 reported cases and 4 deaths. In 2005, and 2006, Illinois reported 252 cases and 12 deaths and 215 cases and 10 deaths respectively
Illinois Department of Public Health. (IDPH, 2009). West Nile Virus
Retrieved from

9. CURRENT STATUS OF WNV IN ILLINOIS
Only 5 reported human cases this year in Cook, St. Clair, Tazewell and Williamson counties
Most affected are the middle aged and elderly
1.5 times as many males as females are diagnosed with WNV
Currently, in 2009, only 5 human cases have been reported in 5 counties (Cook, St. Clair, Tazewell and Williamson).
The most affected individuals are the middle aged and the elderly people with the ratio of 1.5 times as many males as females are diagnosed with WNV.
Illinois Department of Public Health. (IDPH, 2009). West Nile Virus-
2009. Human Case Data. Retrieved from
_09.htm

10. NEXT LINE OF ACTION
More aggressive WNV surveillance is needed by IDPH for proper control and eradication measures
Recruit more personnel
Surveillance: Illinois Department of Public Health (IDPH) maintains a sophisticated disease surveillance system to monitor some insects and animals that can potentially harbor the virus. There are still more to be done.
The IDPH and the state government are expected to continue to keep the public informed whenever and whereever there is any incidence of WNV. More resources need to be made available, including recruitment of more infectious disease physicians, infectious control practitioners and other needed health care personnel.
Illinois Department of Public Health. (IDPH, 2009). West Nile Virus.
Retrieved from

11. AWARENESS IN SCHOOLS AND NEIGHBORHOODS
Inform youth of protection measures
Reduce mosquito dwelling places
IDPH campaigns involving posters, bill boards and the use electronic media
Youth must be informed the need to use mosquito repellants when playing outdoors. The need to maintain clean neighborhood to avoid a dwelling place for mosquitoes should be more strongly encouraged. There is a strong need for campaigns involving, posters, bill boards, and use of electronic media to alert the need to report any suspected symptom or dead birds to school health officials as the need arises. Youth are a particularly good target audience for electronic messaging.
Illinois Department of Public Health. (IDPH, 2009). West Nile Virus.
Retrieved from

12. PARTNER WITH HEALTH CARE
WNV information sharing between IDPH and health care facilities in the state
Monitoring of the elderly in nursing homes and other medical facilities
Posting of WNV recent updates on strategic places in hospitals, clinics and other health care agencies
Health Care Workers: The IDPH should continue to work in partnership with all the health care facilities in the state in sharing information concerning outbreaks in any of the 102 counties in the state. There should be close monitoring of the elderly in nursing homes and other facilities. Suspected West Nile Virus confirmed symptoms must be reported immediately. Information should also be posted on strategic places in hospitals and clinics as a reminder to visitors, the out patients and the patients admitted into various hospital wards.

13. MORE PUBLIC AWARENESS
Need for IDPH and other stakeholders in the state of Illinois to step up public awareness.
IDPH partnership with CDC for efficient education tools and programs for health professionals.
Mobile health clinics in the affected areas of the state
There is a need for IDPH and other stakeholders in the state of Illinois to step up the public campaign. There is a need for more partnership with CDC to develop efficient education tools and programs for media, the public and health professionals. The IDPH researching the possibility of establishing mobile health clinics in the rural areas of the state where the incidence of WNV seems high. This will help in faster laboratory testing for WNV. The public must become better informed that the more they stay outside, the more they are exposed to mosquitoes, and the need for use of insect repellents should be more strongly encouraged. Individuals over 50 years and above should avoid mosquito bites when they are sick because of high risk involved to get severe illness.
Illinois Department of Public Health. (IDPH, 2009). West Nile Virus.
Retrieved from

14. PERSONAL PRECAUTIONS
Insect repellent and insecticides (Westnilevirusfacts.org, 2009; CAL NEWS, 2009)
Light-colored long pants and long-sleeved shirts
Clean living environment
Limit outdoor exposure
Again, here are the personal precautions that are recommended by IDPH. Wear insect repellents. Wear light-colored long pants and long-sleeved shirts to cover exposed skin. Clean roof gutters and screen regularly. Get rid of old tires, buckets, drums, bottles and any other water-holding containers. Limit outdoor exposure.
CAL NEWS. (2009). University of Wisconcin, College of Agricultural
& Life Sciences. Retrieved from
Illinois Department of Public Health. (IDPH, 2009). West Nile Virus
Retrieved From:
htm
Westnilevirusfacts.org (2009). Get the facts about West Nile Virus.
Retrieved from

15. FIGHT THE BITE Illinois is facing a great challenge
Pro-active approach
Illinois is facing a great challenge. The state has lost many lives as a result of WNV, although there is evidence that this year had less fatalities compared to previous years (IDPH, 2009). One of the best ways to reduce WNV incidence is for everyone to become involved. West Nile encephalitis and other mosquito-borne illnesses are prevented by reducing the number of mosquitoes around homes and neighborhoods. Personal precautions to avoid mosquito bites should also be encouraged, but community action is necessary to really have an impact.
Illinois Department of Public Health. (IDPH, 2009). West Nile Virus.
Retrieved from

16. PHOTO GALLERY OF WEST NILE VIRUS
In areas like the Chicago suburb of Oak Lawn, the American Robin seems to be very important in the spread of West Nile virus.
Photo: courtesy Gabe Hamer, UW-Madison
This is the American Robin. This bird seems to be important in the spread of WNV.
Dewitt, T.(2009). University of Wisconsin News. Do Chicago’s Suburbs hold the key to understanding West Nile Virus? Retrieved from

17. Photo: courtesy Gabe Hamer, UW-Madison
Here, an American robin is fitted with a radio tag in the Chicago
suburb of Oak Lawn.
Researchers are tracking the birds in an effort to understand why West Nile occurs more often in some locations than others.
Dewitt, T.(2009). University of Wisconsin News. Do Chicago’s Suburbs hold the key to understanding West Nile Virus? Retrieved from

18. Illinois Department of Public Health. (IDPH, 2009). West Nile Virus.
West Nile Virus culex mosquito feeding on its prey
Culex mosquito
Illinois Department of Public Health. (IDPH, 2009). West Nile Virus.
Retrieved from

19. Photo: courtesy Gabe Hamer, UW-Madison
Culex pipiens is the primary vector of West Nile Virus in the Mid western states.
Photo: courtesy Gabe Hamer, UW-Madison
This picture shows the mosquito specie
Culex pipiens engorged with blood.
Dewitt, T.(2009). University of Wisconsin News. Do Chicago’s Suburbs hold the key to understanding West Nile Virus? Retrieved from

20. Illinois Department of Public Health. (IDPH, 2009). West Nile Virus.
WNV traps are kept in suspected areas and after the mosquitoes collected are tested in the laboratory to ascertain the presence of the virus.
WNV Mosquito Trap
Illinois Department of Public Health. (IDPH, 2009). West Nile Virus.
Retrieved from

21. Illinois Department of Public Health. (IDPH, 2009). West Nile Virus.
Health Official collects WNV mosquitoes for laboratory analysis
WNV Mosquito Trap
Illinois Department of Public Health. (IDPH, 2009). West Nile Virus.
Retrieved from

22. Illinois Department of Public Health. (IDPH, 2009). West Nile Virus.
Another WNM mosquito net trap for laboratory analysis
WNV Mosquito Trap
Illinois Department of Public Health. (IDPH, 2009). West Nile Virus.
Retrieved from

23. WNV Mosquito breeding site-flooded foundation
Public health worker is seen inspecting the breading site for culex mosquitoes for laboratory testing and analysis. Such breeding sites are important in order to reduce the population of the WNV mosquitoes by massive killing.
WNV Mosquito breeding site-flooded foundation
Illinois Department of Public Health. (IDPH, 2009). West Nile Virus.
Retrieved from

24. CONCLUSION The threat of West Nile Virus in Illinois is serious
Awareness should go beyond the health sector
Pro-active attitude to deal with WNV is needed
I hope that this presentation has let you see the broad picture of the WNV threat and has shown you why we need to take immediate action. More partnerships are needed and every person must take responsibility for the immediate environment. This will not only reduce the activities of the mosquito-carrying disease, but also will save a lot of people from some WNV associated illnesses.
United States Geological Survey (USGS, 2009). Effects of West Nile
Virus. Retrieved from
sheets/pdfs/fact_wnv_effects_2004.pdf

25. ACKNOWLEDGEMENTS Illinois Department of Public Health
Centers for Disease Control and Prevention
My sincere appreciation goes to the Illinois Department of Public Health for the data, photos and other relevant information they made available to me for this work.
I also thank the CDC for making the rest of the information available for me to use during this project.

26. THANK YOU
Thanks for being a great audience and I am hopeful that this presentation was useful to you.

27. SOURCES FOR FURTHER READING
Medlineplus (2008). West Nile Virus. Retrieved from
National Institute of Allergy and Infectious Diseases. (NIAID, 2008). West Nile virus. Retrieved from
National Biological Information Infrastructure (NBII, 2009). West Nile Virus. Retrieved from
WebMD. (2009). Spatio-temporal Cluster Analysis of County-based Human West Nile Virus Incidence in the United States. Retrieved from
Ruiz, M. O; Walker, E. D; Foster, E. S; Haramis, L. D; & Kitron, U. D. (2007). Association of West Nile Virus Illness and urban landscapes of Chicago and Detroit. Retrieved from
Miramontes, Jr, R; Lafferty, W; Lind, B; & Oberle, M. (2006). Is Agriculture Activity Linked to the Incidence of Human West Nile Virus ? American Journal of Preventive Medicine, Volume 30, Issue 2, Pages Retrieved from
Peterson, L. R; & Roehrig, J. T. (2007). Flavivirus DNA Vaccines-Good Science, Uncertain Future. Editorial Commentary. Journal of Infectious Diseases Pgs
These sources are great for further reading. They have great materials on WNV and give good insight concerning most of the topics discussed in this presentation.

28. REFERENCES
CAL NEWS. (2009). University of Wisconcin, College of Agricultural
& Life Sciences. Retrieved from
Center for Disease Control. (CDC). 2006). West Nile Virus. Retrieved from
Chicago Tribune. (2009). West Nile Virus researchers focus on
Neighborhood birds. Retrieved from
virus aug10,0, story
Dewitt, T.(2009). University of Wisconsin News. Do Chicago’s Suburbs hold
the key to understanding West Nile Virus? Retrieved from
Illinois Department of Public Health. (IDPH). (2009). West Nile Virus.
Retrieved from
Illinois Department of Public Health. (IDPH). (2009). West Nile Virus
Retrieved from
Illinois Department of Public Health. (IDPH). (2009). West Nile Virus- 2009
Human Case Data. Retrieved from
United States Geological Survey (USGS, 2002). Wild Birds Help
Scientists Understand West Nile Virus. Retrieved from
nwhc.usgs.gov/publications/fact_sheets/pdfs/fact_westnile_res.pdf

29. REFERENCES CONTINUED
United States Geological Survey (USGS, 2009). Effects of West Nile
Virus. Retrieved from
sheets/pdfs/fact_wnv_effects_2004.pdf
UPI.com (2009). Science News: Cells Predict West Nile VirusInfection.
Retrieved from
West-Nile-virus-infection/UPI /
Watson, J. T; Jones, R. C; Gibbs, K; & Paul, W. (2004). Dead Crows Reports
and locations of Human West Nile Cases, Chicago, Emerging Infectious
Diseases • Vol. 10, No. 5, May Retrieved from
WebMD. (2009). West Nile Virus. Retrieved from
guides/west-nile-virus-treatment-overview
Westnilevirusfacts.org (2009). Get the facts about West Nile Virus. Retrieved
From