Assessment of the Costs Related to West Nile Virus Monitoring in Lombardy Region (Italy) between 2014 and 2018.

In Italy, the West Nile Virus surveillance plan considers a multidisciplinary approach to identify the presence of the virus in the environment (entomological, ornithological, and equine surveillance) and to determine the risk of infections through potentially infected donors (blood and organ donors). The costs associated with the surveillance program for the Lombardy Region between 2014 and 2018 were estimated. The costs of the program were compared with a scenario in which the program was not implemented, requiring individual blood donation nucleic acid amplification tests (NAT) to detect the presence of WNV in human samples throughout the seasonal period of vector presence. Considering the five-year period, the application of the environmental/veterinary surveillance program allowed a reduction in costs incurred in the Lombardy Region of 7.7 million EUR. An integrated surveillance system, including birds, mosquito vectors, and dead-end hosts such as horses and humans, can prevent viral transmission to the human population, as well as anticipate the detection of WNV using NAT in blood and organ donors. The surveillance program within a One Health context has given the possibility to both document the expansion of the endemic area of WNV in northern Italy and avoid most of the NAT-related costs.

Assessment of West Nile Virus Lineage 2 Dynamics in Greece and Future Implications.

The emergence of West Nile Virus lineage 2 (WNV-2) has contributed to multiple major human outbreaks in Greece since 2010. Studies to date investigating biological and environmental factors that contribute to West Nile Virus (WNV) transmission have resulted in complex statistical models. We sought to examine open publicly available data to ascertain if a predictive risk assessment could be employed for WNV-2 in Greece. Based on accessible data, factors such as precipitation, temperature, and range of avian host species did not yield conclusive outcomes. However, by measuring the average rate of temperature change leading up to peak caseloads, we found a predictive characteristic to the timing of outbreaks. Detailed evolutionary studies revealed possible multiple introductions of WNV-2 in Europe, and that Greece acts through a source-sink inversion model, thereby allowing continued reseeding of WNV transmission each year by overwintering the Culex pipiens mosquito vector. Greece has proven an excellent model in WNV surveillance and has demonstrated the importance of rapid reporting for proper preparedness and response to vector-borne diseases.

Epidemiological situation of transboundary animal diseases in North African countries-proposition of a regional control strategy.

The Food and Agricultural Organization (FAO) defined transboundary animal diseases (TADs) as those that are of significant economic, trade, and food security importance for a considerable number of countries. TADs can easily spread to other countries, reach epidemic proportions, and where control, management, or exclusion is required cooperation between several countries. The North African countries are vulnerable to several TADs by virtue of its geographical location, its borders with the Sahel region, and peculiar control constraints on the budgets of the national veterinary services of each country and on the livelihoods of livestock owners across the region. In a narrative approach, we comprehensively described the epidemiology of TADs in North African countries, eradication constraints and control measures adopted to conclude with a proposition of a regional control strategy. Our review uncovered foot-and-mouth disease, peste des petites ruminants, bluetongue, sheep/goats pox, brucellosis, West Nile and Rift Valley fever, as the major TADs in this region, while the major constraints identified were illegal animal movement, communal clashes, unreported outbreaks, poor vaccination coverage, and other factors peculiar to each etiology. Therefore, the establishment of early warning systems and proper implementation of control measures at regional level are highly recommended to the relevant stakeholders involved in TADs control in the region.

Early detection of West Nile virus in France: quantitative assessment of syndromic surveillance system using nervous signs in horses.

West Nile virus (WNV) is a growing public health concern in Europe and there is a need to develop more efficient early detection systems. Nervous signs in horses are considered to be an early indicator of WNV and, using them in a syndromic surveillance system, might be relevant. In our study, we assessed whether or not data collected by the passive French surveillance system for the surveillance of equine diseases can be used routinely for the detection of WNV. We tested several pre-processing methods and detection algorithms based on regression. We evaluated system performances using simulated and authentic data and compared them to those of the surveillance system currently in place. Our results show that the current detection algorithm provided similar performances to those tested using simulated and real data. However, regression models can be easily and better adapted to surveillance objectives. The detection performances obtained were compatible with the early detection of WNV outbreaks in France (i.e. sensitivity 98%, specificity >94%, timeliness 2·5 weeks and around four false alarms per year) but further work is needed to determine the most suitable alarm threshold for WNV surveillance in France using cost-efficiency analysis.

Estimating the economic impact of a possible equine and human epidemic of West Nile virus infection in Belgium.

This study aimed at estimating, in a prospective scenario, the potential economic impact of a possible epidemic of WNV infection in Belgium, based on 2012 values for the equine and human health sectors, in order to increase preparedness and help decision-makers. Modelling of risk areas, based on the habitat suitable for Culex pipiens, the main vector of the virus, allowed us to determine equine and human populations at risk. Characteristics of the different clinical forms of the disease based on past epidemics in Europe allowed morbidity among horses and humans to be estimated. The main costs for the equine sector were vaccination and replacement value of dead or euthanised horses. The choice of the vaccination strategy would have important consequences in terms of cost. Vaccination of the country's whole population of horses, based on a worst-case scenario, would cost more than EUR 30 million; for areas at risk, the cost would be around EUR 16-17 million. Regarding the impact on human health, short-term costs and socio-economic losses were estimated for patients who developed the neuroinvasive form of the disease, as no vaccine is available yet for humans. Hospital charges of around EUR 3,600 for a case of West Nile neuroinvasive disease and EUR 4,500 for a case of acute flaccid paralysis would be the major financial consequence of an epidemic of West Nile virus infection in humans in Belgium.

West Nile Virus Fitness Costs in Different Mosquito Species.

West Nile virus (WNV) remains an important public health problem causing annual epidemics in the United States. Grubaugh et al. observed that WNV genetic divergence is dependent on the vector mosquito species. This suggests that specific WNV vector-bird species pairings may generate novel genotypes that could promote outbreaks.

A continental risk assessment of West Nile virus under climate change.

Since first introduced to North America in 1999, West Nile virus (WNV) has spread rapidly across the continent, threatening wildlife populations and posing serious health risks to humans. While WNV incidence has been linked to environmental factors, particularly temperature and rainfall, little is known about how future climate change may affect the spread of the disease. Using available data on WNV infections in vectors and hosts collected from 2003-2011 and using a suite of 10 species distribution models, weighted according to their predictive performance, we modeled the incidence of WNV under current climate conditions at a continental scale. Models were found to accurately predict spatial patterns of WNV that were then used to examine how future climate may affect the spread of the disease. Predictions were accurate for cases of human WNV infection in the following year (2012), with areas reporting infections having significantly higher probability of presence as predicted by our models. Projected geographic distributions of WNV in North America under future climate for 2050 and 2080 show an expansion of suitable climate for the disease, driven by warmer temperatures and lower annual precipitation that will result in the exposure of new and naïve host populations to the virus with potentially serious consequences. Our risk assessment identifies current and future hotspots of West Nile virus where mitigation efforts should be focused and presents an important new approach for monitoring vector-borne disease under climate change.

The impact of West Nile virus on the abundance of selected North American birds.

BACKGROUND: The emergence of West Nile virus (WNV) in North America has been associated with high mortality in the native avifauna and has raised concerns about the long-term impact of WNV on bird populations. Here, we present results from a longitudinal analysis of annual counts of six bird species, using North American Breeding Bird Survey data from ten states (1994 to 2010). We fit overdispersed Poisson models to annual counts. Counts from successive years were linked by an autoregressive process that depended on WNV transmission intensity (annual West Nile neuroinvasive disease reports) and was adjusted by El Niño Southern Oscillation events. These models were fit using a Markov chain Monte Carlo algorithm. RESULTS: Model fit was mostly excellent, especially for American Crows, for which our models explained between 26% and 81% of the observed variance. The impact of WNV on bird populations was quantitatively evaluated by contrasting hypothetical count trajectories (omission of WNV) with observed counts. Populations of American crows were most consistently affected with a substantial cumulative impact in six of ten states. The largest negative impact, almost 60%, was found in Illinois. A regionally substantial decline was also seen for American Robins and House Sparrows, while the other species appeared unaffected. CONCLUSIONS: Our results confirm findings from previous studies that single out American Crows as the species most vulnerable to WNV infection. We discuss strengths and limitations of this and other methods for quantifying the impact of WNV on bird populations.

West Nile virus in Europe: a comparison of surveillance system designs in a changing epidemiological context.

Current knowledge suggests that there is a low-level and recurrent circulation of West Nile virus (WNV) in Europe, with sporadic human and/or equines cases. However, recent events indicate that this picture is changing, raising the possibility that Europe could experience a modification in the virus' circulation patterns. We used an existing model of WNV circulation between Southern Europe and West Africa to estimate the sample size of equivalent West Nile surveillance systems, either passive (based upon horse populations and sentinel veterinarians) or active (sentinel horses, sentinel chickens, or WNV genome detection in trapped mosquito pools). The costs and calendar day of first detection of these different surveillance systems were compared under three different epidemiological scenarios: very low level circulation, low level recurrent circulation, and epidemic situation. The passive surveillance of 1000 horses by specialized veterinarian clinics appeared to be the most cost-effective system in the current European context, and estimated median dates of first detection appeared consistent with recent field observations. Our results can be used to optimize surveillance designs for different epidemiological requirements.

Using a neural network for mining interpretable relationships of West Nile risk factors.

The West Nile Virus (WNV) is an infectious disease spreading rapidly throughout the United States, causing illness among thousands of birds, animals, and humans. Yet, we only have a rudimentary understanding of how the mosquito-borne virus operates in complex avian-human environmental systems. The four broad categories of risk factors underlying WNV incidences are: environmental (temperature, precipitation, wetlands), socioeconomic (housing age), built-environment (catch basins, ditches), and existing mosquito abatement policies. This research first built a model incorporating the non-linear relationship between WNV incidences and hypothesized risk factors and second, identified important factor(s) whose management would result in effective disease prevention and containment. The research was conducted in the Metropolitan area of Minnesota, which had experienced significant WNV outbreaks from 2002. Computational neural network (CNN) modeling was used to understand the occurrence of WNV infected dead birds because of their ability to capture complex relationships with higher accuracy than linear models. Further a detailed interpretation technique, based on weights and biases of the network, provided a means for extracting relationships between risk factors and disease occurrence. Five risk factors: proximity to bogs, lakes, temperature, housing age, and developed medium density land cover class, were selected by the model. The detailed interpretation indicated that temperature, age of houses, and developed medium density land cover were positively related, and distance to bogs and lakes were negatively related to the incidence of WNV. This paper provides both applied and methodological contributions to the field of health geography. The relationships between the risk factors and disease occurrence could contribute to vector control strategies such as targeted insecticide spraying near bogs and lakes, mosquito control treatments for older houses, and extensive mapping, inspection, and treatments of catch basins. The proposed interpretation technique expanded the role of CNN models in health sciences as both predictive and explanatory tools.

Global change: impact, management, risk approach and health measures--the case of Europe.

Global changes, including an increase in trade and global warming, which act on the environment, are likely to impact on the evolution of pathogens and hence of diseases. To anticipate the risks created by this new situation, a French group of experts has developed a method for prioritising animal health risks. This is a two-phase method: the first step is to identify the diseases whose incidence or geographical distribution could be affected by the changes taking place, and the second step is to evaluate the risk of each of these diseases. As a result of this process, six priority diseases were selected: bluetongue, Rift Valley fever, West Nile fever, visceral leishmaniasis, leptospirosis and African horse sickness. The main recommendations were: to develop epidemiological surveillance, to increase knowledge of epidemiological cycles, to develop research into these diseases and to pool cross-border efforts to control them.

The economic impact of West Nile virus infection in horses in the North Dakota equine industry in 2002.

This study estimated economic impacts associated with the West Nile virus (WNV) outbreak in horses for North Dakota in 2002. The 2002 epidemic in the United States was the largest meningoencephalitis epidemic reported in the Western Hemisphere. Over 15,257 horse cases were reported in 43 states with most cases occurring in central United States. North Dakota reported over 569 horse cases, with a mortality rate of 22%. The total costs incurred by the state were approximately US$1.9 million. The costs incurred by horse owners were about US$1.5 million. Of the US$1.5 million, about US$781,203 and US$802,790 were spent on medical costs and losses due to inability to use animals because of the disease, respectively. Medical costs included the cost of vaccinating 152 horses, and the treatment costs for 345 horses which were US$4,803 and US$524,400 respectively. Costs associated with mortality were US$252,000 for the 126 horses which died of WNV. The state government spent US*$400,000 on WNV monitoring, control, and surveillance under the WNV-control program in 2002. Despite these conservative estimates, the data suggest that economic costs attributable to WNV epidemic to horse owners in North Dakota were substantial.

Serological assessment of West Nile fever virus activity in the pastoral system of Ferlo, Senegal.

The Ferlo area (north-central Senegal) is characterized by a system of temporary ponds favorable to arboviruses among which West Nile fever (WNF) was already identified. During the rainy season in 2003, a serological study was undertaken on horses to assess the activity of the WNF virus (WNFV) in Barkedji (Ferlo). The observed serological prevalence rate was 78.3% for neutralizing antibodies, with a 95% confidence interval (CI) of [64.0, 92.7]. This prevalence rate significantly increased with age (P = 10(-5)). This study confirmed that WNF was endemic in the Ferlo. The transmission risks depended on the introduction of the WNFV in the ecosystem--probably with migrating birds, on its amplification in hosts and on the vector-population dynamic. Further studies are needed to investigate how the cycle is initiated in Barkedji at the beginning of the rainy season and the impact of climatic variations on the risk of transmission of WNF. A surveillance system should be implemented: (a) to assess the clinical impact of the WNF on human and equine populations, (b) to provide an early detection of virulent strains, and (c) to assess the risk of WNF transmission to disease-free ecosystems via migrating birds.

Evaluation of antigen-capture ELISA and immunohistochemical methods for avian surveillance of West Nile virus.

Accurate detection of West Nile virus (WNV) in corvids is essential for monitoring the spread of virus during the mosquito season. Viremia in corvids is very high, with titers approaching 10(8) viral particles/ml. In the presence of such marked viremia, the sensitivity of real-time reverse transcription-polymerase chain reaction (RT-PCR) analysis is unnecessary, and more cost-effective methods should be assessed. To this end, antigen-capture ELISA (ACE) and immunohistochemical (IHC) assays were evaluated. Skin, cloacal swab specimens, and feathers from corvids were tested by use of ACE, and results were compared with results obtained from use of real-time RT-PCR analysis. Of the 3 sample types, skin gave the best sensitivity (98%) and specificity (100%). Skin, brain, kidney, and spleen from corvids were analyzed by IHC, and results were compared with real-time RT-PCR results. Kidney and spleen were more often positive by use of IHC than were brain and skin tissue; however, IHC did not perform as well as ACE in the identification of virus-positive birds. Results of this study support the use of a skin sample in an ACE format as an effective surveillance method for corvids.

Assessment of the efficacy of a single dose of a recombinant vaccine against West Nile virus in response to natural challenge with West Nile virus-infected mosquitoes in horses.

OBJECTIVE: To determine the onset of immunity after IM administration of a single dose of a recombinant canarypox virus vaccine against West Nile virus (WNV) in horses in a blind challenge trial. ANIMALS: 20 mixed-breed horses. PROCEDURE: Horses with no prior exposure to WNV were randomly assigned to 1 of 2 groups (10 horses/group). In 1 group, a recombinant canarypox virus vaccine against WNV was administered to each horse once (day 0). The other 10 control horses were untreated. On day 26, 9 treated and 10 control horses were challenged via the bites of mosquitoes (Aedes albopictus) infected with WNV. Clinical responses and WNV isolation were monitored for 14 days after challenge exposure; antibody responses against WNV after administration of the vaccine and challenge were also assessed in both groups. RESULTS: Following challenge via WNV-infected mosquitoes, 1 of 9 treated horses developed viremia. In contrast, 8 of 10 control horses developed viremia after challenge exposure to WNV-infected mosquitoes. All horses seroconverted after WNV challenge; compared with control horses, antibody responses in the horses that received the vaccine were detected earlier. CONCLUSIONS AND CLINICAL RELEVANCE: In horses, a single dose of the recombinant canarypox virus-WNV vaccine appears to provide early protection against development of viremia after challenge with WNV-infected mosquitoes, even in the absence of measurable antibody titers in some horses. This vaccine may provide veterinarians with an important tool in controlling WNV infection during a natural outbreak or under conditions in which a rapid onset of protection is required.