Lessons from the West Nile Viral Encephalitis Outbreak in New York City, 1999: Implications for Bioterrorism Preparedness

• NCJ Number: 189845
• Journal: Clinical Infectious Diseases Volume: 32 Issue: 2 Dated: 2001 Pages: 277-282
• Author(s): Annie Fine; Marcelle Layton
• Date Published: 2001
• Length: 6 pages
• Publication Format: Article
• Publication Type: Historical Overview
• Language: English
• Country: United States of America
• Note: Downloaded August 3, 2001

Annotation

This article provides an overview of the critical elements needed to manage a large-scale, fast-moving infectious disease outbreak.

Abstract

The involvement and expertise of infectious disease physicians, microbiologists, and public health practitioners are essential to the early detection and management of epidemics. This is the case for both those that are naturally occurring, such as the 1999 outbreak of West Nile virus (WN virus) in New York City, and those that might follow covert acts of bioterrorism. The experience with the WN virus outbreak offers practical lessons in outbreak detection, laboratory diagnosis, investigation, and response that might usefully influence planning for future infectious disease outbreaks. The detection of the WN virus outbreak in New York City occurred because an infectious disease practitioner noticed an unusual manifestation of the disease and promptly notified the New York City Department of Health (NYCDOH). An epidemiological investigation led to the conclusion that all case patients later identified were adults from the same neighborhood in northern Queens. The results of initial serological tests performed on the patients who had not traveled outside the Northeast led to the diagnosis of WN virus, a disease transmitted by the adult mosquito. The public health response required rapid reduction of the adult mosquito population in areas where transmission had been documented. A massive public education effort was conducted to provide information on the outbreak, the pesticides used, and the personal protective measures recommended to avoid mosquito bites. Based on this experience, the recommendations for improving public health capacity to respond to bioterrorism are to enhance awareness and training of clinicians, build public health resources and expertise, and improve communication between human and animal health authorities. Also, improved local and State public health laboratory capacity is needed for diagnosing unusual microbial pathogens. Unified, consistent public health messages will need to be given to the public in the event of an act of bioterrorism. 5 references.