Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,Active Human Surveillance,Michelle Korth,MSPH,Office of Epidemiology,Utah Department of Health,February 2004,Major mode of transmission:mosquito bite,Modes of Transmission,Mosquito bite,Blood transfusion,Organ transplant,Intrauterine,Breast feeding,Occupational exposure,How will we find cases?,Passive surveillance,Physician reporting,Laboratory reporting,How will we find cases?,Active surveillance,Weekly contact with hospitals,Lab evaluation of tests ordered,Blood donor screening,CDC studies,Pregnancy risk study,Organ transplant follow-up,Pediatric study,Active Surveillance,Weekly contact of hospitals,July through October,Identify clusters or unusual prevalence of aseptic meningitis or encephalitis,Identify other causes of central nervous system disease in community,Active Surveillance cont.,Laboratory evaluation of tests ordered,Proposed activity,Issue:difficult to assess baseline rates,Numbers of lumbar puncture tests ordered,Confounder:chronic,post-surgical illness,Purpose:identify baseline of aseptic meningitis/encephalitis in Utah,Active Surveillance cont.,Blood donor screening,Estimate in 2002:1 in 1,000 donors were viremic in areas reporting high CNS illness due to WNV and blood products infectious,Screening initiated July 2003,all 3 blood banks in Utah participating,Blood products of donors that are reactive are removed,LHDs asked to identify those that donated blood 2 weeks prior to WNV infection,Active Surveillance cont.,Pregnancy risk study,Identify transplacental transmission and associated risk to infant and mother,Also,may identify risk of transmission through breast milk,1,st,2,nd,or 3,rd,trimester WNV infection,Diagnostic samples,Maternal serum,cord serum,cord tissue,placental tissue,colostrum or breast milk,Voluntary,Partnership with physicians,state&local health department,and the Centers for Disease Control and Prevention,Active Surveillance cont.,Organ transplant,Patients in immunosuppressed condition risk?,Transplant within 4 weeks prior to symptom onset,No other exposure identified,Active Surveillance cont.,Pediatric study,CDC proposed new study for 2004,Assess effects of WNV infection on pediatric population,Different illness presentation?,Details to follow,Human Case Results,Published on website,County of exposure,Syndrome,WN fever,WN meningitis,WN encephalitis,Further demographics dependent on#of cases,Distribute info on ID and WNV listserver,To subscribe email epiutah.gov,Reminder:,No human vaccineNo drug treatmentSupportive therapyLong term sequelae,PREVENTION IS KEY,Questions?,