On Monday, I heard the news that would shape the rest of my week, West Nile Virus (WNV) found among 6 dead birds. Similar to how I mentioned in previous posts that the Jamestown Canyon Virus (JCV) positive may have been the earliest positive (of year) in Maine history, these WNV positives, reported by the Maine CDC, are the earliest to have been found in birds. These birds were found in 5 different towns across the state and has added a spark to identification efforts this week. The Maine CDC additionally released that a human case is being investigated, but WNV was not likely to have been contracted in Maine as this person had been traveling. Additionally I was tasked with completing a literature review of recent publications for my own education and to add to the labs accessible papers to read.
West Nile Virus
WNV is an RNA virus that resides in the Flavivirus genus. An infection may develop into West Nile Fever that in most extreme cases can affect the central nervous system as an encephalitis or meningitis (although very uncommon). The young, elderly, and immunocompromised are at highest concern for WNV, but the vast majority of people may be asymptomatic or have flu-like symptoms. The chain of transmission for this virus begins as birds are the primary host. Acting as a reservoir, mosquitos will bite an infectious bird obtaining the pathogen. This is primary completed by mosquitoes in the genus Culex with Cu. pipiens and Cu. restuans of most concern to our lab. This is because both of these species are found throughout Maine and while they do not target human bloodmeals, if that is the only option presented they will respond accordingly. Humans and horses are considered “dead-end” hosts as once bite and if infected, the pathogen will not be transmitted further. From a public health perspective, these communicable diseases are often underrepresented in health education as other pathogens may persist as communicably acquirable. My work this summer has be on the more ecological perspective rather than clinical, so at this point it is important to get our collected samples tested before this issue becomes larger than it is, becoming a clinical threat to the community.
With this being said, many members of the lab put in a lot of effort to clear out unidentified mosquitos from the freezer. Additionally, having a positive result for WNV increases the number of species that will be sent to the state laboratory in order to not rule out any potential vectors. We have been able to get the large majority of mosquitos identified, accessioned, and packaged to be tested. Time will tell if the dead birds containing WNV were an indicator of what is to come, but at this point we are treating WNV as a priority until further notice.
If you are interested, I have added the link to the Maine CDC press release at the bottom of this post.
NEVBD Summer Seminar
Switching gears a bit, I was able to attend the last of the NEVBD Summer Seminar meetings. On this meeting, we were introduced to Jenifer White, MPH, an epidemiologist for the NY State Department of Health. Jenifer works in the Department of Communicable Diseases as the director. Her work primarily focuses on vector-borne disease surveillance as NY has regional vector ecology laboratories, and human surveillance centers. Jenifer has had extensive experience dealing with WNV as she told us all that NY was the first state to have a WNV case.
As an epidemiologist she works as an investigator identifying where people are getting sick, how they are getting sick, and what can be done to prevent this. Where people are contracting diseases is a very important aspect to consider and led many of her points. If a person has contracted an illness/disease from a regional location that is out of the ordinary, this may lead to additionally interviews being held to determine if travel or some other factor played a role. An example she gave was the current Dengue Virus concern coming from the tropics and specially Puerto Rico. If a person was traveling in one of these areas that is having this public health issue, and returns home sick, it may be mistaken for another cause if not reported by a patient. Unlike WNV, Dengue is not a “dead-end” host virus, blood transfusions, organ donation, and maternal transmission are all possible. Zika virus is another arbovirus that people may come into contact with while travelling. Most people infected with Zika are asymptomatic, but they may transmit the virus to their partner via sexual transmission along with all others associated with Dengue. This would obviously become a major health issue for all of those involved and is not all that unlikely as there was a major outbreak of Zika in the U.S. back in 2015/16. Since data on infectious diseases have kept for a long time, epidemiologists similar to her are able to work up a severity to a threat and determine how the public or clinicians should be educated moving further. I find the clinician aspect very interesting as most people believe doctors to be all knowing in a sense. But like everyone else, if a certain cause is not on their mind while finding a diagnosis, possibilities may be overlooked.
While actively working on the vector-borne disease side of the Department of Communicable Diseases, Jenifer explained that her work is not solely in this field. She mentioned that in time of need or priority her focus may shift to other infectious disease. As an example, she explained that during the COVID-19 pandemic, she did not work on vector-borne disease related projects for 2 years. It goes to show that if pursuing a career in this field it pays off to be multifaceted and able to acquire or build off new skills.
It was overall a great week to be working in the vector-borne disease world, if you chose to look at it that way. Regardless I was able to learn more about the arboviral disease I have been writing about all summer, as they pertain to a current health concern. Next week will conclude my summer as a NEVBD-TEC Intern and I am excited to see what the week holds!
ME CDC WNV Press Release 7/31/24
ME CDC JCV Press Release 7/9/24
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