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P. Bryon Backenson
Geraldine S. Johnson
Arthropod-Borne Disease Program, NYSDOH
5/2002
Tick Borne DiseasesTick Borne Diseases • Lyme Disease • Babesiosis
• Ehrlichiosis • Rocky Mountain Spotted Fever
Mosquito-Borne DiseasesMosquito-Borne Diseases • Viral Encephalitides
West Nile Virus
Eastern Equine Encephalitis
St Louis Encephalitis
California Viruses--Lacrosse, JC, others
• Malaria
Ticks and Tick-Borne DiseasesTicks and Tick-Borne Diseases
Tick-borne Diseases Tick-borne Diseases in New York Statein New York State
Disease VectorLyme disease Ixodes scapularis (deer tick)
Babesiosis I. scapularis (deer tick)
Human granulocytic ehrlichiosis (HGE)
I. scapularis (deer tick)
Human monocytic ehrlichiosis (HME)
Amblyomma americanum (Lone Star tick)
Rocky Mountain spotted fever Dermacentor variabilis (American dog tick)
Powassan encephalitis Ixodes cookei (woodchuck tick)
Tularemia D. variabilis (American dog tick), A. americanum (Lone Star tick)
• Causative Agent: Borrelia burgdorferi, a bacteria
• Reservoir: White footed mouse
• Vector: Deer tick - Ixodes scapularis
• Host: White tailed deer
Lyme DiseaseLyme Disease
Lyme Disease: Clinical SymptomsLyme Disease: Clinical Symptoms
• Early Lyme disease– 3 to 30 days after bite of infected tick– Erythema migrans (EM) rash (60-80%)– Fatigue, fever, headache, muscle aches, joint pain
and mild neck stiffness
• Late Lyme Disease – weeks to years after tick bite– arthritis, neurologic – cardiac (rare)
Lyme Disease: Diagnosis and Lyme Disease: Diagnosis and TreatmentTreatment
• Erythema migrans rash
• Testing– Serologic antibody testing
• Screening: ELISA/EIA/IFA• Secondary: Western Blot
• Proper antibiotic treatment– Usually rapid and complete recovery,
especially when treated early
Photo: R. Dattwyler
Lyme Disease Cases Reported Lyme Disease Cases Reported by State Health Departments*, by State Health Departments*,
1990-19991990-1999
NY33%
PA14%
NJ12%
CT17%
MA3%
Rest of US21%
* Centers for Disease Control and Prevention
NIAGARA
MONROE
SUFFOLK
NASSAU
ROCKLAND
NEW YORK CITY
CHAUTAUQUA
CATTARAUGUSALLEGANY
WYOMING
GENESEE
ORLEANS
LIVINGSTON
WAYNE
ONTARIO
YATES
SCHUYLER
STEUBEN
CHEMUNG
SENECA
TOMPKINS
BROOME
CORTLAND
CAYUGA
ONONDAGA
OSWEGO
LEWIS
MADISON
CHENANGO
OTSEGO
DELAWARE
HERKIMER
FULTON
MONTGOMERY
SCHOHARIE
GREENE
COLUMBIA
ALBANY
RENSSELAERSCHENECTADY
SARATOGA
WASHINGTON
WARRENHAMILTON
SULLIVAN
ULSTERDUTCHESS
JEFFERSON
ST LAWRENCE
FRANKLIN
CLINTON
ESSEX
ORANGE
PUTNAM
ONEIDA
ERIE
TIOGA
WESTCHESTER
Distribution of Distribution of Ixodes scapularis Ixodes scapularis In New York State In New York State
(1977 – 2002)(1977 – 2002)
Counties with confirmed distribution(one or more locally acquired specimens submitted)
Counties with no confirmed distribution(No locally acquired specimens submitted)
Lyme Disease Cases by Year of ReportLyme Disease Cases by Year of Report
New York State (Excluding New York City) 1986-2001
0
1000
2000
3000
4000
5000
86 87 88 89 90 91 92 93 94 95 96 97 98 99 00 01
Year of Report
Number
of
Cases
NYS Lyme Disease CasesNYS Lyme Disease Cases by month of onset, 1996-2001
n = 5303 (‘96), 3325 (‘97), 4554 (‘98), 4403 (‘99), 4330 (‘00), 3479 (‘01)*
0
200
400
600
800
1000
1200
1400
1600
1800
2000
1996 1997 1998 1999 2000 2001
Average Annual Lyme Disease Incidence Rate*Average Annual Lyme Disease Incidence Rate* by Sex and Age Group in New York State (Excluding New York City)
1986 - 2001
0
5
10
15
20
25
30
35
40
0-4 5-9 10-14 15-19 20-29 30-39 40-49 50-59 60-69 70-79 80+
Age Group
Male Female
* Number of cases per 100,000 population
Incidence
Rate per
100,000
Population
Lyme Disease Cases by Sex and AgeLyme Disease Cases by Sex and Age Group GroupNew York State (Excluding New York City)
1986 - 2001
0
500
1000
1500
2000
2500
3000
3500
4000
4500
0-4 5-9 10-14 15-19 20-29 30-39 40-49 50-59 60-69 70-79 80+
Age Group
Male Female
Number
of
Cases
*Per 100,000 population
by County in New York State (Excluding New York City)1986 - 2001
Average Annual Lyme Disease Incidence*Average Annual Lyme Disease Incidence*
NIAGARA MONROE
SUFFOLK
NASSAU
ROCKLAND
NEW YORK CITY
CHAUTAUQUA
CATTARAUGUSALLEGANY
WYOMING
GENESEE
ORLEANS
LIVINGSTON
WAYNE
ONTARIO
YATES
SCHUYLER
STEUBEN
CHEMUNG
SENECA
TOMPKINS
BROOME
CORTLAND
CAYUGA
ONONDAGA
OSWEGO
LEWIS
MADISON
CHENANGO
OTSEGO
DELAWARE
HERKIMER
FULTON
MONTGOMERY
SCHOHARIE
GREENE
COLUMBIA
ALBANY
RENSSELAERSCHENECTADY
SARATOGA
WASHINGTON
WARRENHAMILTON
SULLIVAN
ULSTERDUTCHESS
JEFFERSON
ST LAWRENCE
FRANKLIN
CLINTON
ESSEX
ORANGE
PUTNAM
ONEIDA
ERIE
TIOGA
WESTCHESTER
<= 9
10 - 49
50 - 99
100-946
* Per 100,000 population
by County in New York State
2000
(Excluding New York City)
Lyme Disease Incidence*Lyme Disease Incidence*
Annual Proportion Annual Proportion ofof Lyme Disease CasesLyme Disease Cases
by Region in New York State (Excluding New York City) 1986-2001
0%
50%
100%
Year of Report
Percent
of
Cases
Nassau & Suffolk
Westchester,Putnam
Rockland
Dutchess
Columbia
Elsewhere
&
&
Suffolk 40.2 / 43.2Nassau 6.4 / 6.4
Westchester 45.1 / 28.4
Putnam 79.5 / 283.0Orange 11.0 / 166.1
Dutchess 53.1 / 376.2Ulster 4.8 / 112.0
Columbia 6.3 / 936.7Greene 26.7 / 207.5
Rensselaer 0.6 / 44.6Albany 1.4 / 23.4
Lyme Disease Incidence (per 100,000 population)Lyme Disease Incidence (per 100,000 population)
12 Selected Counties in New York State – 1990 vs. 2000
Rockland 0.4 / 20.2
• Causative Agent: Babesia microti, a protozoan parasite
• Reservoir: White footed mouse
• Vector: Deer tick - Ixodes scapularis
• Host: White tailed deer
BabesiosisBabesiosis
Babesiosis: Disease Babesiosis: Disease CharacteristicsCharacteristics
• Malaria-like illness
• Occasionally transmitted through blood transfusion
• Symptoms: Fever, chills, headache, muscle aches, fatigue. Can be severe and require hospitalization. Potentially fatal.
• Incubation period typically 1-8 weeks.
0
15
30
45
60
<=4 5-9 10-14 15-19 20-29 30-39 40-49 50-59 60-69 70-79 80+
Age
MaleFemale
Number
of
Cases
Babesiosis Cases by Sex and Age GroupBabesiosis Cases by Sex and Age GroupNew York State (excluding New York City)
1993 - 2001
0
10
20
30
40
50
60
NYS Babesiosis CasesNYS Babesiosis Cases by month of onset, 1996-2001
n =37 (‘96), 26 (‘97), 107 (‘98), 61 (‘99), 72 (‘00), 78 (‘01)*
1996 1997 1998 1999 2000 2001
NIAGARA
MONROE
SUFFOLK
NASSAU
ROCKLAND
NEW YORK CITY
CHAUTAUQUA
CATTARAUGUSALLEGANY
WYOMING
GENESEE
ORLEANS
LIVINGSTON
WAYNE
ONTARIO
YATES
SCHUYLER
STEUBEN
CHEMUNG
SENECA
TOMPKINS
BROOME
CORTLAND
CAYUGA
ONONDAGA
OSWEGO
LEWIS
MADISON
CHENANGO
OTSEGO
DELAWARE
HERKIMER
FULTON
MONTGOMERY
SCHOHARIE
GREENE
COLUMBIA
ALBANY
RENSSELAERSCHENECTADY
SARATOGA
WASHINGTON
WARRENHAMILTON
SULLIVAN
ULSTERDUTCHESS
JEFFERSON
ST LAWRENCE
FRANKLIN
CLINTON
ESSEX
ORANGE
PUTNAM
ONEIDA
ERIE
TIOGA
WESTCHESTERQUEENS
KINGS
RICHMOND
BRONX
NEW YORK
1
464
1
1
6
2
28
21
2
1
1
12
1
3
1
Geographic DistributionGeographic Distribution of Babesiosis Casesof Babesiosis Cases in New York State*in New York State*
by County of Residence by County of Residence 1986 - 20011986 - 2001 Reported
BabesiosisCase in County
No ReportedBabesiosisCase in County
Excluding New York City
N=528
*
1
• Causative Agent: Anaplasma phagocytophila, a rickettsia
• Reservoir: Unknown, probably white- footed mouse or other small mammal
• Vector: Deer tick - Ixodes scapularis
• Host: Unknown, probably white-tailed deer or other mammal
Human Granulocytic Human Granulocytic Ehrlichiosis (HGE)Ehrlichiosis (HGE)
• Causative Agent: Ehrlichia chaffeensis, an ehrlichia
• Reservoir: Unknown, probably small mammal
• Vector: Lone Star tick – Amblyomma americanum
• Host: Unknown, probably medium-large mammal
Human Monocytic Human Monocytic Ehrlichiosis (HME)Ehrlichiosis (HME)
Ehrlichiosis: Disease Ehrlichiosis: Disease CharacteristicsCharacteristics
• Symptoms: Fever, chills, headache, muscle aches, fatigue. Can be severe and require hospitalization.
• Sometimes confused with RMSF, but ehrlichiosis typically lacks a prominent rash.
• Incubation period typically 1-3 weeks.
0
15
30
45
60
<=4 5-9 10-14 15-19 20-29 30-39 40-49 50-59 60-69 70-79 80+
Age
MaleFemale
Human Granulocytic Ehrlichiosis (HGE)Human Granulocytic Ehrlichiosis (HGE)by Sex and Age Group in New York State*
* Excluding New York City
1996 - 2001
Number
of
Cases
NIAGARA MONROE
SUFFOLK
NASSAU
ROCKLAND
NEW YORK CITY
CHAUTAUQUA
CATTARAUGUSALLEGANY
WYOMING
GENESEE
ORLEANS
LIVINGSTON
WAYNE
ONTARIO
YATES
SCHUYLER
STEUBEN
CHEMUNG
SENECA
TOMPKINS
BROOME
CORTLAND
CAYUGA
ONONDAGA
OSWEGO
LEWIS
MADISON
CHENANGO
OTSEGO
DELAWARE
HERKIMER
FULTON
MONTGOMERY
SCHOHARIE
GREENE
COLUMBIA
ALBANY
RENSSELAERSCHENECTADY
SARATOGA
WASHINGTON
WARRENHAMILTON
SULLIVAN
ULSTER
DUTCHESS
JEFFERSON
ST LAWRENCE
FRANKLIN
CLINTON
ESSEX
ORANGE
PUTNAM
ONEIDA
ERIE
TIOGA
WESTCHESTERQUEENS
KINGS
RICHMOND
BRONX
NEW YORK
Geographic DistributionGeographic Distribution of Human Granulocytic of Human Granulocytic
Ehrlichiosis (HGE) CasesEhrlichiosis (HGE) Cases in New York State*in New York State*
by County of Residence by County of Residence 1996 - 20011996 - 2001
No ReportedEhrlichiosis
(HGE)Case in County
N=461
*
7
107
3
Excluding New York City 85
214395
1
ReportedEhrlichiosis
(HGE)Case in County
NIAGARA
MONROE
SUFFOLK
NASSAU
ROCKLAND
NEW YORK CITY
CHAUTAUQUA
CATTARAUGUSALLEGANY
WYOMING
GENESEE
ORLEANS
LIVINGSTON
WAYNE
ONTARIO
YATES
SCHUYLER
STEUBEN
CHEMUNG
SENECA
TOMPKINS
BROOME
CORTLAND
CAYUGA
ONONDAGA
OSWEGO
LEWIS
MADISON
CHENANGO
OTSEGO
DELAWARE
HERKIMER
FULTON
MONTGOMERY
SCHOHARIE
GREENE
COLUMBIA
ALBANY
RENSSELAERSCHENECTADY
SARATOGA
WASHINGTON
WARRENHAMILTON
SULLIVAN
ULSTER
DUTCHESS
JEFFERSON
ST LAWRENCE
FRANKLIN
CLINTON
ESSEX
ORANGE
PUTNAM
ONEIDA
ERIE
TIOGA
WESTCHESTER
Counties with confirmed distribution(one or more locally acquired specimens submitted)
Counties with no confirmed distribution(No locally acquired specimens submitted)
Distribution of Distribution of Amblyomma Amblyomma americanumamericanum
In New York State (1991 In New York State (1991 –– 2002)2002)
0
2
4
6
8
10
<=4 5-9 10-14 15-19 20-29 30-39 40-49 50-59 60-69 70-79 80+
Age
MaleFemale
* Excluding New York City
Human Monocytic Ehrlichiosis (HME)Human Monocytic Ehrlichiosis (HME)by Sex and Age Group in New York State*
1996 - 2001
Number
of
Cases
NIAGARA MONROE
SUFFOLK
NASSAU
ROCKLAND
NEW YORK CITY
CHAUTAUQUA
CATTARAUGUSALLEGANY
WYOMING
GENESEE
ORLEANS
LIVINGSTON
WAYNE
ONTARIO
YATES
SCHUYLER
STEUBEN
CHEMUNG
SENECA
TOMPKINS
BROOME
CORTLAND
CAYUGA
ONONDAGA
OSWEGO
LEWIS
MADISON
CHENANGO
OTSEGO
DELAWARE
HERKIMER
FULTON
MONTGOMERY
SCHOHARIE
GREENE
COLUMBIA
ALBANYRENSSELAER
SCHENECTADY
SARATOGA
WASHINGTON
WARRENHAMILTON
SULLIVAN
ULSTER
DUTCHESS
JEFFERSON
ST LAWRENCE
FRANKLIN
CLINTON
ESSEX
ORANGE
PUTNAM
ONEIDA
ERIE
TIOGA
WESTCHESTERQUEENS
KINGS
RICHMOND
BRONX
NEW YORK
Geographic DistributionGeographic Distribution of Human Monocytic of Human Monocytic
Ehrlichiosis (HME) CasesEhrlichiosis (HME) Cases in New York State*in New York State*
by County of Residence by County of Residence 1996 - 20011996 - 2001
No ReportedEhrlichiosis
(HME)Case in County
N=83
*
2
30
Excluding New York City 15
1913
1
ReportedEhrlichiosis
(HME)Case in County
1
11
0
5
10
15
20
25
30
35
40
45
50
NYS Ehrlichiosis CasesNYS Ehrlichiosis Cases by month of onset, 1996-2001
n = 51 (‘96), 81 (‘97), 117 (‘98), 76 (‘99), 103 (‘00), 17 (‘01)*
1996 1997 1998 1999 2000 2001
• Causative Agent: Rickettsia rickettsii, a rickettsia
• Reservoir: typically maintained through tick-tick passage
• Vector: American dog tick – Dermacentor variabilis
Rocky Mountain Spotted FeverRocky Mountain Spotted Fever
Rocky Mountain Spotted Fever: Rocky Mountain Spotted Fever: Disease CharacteristicsDisease Characteristics
• Rash for which it is named occurs only in 40-60% of cases. Rash spreads from palms and soles.
• Symptoms: Fever, nausea, vomiting, muscle pain, lack of appetite, headache. Majority of cases require hospitalization. Potentially fatal.
• Incubation period typically 3-14 days.
NIAGARA
MONROE
SUFFOLK
NASSAU
ROCKLAND
NEW YORK CITY
CHAUTAUQUA
CATTARAUGUSALLEGANY
WYOMING
GENESEE
ORLEANS
LIVINGSTON
WAYNE
ONTARIO
YATES
SCHUYLER
STEUBEN
CHEMUNG
SENECA
TOMPKINS
BROOME
CORTLAND
CAYUGA
ONONDAGA
OSWEGO
LEWIS
MADISON
CHENANGO
OTSEGO
DELAWARE
HERKIMER
FULTON
MONTGOMERY
SCHOHARIE
GREENE
COLUMBIA
ALBANY
RENSSELAERSCHENECTADY
SARATOGA
WASHINGTON
WARRENHAMILTON
SULLIVAN
ULSTER
DUTCHESS
JEFFERSON
ST LAWRENCE
FRANKLIN
CLINTON
ESSEX
ORANGE
PUTNAM
ONEIDA
ERIE
TIOGA
WESTCHESTER
Counties with confirmed distribution(one or more locally acquired specimens submitted)
Counties with no confirmed distribution(No locally acquired specimens submitted)
Distribution of Distribution of Dermacentor Dermacentor variabilisvariabilis
In New York State (1991 In New York State (1991 ––2002)2002)
NIAGARA
MONROE
SUFFOLK
NASSAU
ROCKLAND
NEW YORK CITY
CHAUTAUQUA
CATTARAUGUS ALLEGANY
WYOMING
GENESEE
ORLEANS
LIVINGSTON
WAYNE
ONTARIO
YATES
SCHUYLERSTEUBEN
CHEMUNG
SENECA
TOMPKINS
BROOME
CORTLAND
CAYUGA
ONONDAGA
OSWEGO
LEWIS
MADISON
CHENANGO
OTSEGO
DELAWARE
HERKIMER
FULTON
MONTGOMERY
SCHOHARIE
GREENE
COLUMBIA
ALBANY
RENSSELAERSCHENECTADY
SARATOGA
WASHINGTON
WARRENHAMILTON
SULLIVAN
ULSTER DUTCHESS
JEFFERSON
ST LAWRENCE
FRANKLIN
CLINTON
ESSEX
ORANGE
PUTNAM
ONEIDA
ERIE
TIOGA
WESTCHESTERQUEENS
KINGS
RICHMOND
BRONX
NEW YORK
Local exposure
Travel historyto endemic area
No travelhistory available
Geographic Distribution and ExposureGeographic Distribution and Exposure History of New York State* ResidentsHistory of New York State* Residentswith Rocky Mountain Spotted Feverwith Rocky Mountain Spotted Fever
1977 - 20011977 - 2001
Residence inendemic area
1
1 12
1
2
1
1
2
3 2
1
1
1
3
1
1 1
10
1
4
2
2
12
11 1
2
199
2
116
2
* Excluding New York City
2
47 N=353
1
1
1
1 2
1
1
1
1
2
13
1111
31
11
2
1
11
NYS Rocky Mountain Spotted Fever CasesNYS Rocky Mountain Spotted Fever Cases by month of onset, 1996-2001
n =34 (‘96), 14 (‘97), 13 (‘98), 14 (‘99), 9 (‘00), 3 (‘01)*
0
1
2
3
4
5
6
7
8
9
Ja
n
Ma
r
Ma
y
Jul
Se
p
No
v
Ja
n
Ma
r
Ma
y
Jul
Se
p
No
v
Ja
n
Ma
r
Ma
y
Jul
Se
p
No
v
Ja
n
Ma
r
Ma
y
Jul
Se
p
No
v
Ja
n
Ma
r
Ma
y
Jul
Se
p
No
v
Ja
n
Ma
r
Ma
y
Jul
Se
p
No
v
1996 1997 1998 1999 2000 2001
• Causative Agent: Powassan virus, a flavivirus
• Reservoir: Rodents, possibly other small mammals, birds
• Vector: woodchuck tick - Ixodes cookei
Powassan EncephalitisPowassan Encephalitis
Powassan: Disease Powassan: Disease CharacteristicsCharacteristics
• Symptoms: Fever, chills, headache, muscle aches, fatigue, epilepsy, flaccid paralysis. Can be severe—meningitis and encephalitis--and require hospitalization. Potentially fatal.
• Incubation period typically 1-2 weeks.
• Causative Agent: Francisella tularensis, a bacteria
• Reservoir: numerous animals, particularly rabbits, voles, muskrats, beavers. Can also be maintained in tick population.
• Vector: American dog tick – Dermacentor variabilis, Lone Star tick – Amblyomma americanum
TularemiaTularemia
Tularemia: Disease Tularemia: Disease CharacteristicsCharacteristics
• Variety of presentations, depending on route of inoculation. Symptoms will vary. Potentially fatal—case fatality rate also varies with route of inoculation.
• Potential bioterrorism agent, when aerosolized.
•Incubation period typically 1-14 days.
NYS Tularemia CasesNYS Tularemia Cases by month of onset, 1996-2001
n = 2 (‘96), 0 (‘97), 5 (‘98), 1 (‘99), 0 (‘00), 1 (‘01)*
0
0.5
1
1.5
2
2.5
1996 1997 1998 1999 2000 2001
Mosquitoes and Mosquito-Borne Mosquitoes and Mosquito-Borne DiseasesDiseases
Public Health Importance of Public Health Importance of West Nile VirusWest Nile Virus
• Transmitted by mosquitoes
• May cause serious, sometimes fatal, illnesses in humans
• Outbreaks in Israel (‘50s),Algeria (‘94), Romania (‘96-’97), Czech Republic (‘97), Congo (‘98), Russia (‘99), Israel (‘00) , NYC (‘99-00) 1st in Western Hemisphere
West Nile Virus: SymptomsWest Nile Virus: Symptoms
• Occur from 5-15 days after exposure
• Mild- slight fever and/or headache
• Severe - high fever, head and body aches, disorientation, convulsions, rash
• Most severe - paralysis or death
• Persons most at risk - over 50 years of age
• 1/150 persons infected becomes seriously ill
West Nile Virus Transmission CycleWest Nile Virus Transmission Cycle
West Nile
Virus
Mosquito vectorIncidental infections
Bird reservoir
hosts
Incidental infections
Laboratory ConfirmedLaboratory ConfirmedWNV Infections, NYS, 1999-2001WNV Infections, NYS, 1999-2001
1999 2000 2001
Humans (Deaths)
62 (7) 14 (1) 15 (2)
Mosquito Pools
15 400 300
Birds 142 1263 731 dead, 71 live
Mammals 20 Horses 28 Horses, 5 others
22 Horses
NYS WNV Encephalitis CasesNYS WNV Encephalitis Cases by month of onset, 1996-2001
n = 0 (‘96), 0 (‘97), 0 (‘98), 59 (‘99), 14 (‘00), 15 (‘01)*
0
5
10
15
20
25
30
35
1996 1997 1998 1999 2000 2001
NIAGARA
MONROE
SUFFOLK
NASSAU
ROCKLAND
NEW YORK CITY
CHAUTAUQUA
CATTARAUGUSALLEGANY
WYOMING
GENESEE
ORLEANS
LIVINGSTON
WAYNE
ONTARIO
YATES
SCHUYLER
STEUBEN
CHEMUNG
SENECA
TOMPKINS
BROOME
CORTLAND
CAYUGA
ONONDAGA
OSWEGO
LEWIS
MADISON
CHENANGO
OTSEGO
DELAWARE
HERKIMER
FULTON
MONTGOMERY
SCHOHARIE
GREENE
COLUMBIA
ALBANY
RENSSELAERSCHENECTADY
SARATOGA
WASHINGTON
WARRENHAMILTON
SULLIVAN
ULSTERDUTCHESS
JEFFERSON
ST LAWRENCE
FRANKLIN
CLINTON
ESSEX
ORANGE
PUTNAM
ONEIDA
ERIE
TIOGA
WESTCHESTERQUEENS
KINGS
RICHMOND
BRONX
NEW YORK
West Nile Virus Positive
Specimens, 1999No Confirmed Activity
Birds &/or Mosquitoes Humans (and Birds &/or Mosquitoes)
NIAGARA
MONROE
SUFFOLK
NASSAU
ROCKLAND
NEW YORK CITY
CHAUTAUQUA
CATTARAUGUSALLEGANY
WYOMING
GENESEE
ORLEANS
LIVINGSTON
WAYNE
ONTARIO
YATES
SCHUYLER
STEUBEN
CHEMUNG
SENECA
TOMPKINS
BROOME
CORTLAND
CAYUGA
ONONDAGA
OSWEGO
LEWIS
MADISON
CHENANGO
OTSEGO
DELAWARE
HERKIMER
FULTON
MONTGOMERY
SCHOHARIE
GREENE
COLUMBIA
ALBANY
RENSSELAERSCHENECTADY
SARATOGA
WASHINGTON
WARRENHAMILTON
SULLIVAN
ULSTERDUTCHESS
JEFFERSON
ST LAWRENCE
FRANKLIN
CLINTON
ESSEX
ORANGE
PUTNAM
ONEIDA
ERIE
TIOGA
WESTCHESTERQUEENS
KINGS
RICHMOND
BRONX
NEW YORK
West Nile Virus Positive
Specimens, 2000
No Confirmed Activity
Birds &/or Mosquitoes
Humans (and Birds &/or Mosquitoes)
NIAGARA
MONROE
SUFFOLK
NASSAU
ROCKLAND
NEW YORK CITY
CHAUTAUQUA
CATTARAUGUSALLEGANY
WYOMING
GENESEE
ORLEANS
LIVINGSTON
WAYNE
ONTARIO
YATES
SCHUYLER
STEUBEN
CHEMUNG
SENECA
TOMPKINS
BROOME
CORTLAND
CAYUGA
ONONDAGA
OSWEGO
LEWIS
MADISON
CHENANGO
OTSEGO
DELAWARE
HERKIMER
FULTON
MONTGOMERY
SCHOHARIE
GREENE
COLUMBIA
ALBANY
RENSSELAERSCHENECTADY
SARATOGA
WASHINGTON
WARRENHAMILTON
SULLIVAN
ULSTERDUTCHESS
JEFFERSON
ST LAWRENCE
FRANKLIN
CLINTON
ESSEX
ORANGE
PUTNAM
ONEIDA
ERIE
TIOGA
WESTCHESTERQUEENS
KINGS
RICHMOND
BRONX
NEW YORK
West Nile Virus Positive
Specimens 2001
No Confirmed Activity
Birds &/or Mosquitoes Humans (and Birds &/or Mosquitoes)
Human population*Infected bird risk = population-weighted WNV Risk Map
WNV hot-spots
Constructing human risk Constructing human risk maps for West Nile Virus in New York maps for West Nile Virus in New York
West Nile Virus Mapping Projects:West Nile Virus Mapping Projects:CONSIDERATIONS CONSIDERATIONS
1)METHODOLOGICAL: Will more precise lat/long geolocations change the maps? Initial analyses for tested birds were done with ZIP5 data.
2)METHODOLOGICAL: Can we combine this analysis with others, such as dead crow sightings, to make a better predictive model? Can other anthropomorphic features, such as infrastructure, be included?
3)INSTITUTIONAL: What is the best way to translate these data for end users? Will it support their decision making?
4)BOTH: What obstacles will be faced in making this a real-time system? To make this completely real-time, the following is needed on a real-time basis:
Satellite images Lab results, and geocoded locations on birds,
mammals, and mosquitoes. Final risk maps
WNV Take-Home MessagesWNV Take-Home Messages
• At least 27 states
• Over 75 species of bird
• Over 25 species of mosquito
• 149 human cases
• Report viral encephalitis
• Report dead bird sightings
• Reduce mosquito breeding habitats
• Educate about how to reduce risk of WNV infection
Other Notable Mosquito-borne Other Notable Mosquito-borne Viral Encephalitides in NYSViral Encephalitides in NYS
Eastern Equine Encephalitis• Virus transmitted to horses and humans by
infected mosquitoes.
• Symptoms - sudden onset of fever, muscle aches, headache. Severe - seizures, coma, encephalitis.
• Fatality rate - 33%
• Sporadic isolations from Long Island, around Oneida Lake
Other Notable Mosquito-borne Other Notable Mosquito-borne Viral Encephalitides in NYSViral Encephalitides in NYS
St Louis EncephalitisLaCrosse Encephalitis
Jamestown Canyon Encephalitis• Virus transmitted to horses and humans by
infected mosquitoes.
• Symptoms – typical symptoms leading to encephalitis
• All potentially fatal
• Historic isolations
• Causative Agent: Plasmodium spp., a protozoan parasite
• 4 different Plasmodia cause malaria
• Reservoir: Humans
• Vector: mosquitoes of the genus Anopheles
MalariaMalaria
Malaria: Disease CharacteristicsMalaria: Disease Characteristics
• Most cases in New York are associated with travel to endemic areas.
• Potential transmission through transfusion.
• Millions of infections yearly worldwide.
• Symptoms: Fever, chills, cough, sweats, diarrhea, respiratory distress. Can be severe and require hospitalization. Potentially fatal. Severity will vary with species of plasmodium.
• Incubation period typically 7-30 days, can be up to 8 months.
NYS Malaria CasesNYS Malaria Cases by month of onset, 1996-2001
n = 365 (‘96), 393 (‘97), 333 (‘98), 329 (‘99), 308 (‘00), 75 (‘01)*
0
10
20
30
40
50
60
70
1996 1997 1998 1999 2000 2001
P. Bryon Backenson
Geraldine Johnson
Arthropod-Borne Disease Program
New York State Department of Health
518-474-4568
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