Its 40 reported deaths tie the previous high, Lakey said in a telephone news briefing. Neither Lakey nor a leading U. Centers for Disease Control and Prevention official could explain why Texas has been so hard hit.
Kyle Petersen , a West Nile specialist for the CDC , said the agency would look carefully at that question at the end of the season. Lakey said state health officials are seeing signs that the mosquito-borne outbreak may have peaked in the northern part of Texas, the area by far the hardest hit.
But he added that the number of cases and deaths in the state will keep rising at least into October. The state's previous worst year was , when people were diagnosed with West Nile disease. This year, people already have been diagnosed with neuroinvasive West Nile, the severe form of the disease that affects the brain and can cause paralysis, coma and death.
Neuroinvasive West Nile only affects 1 in people infected with the virus, and most non-neuroinvasive cases are not reported. Harris County has reported 38 cases, 22 of them neuroinvasive and three resulting in deaths. WNV activity typically occurs during the summer months and into the fall.
The annual number of reported WNV disease cases can fluctuate widely, as a result of periodic epidemics. All residents of and visitors to areas where WNV activity has been identified are at risk of WNV infection, particularly people who engage in outdoor work and recreational activities.
West Nile virus disease is a nationally notifiable condition. Cases are reported to CDC by state and local health departments using standard case definitions. The exact factors that contributed to this epidemic are unknown and most likely complex, considering that successful transmission depends on supportive environmental conditions, vector abundance, avian reservoir and susceptible host abundance, pathogenicity of the virus, and sizeable populations of immunologically naive reservoir species.
During , there was some media speculation that more cases of severe disease occurred in younger persons and that the circulating strain of virus possibly was more pathogenic than in prior years. Compared with Texas data for —, we did not find any statistically significant differences in median ages of reported WNND or fatal cases in using the Kruskal-Wallis 1-way analysis of variance on ranks.
Our findings from remain consistent with our experience from prior years; however, it remains critical to emphasize the importance of recognizing disease and testing persons of any age who have clinical signs and symptoms consistent with WNV infection. The WNV outbreak in Texas greatly affected the state economically.
On the basis of the acute medical care and productivity loss cost estimates provided by Barber et al. In addition to these acute costs, the outbreak also required an increase in resources for mosquito control and public health efforts to respond to the epidemic. The long-term economic impact of this outbreak also is expected to be substantial as a consequence of long-term rehabilitation and disability costs 8 , possible risk for chronic kidney disease 9 , and risk for premature death in severe cases The unprecedented outbreak confirms the need for continued vigilance for surveillance to enable timely implementation of control measures to prevent virus transmission.
We expect Texas will continue to experience endemic levels of virus transmission with periodic epizootics. Considering the economic and physical costs to persons severely affected, development of an effective vaccine is urgently needed to prevent disease.
Until a vaccine becomes available, public health authorities will need to maintain their focus on surveillance, disease recognition, implementation of control measures, and public education about protective measures. Her research focuses on vector-borne and zoonotic diseases. We thank Jim Schuermann, Nate Wolfe, and Alexandra Ingber for their assistance with data collection and preparation of this manuscript. Table of Contents — Volume 19, Number 11—November Please use the form below to submit correspondence to the authors or contact them at the following address:.
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