[Infectious Diseases News Brief]

West Nile Virus (WNV) Infection: New York
The New York City Department of Health has announced that an 87-year-old woman who previously tested positive for WNV died in December 2000. The woman, who was earlier reported as testing positive for the virus on August 25, 2000, had been hospitalized in a coma since August 2000. This is the second reported death of a person who tested positive for WNV in 2000; the other individual, an 82-year-old man, died in New Jersey. These deaths serve as a reminder that WNV can potentially be a serious illness, particularly in the elderly. As a result of an active surveillance program, 530 suspected cases of viral meningo-encephalitis were reported and tested for WNV in New York City in 2000. Of the suspected cases, 14 persons tested positive, including 10 from Staten Island, 2 from Brooklyn (including the deceased), 1 from Manhattan, and 1 from Queens. Ages ranged from 36 to 87 years, with the median age being 62 years. Eight cases occurred in men, and 6 cases occurred in women. Of the thirteen surviving cases, a 77-year-old man is currently in a rehabilitation facility and the others are home recovering. In addition to the New York City cases, five cases of WNV, including one death, were reported in New Jersey.
Source: Press Release, New York City Department of Health, January 10, 2001

West Nile Virus (WNV) Infection: New York and Connecticut
In 2000, 21 persons were reported with acute illness due to WNV infection. Most lived in Staten Island but illnesses were also reported from three other New York City boroughs and counties in New Jersey and Connecticut. Because ill persons represent a fraction of those who are infected, serosurveys were conducted in Staten Island (NY), Suffolk County (NY), and Fairfield County (CT), areas that reported many infected birds. Of the 2400 persons in the surveys, 5 aged 14-54 years had lab tests that showed recent infection but did not develop encephalitis. Of 871 residents of Staten Island surveyed, 4 had positive samples indicative of recent infection. Of 834 surveyed in Suffolk County, one had a positive sample, and of 731 surveyed in Fairfield County, none had positive samples. On the basis of Staten Island serosurvey data, an estimated 1574 residents aged >12 years were infected with WNV in 2000; an estimated one in 157 WNV-infected Staten Island residents developed severe neurologic illness. In Suffolk County, although hospital-based surveillance did not identify any persons with severe WNV neurologic illness, an estimated 121 infections occurred among the approximately 100,500 persons aged >12 years in the serosurvey area.
Source: Morbidity and Mortality Weekly Report, Vol 50, No 3, January 26,2001

Salmonella enterica serotype typhimurium: United States
Because Salmonella enterica serotype typhimurium is the most common serotype isolated from persons with salmonellosis in the United States, it is difficult to detect unusual clusters or outbreaks. To determine whether molecular subtyping could be useful in public health surveillance for S. enterica serotype typhimurium, the Minnesota Department of Health initiated the routine use of pulsed-field gel electrophoresis (PFGE) of isolates. From 1994-1998, 998 cases of infection with S. enterica serotype typhimurium were reported (4.4 cases per 100,000 person-years). PFGE was performed on 958 of the isolates (96%), and 174 different patterns were identified. Sixteen outbreaks with a common source were identified, accounting for 154 cases. PFGE subtyping made it possible to confirm 10 outbreaks that involved small numbers of cases in institutional settings. Of six larger, community-based outbreaks, four would probably not have been recognized without PFGE subtyping. These four outbreaks accounted for 96 of the 154 culture-confirmed outbreak cases (62%). Fifty-six of 209 isolates tested for antimicrobial susceptibility (27%) were resistant to at least five antimicrobial agents. The multidrug-resistant isolates identified had unique PFGE patterns. It was concluded that routine molecular subtyping of S. enterica serotype typhimurium by PFGE can improve the detection of outbreaks and aid in the identification of multidrug-resistant strains.
Source: New England Journal of Medicine, Vol 344, No 3, January 18, 2001

The details given are for information only and may be very provisional. Where incidents are considered of national importance and are ongoing, the initial report will be updated as new information becomes available.

[Infectious Diseases News Brief]