Responding to the Public Health Threat of West Nile Virus


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West Nile Virus Outbreak


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In the fall of 1999 the mosquito-borne West Nile virus (WNV) killed 7 people in the NY City area and made dozens more very sick. It was initially misidentified as a different, related mosquito-borne virus often found in the U.S. The outbreak serves as a source of lessons about how public health (PH) officials can be better prepared in responding to potential crises involving uncertain causes, and how they can detect and respond to an act of biological terrorism. This report reviews the WNV outbreak and the response to it, focusing on establishing a chronological account of the events that occurred; and identifying lessons learned for PH and bioterrorism preparedness.




Responding to West Nile Virus


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Public Health Responses to West Nile Virus


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Emerging and re-emerging infectious diseases provide a challenge to public health in that the frequency, location, duration, and severity of the disease and outbreak are not always readily identifiable. In the absence of such information, the need to understand what drives risk perceptions, risk trade-offs, and heterogeneity in population behaviors becomes important in designing effective and appropriate risk communications, public health messages, and interventions. In this thesis, four studies are described that examine risk perceptions, risk trade-offs, and behavioral uncertainties as they relate to West Nile virus (WNV) prevention and control strategies. In Chapter 2, the health belief model was used to examine the influence of health beliefs and demographics on health behaviors recommended to reduce the risk of WNV. Results showed that health beliefs and subsequent behaviors varied based on the perceived risk and disease context. Respondents were more likely to engage in recommended health behaviors if they received timely information, understood the benefits of a particular behavior, and lived in areas exposed to WNV. Chapter 3 explored behavioral and demographic risk factors associated with risk perceptions of WNV and WNV interventions. Unique associations were found which merit further study to understand the extent of their relationships. In Chapter 4, risk trade-offs of WNV interventions were examined between laypeople and health experts using multi-criteria decision analyses. Laypeople perceived some WNV interventions to be more effective than health experts reported them to be. Health experts were most concerned about the effectiveness of such interventions. This showed that laypeople were more willing to make risk trade-offs given the scenario. In Chapter 5, probabilistic modeling techniques were used to characterize variability and uncertainty in population, environmental, pesticide, and exposure characteristics. By modeling a realistic mosquito abatem.




Learning from Experience: The Public Health Response to West Nile Virus, SARS, Monkeypox, and Hepatitis A Outbreaks in the United States


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Over the past three years, the U.S. Department of Health and Human Services (HHS) has made significant investments in state and local public health in an effort to enhance public health emergency preparedness. The RAND Corporation was contracted to work with the HHS Office of the Assistant Secretary for Public Health Emergency Preparedness (OASPHEP) to develop resources and to prepare analyses to help describe and enhance key aspects of state and local public health emergency preparedness. As part of this contract, RAND was asked to study the response of state and local health departments to recent disease outbreaks -- specifically, Severe Acute Respiratory Syndrome (SARS), monkeypox, West Nile virus, and Hepatitis A -- to address the following questions: (1) How did the public health system in the United States respond to each of these disease outbreaks? What were the roles of federal, state, and local health departments, health care providers, community organizations, and other groups, and how did they interact? (2) In what ways did recent federal investment contribute to public health preparedness? (3) What lessons does the public health response to these outbreaks have for future preparedness, particularly to address the threat of bioterrorism? What improvements are needed to public health infrastructure in the United States and in functional capabilities to address a public health emergency? (4) Was the Centers for Disease Control (CDC) guidance helpful in building capacity for health departments to respond to the outbreaks studied? Are there areas in which guidance is still needed?




West Nile Virus Outbreak


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Responding to the Public Health Threat of West Nile Virus


Book Description

Witnesses: Julie Louise Gerberding, M.D., M.P.H., Dir., Centers for Disease Control & Prevention (CDC); Anthony Fauci, M.D., Dir., Nat. Institute of Allergy & Infectious Diseases, Nat. Institutes of Health (NIH); Jesse L. Goodman, M.D., M.P.H., Deputy Dir., Center for Biologics Evaluation & Research, Food & Drug Admin. (FDA); Sidney Andrew Houff, M.D., Ph.D., Prof. & Chmn., Dept. of Neurology, & Dir., Neuroscience & Aging Institute, Loyola Univ. Med. Center, Maywood, IL; John R. Lumpkin, M.D., Dir., IL Dept. of Public Health, Springfield, IL; Nickie Monica, Parish Pres., St. John the Baptist Parish, LaPlace, LA; & Fay W. Boozman, M.D., M.P.H., Dir., Arkansas Dept. of Health.




The Emergence of Zoonotic Diseases


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Zoonotic diseases represent one of the leading causes of illness and death from infectious disease. Defined by the World Health Organization, zoonoses are "those diseases and infections that are naturally transmitted between vertebrate animals and man with or without an arthropod intermediate." Worldwide, zoonotic diseases have a negative impact on commerce, travel, and economies. In most developing countries, zoonotic diseases are among those diseases that contribute significantly to an already overly burdened public health system. In industrialized nations, zoonotic diseases are of particular concern for at-risk groups such as the elderly, children, childbearing women, and immunocompromised individuals. The Emergence of Zoonotic Diseases: Understanding the Impact on Animal and Human Health, covers a range of topics, which include: an evaluation of the relative importance of zoonotic diseases against the overall backdrop of emerging infections; research findings related to the current state of our understanding of zoonotic diseases; surveillance and response strategies to detect, prevent, and mitigate the impact of zoonotic diseases on human health; and information about ongoing programs and actions being taken to identify the most important needs in this vital area.




Under the Weather


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Since the dawn of medical science, people have recognized connections between a change in the weather and the appearance of epidemic disease. With today's technology, some hope that it will be possible to build models for predicting the emergence and spread of many infectious diseases based on climate and weather forecasts. However, separating the effects of climate from other effects presents a tremendous scientific challenge. Can we use climate and weather forecasts to predict infectious disease outbreaks? Can the field of public health advance from "surveillance and response" to "prediction and prevention?" And perhaps the most important question of all: Can we predict how global warming will affect the emergence and transmission of infectious disease agents around the world? Under the Weather evaluates our current understanding of the linkages among climate, ecosystems, and infectious disease; it then goes a step further and outlines the research needed to improve our understanding of these linkages. The book also examines the potential for using climate forecasts and ecological observations to help predict infectious disease outbreaks, identifies the necessary components for an epidemic early warning system, and reviews lessons learned from the use of climate forecasts in other realms of human activity.