Wildlife species from 38 of Florida's 67 counties were surveyed over a 10 year period for the presence of antibody to the five major arboviruses circulating in the state. The routine screening of 7891 sera from wild birds and mammals via the hemagglutination-inhibition (H1) test with selected reactors subjected to serum neutralization testing has 1) provided information regarding geographic distribution and seasonality of circulation of these viruses 2) identified enzootic foci of infection and those species of wildlife most commonly infected and 3) documented the potential value of certain wild mammals as indicators of St. Louis Encephalitis and Venezuelan equine encephalomyelitis virus activity prior to the detection of human cases. Limited studies of Tamiami and Tensaw virus on sera from mammals collected for other purposed provided additional baseline information on the activity of these viruses in Florida mammals. Isolations of eastern equine encephalomyelitis virus were made from the heart of a loggerhead shrike (Lanius excubitor), Tensaw virus from the brain of a gray fox (Urocyon cinereoargenteus), and Keystone virus from the heart of a bluejay (Cyanocitta cristata).
Paired sera from 20 humans with eastern equine encephalitis (EEE) virus infections and from 17 humans with western equine encephalitis (WEE) virus infections, all with previously demonstrated fourfold or greater rises or falls in hemagglutination-inhibiting, complement-fixing, or neutralizing antibody titers, were tested for immunoglobulin M (IgM) and IgG antibodies by an enzyme immunoassay. All individuals with EEE and 14 of 17 individuals with WEE had IgM antibody, some as early as 1 day after onset. Two of the three persons with WEE who did not develop IgM antibody died. IgM antibody declined but persisted for at least 3 months after the onset of illness in one individual each with EEE and WEE. IgG antibody was not detected until the middle of week 2 after onset. The sensitivity of the IgM antibody capture enzyme immunoassay described and the specificity, as shown by the absence of heterologous alphavirus reactivity, indicate that this is the test of choice for the rapid diagnosis of human infections caused by EEE and WEE viruses.
A St. Louis encephalitis (SLE) epidemic in Florida during 25 weeks in 1990-1, resulted in 222 laboratory-diagnosed cases, an attack rate in the 28 affected counties of 2.25/100,000. Disease risk rose with advanced age, to 17.14/100,000 in persons over 80 years, and all 14 fatal cases were in persons over 55 years (median, 70 years). Community serosurveys in Indian River County, the epicenter of the outbreak (attack rate 21/100,000), showed acute asymptomatic infections in 3.6% of the persons surveyed, with higher rates in persons with outdoor occupational exposure (7.4%) and in clients of a shelter for the indigent (13.3%). A matched case-control study found that evening outdoor exposure for more than 2 h was associated with an increased risk for acquiring illness (odds ratio [OR] 4.33, 95% CI 1.23-15.21) while a number of recommended personal protective measures were protective. Four SLE patients were dually infected with Highlands J virus, the first reported cases of acute infection with this alphavirus. The case-control study provided the first evidence that a public education campaign to reduce exposure had a protective effect against acquiring the disease.
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