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West Nile Virus Infection Incidence Based on Donated Blood Samples and Neuroinvasive Disease Reports, Northern Texas, USA, 2012 - Volume 21, Number 4—April 2015 - Emerging Infectious Disease journal - CDC


West Nile Virus Infection Incidence Based on Donated Blood Samples and Neuroinvasive Disease Reports, Northern Texas, USA, 2012 - Volume 21, Number 4—April 2015 - Emerging Infectious Disease journal - CDC

Volume 21, Number 4—April 2015


West Nile Virus Infection Incidence Based on Donated Blood Samples and Neuroinvasive Disease Reports, Northern Texas, USA, 2012

Diana T. CervantesComments to Author , Shande Chen, Laurie J. Sutor, Shelley Stonecipher, Nicolette Janoski, David J. Wright, and Michael P. Busch
Author affiliations: Texas Department of State Health Services, Arlington, Texas, USA (D.T. Cervantes, S. Stonecipher)The University of North Texas Health Science Center, Fort Worth, Texas, USA (S. Chen)Carter BloodCare, Bedford, Texas, USA (L.J. Sutor)Tarrant County Public Health, Fort Worth (N. Janoski)Westat, Rockville, Maryland, USA (D. Wright)Blood Systems Research Institute, San Francisco, California, USA (M.P. Busch)


During the 2012 outbreak of West Nile virus in the United States, approximately one third of the cases were in Texas. Of those, about half occurred in northern Texas. Models based on infected blood donors and persons with neuroinvasive disease showed, respectively, that ≈0.72% and 1.98% of persons in northern Texas became infected.
From the first reported cases of West Nile Virus (WNV) in North America in August of 1999 through 2013, more than 39,000 cases of West Nile virus (WNV) were reported in the United States (1). In 2003, identification of transfusion-transmitted WNV infections (2) led to screening of the blood supply for WNV by using nucleic acid amplification technology (NAT) assays in mini-pools (MP-NAT) (3). Despite the success of MP-NAT screening of samples from blood donors, WNV transmission from infected donors continued. During 2004, screening algorithms expanded, including triggered individual donation NAT (ID-NAT) (3). Approximately 25% of viremic blood donors can be detected by ID-NAT (4).
Estimates of WNV infections in 2003 were derived from viremic blood donor rates detected by MP-NAT throughout the United States. West Nile neuroinvasive disease (WNND) reports were then used to approximate the number of infections relative to WNND cases (5). With the introduction of targeted ID-NAT, estimates of WNV infections from viremic blood donors must account for differential ID-NAT and MP-NAT screening during epidemic seasons.
Nationwide, the largest WNV epidemic since 2003 occurred in 2012, and approximately one third of cases were reported from Texas. Approximately 48% of cases in Texas were in 4 counties: Collin, Dallas, Denton, and Tarrant, located in the northern area of the state. The aim of this study was to estimate the number of WNV infections in this area during the 2012 arboviral season using 2 models: blood donor NAT yield and WNND-based models (5,6).

Dr. Cervantes is the lead epidemiologist at the Texas Department of State Health Services, Health Service Region 2/3. Her primary research interests include epidemiology and surveillance of infectious diseases and modeling of disease transmission.


We thank Merlyn Sayers, Jeff Centilli, and Phillip Williamson for their contributions to this study. We also thank the staff of Collin County Health Care Services, Dallas County Health and Human Services, Denton County Health Department, and Tarrant County Public Health for their investigations of West Nile disease. We also thank Heidi Threadgill, Scott Mize, and Laura Lane, who compiled data of West Nile fever and neuroinvasive disease cases in northern Texas.


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Technical Appendix

Suggested citation for this article: Cervantes DT, Chen S, Sutor LJ, Stonecipher S, Janoski N, Wrigh DJ, et al. West Nile virus infection incidence based on donated blood samples and neuroinvasive disease reports, northern Texas, USA, 2012. Emerg Infect Dis. 2015 Apr [date cited].http://dx.doi.org/10.3201/eid2104.141178
DOI: 10.3201/eid2104.141178

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