West Nile Virus in Rural CommunitiesMICHELE M. REHBEIN

R PHIL IP SCHEIBEL

CATHERINE MILLER-HUNT

WESTERN ILL INOIS UNIVERSITY

MM-REHBEIN@WIU.EDU

West Nile Virus•Arthropod-borne virus (arbovirus)• Viruses transmitted by arthropods, such as mosquitoes

•Belongs to the group flavivirus

•Initially discovered in northwest Uganda in 1937

•By 1999, made its first appearance in the U.S. in NYC

•Growing public health concern• One of the worst vector-borne diseases in the U.S.

•Main vector: Culex mosquito

•Birds are its primary hostwww.plymouthmosquito.org

WNV and Human Health•Affects both humans and animals

•Most people show minor to no symptoms◦ Can last a few days

•More prominent symptoms:◦ Fever, headache, rash, body aches, fatigue, vomiting, diarrhea, joint pain

•Severe symptoms:◦ Neurologic illness – encephalitis or meningitis; high fever; coma; disorientation; seizures; paralysis

•No vaccine or treatment

Arbovirus Surveillance•Arboviruses are a major global health concern and a threat to public health

•Over 30% of emerging infectious diseases are caused by arboviruses

•Arboviruses are on the rise ◦ Climate change◦ Ecological disruption◦ Increased travel and commerce

•Evolution/adaptation in viruses◦ Viruses can mutate and change ◦ Increase in virulence and transmission

Various Culex mosquitoes (photo taken in the lab).

Spread of WNV•Factors which contribute to the spread of WNV:

◦ Climate◦ Hot, dry weather◦ Peak summer months – June through August◦ Over abundance of Culex mosquitoes◦ Culex loves dirty, polluted water

Mosquito larvae (photo taken in the lab).

Climate and WNV•There have been many individual studies that have shown associations with vector-borne diseases and climate change

•Climate change influences West Nile virus◦ Weather and climate patterns have a large effect on WNV infections and how it spreads◦ Can impact abundance of WNV hosts and vectors

•Climate is a good indicator/predictor of vector population presence

Climate and WNV•Warmer and higher temperatures enable mosquitoes to be active longer

◦ Decrease in rainfall pushes vector and host together, forcing them to scarce water sources◦ Culex has a greater chance of interacting with its primary host, birds, allowing the virus to circulate longer ◦ Increase reproductive and transmission rates◦ Climate change modifies seasonal mosquito population levels across the U.S. with consequences for vector ecology

and public health policy (Comrie & Morin, 2013)

West Nile Virus in Rural Illinois•Rural areas face many obstacles and challenges:

◦ Less information is available on WNV distribution in rural settings◦ Many people in these areas suffer from poor socioeconomic

conditions◦ Many work outside or in agriculture industry◦ Growing elderly population◦ Limited or lack of healthcare services or facilities – medically

underserved◦ Types of infectious diseases in that specific area; without proper

diagnosis and treatment, there is no way to clinically combat this disease

•These factors can contribute to severe illness and under reporting of clinical cases of arboviruses Photo taken at Cass County Health Department field site.

West Nile Virus in Rural Illinois•Some groups of people living in rural areas may already experience social disparities

•Hispanic immigration represents the largest source of population growth for rural towns, reviving communities economically and culturally

•Immigrants to rural communities may encounter specific obstacles that prevent them from accessing and using health care services, including communication problems, a lack of health insurance coverage, inability to pay for services, issues with their legal status, discrimination, and transportation problems

West Nile Virus in Rural Illinois Considering these factors, people living in rural areas may

represent a population that is not only vulnerable to vector-borne infections, but may be especially at risk for severe disease complications arising from a lack of adequate medical care

One of our primary goals is to raise awareness about these

issues and help all rural residents through advocacy and empowerment

WNV Surveillance in Rural IL•The WNV project carried out in collaboration with several local health departments• McDonough County• Cass County• Fulton County

•Primary objective was to aid local health departments by providing personnel or resources which they do not have for surveying and monitoring vector-borne diseases• Supply valuable information to be used by health officials and community members • Provide public outreach, communicating and facilitating engagement in these issues (this is

key!)• Fair treatment and meaningful involvement of all people

•Data collected suggested that arboviruses, such as WNV, are more common in western IL than previously thought

WNV Surveillance in Rural IL•Why rural communities are so unique in terms of arbovirus/vector surveillance• Rural communities are important to this surveillance• Minorities growing in the population - could lack resources/health care as well as a

change in culture• We see a lack of scientific information about vector-borne diseases in

Midwestern states• In IL, there is under sampling of mosquitoes in rural areas and a concentration

of studies in urban areas, such as Chicago. • Less is known in regions such as western Illinois

Vector Biology Educational Initiative•We supplied information which can be used by health officials and community members to better protect the public

•Specifically for myself, I have begun to play a big role as a research team leader and have been integral to the planning and execution of nearly every aspect of the research• Designed in this way so I could gain these skills and experiences to pass along to other students

•The WIU vector biology group aims to engage in scientific research that directly benefits local communities

Sophia CabanDept. of Biological Sciences

Michele Rehbein, B.S.Dept. of Biological Sciences/Dept. of Health Sciences & Social Work

Phil Scheibel, M.S.Dept. of Biological Sciences

Vector Biology Educational Initiative•At WIU, many students come from low income families, rural communities, and are first generation college students• Rural communities serve as a link between disparity and environmental justice

•Establishing an educational initiative and structure • Based on the fact there is a recognized decline in expertise related to tropical infectious diseases• Doctors are not trained well enough on this topic• Arboviruses are expanding rapidly and persisting (such as WNV)• No doctor should be ignorant of these diseases, especially ones you would find in a rural setting

• Trying to empower students in the program and reaching them across multiple disciplines in order to provide them with skills and experience that will better prepare them for whatever career they pursue • Medicine• Public Health• Biology

West Nile Virus and the Future•By continuing vector surveillance, numerous communities can be helped

•Engaging in scientific research which can directly benefit local communities

•We will be expanding the study to monitor for other vector-borne diseases

•Help understand WNV transmission and prevalence more within the human population

•Involvement of all people• Starts with outreach• Advocacy for people’s needs • Empowerment through education• Community develops foundation for their information