West Nile Virus 2001
Surveillance Criteria for
Diagnostic Testing of Suspect Human
Cases of West Nile Virus Infection
in New Jersey

To identify human illness caused by West Nile virus (WNV) in New Jersey, the New Jersey medical care community is requested to report immediately to the New Jersey Department of Health (DOH) by telephone (609-588-3121 or 7500) any patients with the following syndromes:

  1. Any adult or pediatric hospitalized patient with a clinical syndrome and laboratory findings that characterized the majority of cases of WNV encephalitis in 1999 and 2000:

    1. Fever equal to or greater than 38oC or 100o F, AND
    2. Neurological symptoms (headache, altered mental status, stiff neck, photophobia) AND
    3. CSF pleocytosis with predominant lymphocytes and moderately elevated protein WITH OR WITHOUT
    4. Muscle weakness (especially flaccid paralysis) confirmed by neurologic exam or EMG


    OR

  2. Any hospitalized adult or pediatric patient with a presumptive diagnosis of viral encephalitis.

    OR

  3. Any hospitalized adult or pediatric patient admitted with presumed Guillain-Barre Syndrome or acute flaccid paralysis.

    OR

  4. Any patient 17 years of age or older with presumptive aseptic meningitis (fever, headache, stiff neck and/or other meningeal signs) AND CSF results consistent with viral infection (pleocytosis with predominant lymphocytes and moderately elevated protein, and a negative gram stain and culture to date).

The NJDOH Public Health and Environmental Laboratory will perform WNV IgM testing by ELISA on sera and cerebrospinal fluid specimens from patients who meet the above criteria.

Acute specimens must be drawn at least 8 days from suspect cases' symptom onset, and convalescent specimens must be drawn at least two weeks after the initial acute specimen was collected. Testing of each specimen may take up to two weeks from time of receipt at the PHEL. Some specimens may require further confirmatory tests at the CDC, which may cause further delay in reporting final test results.

Improperly drawn specimens (acute specimens less than 8 days after symptom onset or convalescent specimens drawn less than fourteen days after the acute specimen) will cause further delay in reporting results since the NJDOH will be requesting additional appropriately-timed specimens.


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