West Nile Virus 2001

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

To identify human illness caused by West Nile virus (WNV) in New Jersey, New Jersey physicians are asked 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 patient with the clinical syndrome that characterized most of the cases of encephalitis in 1999:

    1. Fever equal to or greater than 38oC or 100o F, and

    2. Altered mental status (altered level of consciousness, lethargy, or change in personality), 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 adult or pediatric patient admitted to the hospital with a presumptive diagnosis of viral encephalitis.

    or

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

    or

  4. Any patient 17 years of age admitted with presumptive aseptic meningitis (fever, headache, stiff neck and/or other meningeal signs with CSF pleocytosis with predominant lymphocytes and moderately elevated protein, and a negative gram stain and culture to date) in counties with confirmed West Nile Virus activity (i.e., human, avian or equine cases; positive mosquitoes).

The DOH Public Health and Environmental Laboratory will perform WNV testing on submitted specimens that meet the above criteria. In cases which have a low probability for WNV (e.g., only one or two of the four criteria in section 1, above), the physician can perform preliminary screening by testing a blood specimen for St. Louis encephalitis (SLE). Since SLE and WNV are closely related viruses, a WNV case will react positively to an SLE test. The DOH should be notified of any IgM positive SLE tests in these cases, so that follow-up testing for WNV can be performed.

In addition to the above passive surveillance, active surveillance will be carried out by the DOH or local department of health in the counties nearest to the Meadowlands (Bergen, Passaic, Essex, Hudson, and Union). Infection control professionals in all hospitals in these counties will be called once per week to ascertain whether any patients that meet the above suspect case criteria have been admitted to their hospitals.

mas 5-29-00


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