A seroprevalence study of west nile virus infection in solid organ transplant recipients.
West Nile virus (WNV) causes severe neurological disease in less than 1% of infections. However, meningoencephalitis may be more common in immunosuppressed transplant patients. In 2002, a WNV outbreak occurred in our region. To determine the spectrum of disease of community acquired WNV infection and assess public health behavior patterns in transplant recipients, we carried out a seroprevalence study. Patients were enrolled from outpatient transplant clinics in October 2002 and sera were screened for WNV. Questionnaires about WNV were provided to patients. Eight hundred sixteen organ transplant patients were enrolled. The seroprevalence of WNV IgM was 2/816 (0.25%; 95% CI 0.03-0.88%). By extrapolation to our entire transplant population of 2360 patients, and using data from hospital-based surveillance, the risk of meningoencephalitis in a transplant patient infected with WNV is estimated to be 40% (95% CI 16-80%). With regards to knowledge and behavior, 56% patients knew of and 47% used at least one protective measure against WNV. Only 33% used insect repellent. The risk of meningoencephalitis in transplant recipients is much higher than in the general population. There is incomplete knowledge and poor rates of compliance amongst patients with regards to WNV prevention.
The Immunocompromised Host Infection Service, Multi-organ Transplant and Infectious Diseases, University of Toronto, Toronto, Ontario, Canada, M5G 2N2. deepali.kumar@uhn.on.ca
Deepali
D
Kumar
Michael A
MA
Drebot
Susan J
SJ
Wong
Gillian
G
Lim
Harvey
H
Artsob
Peter
P
Buck
Atul
A
Humar
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000554:Ambulatory Care Facilities; D002170:Canada / Q000453:epidemiology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D016377:Organ Transplantation / Q000009:adverse effects / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000821:virology; D016036:Seroepidemiologic Studies; D011795:Surveys and Questionnaires; D014901:West Nile Fever / Q000097:blood / Q000453:epidemiology*; D014902:West Nile virus / Q000302:isolation & purification