title: Enhanced West Nile virus surveillance in a dengue-endemic area--Puerto Rico, 2007.
abstract: In June of 2007, West Nile virus (WNV) was detected in sentinel chickens and blood donors in Puerto Rico, where dengue virus (DENV) is hyperendemic. Enhanced human surveillance for acute febrile illness (AFI) began in eastern Puerto Rico on July 1, 2007. Healthcare providers submitted specimens from AFI cases for WNV and DENV virology and serology testing. Over 6 months, 385 specimens were received from 282 cases; 115 (41%) specimens were DENV laboratory-positive, 86 (31%) specimens were laboratory-indeterminate, and 32 (11%) specimens were laboratory-negative for WNV and DENV. One WNV infection was detected by anti-WNV immunoglobulin M (IgM) antibody and confirmed by a plaque reduction neutralization test. DENV and WNV infections could not be differentiated in 27 cases (10%). During a period of active WNV transmission, enhanced human surveillance identified one case of symptomatic WNV infection. Improved diagnostic methods are needed to allow differentiation of WNV and DENV in dengue-endemic regions.
authors.affiliation: Epidemiology and Research Office, Puerto Rico Department of Health, San Juan, Puerto Rico. dzq9@cdc.gov
authors.forename: Jomil M
authors.initials: JM
authors.lastname: Torres-Aponte
authors.forename: Richard R
authors.initials: RR
authors.lastname: Luce
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Hunsperger
authors.forename: Jorge L
authors.initials: JL
authors.lastname: Muñoz-Jordan
authors.forename: Manuela
authors.initials: M
authors.lastname: Beltrán
authors.forename: Edgardo
authors.initials: E
authors.lastname: Vergne
authors.forename: D Fermín
authors.initials: DF
authors.lastname: Argüello
authors.forename: Enid J
authors.initials: EJ
authors.lastname: García
authors.forename: Wellington
authors.initials: W
authors.lastname: Sun
authors.forename: Kay M
authors.initials: KM
authors.lastname: Tomashek
mesh_terms: D000328:Adult; D000914:Antibodies, Viral / Q000097:blood*; D003715:Dengue / Q000175:diagnosis / Q000453:epidemiology*; D003716:Dengue Virus / Q000235:genetics / Q000276:immunology; D019353:Endemic Diseases; D005260:Female; D006801:Humans; D008297:Male; D009500:Neutralization Tests; D011647:Puerto Rico / Q000453:epidemiology; D018571:Sentinel Surveillance; D014901:West Nile Fever / Q000175:diagnosis* / Q000453:epidemiology / Q000821:virology; D014902:West Nile virus / Q000276:immunology*; D055815:Young Adult
chemical_list: D000914:Antibodies, Viral