West Nile virus infection in tree squirrels (Rodentia: Sciuridae) in California, 2004-2005.

West Nile virus (WNV) transmission generally involves a mosquito vector and an avian reservoir host, with mammals as incidental hosts. Although most mammalian WNV infections cause low or no morbidity or mortality, tree squirrels are susceptible to WNV-associated neurologic disease with infection prevalence comparable to that in dead birds. Positive species included fox squirrel (Sciurus niger), western gray squirrel (S. griseus), and eastern gray squirrel (S. carolinensis). Kidney tissue (dissected and swabbed), and oropharyngeal (oral) swab samples from tree squirrels submitted by California vector control and rehabilitation agencies were tested by reverse transcription-polymerase chain reaction; cycle threshold values were similar for all three samples, ranging from 21.9 to 26.5. Kidney tissue was more sensitive than oral swabs for detecting WNV in squirrels. Three of 36 live neurologic tree squirrels had viremia approximately 5 log(10) plaque-forming units/mL or greater, similar to WNV-infected birds. Tree squirrels are useful in WNV surveillance and provide localized evidence of WNV transmission to mammals.

Field and laboratory evaluation of diagnostic assays for detecting West Nile virus in oropharyngeal swabs from California wild birds.

Three diagnostic assays for detecting West Nile virus (WNV) in avian oral swabs were evaluated in California in 2004 and 2005: two commercial antigen-capture assays, VecTest and Rapid Analyte Measurement Platform (RAMP), and reverse transcriptase-polymerase chain reaction (RT-PCR) of oral swabs in a specialized viral transport medium (VTM). Results from this study demonstrated that VTM was excellent for transportation and maintenance of WNV in avian oral swab samples and allowed for detection by RT-PCR and subsequent confirmation by virus isolation. Oral swabs and kidney tissue in VTM tested by RT-PCR were found to have similar accuracy in detecting WNV in corvids. The two antigen-capture assays, VecTest and RAMP, provided few false positives for corvids, with over 95% specificity. When performed by multiple local agencies throughout the state, VecTest and RAMP were similarly sensitive for oral swabs of American Crows (Corvus brachyrhynchos) (70% and 64%, respectively). Data from known WNV positive corvid oral swabs in VTM tested by antigen-capture assays at a diagnostic laboratory suggested that RAMP was more sensitive than VecTest. Due to high probability of false negatives, neither test is recommended for use on non-corvids. While WNV antigen-capture assays were effective screening tools for corvids, they were markedly less sensitive for Western Scrub Jays (Aphelocoma californica).

Overwintering of West Nile virus in Southern California.

West Nile virus (family Flaviviridae, genus Flavivirus, WNV) invaded southern California during 2003, successfully overwintered, amplified to epidemic levels, and then dispersed to every county in the state. Although surveillance programs successfully tracked and measured these events, mechanisms that allowed the efficient overwintering and subsequent amplification of WNV have not been elucidated. Our current research provided evidence for three mechanisms whereby WNV may have persisted in southern California during the winters of 2003-2004 and 2004-2005: 1) continued enzootic transmission, 2) vertical transmission by Culex mosquitoes, and 3) chronic infection in birds. WNV was detected in 140 dead birds comprising 32 species, including 60 dead American crows, thereby verifying transmission during the November-March winter period. Dead American crows provide evidence of recent transmission because this species always succumbs rapidly after infection. However, WNV RNA was not detected concurrently in 43,043 reproductively active female mosquitoes comprising 11 species and tested in 1,258 pools or antibody in sera from 190 sentinel chickens maintained in 19 flocks. Although efficient vertical transmission by WNV was demonstrated experimentally for Culex tarsalis Coquillett infected per os, 369 females collected diapausing in Kern County and tested in 32 pools were negative for WNV. Vertical transmission was detected in Culex pipiens quinquefasciatus Say adults reared from field-collected immatures collected from Kern County and Los Angeles during the summer transmission period. Chronic infection was detected by finding WNV RNA in 34 of 82 birds that were inoculated with WNV experimentally, held for >6 wk after infection, and then necropsied. Frequent detection of WNV RNA in kidney tissue in experimentally infected birds >6 wk postinfection may explain, in part, the repeated detection of WNV RNA in dead birds recovered during winter, especially in species such as mourning doves that typically do not die after experimental infection. In summary, our study provides limited evidence to support multiple modes of WNV persistence i n southern California. Continued transmission andvertical transmission by Culex p. quinquefasciatus Say seem likely candidates for further study.

Hepatitis C virus infection in young, low-income women: the role of sexually transmitted infection as a potential cofactor for HCV infection.

OBJECTIVES: We evaluated risk for hepatitis C virus (HCV) infection in women residing in low-income neighborhoods of northern California. METHODS: A population-based sample of 1707 women, aged 18 to 29, were surveyed and screened for sexually transmitted infections and HCV. RESULTS: Women infected with HCV (2.5%) were more likely to have a history of injection and noninjection drug use, to exchange sex for money or drugs, and to have sexually transmitted infections. HCV was independently associated with history of injection drug use, herpes simplex virus type 2 (HSV-2) infection, and heroin and cocaine use. CONCLUSIONS: Injection drug use is the highest risk exposure for HCV, but HSV-2 and noninjection drug use contribute significantly to increased risk. HCV prevention programs in impoverished areas should integrate drug treatment and sexually transmitted infection control.