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West Nile Virus in

Rural Communities
MICHELE M. REHBEIN
R PHILIP SCHEIBEL
C AT H E R I N E M I L L E R- H U N T
WESTERN ILLINOIS UNIVERSITY
MM-REHBEIN@WIU.EDU

West Nile Virus


Arthropod-borne virus (arbovirus)
Viruses transmitted by arthropods, such as mosquitoes

Belongs to the group flavivirus


Initially discovered in northwest Uganda in 1937
By 1999, made its first appearance in the U.S. in NYC
Growing public health concern
One of the worst vector-borne diseases in the U.S.

Main vector: Culex mosquito


Birds are its primary host

www.plymouthmosquito.org

WNV and Human Health


Affects both humans and animals
Most people show minor to no symptoms
Can last a few days

More prominent symptoms:


Fever, headache, rash, body aches, fatigue, vomiting, diarrhea, joint pain

Severe symptoms:
Neurologic illness encephalitis or meningitis; high fever; coma; disorientation; seizures;
paralysis

No vaccine or treatment

Arbovirus Surveillance
Arboviruses are a major global health concern and a threat to public health
Over 30% of emerging infectious diseases are caused by arboviruses
Arboviruses are on the rise
Climate change
Ecological disruption
Increased travel and commerce

Evolution/adaptation in viruses
Viruses can mutate and change
Increase in virulence and transmission

Various Culex mosquitoes (photo taken


in the lab).

Spread of WNV
Factors which contribute to the spread of WNV:

Climate
Hot, dry weather
Peak summer months June through August
Over abundance of Culex mosquitoes
Culex loves dirty, polluted water

Mosquito larvae (photo taken in the lab).

Climate and WNV


There have been many individual studies that have shown associations with
vector-borne diseases and climate change
Climate change influences West Nile virus
Weather and climate patterns have a large effect on WNV infections and how it spreads
Can impact abundance of WNV hosts and vectors

Climate is a good indicator/predictor of vector population presence

Climate and WNV


Warmer and higher temperatures enable mosquitoes to be active longer
Decrease in rainfall pushes vector and host together, forcing them to scarce water sources
Culex has a greater chance of interacting with its primary host, birds, allowing the virus to
circulate longer
Increase reproductive and transmission rates
Climate change modifies seasonal mosquito population levels across the U.S. with
consequences for vector ecology and public health policy (Comrie & Morin, 2013)

West Nile Virus in Rural Illinois


Rural areas face many obstacles and challenges:
Less information is available on WNV distribution in rural
settings
Many people in these areas suffer from poor socioeconomic
conditions
Many work outside or in agriculture industry
Growing elderly population
Limited or lack of healthcare services or facilities medically
underserved
Types of infectious diseases in that specific area; without
proper diagnosis and treatment, there is no way to clinically
combat this disease

These factors can contribute to severe illness and


under reporting of clinical cases of arboviruses

Photo taken at Cass County Health Department field


site.

West Nile Virus in Rural Illinois


Some groups of people living in rural areas may already experience social
disparities
Hispanic immigration represents the largest source of population growth for
rural towns, reviving communities economically and culturally
Immigrants to rural communities may encounter specific obstacles that
prevent them from accessing and using health care services, including
communication problems, a lack of health insurance coverage, inability to
pay for services, issues with their legal status, discrimination, and
transportation problems

West Nile Virus in Rural Illinois


Considering these factors, people living in rural
areas may represent a population that is not
only vulnerable to vector-borne infections, but
may be especially at risk for severe disease
complications arising from a lack of adequate
medical care

One of our primary goals is to raise awareness


about these issues and help all rural residents
through advocacy and empowerment

WNV Surveillance in Rural IL


The WNV project carried out in collaboration with several local
health departments
McDonough County
Cass County
Fulton County

Primary objective was to aid local health departments by providing


personnel or resources which they do not have for surveying and
monitoring vector-borne diseases
Supply valuable information to be used by health officials and community
members
Provide public outreach, communicating and facilitating engagement in these
issues (this is key!)
Fair treatment and meaningful involvement of all people

Data collected suggested that arboviruses, such as WNV, are more


common in western IL than previously thought

WNV Surveillance in Rural IL


Why rural communities are so unique in terms of
arbovirus/vector surveillance
Rural communities are important to this surveillance
Minorities growing in the population - could lack resources/health care
as well as a change in culture

We see a lack of scientific information about vector-borne


diseases in Midwestern states
In IL, there is under sampling of mosquitoes in rural areas and a
concentration of studies in urban areas, such as Chicago.
Less is known in regions such as western Illinois

Vector Biology Educational


Initiative
We supplied information which can be used by health officials and community
members to better protect the public
Specifically for myself, I have begun to play a big role as a research team
leader and have been integral to the planning and execution of nearly every
aspect of the research
Designed in this way so I could gain these skills and experiences to pass along to
other students

The WIU vector biology group aims to engage in scientific research that
directly benefits local communities
Michele Rehbein,
B.S.
Dept. of Biological
Sciences/Dept. of
Health Sciences &
Social Work

Phil Scheibel,
M.S.
Dept. of
Biological
Sciences

Sophia
Caban
Dept. of
Biological
Sciences

Vector Biology Educational


Initiative
At WIU, many students come from low income families, rural communities, and are
first generation college students
Rural communities serve as a link between disparity and environmental justice

Establishing an educational initiative and structure


Based on the fact there is a recognized decline in expertise related to tropical infectious
diseases
Doctors are not trained well enough on this topic
Arboviruses are expanding rapidly and persisting (such as WNV)
No doctor should be ignorant of these diseases, especially ones you would find in a rural setting

Trying to empower students in the program and reaching them across multiple disciplines in
order to provide them with skills and experience that will better prepare them for whatever
career they pursue
Medicine
Public Health
Biology

West Nile Virus and the Future


By continuing vector surveillance, numerous communities can be helped
Engaging in scientific research which can directly benefit local communities
We will be expanding the study to monitor for other vector-borne diseases
Help understand WNV transmission and prevalence more within the human
population
Involvement of all people

Starts with outreach


Advocacy for peoples needs
Empowerment through education
Community develops foundation for their information