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Epidemiological features of and public health response to a St. Louis encephalitis epidemic in Florida, 1990–1

Published online by Cambridge University Press:  03 November 2000

P. J. MEEHAN ,
D. L. WELLS ,
W. PAUL ,
E. BUFF ,
A. LEWIS ,
D. MUTH ,
R. HOPKINS ,
N. KARABATSOS  and
T. F. TSAI
P. J. MEEHAN
Affiliation:
Florida Department of Health and Rehabilitative Services, Tallahassee, FL 32399, USA
D. L. WELLS
Affiliation:
Florida Department of Health and Rehabilitative Services, Tallahassee, FL 32399, USA
W. PAUL
Affiliation:
Division of Vectorborne Infectious Diseases, Centers for Disease Control and Prevention, Ft. Collins, CO 80522, USA
E. BUFF
Affiliation:
Florida Department of Health and Rehabilitative Services, Tallahassee, FL 32399, USA
A. LEWIS
Affiliation:
Florida Department of Health and Rehabilitative Services, Tallahassee, FL 32399, USA
D. MUTH
Affiliation:
Division of Vectorborne Infectious Diseases, Centers for Disease Control and Prevention, Ft. Collins, CO 80522, USA
R. HOPKINS
Affiliation:
Florida Department of Health and Rehabilitative Services, Tallahassee, FL 32399, USA
N. KARABATSOS
Affiliation:
Division of Vectorborne Infectious Diseases, Centers for Disease Control and Prevention, Ft. Collins, CO 80522, USA
T. F. TSAI
Affiliation:
Division of Vectorborne Infectious Diseases, Centers for Disease Control and Prevention, Ft. Collins, CO 80522, USA
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Abstract

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A St. Louis encephalitis (SLE) epidemic in Florida during 25 weeks in 1990–1, resulted in 222 laboratory-diagnosed cases, an attack rate in the 28 affected counties of 2·25/100000. Disease risk rose with advanced age, to 17·14/100000 in persons over 80 years, and all 14 fatal cases were in persons over 55 years (median, 70 years). Community serosurveys in Indian River County, the epicenter of the outbreak (attack rate 21/100000), showed acute asymptomatic infections in 3·6% of the persons surveyed, with higher rates in persons with outdoor occupational exposure (7·4%) and in clients of a shelter for the indigent (13·3%). A matched case-control study found that evening outdoor exposure for more than 2 h was associated with an increased risk for acquiring illness (odds ratio [OR] 4·33, 95% CI 1·23–15·21) while a number of recommended personal protective measures were protective. Four SLE patients were dually infected with Highlands J virus, the first reported cases of acute infection with this alphavirus. The case-control study provided the first evidence that a public education campaign to reduce exposure had a protective effect against acquiring the disease.

Type
Research Article
Information
Epidemiology & Infection , Volume 125 , Issue 1 , August 2000 , pp. 181 - 188
Copyright
© 2000 Cambridge University Press