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Arbovirus Case Investigation. Purpose. Determine mode of transmission Characterize the clinical picture of disease Identify risk factors for infection and severe disease Feedback recommendations to patient and family. Part I: Clinical Investigation.
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Purpose • Determine mode of transmission • Characterize the clinical picture of disease • Identify risk factors for infection and severe disease • Feedback recommendations to patient and family
Possible Exposure/ Transmission Information • Yellow fever vaccination • Transfusion/organ transplant • Given blood • Pregnancy • Breastfeeding • Outdoor activities
Travel History • What are dengue endemic regions? • Why focus on dengue endemic regions? • Determine possible exposure setting • Determine if case is imported
Symptoms • Onset date • Meningitis (CSF white blood cell count >5) • Encephalitis (Evidence of brain involvement) • West Nile Fever • Other (movement disorders, flaccid paralysis, rhabdomyolysis,etc.) • Treatment
Environment Around the Home • Man-made mosquito breeding sites • Containers • Tires • Tarps • Natural mosquito breeding sites • Ponds • Wooded areas (Hardwoods)
Recommendations • Personal protection • Get rid of tires and containers • Drain birdbaths and pots weekly • Clean gutters • Fill Ditches • Use Larvacidal “dunks”
Latitude and Longitude • Exact location of case • Determine if there is clustering in neighborhoods • Look for patterns and focus area of transmission • Connects human data with bird and mosquito data
Completing the Case Investigation • Yellow Card • Attach all lab results • Blood and/or CSF arbovirus panel • CSF cell count, protein and glucose • Viral cultures if done • Get blood or CSF sent to OLS for confirmatory testing • Complete clinical and environmental investigation