Ecological Complexity and West Nile Virus: Perspectives on Improving Public Health Response

By Rainham, Daniel G. C. | Canadian Journal of Public Health, January/February 2005 | Go to article overview

Ecological Complexity and West Nile Virus: Perspectives on Improving Public Health Response


Rainham, Daniel G. C., Canadian Journal of Public Health


ABSTRACT

The emergence of West Nile Virus, as well as other emerging diseases, is linked to complex ecosystem processes such as climate change and constitutes an important threat to population health. Traditional public health intervention activities related to vector surveillance and control tend to be reactive and limited in their ability to deal with multiple epidemics and in their consideration of population health determinants. This paper reviews the current status of West Nile Virus in Canada and describes how complex systems and geographical perspectives help to acknowledge the influence of ecosystem processes on population health. It also provides examples of how these perspectives can be integrated into population-based intervention strategies.

MeSH terms: Disease transmission; ecological systems; geographic information systems; systems theory; primary prevention

RÉSUMÉ

L'apparition du virus du Nil occidental, à l'instar d'autres maladies émergentes, résulte de processus ecosystemiques complexes, comme le changement climatique, et représente une importante menace pour la santé. Les interventions traditionnelles de santé publique, telles que la surveillance et le contrôle des vecteurs, demeurent limitées dans leur capacité d'endiguer les épidémies ou d'agir sur leurs déterminants. Cet article examine la situation canadienne et l'état actuel des connaissances sur le virus du Nil occidental. En s'appuyant sur une analyse des systèmes complexes et une analyse spatiale, il décrit comment les écosystèmes influencent la santé des populations et, en conséquence, quelles stratégies d'intervention populationnelle pourraient être envisagées.

West Nile Virus (WNV) as well as other emerging infectious diseases have been characterized as important threats to population health,1-3 and constitute a major focus of population health intervention and policy research.4 Fluctuations in climatic variables - most notably temperature, precipitation, humidity and wind - influence the distribution and processes among biological organisms linked to the spatial and dynamic variability of infectious diseases.5 Disease surveillance and vector control activities must acknowledge the inherent complexity characteristic to ecosystem-based transmission cycles, as well as the complex interactions among the determinants of population health.6-8 Population-based intervention strategies will require unconventional analytic tools and alternative conceptual foundations if they are to be successful at tackling public health risks characterized by multiple interactions, non-linear rates of change, and spatio-temporal influences. This paper discusses how complex systems and geographical perspectives can contribute to the design of population health interventions for West Nile Virus, and by extension, other emerging infectious diseases.

Transmission and expansion of West Nile Virus

The sudden appearance of severe and fatal encephalitis in dying corvids (i.e., crows, ravens, blue jays) and in humans in New York City in 1999, and in Canada in 2001, provides a compelling example of the expanding range of emerging diseases and a corresponding expansion in diagnostic capacity to detect emerging health threats. West Nile Virus transmission cycles and maintenance mechanisms are usually very complex, and the virus can easily become established if efficient vectors, suitable amplifying hosts, and reliable overwintering mechanisms are available.9 Indigenous to Africa, Asia, Europe, and Australia, and now North America, the origin of the original strain of WNV is the Middle East, but the mode of introduction is unknown.10 Humans are incidental (dead end) hosts since they can become ill as a result of the virus, but do not develop viremia that is required for the continuation of the transmission cycle if bitten by another mosquito.11

West Nile Virus constitutes a serious threat to human population health and well-being. …

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