West Nile Virus:

Preliminary Information on Lessons Learned

HEHS-00-142R: Published: Jun 23, 2000. Publicly Released: Jun 26, 2000.

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Pursuant to a congressional request, GAO reviewed the lessons learned from the 1999 outbreak of West Nile Virus in New York City and surrounding areas.

GAO noted that: (1) officials involved in the West Nile events indicated that the communications helped update involved parties as the investigation unfolded; (2) however, some key officials indicated that they believed this means of sharing information was time-consuming and inefficient and that alternatives for communicating detailed information were needed so they could use their expertise and skills to conduct the investigation; (3) assessments of the West Nile events and many officials said that the events highlighted the need for better integration and communication between animal/wildlife health communities and public health; (4) since the initial outbreak, the Centers for Disease Control and Prevention, state wildlife veterinarians, and an expanding group of federal and other agencies are using deaths in crows as sentinel events to define the geographic distribution of mosquitoes and birds infected with West Nile virus; (5) during the West Nile investigation, the six New York City Health Department staff who normally track over 50 reportable infectious diseases in the city worked long hours seven days a week to contact relevant officials at 70 hospitals to identify potential cases, interview patients and families, track cases, and ensure laboratory samples were shipped to appropriate parties; (6) officials indicated that the availability of even the small number of trained staff in New York City was critical to the quick response to the initial outbreak; (7) a frequent theme of discussions and assessments has been the adequacy of laboratory infrastructure at the state and federal levels for performing timely and thorough laboratory analyses; (8) officials pointed out that there are only two federal laboratories capable of handling those infectious agents considered of most concern; (9) further, most laboratories are not equipped to identify diseases that are rarely seen; (10) according to officials, laboratory capacity for performing the tests needed to identify the West Nile virus and to diagnose which people had the virus was consumed quickly by this relatively small outbreak; (11) while the West Nile virus outbreak is thought to have been a naturally-occurring event and officials interviewed indicated that the investigation did not find otherwise, at one point there was speculation in media reports that the outbreak might have had an unnatural (bioterrorist) origin; and (12) if it is determined that the outbreak is the result of a bioterrorist incident or threat, then additional organizations would need to become involved to carry out a criminal investigation.

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