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In 2002, the world’s largest outbreak of neuroinvasive West Nile virus (WNV) disease occurred. Illinois reported 21% of the total cases in the United States, the most among all states. The epidemiology of WNV in Illinois in 2002 was examined to determine factors associated with severe disease and death. A total of 884 cases were identified and there were 66 deaths. The overall attack rate of WNV infection was 7.1 per 100,000 population and this increased with age. The median ages of patients and patients who died were 56 and 78 years, respectively. Among patients who died, 91% were diagnosed with encephalitis and the case-fatality rate for patients with encephalitis was 18.6%. Patients more than 50 years old had a significantly higher risk of being reported with encephalitis (relative risk [RR] = 3.3, 95% confidence interval [CI] = 2.6–4.3%) and death (RR = 22.3, 95% CI = 5.5–90.4%). Clinicians evaluating elderly patients with WNV infection should assess patients closely for progression of disease.
Received May 1, 2004. Accepted for publication October 7, 2004.
Acknowledgments: We are indebted to Robin Weaver and Hope Johnson, and Pearlie Jenkins-Knox (IDPH Laboratory) for their exhaustive dedication during laboratory testing; to Ken McCann (Division of Environmental Health, IDPH) for his expertise on geographic information system mapping; to Andrea Winquist (Centers for Disease Control and Prevention) for her thoughtful comments on the manuscript; and to all the public health officials throughout the state who participated in WNV surveillance for their tireless efforts protecting the health of Illinois residents.
Disclosure: No authors had any financial support or relationships that may be perceived as constituting a conflict of interest.
Authors’ addresses: Gregory D. Huhn, Craig Conover, and Mark S. Dworkin, Division of Infectious Diseases, Illinois Department of Public Health, 160 North LaSalle Street, #7 South, Chicago, IL 60601, Telephone: 312-814-4846, Fax: 312-814-4844, E-mails: ghuhn{at}idph.state.il.us, cconover{at}idph.state.il.us, and mdworkin{at}idph.state.il.us. Connie Austin, Carl Langkop, Kate Kelly, and Roland Lucht, Division of Infectious Diseases, Illinois Department of Public Health, 525 West Jefferson Street, Springfield, IL 62761, Telephone: 217-785-7165, Fax: 217-557-4049, E-mails: caustin{at}idph.state.il.us, clangkop{at}idph.state.il.us, kkelly{at}idph.state.il.us, and rlucht{at}idph.state.il.us. Richard Lampman and Robert Novack, Medical Entomology Program, Illinois Natural History Survey, 697 East Peabody Drive, Champaign, IL 61820, Telephone: 217-333-1186, Fax: 217-333-2359, E-mails: rlampman{at}inhs.uiuc.edu and rnovak{at}inhs.uiuc.edu. Linn Haramis, Division of Environmental Health, Illinois Department of Public Health, 525 West Jefferson Street, Springfield, IL 62761, Telephone: 217-782-5830, Fax: 217-785-0253, E-mail: lharamis{at}idph.state.il.us. Rosemary Boker, Division of Laboratories, Illinois Department of Public Health, 2121 West Taylor Street, Chicago, IL 60612, Telephone: 312-793-4760, Fax: 312-793-4765, E-mail: nooker{at}idph.state.il.us. Stephanie Smith and Maria Chudoba, Cook County Department of Public Health, 1010 Lake Street, Suite 300, Oak Park, IL 60301, Telephone: 312-492-2150, Fax: 708-492-2932, E-mails: smwsmith{at}attbi.com and mchodob{at}cookcountygov.com. Susan Gerber, Chicago Department of Public Health, 2160 West Ogden Avenue, Chicago, IL 60612, Telephone: 312-746-5992, Fax: 312-746-6388, E-mail: susangerber{at}sbcglobal.net.
Reprint requests: Gregory D. Huhn, Division of Infectious Diseases, Illinois Department of Public Health, 160 North LaSalle Street, #7 South, Chicago, IL 60601.
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