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West Nile fever - a global change in epidemiology and surveillance in the Czech Republic
VONDRÁKOVÁ, Renata
The main goal of thesis is to explore the changing global epidemiological situation depending on climate changes and to map trends of changes in epidemiological situation. A sub-objective is to find out if there are differences in the geographical distribution of the incidence of West Nile Virus (WNV) in the period 2004-2014 next to map surveillance, to propose options for improving prevention in a changing geographical distribution, to describe cases of the diseases reported in the Czech Republic, to determine whether in the Pilsen and Budweis medical facilities are routinely investigating also on detection of WNV infection and finally to chart the WNV infection rate and its causes in horse breeding. Influence of climate change on distribution of WNV can be very well observed. This change is mainly due to settlement of new countries by the originator and also reservoirs which are moving further to the north or south becouse of climate. Distribution of WNV to the new countries is also supported by the changing of landscape, mainly due to the changing climate. The changes of migration routes of migratory birds which are also affected by climate changes have also the effect on changing geographic distribution. The globalization of the world is also mostly responsible for change of distribution. The change of epidemiological situation is given by that the virus attacks organisms that did not meet with virus until now. Therefore, there is a change in the clinical picture and more serious forms of the disease appear in the greater degree than before. Official statistics numbers of diseases in the EU in 2008-2012 published by the ECDC revealed that number of illnesses depends on the global climate changes and also on the climate in a current year. Data for year 2010 clearly reveal how big influence extreme temperatures have on the number of reported illnesses. With regard to prevention in the Czech Republic, as a main step was to designed the informing of tourists. The substantial part of the repressive measures against WNV disease is to stop transmission of WNV blood transfusions. This deals with in annex 3of Decree no. 143/2008 Coll.. Currently the draft of methodological instruction which sets out the procedure for assessing the risk of WNV infection and the procedure to reduce the risk of transmission of the virus through blood transfusions is in the comment procedure. By the survey of health facilities was found out that it is according the legislation, specifically Decree 233/2011 Coll.. Private microbiology and serology laboratories in Pilsen and Budweis do not test on positivity of WNV. Targeted surveillance of horse WNV in Czech Republic is doing from 2011. In 2011 2013 it was 4 5 WNV positive horses, in 2014 it was already 13 horses from a total of 783 horses tested positive WNV. Various geographic distribution of horses and high specific antibody titers according to veterinarians indicate increasing activity of the virus in the Czech Republic and the possible expansion of WNV into new areas. The thesis also analyzes three cases of WNV disease that have been imported to the Czech Republic from the USA, Tanzania and from Cyprus. In thesis is also described the first autochthonous case of WNV infection in the Czech Republic in 2013 which demonstrates the changing epidemiological situation in the country. Based on the obtained data is appreciable that the virus will be with regard to a changing climate and increased globalization spread to new areas in which will be probably cause diseases with serious clinical course. Whereas the virus has a tends to mutation it is expected also a gradual change of the clinical picture. To stop the spread of the virus should be carried out surveillance at all levels. Insomuch as is not in current time human vaccine available to curb the spread of the The essential elements od prevention includes informing tourists traveling to high-risk countries and countries potentially risky.
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