{"id":469,"date":"2019-05-17T18:42:23","date_gmt":"2019-05-17T18:42:23","guid":{"rendered":"https:\/\/www.vdh.virginia.gov\/clinicians\/?page_id=469"},"modified":"2022-05-23T15:34:52","modified_gmt":"2022-05-23T15:34:52","slug":"tick-and-mosquito-infections","status":"publish","type":"page","link":"https:\/\/www.vdh.virginia.gov\/clinicians\/tick-and-mosquito-infections\/","title":{"rendered":"Tick and Mosquito Infections"},"content":{"rendered":"<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-1162\" src=\"https:\/\/www.vdh.virginia.gov\/content\/uploads\/sites\/134\/2022\/05\/Letterhead-Oliver-2019-1.png\" alt=\"\" width=\"1692\" height=\"480\" \/><\/p>\n<p style=\"text-align: center\">May 28, 2019<\/p>\n<p>Dear Colleague,<\/p>\n<p>Because mosquitoes are most active in Virginia between May and October, I am providing updates to assist you in diagnosing and treating arboviral infections:<\/p>\n<p><span style=\"text-decoration: underline\"><strong>Mosquito-borne Infections<\/strong><\/span><br \/>\n\u2022 <a href=\"https:\/\/www.cdc.gov\/westnile\/index.html\">West Nile virus<\/a> is the leading cause of locally-acquired, mosquito-borne infection in Virginia. In 2018, a record number of infections (48), including 9 deaths, were reported.<br \/>\n\u2022 Based on cases identified in neighboring states with similar vector ecology, <a href=\"https:\/\/www.cdc.gov\/lac\/index.html\">La Crosse virus (LACV) or \u201cCalifornia encephalitis virus\u201d<\/a> may be under-recognized and under-reported in Virginia. Patients suspected of having LACV infections can be tested through Virginia\u2019s state public health laboratory, the Division of Consolidated Laboratory Services. Contact your local health department to request testing.<br \/>\n\u2022 Updated recommendations for <a href=\"https:\/\/www.vdh.virginia.gov\/content\/uploads\/sites\/12\/2019\/04\/Provider_algorithm-1.pdf\">Zika virus testing<\/a> are available on the VDH website.<br \/>\n\u2022 IV quinidine for the treatment of <a href=\"https:\/\/www.cdc.gov\/malaria\/diagnosis_treatment\/artesunate.html\">severe malaria<\/a> is no longer commercially available. IV artesunate has become the first-line drug in the United States; CDC is providing it under an expanded access investigational drug protocol.<\/p>\n<p><span style=\"text-decoration: underline\"><strong>Tick-borne Infections<\/strong><\/span><br \/>\n\u2022 <a href=\"https:\/\/www.cdc.gov\/rmsf\/index.html\">Rocky Mountain spotted fever (RMSF)<\/a> may be over-diagnosed in Virginia. RMSF diagnostic tests can react to non-pathogenic spotted fever group agents carried by Lone star ticks, the most common cause of tick bites in Virginia. VDH recommends that healthcare providers consider <a href=\"https:\/\/www.cdc.gov\/ehrlichiosis\/index.html\">ehrlichiosis<\/a> in differential diagnoses that include RMSF and consider testing patients by a multiplex PCR assay that includes Ehrlichia\/Anaplasma.<br \/>\n\u2022 Testing for emerging viruses (e.g. <a href=\"https:\/\/www.cdc.gov\/powassan\/index.html\">Powassan<\/a> and <a href=\"https:\/\/www.cdc.gov\/heartland-virus\/index.html\">Heartland<\/a> viruses) at CDC may be facilitated by Virginia\u2019s state public health laboratory, the Division of Consolidated Laboratory Services. Contact your local health department to request testing.<\/p>\n<p><span style=\"text-decoration: underline\"><strong>Public Health Actions for Healthcare Providers<\/strong><\/span><br \/>\n\u2022 Remind patients to take steps to <a href=\"https:\/\/www.vdh.virginia.gov\/environmental-epidemiology\/bugs-human-health\/?tab=1\">minimize tick and mosquito bites<\/a>.<br \/>\n\u2022 For people traveling abroad, destination-specific recommendations are available on <a href=\"https:\/\/wwwnc.cdc.gov\/travel\/page\/zika-travel-information\">CDC&#8217;s Travelers&#8217; Health website<\/a>.<br \/>\n\u2022 A resource to assist in distinguishing arboviral infections and recommendations for testing is <a href=\"https:\/\/www.vdh.virginia.gov\/content\/uploads\/sites\/12\/2019\/04\/Arboviral-Infections-Characteristics.pdf\">available on VDH\u2019s website<\/a>.<br \/>\n\u2022 Detailed information about the diagnosis and treatment of arboviral infections is available on <a href=\"https:\/\/www.cdc.gov\/ncezid\/dvbd\/index.html\">CDC\u2019s website<\/a>.<br \/>\n\u2022 If you have additional questions, please contact your <a href=\"https:\/\/www.vdh.virginia.gov\/health-department-locator\/\">local health department<\/a>.<br \/>\nPlease contact Dr. David Gaines, State Public Health Entomologist, at <a href=\"mailto:david.gaines@vdh.virginia.gov\">david.gaines@vdh.virginia.gov<\/a> for additional information.<\/p>\n<p>Sincerely,<\/p>\n<p>M. Norman Oliver, MD, MA<br \/>\nState Health Commissioner<\/p>\n","protected":false},"excerpt":{"rendered":"<p>May 28, 2019 Dear Colleague, Because mosquitoes are most active in Virginia between May and October, I am providing updates to assist you in diagnosing and treating arboviral infections: Mosquito-borne Infections \u2022 West Nile virus is the leading cause of locally-acquired, mosquito-borne infection in Virginia. In 2018, a record number of infections (48), including 9 [&hellip;]<\/p>\n","protected":false},"author":78,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_lmt_disableupdate":"","_lmt_disable":"","footnotes":""},"tags":[],"class_list":["post-469","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.3 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Tick and Mosquito Infections - Clinicians<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.vdh.virginia.gov\/clinicians\/tick-and-mosquito-infections\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Tick and Mosquito Infections - Clinicians\" \/>\n<meta property=\"og:description\" content=\"May 28, 2019 Dear Colleague, Because mosquitoes are most active in Virginia between May and October, I am providing updates to assist you in diagnosing and treating arboviral infections: Mosquito-borne Infections \u2022 West Nile virus is the leading cause of locally-acquired, mosquito-borne infection in Virginia. 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