The Impact of Day Length and the Dispersal of the American robin (Turdus migratorius) on Human West Nile Virus Epidemics in North America Abstract The threat of West Nile Virus (WNV) has become widespread in North America, prompting extensive research into both the prediction and prevention of the disease. Several species are involved in the persistence and transmittance of WNV, thus understanding the species interactions which shape the epidemiological patterns of WNV infection is paramount. Recent research suggests that seasonal increases in human WNV cases in North America can be attributed to the migratory exodus of the American robin (Turdus migratorius), and a corresponding shift in feeding behavior by mosquito vectors to humans. In this study we examine human WNV case data across North America in 2007, compare timing of epidemics to shifts in day length (an indicator of bird migration), and contrast WNV activity between breeding and wintering ranges of T. migratorius. Our findings do not support the claim that increased WNV activity is due to the exodus of robins, as we found no difference between the two ranges. Our study indicates that there is a significant link between increased WNV activity and decreased day length and demonstrates that epidemics occurred simultaneously in all locations in 2007. We conclude that while both bird migration and peak WNV activity are related to seasonality, the latter is not a result of the former. Background West Nile Virus: West Nile Virus (WNV) is a mosquito-borne flavivirus and human, avian, and equine neuropathogen. The virus was first identified in the West Nile district of Uganda in 1937 and is indigenous to Africa, Asia, Australia, and Europe. In the 1990s, human outbreaks of West Nile occurred in Europe and the Mediterranean area. WNV was first observed in the Western hemisphere in 1999 during a meningeoencephalitis epidemic in New York City causing 59 hospitalizations and seven deaths. (1, 2) This outbreak was an unpredicted and startling reminder of the impact of emerging infectious diseases, even in the United States. Since 1999, West Nile has spread west across the continent and has been reported in every state of the continental United States. Sara A. Koehring ’08/’09 and Jamie Fitzgerald, Ph.D. Candidate Clark University, Worcester, MA 01610, USA Faculty Sponsor: Dr. Todd Livdahl, Biology Department Purpose Research efforts have recently focused on understanding the patterns of WNV outbreaks observed in North America as they relate to bird migration, and the causes contributing to these patterns. Kilpatrick et al (9) examined a seasonal 7-fold shift in feeding preference by C. pipiens from Turdus migratorius to humans in Maryland, USA. PCR analysis of blood meals isolated from 148 mosquitoes indicated not only a change in host frequency, but that T. migratorius was preferred over any other bird in the area, and that humans were the preferred mammal. Since an increase in human WNV cases occurs during the period of robin dispersal, the Fig. 1: American Robin (Turdus migratorius) authors propose that their absence leads to a shift in mosquito (photo credit: Project Wild Bird: Field Guide to Birds of North America) feeding behavior from birds to humans, and is largely responsible for human WNV epidemics. The purpose of this study was to test these claims across a broader scale by examining WNV case data and by relating it to bird migration across North America. We predicted that if the claims make by Kilpatrick et al (9) are true, then peaks in human WNV cases should be timed with bird dispersal, or with factors indicating and driving bird migration. Due to the lack of comprehensive bird migration data, we used day length as a well-established and reliable indicator of bird dispersal (12-14). Further, we predicted that if increased WNV activity in humans were in fact due to the exodus of T. migratorius from an area, then the intensity of the increase should be more severe in areas where most, if not all, robins migrate than it would be in areas where many robins remain throughout the year. Fig. 4: Distribution of Culex pipiens (photo: NASA/Goddard Space Flight Center, Scientific Visualization Studio) Fig. 5: Distribution of Aedes vexans (photo: NASA/Goddard Space Flight Center, Scientific Visualization Studio) Methods We examined data from the most recent year (2007) for which complete data sets were available at the time of this study. We selected three geographical regions based specifically on the range of T. The West Nile Virus is an arthropod-borne migratorius; the northern region (Ontario, Saskatchewan, Alberta and Manitoba) is considered breeding virus, also known as an arbovirus. Arboviruses range for T. migratorius, the middle region (Montana, North Dakota, and Minnesota) contains areas that survive in nature through blood-feeding are breeding and breeding/wintering ranges, and the southern region (Colorado, Kansas, and arthropods which transmit the virus to susceptible Missouri) is considered breeding/wintering range (Figure 6). vertebrate hosts. When an infected arthropod takes Human WNV data for the northern region were collected from the Public Health Agency of a blood meal from a vertebrate the virus is passed Canada’s West Nile Virus Monitor webpage (15), using the West Nile National Surveillance Report for to the vertebrate (Figure 1). WNV is transmitted 2007 (24). Data for the middle and southern regions were collected from the United States Geological via vector mosquitoes. Birds are the reservoir or Services (USGS) Disease Maps webpage (16). Error was estimated to be 1 for Montana, 2 for amplifying host while humans and other mammals North Dakota, and 2 for Colorado, as data were extracted from a graph. are typically incidental hosts. Different mosquitoes Fig. 1: West Nile Virus Transmission Cycle (photo credit: www.fda.gov) Day length was calculated from sunrise and sunset times acquired from the United States Naval are considered to be the primary vectors in Observatory (17). Data from a centralized location served as representative for each province or state. different geographical regions. In Canada the major mosquito species involved in the Fig. 6: Distribution of American Robin (Turdus Rise and set times were recorded for Wednesdays only, and were used as an estimate of average day transmission cycle of WNV are Culex pipiens and Aedes vexans while in Eastern and Western migratorius). Red outline indicates Canadian length for each week. provinces used, blue outline indicates northern US the main species are Culex pipiens and Culex tarsalis, respectively. (3) Figures 2 and 3 show Human population data for 2007 were acquired for each state from the United States Census US states used, green outline indicates Culex pipiens and Aedes vexans while Figures 4 and 5 illustrate their respective geographic southern US states used.(photo adapted from: Bureau (projected by the US Census Bureau in association with the Federal State Cooperative Program distributions. Canadian Wildlife Service & Canadian Wildlife for Population Estimates) (18), and for each province from Statistics Canada (projected by Statistics Federation © 2008, www.hww.ca) Canada based on 2001 census data) (19). Clinical Manifestations: Approximately 80% of persons infected with WNV are The total number of human WNV cases in each province or state was plotted against day length in order to determine and asymptomatic and exhibit no signs of infection (4). Mild symptoms displayed in roughly 20% compare the day length at which peak WNV activity occurred in each region. Single factor ANOVA without replication was used to of human WNV cases include fever, vomiting, nausea, head and body aches, and in some compare between regions the day length at peak activity, and the number of weeks post-solstice peak activity occurred. The measure of cases, swollen lymph glands or a dermatological rash on the back, chest, and stomach. These WNV activity in each province and state was standardized by dividing the number of reported human cases by the population. Single symptoms typically last only a few days, but even healthy people may be ill for several weeks. factor ANOVA without replication was used again to determine differences in this standardized measure between regions. Approximately 1 in 150 people infected with WNV will develop severe neurological syndromes such as meningitis, encephalitis, and flaccid paralysis (5). Symptoms resulting from acute cases of WNV include high fever, headache, neck stiffness, disorientation, stupor, Table 1: Summary of data and ANOVA analysis for north, middle and south regions Peak WNV activity in all provinces and states occurred 6-9 weeks after the North Region Middle Region South Region ANOVA coma, muscle weakness, tremors, convulsions, vision loss, numbness, and paralysis. These summer solstice week, or the week with the longest calculated day lengths, Ontario 14:27 Montana 13:55 Colorado 13:40 F=16.35 symptoms can persist for several weeks and neurological damage is usually permanent (4). regardless of location or day length specific to location (see Figures 7, 8, and 15:22 N.Dakota 14:16 Kansas 13:40 p=0.002 Day length at peak Manitoba WNV activity Saskatchewan 15:47 Minnesota 14:16 Missouri 13:25 WNV Activity in 2007: During 2007, 3,630 human West Nile 9). While a significant difference was found between regions in regards to the Alberta 15:22 cases with 117 fatalities were reported across 775 counties in day length at which peak WNV activity occurred (F=16.35, p=0.002), no Ontario 9 Montana 9 Colorado 8 F=1.62 Weeks past Manitoba 7 N.Dakota 8 Kansas 8 p=0.264 44 states and the District of Columbia, indicating that the significant difference was found between regions in regards to the timing of solstice at peak Saskatchewan 6 Minnesota 8 Missouri 9 WNV activity virus has become well established in the United States. (6) peak activity (F=1.62, p=0.264), measured by weeks past solstice, indicating Alberta 7 Ontario 0.001 Montana 0.211 Colorado 0.119 F=0.86 that the difference in day length is likely a product of latitude alone. No Human WNV Manitoba 0.493 N.Dakota 0.577 Kansas 0.014 p=0.462 WNV and Migratory Birds: It is likely that migratory birds cases/population significant difference in intensity of epidemics, measured as human WNV per Saskatchewan 1.451 Minnesota 0.019 Missouri 0.013 (1000) Fig. 2: Culex pipiens were responsible for the initial spread of West Nile given that Alberta 0.092 population, occurred between regions in 2007. (see Table 1) (photo credit: Joseph Hlasek, the increasing number of human WNV cases along the hlasek.com) Atlantic seaboard from 1999 to 2000 correlate with common migratory pathways for avian populations that summer in the Northeastern US (7, 8). The migration patterns of birds that are WNV reservoir and amplification hosts are important for two reasons: (i) their role in carrying the disease across geographical ranges and (ii) because the timing of bird presence and absence in a given area plays a role in which Fig. 3: Aedes vexans (photo credit: Troy Bartlett hosts mosquito species may have access to (9-11). Results © 2004, BugGuide.net) Fig. 7: Number of Human WNV Cases Per Day Length (in Hours) in Northern Region Black vertical line indicates summer solstice Fig. 8: Number of Human WNV Cases Per Day Length (in Hours) in Middle Region Black vertical line indicates summer solstice Fig. 9: Number of Human WNV Cases Per Day Length (Hours) in Southern Region Black vertical line indicates summer solstice Discussion Peak WNV activity does not appear to be driven by bird dispersal in the regions examined in this study. Human WNV cases peaked simultaneously in all three regions, regardless of geographic location or day length, despite the expectation that the timing of bird dispersal varies geographically, and that since birds alter their migratory behaviors in response to local events, some irregularity in bird dispersal would be expected. We propose that while it is likely that both bird dispersal and a shift in mosquito feeding behavior occur in response to similar cues, the latter is not a direct result of the former. Further, if T. migratorius dispersal is responsible for a shift in target hosts of Culex spp., and corresponding increase in human WNV cases, then more extensive increases would be expected in regions of heavier migration, and less extensive increases expected in regions where birds remain. Our findings do not support bird dispersal as a cause of increased WNV incidence, as no difference in human WNV cases per population occurred between breeding and wintering ranges of T. migratorius. It is, however, noteworthy that in all cases, peak WNV activity occurred 6-9 weeks post-solstice, and that timing in relation to solstice, or the number of days post-solstice, was more important than actual hours of light per day in determining WNV activity. The regularity of this observation is indicative of a link between WNV activity and decreasing day length, and warrants further investigation. A change in host preference observed by Kilpatrick et al (16) can not be disregarded, and further exploration may lead to an alternate explanation of the phenomenon, or its relationship with WNV activity. Increasing mosquito numbers and geographic range would undoubtedly prove useful, and new techniques would allow more accurate and definitive repetition of earlier analysis (e.g., 17, 18) and its relation to modern WNV epidemics. Studies should be performed in areas of low to no bird migration, as a decline in avian blood meals corresponding to increases in human blood meals in such area indicates host preferences change regardless of bird migration. Future research efforts may also be directed at quantifying mosquito activity, and the number of WNV positive mosquito pools, as increased WNV incidence in humans may simply be due to a larger population or proportion of infected mosquitoes. If no change is observed these parameters, then a change in WNV incidence may implicate other causes such as host availability or mosquito feeding preferences. Further, seasonal abundance of mosquitoes varies geographically and in relation to climate, thus disease is more likely to persist in areas where mosquito activity is constant. This study examined data spanning only one year (2007). The expansion of these efforts to a broader temporal scale may illuminate additional factors driving the seasonality of peaks in WNV activity, such as the influence of temperature or precipitation, or may alter our perception of the patterns examined here. Further investigation into mosquito responses, decisions, and actions are undoubtedly necessary to understand the factors driving WNV epidemiology. It is possible that the mosquitoes are responding directly and actively to decreases in day length, rather than indirectly or passively to changes in host availability. Other behavioral changes could account for the shift in host preference, such as slower and lower flight or activity related to changes in temperature, humidity, day light changes, or other unknown factors. Mosquitoes may sense or derive different elements from mammals than birds, and may prepare for winter by altering feeding behaviors. While speculative and hypothetical examples, these possibilities illustrate the limited knowledge that exists regarding mosquito behavior. It is imperative that future research focus on the drivers of mosquito behaviors if we are to truly understand mosquito-borne disease. Conclusion While a definite seasonal pattern to WNV incidence has been established, our data do not support that it is the direct result of bird dispersal. It is likely that additional and, as yet, unknown factors are responsible for the observed pattern of epidemics, and indeed that these factors are multiple and dynamic. Given the prevalence and epidemiological implications of WNV, the understanding of these phenomena is an important priority for science and medicine. As always, more research is both warranted and needed, not only to advance our understanding of West Nile Virus, but of all vector-borne diseases, and the organisms and systems involved in their persistence. References 1. Campbell GL, Marfin AA, Lanciotti RS, Gubler DJ. West Nile Virus. The Lancet. 2002; 2(9):519-29. 2. Huhn GD, Sejvar JJ, Montgomery SP, Dworkin MS. West Nile virus in the United States: an update on an emerging infectious disease. American Family Physician. 2003; 68(4):653-60. 3. Hayes EB KN, Nasci RS, Montgomery SP, O'Leary DR, Campbell GL,. Epidemiology and transmission dynamics of West Nile virus disease. Emerging Infectious Diseases. 2005; 11(8):1167-73. 4. Center for Disease Control and Prevention. West Nile Virus Fact Sheet. 2005. 5. Watson JT, Pertel PE, Jones RC, Siston AM, Paul WS, Austin CC, et al. Clinical Characteristics and Functional Outcomes of West Nile Fever. Annals of Internal Medicine. 2004; 141(5):360. 6. Center for Disease Control and Prevention. Statistics, Surveillance, and Control: Maps and Data. 2007 [cited 2007; Available: http://www.cdc.gov/ncidod/dvbid/westnile/surv&control.htm#surveillance] 7. Reed KD, Meece JK, Henkel JS, Shukla SK. Birds, Migration and Emerging Zoonoses: West Nile Virus, Lyme Disease, Influenza A and Enteropathogens. Clinical Medicine and Research. 2003; 1(1):5-12. 8. Rappole JH, Derrickson SR, Hubalek Z. Migratory Birds and Spread of West Nile Virus in the Western Hemisphere. Emerging Infectious Diseases. 2000; 6(4):319-28. 9. Kilpatrick AM, Kramer LD, Jones MJ, Marra PP, Daszak P. West Nile Virus Epidemics in North America Are Driven by Shifts in Mosquito Feeding Behavior. PLoS Biology. 2006; 4(4):606-10. 10. Tempelis CH, Francy DB, Hayes RO, Lofy MF. Variations in Feeding Patterns of Seven Culicine Mosquitoes on Vertebrate Hosts in Weld and Larimer Counties, Colorado. American Journal of Tropical Medical Hygiene. 1967; 16(1):111-9. 11. Tempelis CH, Reeves WC, Bellamy RE, Lofy MF. A Three-Year Study of the Feeding Habits of Culex Tarsalis in Kern County, California. American Journal of Tropical Medical Hygiene. 1965; 14(1):170-7. 12. New World Encyclopedia. Bird Migration. 2008 [cited Dec 2008]; Available: http://www.newworldencyclopedia.org/entry/Bird_migration?oldid=678335 13. Pough FH, Janis CM, Heiser JB. Vertebrate Life. 6th ed. Upper Saddle River, NJ: Prentice-Hall, Inc. 2002. 14. Sparks TH. Phenology and the changing pattern of bird migration in Britain. International Journal of Biometeorology. 1999; 42(3):134-8. 15. Public Health Agency of Canada. West Nile Virus MONITOR. 2008 [cited Dec 2008; Available: http://www.phac-aspc.gc.ca/wnv-vwn/index-eng.php] 16. United States Geological Services. USGS Disease Maps. 2007 [cited 2008; Available from: http://diseasemaps.usgs.gov/index.html] 17. United States Naval Observatory: Astronomical Applications Department. Information Center: Sun or moon rise/set table for one year. 2008 [cited Dec 2008]; Available: http://aa.usno.navy.mil/data/docs/RS_OneYear.php] 18. United States Census Bureau. Population Finder. 2008 [cited Dec 2008]; Available: http://www.census.gov/index.html] 19. Statistics Canada. CANSIM Table: Population by year, province and territory. 2007 [cited 2008]; Available: http://www40.statcan.gc.ca/lo1/cst01/demo02a-eng.htm]