This subproject is one of many research subprojects utilizing theresources provided by a Center grant funded by NIH/NCRR. The subproject andinvestigator (PI) may have received primary funding from another NIH source,and thus could be represented in other CRISP entries. The institution listed isfor the Center, which is not necessarily the institution for the investigator.The primary benefit of the study will be to produce an accurate estimate of the ratio of neuroinvasive WNV disease to total WNV infections among chronically immunosuppressed transplant patients. Transplant clinicians could use this information to modify their 'index of suspicion' for WNV disease when presented with acutely ill transplant patients with neurologic symptoms, and to better educate their patients about the health risks and preventive measures associated with WNV. Treatment modalities for WNV are under development, including WNV-specific immunoglobulin (Omr-Ig-am) and consensus interferon. If the transplant population is clearly identified as a group at great risk for neuroinvasive disease, we will be able to justify aggressive therapeutic managements and work with the pharmaceutical industry in drug studies and expanded access trials. Given the urgency of this study from both epidemiologic and clinical standpoints, the Centers for Disease Control will collaborate with us, specifically with Dr. Grant L.Campbell, chief epidemiologist for the arbovirus diseases branch of the division of vector- borne infectious diseases and Dr. Robert Lanciotti, chief of the diagnostic and reference laboratory of the arbovirus diseases branch, both located in Fort Collins, Colorado. The Centers for Diseases Control has agreed to perform the WNV serologic testing and epidemiologic assessment of the data, as they have identified the question of the incidence of neuroinvasive disease in the transplant population as a significant public health issue
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