Abstract
This study aimed at estimating, in a prospective scenario, the potential economic impact of a possible epidemic of WNV infection in Belgium, based on 2012 values for the equine and human health sectors, in order to increase preparedness and help decision-makers. Modelling of risk areas, based on the habitat suitable for Culex pipiens, the main vector of the virus, allowed us to determine equine and human populations at risk. Characteristics of the different clinical forms of the disease based on past epidemics in Europe allowed morbidity among horses and humans to be estimated. The main costs for the equine sector were vaccination and replacement value of dead or euthanised horses. The choice of the vaccination strategy would have important consequences in terms of cost. Vaccination of the country’s whole population of horses, based on a worst-case scenario, would cost more than EUR 30 million; for areas at risk, the cost would be around EUR 16–17 million. Regarding the impact on human health, short-term costs and socio-economic losses were estimated for patients who developed the neuroinvasive form of the disease, as no vaccine is available yet for humans. Hospital charges of around EUR 3,600 for a case of West Nile neuroinvasive disease and EUR 4,500 for a case of acute flaccid paralysis would be the major financial consequence of an epidemic of West Nile virus infection in humans in Belgium.
Highlights
West Nile virus (WNV) is a vector-borne pathogen, member of the genus Flavivirus; its main vectors are mosquitoes belonging to the Culicidae family, genus Culex [1,2]
In order to determine the proportion of Belgian territory representing a habitat suitable for Cx. pipiens, land cover data were extracted from the CORINE (Coordination de l’information sur l’environnement) land cover (CLC) database [17]; suitability of different land covers was further determined for Cx. pipiens and the proportion of these suitable land covers was estimated at the district level [18]
West Nile virus outbreak in horses in 2000; a 5% threshold seemed realistic. b Active individuals include all persons of working age, who carry out a paid activity and job seekers [61]. c We considered unemployed people to be those who did not work, and people not on the labour market,such as housewives/house husbands. d We made a distinction between employees and workers. e All information regarding costs for a hospitalised case was obtained from hospital records regarding a patient hospitalised in Belgium for
Summary
West Nile virus (WNV) is a vector-borne pathogen, member of the genus Flavivirus (family Flaviviridae); its main vectors are mosquitoes belonging to the Culicidae family, genus Culex [1,2]. The infection is maintained in a bird–mosquito enzootic cycle, and birds, especially passerines, are the primary reservoir hosts. Horses and humans are considered as accidental dead-end hosts, and are thought not to transmit the virus to other mosquitoes [3]. The disease generates clinical signs mainly in horses and humans, while most infected birds in Europe are not clinically affected [4]. After an incubation period of 2 to 14 days, two main clinical pictures can be observed: an influenza-like syndrome (West Nile fever, WNF) and a neuroinvasive form (West Nile neuroinvasive disease, WNND) [4]
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