E.M. declares the following potential conflicts of interest (alphabetical order for the past five years): CSL (honoraria), Dynavax (honoraria), GSK (research funding, consultancy, honoraria, clinical trial site), Merck (consultancy, honoraria, clinical research and clinical trial site), Novartis (honoraria), Novavax (consultancy), Sanofi Pasteur (consultancy and honoraria), and Solvay (consultancy and honoraria). S.v.d.W. declares Danone (consultancy); GSK (research funding; clinical research); Roche (clinical research). The other

authors declare no conflict of interest. Funding: This study was funded by FLUSECURE. Flusecure has been made possible by contributions of the European Commission DG Sanco and the participating member states. The study was also funded by the Canadian Institutes of Health Research #170702. “
“West Nile virus (WNv) is a mosquito-borne flavivirus that causes a range of symptoms in humans from mild fever Fludarabine chemical structure to neurological symptoms. Following the first cases in New York City in 1999, WNv spread rapidly across the North American continent [1]. Since the introduction of WNv to the province of Saskatchewan, there have been two outbreak years: 2003 and 2007. The Saskatchewan Ministry of Health reported a total of 2322 clinical cases (90% were West Nile Non-Neurological Syndrome) and 184 non-clinical cases of human WNv disease in Saskatchewan from 2002 to 2009 (http://www.health.gov.sk.ca/wnv-surveillance-results).

When these numbers are compared to a total of 4555 clinical cases in Canada from SCH727965 mouse 2002 to 2009, the relative severity of the problem of this disease in Saskatchewan, a province of just over 1 million residents, becomes apparent (http://www.phac-aspc.gc.ca/wnv-vwn/mon-hmnsurv-archive-eng.php). As immunity is believed low, public health is likely to face significant challenges from this disease into the future. Currently available preventative measures are directed at minimizing exposure to the mosquitoes, the WNv vector. These measures include mosquito control programs using biologically based pesticides to reduce vector numbers, applying mosquito repellents, encouraging yard

maintenance to minimize vector larval habitat areas, and avoiding exposure at times of the day when mosquitoes are most active. These measures require a near constant renewal of interest Unoprostone and resources from health officials and the public and do not provide prolonged protection from the disease. In addition, these measures are not equally applicable in rural and urban settings. The use of intensive mosquito control techniques to control mosquito numbers often is not practical in rural areas. Saskatchewan has large numbers of small communities and farms surrounded by thousands of square kilometers of mosquito habitat in agricultural fields, rangeland and other natural areas. As a consequence people living in rural areas are approximately six times more likely to be exposed to WNV, compared to urban residents [2].