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West Nile Alert
This Year, Experts Expect The Perennial Virus To Break New Ground


May 7th, 2004

By Ken McGrath : eCureMe Staff Writer
May 6th, 2004 : Physician Reviewed



Like a microscopic immigrant, the West Nile virus arrived in New York City in 1999 and public health officials expect it to complete its all American journey this summer by arriving in California. The West Coast is expected to be the next "hot spot" for the disease, but doctors and scientists are still urging people across the country to exercise caution, even as researchers are getting closer to a vaccine.


West Nile Alert



Cross Country

For the last several years, typically starting in late July and continuing through early autumn, a wave of West Nile diagnoses and deaths has captured the public’s attention. Carried in the bloodstream of infected birds and spread to humans through contact with mosquitoes that have fed on infected birds, each year the epicenter of the outbreak has fallen farther west. In 2003, over 9,800 cases were diagnosed throughout 46 of the lower 48 states. 262 cases were fatal. However, 2,863 of the diagnoses were made in Colorado alone. In 2002 the state had only reported 14 cases.

The fear among experts is that the disease may cross the Rockies this year, and California’s experience in 2004 could be similar to Colorado’s in 2003. Speaking about the virus’ apparent Westward migration, Dr. Grant L. Campbell, head of the branch of the Centers for Disease Control (CDC) that tracks West Nile, told reporters, "California should light up this year - but it all depends on climate and mosquito control and luck." Some experts have noted that California may be in a better position to deal with the disease when it arrives: the state has had plenty of advanced warning and maintains a strong mosquito monitoring program. However alert though, it’s sure that the Golden State will be facing the virus in one way or another: already this season three birds in the state have tested positive.



Relative Danger

Though the disease may be unfamiliar to Californians, it’s by no means new. West Nile was identified in Uganda, in 1937, and has since spread through much of Asia, Africa and Europe. Compared to other diseases that have spread around the globe, West Nile has a relatively low impact on humans.

Even in areas where the disease exists in the mosquito population, less than 1% of the bugs carry it. About 20% of people bitten by infected mosquitoes will experience the most common symptoms; headaches, body aches and fever. Most who are bitten won’t notice any signs of the infection before it passes. The real risk of West Nile infection is the possibility it will develop into a case of encephalitis. Encephalitis occurs when, as a reaction to infection, the brain becomes inflamed. Once a patient falls ill with West Nile encephalitis, there’s little doctors can do other than try to alleviate discomfort and assist breathing. In extreme cases, the inflammation can cause death. Even so, most whose infections do lead to encephalitis, less than 1% of those initially bitten by a West Nile mosquito (though the rate is higher for older adults) will recover.

As always, prevention is the best medicine. To avoid contact with the disease in the first place, experts recommend that in the coming summer months, Americans should make sure they wear insect repellant that contains DEET when they venture outside. It’s also helpful to wear long sleeves and pants outdoors, instead of shorts and t-shirts, in order to give the bugs less to feed on. Staying inside during dusk and dawn, prime mosquito feeding hours, can’t hurt either. To keep the number of mosquitoes to a minimum, people are urged to remove any standing water from their property. Mosquitoes frequently lay their eggs in standing water, and old tires, neglected garbage cans, large puddles, dog dishes and birdbaths can mean more mosquitoes and more disease.



The Future of West Nile

In the not too distant future, preventing West Nile may be as simple as getting a shot. A number of drug companies and government agencies are planning to test vaccines in the next few years. As soon as this summer, dozens of hospitals across North America will be participating in a study that injects antibodies from patients who have fought off the disease into those who are infected, hopefully killing off the virus. Other researchers are using weakened forms of Yellow Fever virus and Dengue Fever virus as the basis for a vaccine. A recent study conducted by Hawaii Biotech, Inc. used a protein similar to the West Nile virus to inoculate animals, and found that 100% of the tested subjects developed a resistance to the disease.

Still, it’s likely to be a matter of years before a vaccine can be fully approved and tested by the FDA. In the mean time, West Nile’s cross continental spread may be good news, at least in the short term. Though scientists don’t know exactly why, when West Nile hits an area particularly hard one season, it tends to abate the next. Ohio, which has already reported the first human case of the disease this year, reported 108 cases in 2003 - down from 441 in 2002.

Until epidemiologists can get a handle on this season’s toll, however, West Nile is likely to keep the scientific community, and the public, guessing.




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