Disease in the News
West Nile Virus

Disease in the News – West Nile Virus The West Nile virus made its deadly debut in New York City September 27, 1999. The virus had never been seen in the Western Hemisphere of the United States. It is said to be usually found in Africa and Europe. When it made its debut, it was first believed to have been the St. Louis encephalitis. Experts at the Federal Centers for Disease Control and Prevention (CDC) have confirmed the virus to be West Nile. Nearly twice as many people in the New York region have been stricken by the mosquito borne illness as earlier recognized (Fish, 1999). The outbreak of the West Nile had New Yorkers shocked that a mosquito bite could be so deadly. During the time of the outbreak, there were 37 confirmed cases of the West Nile virus in New Yorkers. Twenty-five of these New Yorkers were from New York City, eight from Westchester County, and four from Nassau County. Although there are confirmed cases, 162 cases were still under investigation and eight deaths had doctors still studying the tissue and blood of the victims (Albany Times Union, 1999). There are 70 types of mosquitoes living in New York, but only 30 of them carry the virus. The West Nile virus outbreak stemmed from prolonged drought, which produced a large supply of the northern house mosquito, Culex pipiens. The Culex pipiens lives near people but generally feeds on birds. This particular mosquito is efficient at transmitting certain viruses from birds to humans. The Culex pipiens mosquito likes stagnant water with rotting leaves. This helps to provide food in abundance for its larvae. In New York City, the storm-sewer catch basins are a popular breeding area for the mosquitoes and can be found on nearly every street corner. Heavy and frequent rains usually flush out these basins. Alternatively little rainfall concentrates more mosquitoes by the thousands. West Nile virus is transmitted to humans from mosquitoes that have bitten infected birds. Large numbers of dead crows have been found in areas from Connecticut to Suffolk County on Long Island. A bird testing positive for West Nile was found in Westport, Connecticut, and a dead crow was found in Scarsdale, Westchester County, New York. Health officials from the Centers for Disease Control and Prevention (CDC) confirmed that several birds from the Bronx Zoo and its surrounding area were infected with West Nile. There have been many reports received by New York State officials from bird-watchers, conservationists, and other observing individuals, of dead birds found around the region. With the large number of dead birds found, other federal agencies have put states bordering New York on alert to look for large groups of dead birds. Scientists were concerned with the birds fall migration because they would carry the virus with them south bound, possibly causing another outbreak. Symptoms of the West Nile virus include: vision loss, numbness, stupor, coma, tremors, convulsions, paralysis, chills, sore throat, backache, breathing problems, fatigue, skin rash, fever, swollen lymph glands, and headache. Nearly 80% of those infected with the virus will never see symptoms and will never be physically affected (Woodside, 1999). The majority of infections go unreported. For a case to have a chance of being reported or confirmed the symptoms would have to be more intense. Severe cases can affect the nervous system and cause encephalitis inflammation of the brain, or meningitis, inflammation of the membrane around the brain, and spinal cord. As of September 13, 2011, two hundred cases were confirmed in the United States. One hundred and thirty-four of those have affected the patients’ nervous system according to the CDC (Times Union, 2011). The virus is primarily transmitted through mosquito bites, but it can in rare cases be transmitted through contaminated organ transplants or blood transfusions. Other rare cases that have been reported are pregnant women passing the virus along to their children by breast feeding. The virus cannot be transmitted by air and a person with West Nile virus is not contagious to others. Mayor Rudolph (Rudy) W. Giuliani created a schedule for spraying New York City for the mosquitoes periodically as the need arises. Implementing the scheduled spraying should reduce the number of mosquitoes. There are many effective, long-term programs around the country, mainly in California and Florida (Fish, 1999). Westchester County, New York, instituted a mosquito surveillance program in 1981 partly in response to a fatal case of La Crosse encephalitis in Pound Ridge, New York. The program quickly revealed another encephalitis virus called Jamestown Canyon virus, in Lewisboro. In 1997, Connecticut established a state-wide surveillance program after the deadly Eastern Equine encephalitis (EEE) virus found in mosquitoes from the southeastern part of the state. Officials only thought to look for the virus after health officials of Rhode Island, which has a good monitoring program, found it in mosquitoes near the Connecticut boarder (Fish, 1999). Prevention of the West Nile virus is possible. Taking personal protective measures to reduce exposure to mosquito bites can reduce the risk of contracting West Nile. The chance of contracting West Nile tends to increase in the late summer through mid-fall. State and county health officials encourage New Yorkers to protect themselves when outdoors, especially during dawn and dusk. This is the time mosquito activity is at its greatest. The Centers for Disease Control and Prevention recommends applying insect repellent containing DEET, picaridin, or oil of lemon eucalyptus when spending time outdoors. People are advised to eliminate standing water in backyards to reduce the number of mosquitoes around the home or property and make sure screens on the windows and doors are in good condition. It is urged that people dispose of used tires, tin cans, plastic containers, ceramic pots, or similar items in which water collects. Drilling holes in the bottom of recycling bins kept outdoors helps to eliminate water collection. Making sure roof gutters drain properly and cleaning clogged gutters also helps to reduce mosquito breeding places. A recent report of a West Nile virus finding in a mosquito in Melville, New York, has prompted the Nassau County Department of Health to announce the first wave of pesticide treatment to begin immediately. So far this year, Suffolk County, New York, has reported 32 mosquito samples and one dead crow as testing positive for the virus (Kitchen, 2012). As a precautionary measure, Southaven County Park in Shirley, New York, and a few other parks in Suffolk County, New York, is closing for nighttime activities. Suffolk county Health Department will continue mosquito surveillance and will work with the Parks Department to determine when the nighttime activities may resume. During the week ending July 15, 2012, the Onondaga County Health Department trapped about seven thousand mosquitoes, down from thirty-nine thousand for the same week last year (Kitchen, 2012). The first known and confirmed case of West Nile virus in the United States occurred in New York City in 1999. Over the past 13 years, it has spread to every state. During these years thousand have been affected, including those resulting in brain damage and death. Some of the infections are never diagnosed because they are mild or the patient did not see a doctor. Most cases occur in August and early September. It is impossible to predict whether the trend will continue or if there will be another big epidemic. It mainly depends on the weather patterns, including heat waves and rain storms. A majority of the states, who have been infected, have mosquito monitoring surveillance and traps in place. For a safeguard precaution, many states have implemented pesticide spraying programs and have given their citizens information to help safeguard their families, homes, and property.

References
First Human Case of West Nile Virus in Albany County. (September 21, 2011). Times Union. Business News
Fish, D. (September 28, 1999). When a Disease Gets Wings. The New York Times. Opinion and Editorial
Kitchen, P. (July 18, 2012). County Plans Mosquito Spraying. Newsday. Business News
Steinhauer, J. (September 28, 1999). Outbreak of Virus in New York Much Broader Than
Suspected. The New York Times. News
West Nile Risk is Another Legacy of Storms. (September 22, 1999). Times Union. Business News
Woodside, C. (October 03, 1999). State Scrambles to Control a New Virus. The New York
Times. Regional News.