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Mosquito-borne virus kills child

The 18-month-old girl died earlier this month after battling a brain-swelling illness for two months.

By BRIDGET HALL GRUMET
Published September 27, 2005

A Land O'Lakes toddler has died of Eastern equine encephalitis, the first-known fatality caused by the mosquito-borne virus in Florida this year.

The 18-month-old girl died Sept. 6 after battling the brain-swelling illness for two months. The Pasco County Health Department issued a notice in July when the girl was diagnosed, but officials did not know she later died.

That information came to light Tuesday, when the girl's grandmother notified the St. Petersburg Times. She called after reading a comment from Pasco health department director Dr. Marc Yacht, who said he didn't know the girl's condition, but "hopefully that child is doing fine."

"She lived for two months," the grandmother told the Times. "That was a miracle in itself."

The disease, although extremely rare, is fatal for a third of the people infected. Earlier this month, a 5-year-old girl and an 83-year-old man in the Boston area died of the disease.

Four other Floridians have been diagnosed with Eastern equine encephalitis this year, but county and state officials did not have any information Tuesday about their condition.

"It makes sense" that the public should know, Yacht said Tuesday, after learning the Land O'Lakes girl had died.

But the reality is, nobody tracks cases in Florida. The state Department of Health laboratory confirms whether a person has a disease such as Eastern equine encephalitis. The lab notifies the county health department so it can warn the public to take appropriate protective measures.

The patient's name and other identifying information are not released to the public, however. And neither state nor county health officials get updates on the patient's condition, said Dr. Carina Blackmore, the state's public health veterinarian.

"We don't track each individual case partly because of confidentiality," Blackmore said.

Because there are so few cases of Eastern equine encephalitis in Florida each year, she added, following the patients would not produce useful statistical data.

In the meantime, the number of cases of another mosquito-borne disease, West Nile virus, has spiked from 12 to 18 in Pinellas County. But Pinellas public health officials didn't release information about the six most recent cases because the county health department's spokeswoman, Jeannine Mallory, traveled to Mississippi to help with Hurricane Katrina relief.

The department had been releasing information about each case as it received positive tests. But Mallory said the delay shouldn't make a difference to county residents because people already know the county is under medical alert and that they should take precautions.

"We don't have to release it and it doesn't change people's behavior," she said. "The medical advisory is still in effect...I'm going to have to plead hurricane on this."

All of the Pinellas patients are in the mid-county and Seminole area, Mallory said. The patients are recovering, and none developed the most severe symptoms of West Nile, such as coma and paralysis.

The new patients are a 56-year-old man; a 59-year-old man; a 42-year-old man; a 75-year-old woman; a 53-year-old man; and a 72-year-old man.

The patients began showing symptoms between July and mid-August. Because the two patients who developed symptoms most recently were diagnosed over a month ago, health officials hope that the outbreak in Pinellas has peaked.

"It seems to be dissipating," Mallory said. "I don't think we can say for sure because mosquito season goes on for a couple of months. But it would appear that the county's spraying efforts have paid off."

Both West Nile virus and Eastern equine encephalitis are spread by mosquitoes that contract the disease from infected birds. West Nile is the less serious of the two - about 80 percent of the people who get it never even have symptoms - but it grabs more headlines.

"West Nile has gotten a lot of attention lately because it's a new disease to America," said Dr. John Sinnott, chief of infectious diseases at the University of South Florida. "It appeared around 1998 and has rapidly spread throughout the lower 48 states."

Eastern equine encephalitis has been around more than 50 years - long enough for many animals to develop an immunity to it, making the disease much rarer, Sinnott said.

The outbreaks of both viruses this summer have prompted Pinellas, Pasco and Hillsborough counties to step up their mosquito-spraying efforts. Officials have urged residents to avoid mosquito exposure by wearing insect repellent, covering up with long-sleeved clothing, emptying pools of standing water and avoiding the outdoors at dusk and dawn, when mosquitoes are most active.

Are people getting the message?

"I see my neighbors running around at dusk, jogging and gardening," said Sinnott, who lives in St. Petersburg. "I think people need to understand this is risky behavior. While there's not 100-percent risk, certainly a lot more people get West Nile than get hit by lightning."

-- Times staff writer Lisa Greene and researcher Caryn Baird contributed to this report.

[Last modified September 27, 2005, 21:30:50]