State: Broad action needed on the West Nile virus

ATLANTA -- States, counties and individuals should take broad action to combat West Nile virus, the Centers for Disease Control and Prevention said Thursday, emphasizing that the disease is expected eventually to spread nationwide.

"We know there are potential mosquito vectors for West Nile throughout the lower 48 states," said Dr. Stephen Ostroff, CDC's coordinator of West Nile efforts.

But the scientists also said there is nothing to be alarmed about. The virus does not pose the threat of a massive epidemic, they said as they encouraged an expansion in mosquito control programs and common sense prevention techniques.

So far this summer, CDC said, 142 infected birds have been found in Washington and nine states, including Georgia, where two infected birds have been found, and Florida, now up to 21.

North Florida is now a West Nile belt: Infected birds have been confirmed in every county across the Panhandle, Ostroff said. There have also been three infected horses, all in Florida, and one human case: 73-year-old Seymore Carruthers of Sirmans, who remains hospitalized in critical condition.

Mosquitoes carrying the virus have been found in only four states, though: New York, New Jersey, Connecticut and Maryland. The virus' unpredictable movement is proving to be one of its biggest puzzles.

"The distribution of findings is different so far this year than it was in 2000," Ostroff said. "This time last year, the most positive (birds) we were aware of were in the New York City metropolitan area. But this year, only 44 percent of the birds are in those areas, and larger numbers are in places like Maryland."

Cases of West Nile infection in horses and humans are also much sooner in the year than in 2000 or 1999, when the virus was first noted in America. The first horse case was reported June 24, compared with Aug. 17 last year. Carruthers became ill July 15, the earliest human case so far.

But whether earlier onset of cases means greater risk of infection in the Southeast, where mosquito season lasts far longer than in the Northeast, is an open question.

Weather patterns have further complicated predictions. The drought of the past several summers has given way to heavy rains in the past month, probably invigorating mosquito populations.

"We appear to be at a phase where the numbers are increasing," said Dr. Kathryn Converse of the National Wildlife Health Center in Madison, Wis., which tests birds for West Nile. "We'll find out in a couple of weeks whether those will stay level or drop back down."

West Nile virus, which resides in birds but is transmitted by mosquitoes to humans, horses and other mammals, causes no symptoms in most of those bitten, and a flu-like syndrome of aches, fever and headache in a few. But in the elderly and chronically ill, as well as those with impaired immune systems, it can escalate into sometimes-fatal encephalitis.

In related news, researchers from the New York City Department of Health and the CDC reported in the journal the Lancet that nearly 8,200 people in the New York metropolitan area were infected with the virus during its first outbreak. Many had mild symptoms and did not realize what they had contracted, the research indicates.

The study was conducted in October 1999. The researchers tested blood from people who lived at the epicenter of the outbreak and concluded that about 1,200 people had the virus. They extrapolated that number to 8,200 for the whole metropolitan area.

For every case of West Nile meningoencephalitis, there were 170 cases of more mild fevers or flus caused by the virus, the research showed.

The findings also indicated that "in the very epicenter of the outbreak . . . 70 percent of the population never used mosquito repellent, even though they were aware of the virus," said Dr. Farzad Mostashari, a medical epidemiologist in the Communicable Disease Program in the New York City Department of Health and the study's lead author.

Ostroff of the CDC said that the research is further proof that people should protect themselves from mosquito bites and eliminate common areas for mosquito breeding such as clogged gutters, stagnant bird ponds and overturned trash can lids.

He also urged the public to report dead bird sightings to local and state public health officials.

On the other hand, he said, people should not panic about the disease, he said. "There are a variety of risks, and you can do something about it," he said, "(but) would I stay indoors for the rest of the summer? No!"

Encephalitis suspected in 9-year-old boy's death

Encephalitis is suspected in the death of a 9-year-old Panhandle boy, and tests are being performed to determine what type it might have been.

James "Cody" Landsverk of Niceville died Wednesday at Sacred Heart Children's Hospital two weeks after getting sick. Lab results to confirm encephalitis are expected Monday at the earliest.

Meanwhile, a southeast Georgia man has been diagnosed with Eastern equine encephalitis.

The 70-year-old man from Winokur, about 15 miles from the Florida line, was in serious condition at a Savannah hospital Wednesday night.

Health officials stressed the man did not have West Nile virus, the less common, mosquito-borne disease.

Eastern equine encephalitis and St. Louis encephalitis are two other mosquito-borne forms of the disease.

Florida's Health Department has issued two encephalitis alerts since Saturday warning people in 14 north Florida counties to stay indoors when mosquitoes are active or cover up and use repellent.

Okaloosa County, where Cody lived, is not one of the counties covered by the alert based on the West Nile case in Madison County and nine cases of Eastern equine encephalitis in horses.

But a dead blue jay found in Okaloosa County has tested positive for the West Nile strain.

"We are tracking any suspected human cases in order to determine if the infection is being experienced by human beings," said Dr. Karen Chapman, director of the Okaloosa County Health Department.

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Lucy Morgan

From the Times state desk