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New York reeling from bouts with deadly diseases
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9-20-99 New York. New York City and New York state health officials have asked the national Centers for Disease Control and Prevention (CDC) to examine two unrelated outbreaks of encephalitis and E. coli that together have killed four and sickened hundreds more. New York Mayor Rudolph Giuliani ordered aerial and ground spraying of all five boroughs with malathion and other insecticides last week in an effort to wipe out a mosquito population that is carrying St. Louis Encephalitis (SLE). The New York City Department of Health has confirmed 12 cases of SLE, and 78 more cases are still under investigation. Three people, all elderly, have already died of the disease, which can cause severe inflammation of the brain. Each day, about 15 new cases are reported and roughly the same number are dismissed. Because the incubation period for the disease can stretch to 15 days, experts warn that the outbreak may continue even after the spraying ends. "You could still see human cases after all the mosquitoes are dead," said Roy Campbell, MD, medical epidemiologist at the CDC. The odds of contracting SLE are remote, Campbell said. In the most extreme outbreaks, about one in 200 mosquitoes carries the disease, though normally the number is closer to one in 1,000. What's more, only about one in 200 people bitten by an infected mosquito will get sick. "Though everybody-regardless of age-has an equal susceptibility, this virus and its close relatives are more likely to cause severe illness in people over 50," he said. "That's why the clinical cases are the tip of the iceberg." Hundreds of other New York state residents have become sick in the Albany area after a tainted water supply contaminated with E. coli was used by vendors at the Washington County Fair. New York State Department of Health officials discovered the bacteria in an underground aquifer being tapped by the wells at the fair. "But how it got there is still a matter of speculation and theory," said Kristine Smith, spokesperson for the New York State Department of Health. Identical strains of E. coli were matched from the well and the patients, but they have not isolated the strain in any manure samples. Smith said "the working hypothesis" is that rainwater washed over cow feces in the fair's cattle barn, then seeped into the aquifer. The Department of Health has received alerts for 971 suspected cases, of which 122 have been confirmed. Two people have died from the bacteria. Officials said the worst of the outbreak is over. "Pretty much all of the cases have come to light," said David Swerdlow, MD, medical epidemiologist at the CDC. "Most of the people who have been exposed have already been diagnosed."
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