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| The facts on West Nile virus |
What is West Nile virus? West Nile virus is a potentially serious illness now established as a seasonal epidemic in North America that flares up in the summer and continues into the fall.
What are the symptoms of WNV? The majority of people (about 80%) who become infected with the virus will have no symptoms. But about 20% will develop mild or moderate flulike symptoms such as headache, fever, body aches, swollen glands, and muscle weakness. Some people, especially the elderly, may experience more severe symptoms, including higher fever, neck stiffness, and encephalitis or inflammation of the brain.
How does WNV spread? Mosquitoes that become infected by feeding on infected birds can inject WNV to humans and other animals when they bite. Transfusions, transplants, and mother-to-child. WNV has been spread through blood transfusions, organ transplants, breastfeeding, and even during pregnancy from mother to baby.
How soon do infected people become sick? People typically develop symptoms between three and 14 days after they are bitten by an infected mosquito.
How is WNV infection treated? Because no specific treatment for people is available, they are treated symptomatically.
What is my risk of getting sick from WNV? People older than 50 are more likely to develop serious symptoms of WNV. Being outside means being at risk. Avoid mosquito bites if you spend a lot of time outside.
What can I do to prevent contracting WNV?
• When outdoors, use insect repellents containing DEET (N, N-diethy-meta-toluamide). Wear long sleeves and pants and light-colored clothing so you can see mosquitoes that land on you.
• Avoid spending time outside at dawn and dusk when mosquitoes are active. They are especially active for two hours after sunset.
• Eliminate all sources of standing water that can support mosquito breeding.
• Make sure that doors and windows have tight-fitting screens. Repair or replace screens that have tears or holes.
What else should I know? If you find a dead bird, don't touch it with your bare hands. Contact your local health department for instructions on reporting and disposing of the body.
For more information, call the CDC public response hotline at (888) 246-2675 (English), (888) 246-2857 (Spanish).
Alicia Hugg
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In California, a 71-year-old Los Angeles County man and a 26-year-old Riverside County man were the first to test positive for WNV in their counties this year. The Los Angeles County resident was not hospitalized and is recovering. The Riverside County victim was hospitalized with meningitis in June and later discharged in good condition.
As manager of the Pasadena Public Health Department’s Office of Communicable Disease Prevention Division, Candy Jara, RN, PHN, receives daily updates from the State Department of Health Services, as well as from Los Angeles County. She said that as of July 1, WNV infection, when documented by laboratory findings, has been added to their list of mandated reportable diseases and conditions.
Los Angeles had its first WNV-related death June 24, when a 57-year-old Orange County man died from encephalitis. That the disease is moving into Northern California was evidenced July 21, when the first dead bird appeared in Santa Clara County. Dead birds, sentinel chickens, and pools of infected mosquitoes also have been found as far north as Butte and Tehama counties.
“We are getting more phone calls from concerned citizens and are being proactive in our response, including press releases, educational forums, and hot lines. Los Angeles County will host a training program for our staff using a CD-ROM or disc so we are all giving out the same information,” Jara said.
Richard Jackson, MD, state public health officer, expects WNV to continue to spread throughout the state and advises residents to take steps now to protect themselves from mosquito bites. “These first West Nile virus cases in Los Angeles and Riverside counties follow a well-established pattern in which dead birds and mosquitoes infected with the virus preceded the reports of human illnesses,” he said.
Carol Glaser, MD, acting chief of the Department of Health Services’ viral department laboratory, thinks the valuable “thing about the WNV indicators are the dead birds, mosquitoes, and chickens because until we have West Nile activity, we will not have West Nile.”
Glaser anticipates more WNV activity during the next few weeks or months when the arbovirus season peaks. Her department is working with the University of California, San Francisco and other institutional review committees to facilitate trials.
“The danger here is that everybody wants to use every medicine.” Glaser stresses the importance of having strong clinical trial data to support the correct use of medicine. “We are encouraging clinical trials. There is an important WNV trial involving interferon in New York led by James Rahal, MD, chief of infectious disease at New York Hospital Queens that is not getting a lot of publicity like the NIH-led trials.”
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