<x-charset iso-8859-1>58 people with serious brain disease, 4 dead, and still climbing sounds like
a major public health issue to me, especially in a relatively small area. I
understand from Jim Miller a follow-up of NYC cases showed 2/3 of recovered
WNV patients had neurological deficits (brain damage) a year later. Don't
know if that's published yet, but it shows we can't just assume everyone who
doesn't die is fine. I hope next year in LA will be less, but I don't think
we know nearly enough to predict that. I think we need to be careful and
targeted in our response, especially in temperate areas like NY. Mosquito
prevention and avoidance are still the most important things, but I don't
think WNV is to be dismissed as a non-problem. We don't know where this is
headed in the long term.
-----Original Message-----
From: Michael Gochfeld [mailto:gochfeld@eohsi.rutgers.edu]
Sent: Monday, August 05, 2002 8:01 AM
To: gochfeld
Cc: dew; WESTNILEVIRUS-L@cornell.edu
Subject: West Nile in Louisiana Aug 5 2002 USA today & Gochfeld
questions
DAN,
Thanks for forwarding the interesting news item from this morning's USA
Today. I'd heard it on the radio. I have several thoughts:
1. I think it pretty much parallels the NY outbreak.
2. 55 cases in Louisiana (with all those mosquitoes). Sounds like a
typical first outbreak. I'd expect at least that many more later in the
year, and they don't have as much frost to curtail the outbreak.
3. I hope they do a serosurvey this year and next to get some estimate
of silent infections.
4. It would be nice to know the age distribution of the non-fatal cases
as well as the fatal cases.
5. It is likely that there will be a shadow epidemic in Lousiana next
year and then only sporadic cases.
6. 22 deaths in three years certainly emphasizes that this is a not a
major public health issue.
7. It's nice that the article emphasizes the control of mosquito
breeding places (actually more than broadcast spraying, and that the
spraying of the State's swamps is called into question by a local
expert).
8. There's still very little published about the efficacy of spraying.
9. If this builds public health infrastructure, more power to it. If it
just buys pesticides in bulk it's unfortunate.
10. This is still exciting stuff for an avian ecologist-environmental
health person. The prediction that the virus would quickly spread
southward was made in Oct 1999. The prediction that it would spread to
the 100th parallel wasn't made at the time.
11. The main avian transporters haven't been clarified.
12. . It would be valuable to know about the sequelae in the survivors
of the encephalitis. Eastern Equine leaves its survivors in pretty bad
shape. From what I've read, West Nile is most like Venezuelan Equine
with nearly full recovery. But you never read about such stuff.
Michael Gochfeld
=================================================
Top News
Monday, Aug. 5, 2002
La. Declares West Nile Emergency
SLIDELL, La. (AP) - After four deaths in the
biggest outbreak of
the West Nile virus since it was first detected
in the Northeast
three years ago, Louisiana's governor declared a
state of emergency
and asked for federal aid for more spraying in
the swampy,
mosquito-filled state.
The outbreak has infected 58 Louisiana residents.
The four
deaths are the first in the country this year,
bringing the
national toll to 22 since 1999, when the
mosquito-borne virus was
first detected in the New York area.
The virus has since headed west and south. Eight
people in Texas
and five in Mississippi are sick with West Nile
encephalitis, a
potentially fatal swelling of the brain. The
virus has been found
in birds or animals in the Dakotas, Nebraska and
Oklahoma.
``It will eventually get to all the Western
states over time, we
believe,'' Dr. Roy Campbell, medical
epidemiologist at the Centers
for Disease Control and Prevention, said at a
news conference
Friday.
The Lousiana victims were three men, ages 53 to
75, and an
83-year-old woman, all of whom died in the past
few weeks, state
health officials said. Twelve people remained
hospitalized, four in
intensive care.
``This is only the beginning,'' said Dr. Raoult
Ratard, the
state epidemiologist.
Gov. Mike Foster declared a statewide emergency
Friday, hoping
to get $3 million to $5 million in federal money
for parishes that
are rapidly using up their mosquito spraying
budgets.
The virus is carried by mosquitoes that feed on
infected birds
and other animals. Most people bitten by the
infected insects do
not get sick, but the virus can cause flu-like
symptoms and
encephalitis in the weak and elderly.
Until June, Louisiana's only human West Nile case
was last year,
in a homeless man in suburban New Orleans. He
survived.
Experts said the virus has now spread to
virtually every part of
watery Louisiana, where mosquitoes are jokingly
called the state
bird. The outbreak here is the deadliest since
the virus killed
seven people and hospitalized 55 others in the
New York City area
in 1999.
Across southeastern Louisiana, people have been
putting fresh
water in birdbaths and dumping water out of
flowerpot saucers to
deprive mosquitos of the standing water they need
to breed. St.
Tammany Parish north of New Orleans has sprayed
for mosquitoes
every night for the past month, three to four
times more often than
typical during the summer.
Sales of mosquito traps and insect repellents
have been brisk.
Lois Murphy, 76, said her boss at an antiques
shop in St.
Tammany Parish has made all employees apply
insect repellent. ``He
makes us spray ourselves twice a day,'' she said.
Dr. Roy Campbell, an epidemiologist at the
Centers for Disease
Control and Prevention, said Louisiana residents
are not
necessarily at greater risk because of the
state's bayous and other
mosquito-breeding terrain. The severity of the
outbreak depends on
the species of mosquito, the climate and other
factors, he said.
Wayne Machado, owner of Mosquito Control Inc.,
said the species
that carries the disease usually breeds near
homes instead of in
swamps.
Since 1999, the virus has been found in more than
30 states,
reaching Texas, Nebraska, Oklahoma, North Dakota,
South Dakota,
Minnesota and West Virginia this year.
Overall, the number of human cases this year has
already
surpassed the 64 reported last year; 43 were
reported in Louisiana
and Mississippi on Friday alone.
On the Net:
CDC:
http://www.cdc.gov/ncidod/dvbid/westnile/index.htm
State mosquito control association:
http://homepages.xspedius.net/cpmc
Louisiana arbovirus database:
http://arbonet.caeph.tulane.edu
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Received on Mon Aug 05 13:40:01 2002
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