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Subject: Update: Range & Cases US, 2003 (5)

Date: 8 Aug 2003
Posted by: ERAP


With the exception of the first item [0], this message is forwarded 
verbatim from ProMED-mail  (Id#20030807.1946) distributed Aug 7, 2003:

[0]
HARRIS CO, TEXAS
From: "Parsons, Ray (PHES)" <rparsons@harriscountyhealth.com>
Date: Tue, 5 Aug 2003

Update on West Nile virus and St.Louis encephalitis from Harris 
County(Houston) Texas.
Positive dead birds    92
Positive mosquito pools  WNV   22      SLE    1

------------------

[Now that the West Nile virus (WNV) surveillance data reported to CDC
through ArboNET are appearing weekly in MMWR (see part 7 below),
ProMED-mail will no longer provide abstracted information from the USGS
West Nile virus maps. A summary map of the current situation is reproduced
in MMWR, and the more detailed USGS maps, down to county level in some
categories, can be accessed via <http://westnilemaps.usgs.gov> for anyone
requiring such detailed information.

Now that the 2003 West Nile virus season is in full swing, only extensions
of West Nile virus geographic range or host species, and exceptional items,
will be posted separately from these weekly updates.  - Mod.CP]

In this update:
[1] Alligators, role as amplifying hosts
[2] Equines (Tennessee)
[3] First human case (Pennsylvania, Bucks County)
[4] First human case (Kansas)
[5] Second human case (New Mexico)
[6] First human case, suspected (Kentucky)
[7] Four confirmed, plus 17 suspected human cases (Nebraska)
[8] First human case (Arkansas)
[9] First human case (North Carolina)
[10] Human cases (Wyoming)
[11] CDC-ArboNET West Nile virus update (31 Jul to 6 Aug 2003)

******
[1]
Date: Sun 3 Aug 2003
From: Dale E Reddick <dereddi@hargray.com>
Source: Palm Beach Post, Associated Press report, Sun 3 Aug 2003 [edited]
<http://www.palmbeachpost.com/hp/content/news/0803gators.html>


Potential Role of Alligators in West Nile Virus Transmission
--------------------------------------------------
Alligators might be as effective as birds at transmitting West Nile virus,
University of Florida scientists have reported.

The virus is spread by mosquitoes, which transmit it from infected birds.
But researchers found levels of the virus in alligators that are as high as
in birds, which means that the reptiles can likely pass on the infection to
other animals, said Elliot Jacobson, an expert in reptile disease at the
university. "They have levels overlapping with that of some birds, and a
certain level needs to be reached in order to infect mosquitoes," Jacobson
said. "Horses and humans do not have these levels."

The findings come from a study of about 300 captive alligators that died in
2002 in Christmas [Florida]. Necropsies showed that the alligators had
viral loads of West Nile virus that were high enough to infect mosquitoes.
The alligators were probably infected initially by mosquitoes, which bite
the alligators' soft eyelids, tongues, and mouths, Jacobson said. Then the
alligators spread the virus among themselves through water in their holding
tanks. Although birds often die within hours of contracting the virus,
alligators may live for days or weeks after being infected, Jacobson said.
That would allow the alligator to pass the virus on to more mosquitoes.

But overall, Jacobson said alligators probably play a small role in
transmitting the virus to mosquitoes and people because there haven't been
more human cases in areas with alligators.

--
Dale E Reddick
<dereddi@hargray.com>

******
[2]
Date: Sun 3 Aug 2003
From: ProMED-mail <promed@promedmail.org>
Source:  WKRN.com, Sun 3 Aug 2003 [edited]
<http://www.wkrn.com/Global/story.asp?S=1385978>


Tennessee: First Equine Deaths Due to West Nile Virus Infection
---------------------------------------------------------------
2 horses in East Tennessee have died as the result of the West Nile virus
infection. The deaths in Blount County and Hamilton County are the first
confirmed in 2003 among Tennessee's horse population. No human cases have
been reported in Tennessee, although 55 people developed the disease in
2002 and 7 died from it.

******
[3]
Date: Sun 3 Aug 2003
From: ProMED-mail <promed@promedmail.org>
Source: The Morning Call, Thu 31 Jul 2003 [edited]
<http://www.mcall.com/news/local/quakertown/all-b1_2nilejul31,0,3139139.story?coll=all-newslocalquakertown-hed>


Pennsylvania: First Human Case of West Nile Virus Infection in Bucks County
-------------------------------------------------
West Nile virus hit Bucks County without warning on Wed 30 Jul 2003,
afflicting a 39-year-old man who has been hospitalized with symptoms that
suggest the disease had progressed beyond its early flu-like stage. The
victim is the first person from Bucks County to contract the disease since
the virus started showing up on the East Coast in 1999, said Dr. Lewis D.
Polk, medical director of the Bucks County Health Department. In previous
years, he said, birds and horses in Bucks County have tested positive for
the disease, and mosquito pools were found to contain West Nile-carrying
insects. So far in 2003, Polk said, the county Health Department has tested
several dead birds and larva samples taken from mosquito nests, but no
positive tests had been reported. Last year, 62 Pennsylvanians tested
positive for West Nile virus. There were 9 fatalities.

The Bucks County man was one of 7 victims of West Nile virus infection
announced on Wednesday by the state Health Department. Until then, there
had been only a single positive human case in Pennsylvania in 2003; a woman
from Philadelphia. State health officials said the other victims included a
44-year-old woman from Lancaster County, a 53-year-old man from York
County, a 46-year-old man from Allegheny County, a 75-year-old man from
Lawrence County, a 43-year-old woman from Lebanon County, and a 53-year-old
man from Cameron County.

[Byline: Hal Marcovitz]

******
[4]
Date:  Sun 3 Aug 2003
From: ProMED-mail <promed@promedmail.org>
Source: Lawrence Journal-World, Sat 2 Aug 2003 [edited]
<http://www.ljworld.com/section/health/story/140768>


Kansas: First Human Case of West Nile Virus Infection in 2003
---------------------------------------------------
Kansas health officials have confirmed the first human case of West Nile
virus in the state for 2003. A 38-year-old Gray County resident first
reported signs of meningitis on 20 Jul 2003 and is now recovering, said
Sharon Watson of the Kansas Department of Health and Environment. West Nile
virus can cause meningitis in humans.

In its second year in Kansas, the virus has been confirmed by the
department in 25 counties. All other cases have been in birds, horses or
mosquito pools. Gray County is in southwest Kansas. Last year, 103 of 105
Kansas counties reported cases in either humans, horses, birds, or
mosquitoes. There were 22 human cases but no deaths.

Kim Ens, disease control program coordinator for the Douglas County Health
Department, said more cases of the disease typically were found in the
second year of an outbreak. But she said drought this year might have kept
West Nile from spreading as quickly, because mosquitoes, which transmit the
virus, don't have as much standing water in which to lay eggs. But Watson
said the state had anticipated more cases beginning earlier this year based
on studies of the virus in states on the East Coast. So far, she said, the
virus does seem to have appeared at an accelerated rate. The first case
this year was confirmed 28 May 2003, whereas 2002's first case was in late
July.

[Byline: Caroline Boyer]

--
ProMED-mail
<promed@promedmail.org>

******
[5]
Date: Wed 6 Aug 2003
From: Ami Logan <SweetSunflower29@msn.com>
Source: KOAT Action 7 News, Wed 6 Aug 2003 [edited]


New Mexico: 2nd Human Case of West Nile Virus Infection
----------------------------------------------------------
There has been another confirmed human case of West Nile virus in New
Mexico. The first case this year was reported last week in Valencia County.
The patient in the second case is from Colfax County in northern New Mexico
and involved a 42-year-old woman who reported the sudden onset of flu-like
symptoms. Her doctor was alert to the possibility of West Nile and had the
disease confirmed by lab tests. State health officials said the virus was
more advanced in the Valencia County case. They said West Nile only shows
symptoms in 20 percent of the people who contract it. The serious cases
progress to encephalitis, and that's what the Valencia County woman had.
The experts said that in only one in 150 cases does West Nile get that far.
The woman recovered and has since been released from the hospital.

--
Ami Logan
<SweetSunflower29@msn.com>

******
[6]
Date: Wed 6 Aug 2003
From: ProMED-mail <promed@promedmail.org>
Source: The Cincinnati Enquirer, Wed 6 Aug 2003 [edited]
<http://www.enquirer.com/editions/2003/08/06/loc_kywestnile06.html>


Kentucky: First Case of Suspected West Nile Virus Infection
----------------------------------------------------
A Boone County resident is believed to be the first person from the
Tristate, as well as the first Kentuckian, to be stricken with West Nile
virus this year. The person, who developed symptoms of the mosquito-borne
illness within the past 2 weeks, is listed as a "probable" case by the
Kentucky Cabinet for Health Services. That means state laboratory tests for
the virus were positive but must be confirmed through additional testing by
the federal Centers for Disease Control and Prevention, said Dr. Sue
Billings, an epidemiologist with the Kentucky Health Services Department.
Billings said the person sought treatment after showing symptoms of the
virus about 2 weeks ago. Those can include fever, headache, muscle aches,
and chills. The Boone County "case was not hospitalized and is doing well,"
Peggy Patterson, a spokeswoman for the Northern Kentucky Independent
District Health Department, said Tuesday.

Horses or birds with West Nile virus have been reported in 9 Kentucky
counties in 2003, including Kenton County. On Monday, Northern Kentucky
health officials confirmed that mosquitoes trapped in a Boone County pool
recently tested positive for the West Nile virus.

[Byline: Cindy Schroeder]

******
[7]
Date: Wed 6 Aug 2003
From: ProMED-mail <promed@promedmail.org>
Source: Lincoln Journal Star, Associated Press report, Wed 6 Aug 2003 [edited]
<http://www.journalstar.com/latest_reg.php?story_id=69489>


Nebraska: 4 Human Cases of West Nile Virus Confirmed; 17 Cases and 31 Blood
Donations Pending
--------------------------------------------------
4 human cases of West Nile virus infection have been confirmed in Nebraska,
and 17 other probable cases are awaiting confirmation. The Centers for
Disease Control and Prevention confirmed cases in 2 Buffalo County men,
ages 60 and 76; a 45-year-old Gage County woman; and a 19-year-old
Lancaster County woman, state health officials said Tue 5 Aug 2003.

State health officials last month reported its first presumed human case of
West Nile in a Nebraska City woman in Otoe County. Dr. Richard Raymond, the
state's chief medical officer, said initial test results at the state
health lab for West Nile Virus in that case were not confirmed by the CDC.

In addition, the American Red Cross reports 31 positive blood donors,
giving Nebraska the highest number of positive blood donors in the country,
health officials said. None of those tests has been confirmed but may be
tested further if the donor develops symptoms of West Nile virus.

There have also been 50 positive birds and 242 positive pools of mosquitoes
found in the state. The Department of Agriculture reports 14 positive horse
cases.

[see: Nebraska Department of Health and Human Services website:
<http://www.hhs.state.ne.us/wnv>]

******
[8]
Date: Thu 7 Aug 2003
From: ProMED-mail <promed@promedmail.org>
Source: The Log Cabin Democrat of Conway, Arkansas, Associated Press
report, Thus 7 Aug 2003 [edited]
<http://www.thecabin.net/stories/080703/loc_0807030011.shtml>


Arkansas: First Human West Nile Virus Case of 2003
--------------------------------------------------
Arkansas has its first human case of West Nile virus this year, state
health officials said on Wed 6 Aug 2003.The case, in Jefferson County, was
confirmed by the state Health Department's laboratory. Ann Wright, a
spokeswoman for the department, said a suspected human case of the disease
was reported in July 2003 in Washington County, but state tests came back
inconclusive. She said the tests were being reviewed by the Centers for
Disease Control and Prevention in Atlanta.

During 2002, the state had 43 confirmed human cases, resulting in 5 deaths.

Also on Wednesday, the department said that birds in Cleburne, Mississippi,
and Sebastian counties tested positive for West Nile virus. Earlier in
2003, birds tested positive for the virus in Arkansas, Benton, Clark,
Crawford, Hot Spring, Jefferson, Little River, and Union counties. Horses
also have tested positive in Logan and Sebastian counties, and a positive
mosquito pool was reported in Greene County.

******
[9]
Date: Thu 7 Aug 2003
From: ProMED-mail <promed@promedmail.org>
Source: The Herald, Wed 6 Aug 2003 [edited]
<http://www.heraldsun.com/state/6-379006.html>


North Carolina: Human Case of West Nile Virus Infection Confirmed
-----------------------------------------------------------------
A man in an unnamed eastern North Carolina community is the first in the
state to be infected with the West Nile virus this year, health officials
said on Wed 6 Aug 2003. The victim is recovering from the virus at home,
was not hospitalized and never displayed neurological problems, which can
include inflammation of the brain or the lining of the brain and spinal
cord, health officials said.

The virus has been found in 2003 in birds from 24 counties from Dare County
on the coast to Macon County in the west. Wild birds carry the virus.
Mosquitoes bite the birds and then can transmit the virus to humans.

The North Carolina man was probably among the 20 percent of human cases who
develop a mild illness with fever, headaches, body aches, an occasional
skin rash, and swollen lymph nodes, state officials said. A blood sample
sent to the state public health laboratory confirmed the man's exposure to
the virus.

******
[10]
Date: 7 Aug 2003
From: ProMED-mail <promed@promedmail.org>
Source: Casper Star-Tribune, Associated Press report, Wed 6 Aug 2003 [edited]
<http://www.trib.com/AP/wire_detail.php?wire_num=116515>


Wyoming: Second Human Case of West Nile Infection Reported
---------------------------------------------------
A Laramie County woman has become the second person in Wyoming to come down
with West Nile virus infection in 2003. The woman had only light symptoms
and was recovering, Cheyenne-Laramie County Health Department Director Gus
Lopez said Wed 6 Aug 2003.

Health officials said the risk for more West Nile cases in Laramie County
is high due to heavy spring precipitation and current hot weather. 8 cases
of the virus in birds and 2 in horses have been confirmed in Laramie County
this year.

On Fri Aug 2003, a Torrington woman was diagnosed with Wyoming's first West
Nile case of the year. The diagnosis came a month earlier in the year than
last year's diagnosis of 2 Wyomingites, the only 2 cases of 2002.

Health officials in Wyoming said they have been on heightened alert for
West Nile since the recent death of a 77-year-old Greeley, Colo., woman.
The woman was hospitalized after experiencing headaches, dizziness, and nausea.

The number of West Nile cases typically peaks in early September. During
2002, the malady was found in 96 horses, 20 birds, and 2 humans in Wyoming.
The 2 human cases were not fatal.

******
[11]
Date: Thu 7 Aug 2003
From: ProMED-mail <promed@promedmail.org>
Source: Morbidity and Mortality Weekly Report, Fri 8 Aug 2003 / 52(31);741
[edited]
<http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5231a6.htm>


United States: West Nile Virus Activity; Thu 31 Jul to Wed 6 Aug 2003
----------------------------------------------------------------------
This report summarizes West Nile virus (WNV) surveillance data reported to
CDC through ArboNET as of 3 a.m., Mountain Daylight Time, Wed 6 Aug 2003.

During the reporting week of 31 Jul to 6 Aug 2003, a total of 109 human
cases of WNV infection were reported from 13 states (Colorado, Iowa,
Kansas, Kentucky, Louisiana, Minnesota, Mississippi, Nebraska, New Mexico,
North Dakota, Ohio, South Dakota, and Texas), including 4 fatal cases from
3 states (Alabama, Colorado, and Texas). During the same period, WNV
infections were reported in 622 dead birds, 191 horses, one dog, 4
unidentified animal species, and 359 mosquito pools.

During 2003, a total of 153 human cases of WNV infection have been reported
from Colorado (n = 72), Texas (n = 19), Louisiana (n = 15), South Dakota (n
= 8), Ohio (n = 7), Alabama (n = 6), Nebraska (n= 6), Florida (n = 4),
Minnesota (n = 4), Mississippi (n = 4), Iowa (n = 2), New Mexico (n = 2),
Kansas (n = one), Kentucky (n = one), North Dakota (n = one), and South
Carolina (n = one). Among 150 (98 percent) cases for which demographic data
were available, 81 (54 percent) occurred among men; the median age was 45
years (range: 17 months to 87 years). Of the 153 cases, 4 fatal cases were
reported from Alabama (n = one), Colorado (n = one), and Texas (n = 2). In
addition, 1770 dead birds with WNV infection were reported from 36 states
and New York City; 282 WNV infections in horses have been reported from 22
states (Alabama, Arkansas, Colorado, Florida, Georgia, Kansas, Kentucky,
Minnesota, Mississippi, Missouri, Montana, Nebraska, New Mexico, North
Carolina, North Dakota, Oklahoma, South Dakota, Tennessee, Texas, Virginia,
Wisconsin, and Wyoming), 3 WNV infections were reported in dogs, and 5
infections were reported in unidentified animal species.

During 2003, WNV seroconversions have been reported in 185 sentinel chicken
flocks from 8 states (Colorado, Florida, Georgia, Iowa, Louisiana,
Nebraska, North Carolina, and Virginia). Louisiana and South Dekota each
reported 3 seropositive sentinel horses. A total of 1038 WNV-positive
mosquito pools have been reported from 20 states (Colorado, Connecticut,
Georgia, Illinois, Indiana, Kansas, Louisiana, Maryland, Massachusetts,
Michigan, Mississippi, Missouri, Nebraska, New Jersey, North Dakota, South
Dakota, Tennessee, Texas, Virginia, and Wisconsin) and New York City.

Additional information about WNV activity is available from CDC at
<http://www.cdc.gov/ncidod/dvbid/westnile/index.htm> and
<http://www.cindi.usgs.gov/hazard/event/west_nile/west_nile.html>
<http://westnilemaps.usgs.gov/>

--
ProMED-mail
<promed@promedmail.org>

[The cases in Arkansas, North Carolina, Wyoming, and the unconfirmed cases
in Pennsylvania and Nebraska described above, are in addition to the data
included in the CDC-ArboNET report for the period 31 Jul to Wed 6 Aug 2003.
Please note that ProMED-mail will no longer post data on individual cases
except where that case may be the first in an area. We thank the many
correspondents who have contributed to the surveillance effort by reporting
from their own areas. It has become clear from the evidence of early
detection of West Nile virus infection in blood donations from healthy
donors that the reporting of symptomatic cases of West Nile virus infection
may give a subaccurate indication of the prevalence of the virus in the
human population. - Mod.CP]

[see also:
West Nile virus update 2003 - USA (01) 20030103.0016
West Nile virus update 2003 - USA (02) 20030109.0072
West Nile virus update 2003 - USA (03) 20030116.0135
West Nile virus update 2003 - USA (04) 20030206.0323
West Nile virus update 2003 - USA (05) 20030502.1101
West Nile virus update 2003 - USA (06) 20030509.1155
West Nile virus update 2003 - USA (07) 20030516.1218
West Nile virus update 2003 - USA (08) 20030522.1255
West Nile virus update 2003 - USA (09) 20030601.1339
West Nile virus update 2003 - USA (10) 20030606.1398
West Nile virus update 2003 - USA (11) 20030613.1455
West Nile virus update 2003 - USA (12) 20030620.1520
West Nile virus update 2003 - USA (13) 20030627.1586
West Nile virus update 2003 - USA (14) 20030705.1646
West Nile virus update 2003 - USA (15) 20030711.1706
West Nile virus update 2003 - USA (16) 20030718.1759
West Nile virus update 2003 - USA (17) 20030724.1807
West Nile virus update 2003 - USA (18) 20030803.1899
West Nile virus, human - USA (SC) 20030615.1480
West Nile virus, human - USA (Washington): suspected  20030601.1334
West Nile virus, human - USA (Washington): NOT 20030606.1393
2002
----
West Nile virus update 2002 - USA (12)  20020719.4797
West Nile virus update 2002 - USA (34)  20021219.6096
West Nile virus - USA 2001: final report  20020613.4491
2001
----
West Nile virus surveillance - USA 2000 final report 20010423.0792
West Nile virus surveillance - USA  20010129.0207
West Nile virus surveillance 2001 - USA (34) 20011130.2914
West Nile virus, horses - USA 2000: final report 20010831.2079
2000
----
West Nile virus surveillance - USA  20000720.1198
West Nile virus surveillance - USA (54) 20001223.2267
West Nile virus, Congressional report - USA  20000626.1056
1999
----
West Nile virus - USA: Summary to date  19991022.1890
West Nile virus - USA: USGS summary  19991029.1958
West Nile virus - USA: USGS summary (02) 19991103.1972]
.................mpp/cp/pg/mpp

-----
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