Springfield State Journal Register

May 27, 2003

West Nile repeat predicted


WASHINGTON - With officials bracing for another deadly outbreak of West Nile virus this summer, some experts worry that federal efforts to fight the disease are being undercut by concerns over SARS and bioterrorism.

"It might be said that the mosquito-borne West Nile virus represents a bigger threat than SARS in that it 'jumps species' with more than 230 types of animals, including 138 species of birds, known to be infected to date," said Dr. Paul Epstein, associate director of the Center for Health and the Global Environment at Harvard Medical School.

"We're budgeting a lot of money for bioterrorism, but we've got an agent loose in nature that we don't understand," Epstein said.

Illinois led the nation last year with 64 West Nile deaths and 884 human infections.

The virus is carried by birds and other animals and spread to humans by mosquitoes. Most people don't get ill or develop only mild, flu-like symptoms such as fever, headache and body aches. But older people and those with weaker immune systems might develop more serious health problems, including a potentially fatal swelling of the brain.

No treatment exists, but the National Institutes of Health is working on one. There's a horse vaccine, but a human vaccine still is a few years off.

Great strides have been made in the past year to protect the nation's blood supply, health officials say. Last year, 21 people in 10 states, including Illinois, were infected through blood transfusions and organ transplants.

Beginning July 1, national blood banks will begin screening blood donations for West Nile virus.

"We've gone in nine months from no tests to tests that will have been installed in a number of centers around the country to test the whole blood supply," said Dr. Louis Katz, past chair of the American Association of Blood Banks' transfusion safety committee.

"It's really a spectacular accomplishment," said Katz, comparing it to the five years it took to develop a way to screen blood for the HIV virus.

Disease experts predict this year's West Nile virus season will be at least as bad as last year, but how bad nobody really knows.

What experts do know is that early reports of West Nile virus among birds and animals indicate they're in for another busy year.

A horse in Minnesota has died from the virus. Dead birds testing positive for West Nile virus have been found in Florida, Georgia, Louisiana, North Carolina, Minnesota and Michigan. Louisiana officials have reported two human cases.

"When you look at this early season activity, you go 'wow, this is setting up very much like last year.' That's why we're very concerned it may be a repeat of last year," said Anthony Marfin, a medical epidemiologist with the Centers for Disease Control.

What infectious disease specialists find so amazing about West Nile virus is its rapid spread across the country.

In 1999, just 83 cases of West Nile virus and nine deaths were reported in the New York area. In 2001, the cases of human infection occurred in 10 states with 66 cases and nine deaths. By last year, the virus had spread to 44 states. There were 284 deaths and 4,156 infections from the mosquito-borne virus.

Illinois and other state public health officials are focusing on public education efforts and seeking more federal money for mosquito control.

"We're seeing states not only gear up, but actually expecting it to be worse than last year as West Nile moves across the country into areas where we didn't see it last year. You have to be prepared for the worst-case scenario," said Helen Fox Fields, senior director of infectious disease policy for the Association of State and Territorial Health Officials.

Officials at the Centers for Disease Control are discussing the creation of a national mosquito control plan with state and local officials. Until now, mosquito-borne diseases haven't received much attention in the United States and mosquito control has been left largely to local governments, she said.

In Congress, the Senate Health, Education, Labor and Pensions Committee last week approved a bill that would authorize grants of up to $100,000 to help cities implement mosquito control plans.

Sen. Dick Durbin, D-Ill., a member of the Senate Appropriations Committee, is seeking $750,000 for Illinois' West Nile virus research efforts.

A bill pending in the Illinois General Assembly would generate $3 million for mosquito control through a 50-cent tax on the sale of new tires.

"There is no way to know what it will be like. But we're making the assumption that it will be here," said Jena Welliever, spokeswoman for the Illinois Department of Public Health.

In June, the state will offer an 800-number hot line for people to get answers about West Nile virus. Prevention tips will be put on people's doorknobs, and the state is considering paid commercial ads to get the word out.