WEST NILE VIRUS IS OUT THERE!   STAY INFORMED!

THE WHITE HOUSE

Office of the Press Secretary

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For Immediate Release November 1, 2000

West Nile Virus-President Declares an Emergency in the State of New Jersey

PRESIDENT CLINTON DECLARES AN EMERGENCY IN THE STATE OF NEW JERSEY

The President today declared an emergency exists in the State of New Jersey and ordered Federal aid to supplement state and local recovery efforts in the area affected by the West Nile Virus on August 5, 2000 and continuing.

The President's action authorizes FEMA to provide appropriate assistance for required emergency measures, authorized under Title V of the Stafford Act, to save lives, protect property and public health and safety in the counties of Atlantic, Bergen, Burlington, Camden, Cape May, Cumberland, Essex, Gloucester, Hudson, Hunterdon, Mercer, Middlesex, Monmouth, Morris, Ocean, Passaic, Salem, Somerset, Sussex, Union, and Warren.

Specifically, FEMA is authorized to provide up to $5 million for emergency protective measures to local governments at 75 percent Federal funding.

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West Nile Virus Symptoms

• The sometimes-fatal disease can cause encephalitis, a swelling of the brain. The four main symptoms of West Nile virus are a fever, an altered mental state, spinal fluid with elevated levels of protein and muscle weakness.

West Nile Virus Locations In The U.S.

• An 87-year-old Brooklyn woman who tested positive for the West Nile virus has died, the city health department announced. The woman tested positive for the mosquito-borne virus August 25. She had been hospitalized in a coma since August and died last month, City Health Commissioner Dr. Neal L. Cohen said in a written statement Wednesday.

• An 82-year-old New Jersey man died of the virus in September.

• Eighteen people, including 14 from New York and four from New Jersey, were hospitalized with "severe" illnesses caused by West Nile viruses in 2000, the U.S. Centers for Disease Control reported.

•Fourteen city residents, ranging in age from 36 to 87, tested positive for the virus in 2000. Ten of those were from the borough of Staten Island, two were from Brooklyn, and one each from Manhattan and Queens.

• Seven people from the New York metropolitan region died as a result of West Nile in 1999, the Centers for Disease Control said.

• November 1, 2000 - The President today declared an emergency exists in the State of New Jersey and ordered Federal aid to supplement state and local recovery efforts in the area affected by the West Nile Virus on August 5, 2000 and continuing.

• The youngest horse ever known to develop clinical illness due to WNV in the United States, a 4-month-old colt in Monmouth County, New Jersey, had clinical onset in October 2000.

• New York State re-evaluated the status of several wild mammals previously reported as positive. As a result, only 5 mammals (other than humans and horses) are now classified as WNV-positive, rather than the 25 reported previously from New York.

• Since 1 May 2000, a total of 143 counties in 12 States and the District of Columbia had confirmed findings of WNV in a mosquito, bird, or mammal: Connecticut (8), Delaware (2), District of Columbia (1), Maryland (8), Massachusetts (11), New Hampshire (2), New Jersey (20), New York (61), North Carolina (1), Pennsylvania (17), Rhode Island (4), Vermont (1), and Virginia (7). The report lists positive findings in each county, and (to a limited extent) gives species of mosquitoes and birds involved.

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June 30, 2001 • BY WENDY WENDLAND-BOWYER • FREE PRESS STAFF WRITER

State on West Nile virus alert

Dead crows may signal fast-spreading infection

"We all pretty much agree it is not 'if,' it is just a matter of 'when,' " Ned Walker, associate professor of entomology at Michigan State University, said Friday. "It moved so far, so fast last year.... Erie, Pa., is not that far away."

Until 1999, the virus had been relatively common in Africa, eastern Europe, west Asia and the Middle East but had never been found in this part of the world. It arrived in New York that year and spread up and down the East Coast. Last year, it came as close to Michigan as Erie, just 156 miles from Detroit across Lake Erie.

State officials are concerned because Michigan has the right type of mosquitoes, birds and conditions for the virus to spread. Last year, Michigan received a $90,000 grant from the U.S. Centers for Disease Control and Prevention to beef up its West Nile efforts. MSU and the state departments of Community Health, Agriculture and Natural Resources are working together on virus monitoring.

Mary Grace Stobierski, head of the health department's infectious disease epidemiology unit, said Michigan is focusing on monitoring crows because other states have found the bird to be particularly sensitive to the virus. Infected crows are likely to die. "They are easy to spot and easy to identify," she said. A major part of the monitoring effort is asking anyone who spots a dead crow to call the state's West Nile virus hot line. The crows may be sent to MSU for testing.

This year, about 13 dead crows have been tested. None was confirmed positive, but one crow from Monroe County was sent to a government lab in Colorado for further tests. Tests being done there have indicated the bird is not infected, said Geralyn Lasher, state health department spokeswoman.

West Nile encephalitis -- or West Nile virus, as the disease is commonly known -- spreads when mosquitoes feed on infected birds, then bite a human or animal. The virus infects the brain and can cause symptoms similar to St. Louis encephalitis or viral meningitis. Although most infected people have no symptoms, others may experience a high fever, stiff neck, convulsions, paralysis and death.

In 1999, there were 62 cases of severe West Nile virus in the United States, including seven deaths. In 2000, there were

17 cases through September, including one death.

The mosquito that spreads the virus belongs to the Culex species. This mosquito loves urban areas, making southeastern Michigan particularly vulnerable. Michigan has about 33 types of mosquitoes, said William Lechel II, director of the Saginaw County Mosquito Abatement Commission, which oversees mosquito control. And this year's mosquito population is thriving.

Ontario, Canada, is also on heightened alert. Authorities have tested about 400 dead crows and bluejays and found no evidence of the virus, said David Jensen, a spokesman for the Ontario Interior Ministry.

Last year, a preliminary test on a bird in the Windsor area came back positive, but further tests revealed no virus was present, Jensen said. Still, the scare was enough to catch the attention of Michigan public health officials. "What it did do was send a warning message to the rest of us that it is coming, if not this year, then the next year," said Dr. Donald Lawrenchuk, Wayne County Health Department medical director. His department held a conference on the virus this year. "The experts told us in our conference that we have a 50-50 chance of the West Nile conference coming to Michigan this year. It's better to be proactive than reactive."

Spot a dead crow? The health department wants to know. Many health officials expect the West Nile virus to arrive in Michigan soon, and to prepare, the state has gone on heightened alert. That includes testing dead crows, checking trapped mosquitoes, monitoring horses and watching for infected people.

Questions, preparations, prevention

•What is the West Nile virus? A virus spread by mosquitoes that feed on infected birds, then bite humans or other animals.

•What are its symptoms? Most people have no symptoms, but some become ill three to 15 days after the bite. About 1 in 4 will have a fever, headache and body aches, sometimes with a rash and swollen lymph nodes. Some may have a more severe headache, high fever, stiff neck, disorientation, convulsions and muscle weakness. Occasionally, it causes death.

•What can be done? Report any dead crows immediately. Call the West Nile Virus Hot Line at 888-668-0869 anytime. Wear long-sleeve shirts and long pants whenever in mosquito-filled areas and apply insect repellent with the active ingredient DEET, but avoid spraying DEET on very young children. Drain long-standing water from birdbaths, flower pots, pet bowls, clogged rain gutters, swimming pool covers, discarded tires and similar places. Repair torn screens. For more information, go to the Michigan State University Web site at www.mda.state.mi.usand click on "West Nile virus." Or check the U.S. Centers for Disease Control and Prevention site, www.cdc.gov/ncidod /dvbid/westnile/index.htm.

Sources: Michigan State University, Michigan Department of Community Health

Contact WENDY WENDLAND-BOWYER at 313-223-4792 or [email protected].

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Florida man may have West Nile virus

TALLAHASSEE, Florida (CNN) -- Florida health officials say a man in the state apparently has the West Nile virus. However, because it is the state's first human case of the disease, officials have asked the federal Centers for Disease Control and Prevention in Atlanta, Georgia, to confirm the diagnosis.

State Health Department spokesman Frank Penela said a man over the age of 50 and from Madison County is undergoing medical tests that will be completed by the end of the week.

Authorities would not identify the man, who remained hospitalized. He had been in critical condition with fever, fatigue, dizziness, weakness, confusion, headaches and joint problems -- all symptoms of the disease, Penela said.

"He's actually getting better," Penela said.

Concern about the disease is also evident in neighboring Georgia. Barbara Joye, a spokeswoman for the Georgia Department of Human Resources, which includes the state's Division of Public Health, said the division has received many calls from Georgia physicians with patients suffering from "apparent viral encephalitis." "We are testing several of these, including a patient from the Waycross public health district" in south-central Georgia near the Florida border.

Mosquitoes spread the disease by feeding on the blood of infected birds. A person cannot spread the disease to another person. It can cause encephalitis, or swelling of the brain. "There is no need to panic, but it is important to take the necessary measures to guard against mosquito bites," said Health Department Secretary Robert G. Brooks.

In addition to the one possible human case, the first cases of animals with the virus were discovered in Florida this month. Tests have been performed on 14 birds in six counties, and on one horse.

A medical alert that was issued last month for Holmes, Washington and Jackson counties has been extended to Bay, Calhoun, Gulf, Franklin., Liberty, Gadsden, Wakulla, Leon, Jefferson, Madison and Taylor counties.

In Georgia, authorities said a hawk found in June in DeKalb County, a suburb of Atlanta, tested positive for West Nile virus. The bird was found by a man walking his dog. It was Georgia's second confirmed case in a bird. A crow infected with West Nile virus was found in Lowndes County, Georgia, by a citizen in early July.

Florida residents were urged to avoid outdoor activities between dusk and dawn, when mosquitoes are likely to bite; to wear long pants and long-sleeved shirts; to use mosquito repellent; and to get rid of stagnant water where mosquitoes might breed. "Just spray and just do the common sense things you'd do at this time of the year," Penela said.

People over the age of 50 are at greatest risk of contracting West Nile, the department of health said.

The first case of West Nile Virus in the Western Hemisphere was reported in August 1999. From 1999 to 2000, 82 cases of the disease and nine deaths occurred in the New York City and New Jersey metropolitan areas

Source URL: http://www.cnn.com/2001/HEALTH/conditions/07/24/west.nile.florida/index.html

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CDC urges more action against West Nile

ATLANTA, Georgia (AP) -- Federal officials warned health agencies Thursday to step up mosquito-control efforts and other measures to stop the spread of the dangerous West Nile virus, which is turning up in the Southeast.

The virus, which has killed nine people in New York and New Jersey since 1999, appeared this month in a Florida man and in dead birds in Florida, Georgia and Virginia. Mosquitoes can carry the virus from birds to humans and other animals.

"Most of us believe it's only a matter of time before we see additional findings between Florida and where it's already been reported," said Dr. Stephen Ostroff, a CDC epidemiologist.

The CDC urged Americans to clean out standing water from clogged gutters, stagnant bird ponds, overturned trash can lids and anywhere else mosquitoes can gather and lay eggs.

"The best advice I have is not to get the mosquito bite in the first place," Ostroff said.

Florida agriculture officials plan to spray for mosquitos in rural Madison County.

For most people, the virus causes no more than a flu-like sickness. But it can kill people who are elderly or have weakened immune systems.

Source URL: http://www.cnn.com/2001/HEALTH/conditions/07/26/cdc.westnile.ap/index.html

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Friday July 27 10:23 AM ET

Thousands Infected with West Nile Virus in 1999

By Keith Mulvihill

NEW YORK (Reuters Health) - Scientists from the New York City Department of Health and the U.S. Centers for Disease Control and Prevention (news - web sites) (CDC) report that thousands of New Yorkers were probably infected with the West Nile virus (news - web sites) during the 1999 outbreak, but these cases went undetected. ``Our best guess is that roughly 8,200 people were infected with the West Nile virus,'' Dr. Farzad Mostashari of the New York City Department of Health told Reuters Health.

There is no treatment for West Nile infection in humans, which can spread to the brain (a condition known as encephalitis) or the tissues surrounding the brain (a condition known as meningitis). Efforts are under way to develop a vaccine against the disease, but are not expected to be completed for many years.

While the outbreak of 1999 caused 59 cases of the illness in patients that required hospitalization, including seven deaths, the new report indicates that many more people were infected but developed either no symptoms or a milder form of the illness, called West Nile fever. In West Nile fever, the virus can cause flu-like symptoms including fever with headache, severe fatigue, muscle ache and painful joints, according to Mostashari.

In 2000, there were 17 reported cases of West Nile virus infections and so far this year only one human case, in Florida, has been reported. However, the virus has been detected in birds in a number of states, including Florida and Georgia, the CDC announced on Thursday.

In the study, the researchers selected homes within a 4.5-square mile area around the outbreak's epicenter and visited them between October 2 and 6, 1999, about 6 weeks after the peak of the outbreak. The homes were largely in northern Queens, one of the five boroughs that make up New York City.

In all, 677 people from 459 households provided blood samples and completed a questionnaire that aimed to assess any recent illness that they may have experienced. The blood samples were tested for antibodies for West Nile virus.

Writing in the July 28th issue of the medical journal The Lancet, the researchers report that 19 individuals tested positive for antibodies to West Nile virus. Only six individuals in this group could recall symptoms of a recent illness.

On the basis of these findings, the investigators estimate that for every severe case of West Nile virus infection resulting in either encephalitis or meningitis, ``140 symptomless and mildly symptomatic infections occurred in the outbreak epicenter'' including as many as 30 people who suffered West Nile fever.

The authors estimate that 8,200 individuals living in New York City were infected with the West Nile virus.

``That number is an estimate,'' Mostashari told Reuters Health. ``But we are 95% confident that number is between 3,500 and 13,000 people,'' he said.

To prevent infection, the researchers recommend limiting exposure to mosquitoes by staying indoors during peak mosquito biting hours at dusk, putting screens in windows and the use of insect repellent that contains the chemical DEET. ``Although 85% of respondents could name at least one protective measure, only 61% took any measure to protect themselves against mosquito bites,'' the authors write. What's more, even after the highly publicized outbreak of the virus, only 9% of those surveyed reported consistent use of insect repellant to ward off mosquito bites and as many as 70% said that the never used any mosquito repellant, the report indicates.

``West Nile virus is going to be around for a long time. Those living in communities where the illness is prevalent need to stay vigilant every summer,'' Mostashari said. ``People who were outdoors the most were at the highest risk for contracting the illness,'' he added. Mostashari also stressed that he and his colleagues are ''not recommending that everyone who comes down with a fever be tested for the West Nile virus.'' Instead, ``it is important for people to realize that the total risk to them is more than we previously realized.'' And Mostashari advises that doctors should pay close attention to clusters of summertime fevers that may be the first sign of a West Nile virus outbreak, ``and not just write it off as the flu.''

``The good news for public health is that fewer than 1% of cases of West Nile fever develop into meningoencephalitis,'' writes Dr. Z. Hubalek of the Institute of Vertebrate Biology in Valtice, Czech Republic, in an accompanying commentary.

``The bad news is that more than 90% of the milder cases are not diagnosed correctly, and that the severity of symptoms and the fatality rate may vary from outbreak to outbreak,'' he adds.

``I don't think this information is a surprise, especially in the context of what we know about other outbreaks of West Nile virus in other parts of the world,'' Dr. Steven Morse, an epidemiologist and director of the Center for Public Health Preparedness at Columbia University, New York, told Reuters Health.

``We know that for every severe case of infection of West Nile virus reported that there is likely to be several fairly mild cases that will result in flu-like symptoms,'' he added. ``Upon hearing this new information people definitely shouldn't panic. In New York (City) appropriate action is being taken to control future outbreaks and we need to continue those efforts,'' Morse said.

The risk of being infected with West Nile virus by a bite from an infected mosquito is less than 1%, according to the CDC in Atlanta, Georgia. Fatality from the disease is 3% to 15% in infected people, with the greatest risk of death in the elderly. Birds are the main carriers of the infection, which is spread by mosquitoes. Humans are only believed to catch the disease from mosquitoes, and are not thought to be able to catch it from other infected animals or from one another.

SOURCE: The Lancet 2001;358:254-255, 261-264.

Source URL: http://dailynews.yahoo.com/h/nm/20010727/hl/wnile_1.html

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13:11 27 July 01 • By Catherine Zandonella

Florida fears massive outbreak of West Nile virus

The discovery of West Nile virus disease in a Florida man has public health officials wondering if the state - which is heavily populated with mosquitoes and elderly people - could be the scene for a massive outbreak of the disease. A study of the 1999 outbreak in New York published in the Lancet on Friday shows that up to 13,000 people were infected.

A similar infection rate in Florida's elderly population could have severe consequences since the elderly are much more susceptible to the disease caused by the virus. Mosquitoes transmit the virus. Steven Wiersma, the state epidemiologist for Florida, says his staff is very concerned about the risk for the elderly. "We are definitely telling people over 50 years old to protect themselves from mosquitoes."

West Nile virus is entering its third year in North America after arriving in New York, presumably on an intercontinental flight or ship. The virus is especially lethal in crows and horses, but can also infect cats, reptiles and humans. The analysis of the 1999 outbreak found that between 3500 people and 13,000 people, or an average of 2.6 per cent of the population in the area, were infected. The majority never experienced symptoms, but approximately 20 per cent reported a flu-like fever and one per cent succumbed to a deadly brain-swelling disease called meningoencephalitis. Elderly and immuno-compromised people are most at risk of encephalitis, for which there is no cure or vaccine.

Hot and humid

Florida's humid summers and mild winters make it attractive to retirees and mosquitoes alike, a potentially deadly combination.

"The age distribution of the population definitely affects the likelihood of a patient progressing to encephalitis," said Farzad Mostashari, the lead author of the New York study and an epidemiologist with the New York City Department of Health.

Since the virus entered the continent, nine people have died from the disease, seven in 1999 and two last year. This year's only case to date, 73-year old Seymore Caruthers of Madison County, Florida, remains in hospital in critical condition. The demographics of the 1999 outbreak are similar to previous outbreaks in Israel, the Czech Republic and other countries, says Mostashari.

Virulent virus

Scientists at the Centres for Disease Control and Prevention (CDC) are monitoring the virus for mutations that might indicate the virus is becoming more virulent, says Stephen Ostroff, a medical epidemiologist at the CDC headquarters in Atlanta, Georgia.

So far detection of the virus in Florida has been confined to a rural area, but Thursday's discovery of an infected bird in the county adjacent to the City of Orlando might indicate it is spreading to more populated areas.

What might save Florida is the state's active disease surveillance system, which includes sentinel chickens that periodically have blood drawn to check for virus. Already one chicken has tested positive.

Across the US, states have set up monitoring programs, and several states are spraying for mosquitoes and advising individuals to report any dead birds they find. When asked if he thought the virus would spread to every state, Ostroff replied, "There is no reason that it can't."

Journal reference: The Lancet (vol 358, p 261)

Source URL: http://www.newscientist.co.uk/news/news.jsp?id=ns99991085