local doctor[friend] say,s he fears-that this winter will be a doozy. he also said-he fears alot of''carriers'' amongst poor & malnourished.--what,s coming across borders?--welfare-reform will backfire--lack of sanitation big-concern--epidemics & new-resistant strains.=[WASH HANDS FREQUENTLY] carry bleach water with you.watch those-door knobs.& public toilets.

-- building my immune system. (dogs@zianet.com), September 29, 1999

Answers

West Nile Fever, which attacks BRAINS is thought to be travelling the Atlantic Flyway south with migrating birds. What will happen WHEN they come in contact with the BILLIONS of mosquitos now breading in North Carolina???

West Nile Fever is INCURABLE.

Sounds like 4 horses are beginning to snort just prior to the ride...

-- K. Stevens (kstevens@ It's ALL going away in January.com), September 29, 1999.

Um...saw a doctor on the CBS Evening News the other night, talking about West Nile Encephalitis. She said that while you might be bitten by a mosquito which is carrying the disease, it's not that easy to contract. Also, that it has a 90% survival rate. Is this fever you're speaking of a different strain? The one being discussed on the news was the one that has struck people in the NYC area.

-- CD (CDOKeefe@aol.com), September 29, 1999.

Saw this on national news, Tom Brokaw, last evening. Forty-five people have been stricken in NYC and some (forgot number) have died. Man shown in hospital has been there since sometime in August, and barely survived. My brother lives in Brooklyn, so I am geared to this news, particularly since his work for NYC as a bus dispatcher keeps him outdoors all day long every day.

In same news, a woman (?biologist) was interviewed who's written a new book about deadly new viruses becoming more and more common, and no cures for them. She expects many more. Very scarey stuff!!!

-- Elaine Seavey (Gods1sheep@aol.com), September 29, 1999.

A lady died(in Simi Valley,Ca.) of encephilitis in 1982 or there abouts.The out break in N.Y. and of the likelyhood of spreading is scary.

-- Maggie (aaa@aaa.com), September 29, 1999.

NCID investigates West Nile fever outbreak in Romania

In late summer and early fall, 1996, health officials in Romania diagnosed several hundred meningoencephalitis cases in Bucharest. After laboratory studies identified antibodies to West Nile virus in several patient specimens, the Romanian Ministry of Health asked CDC to further investigate the outbreak, establish a diagnostic capability in local laboratories, and recommend control measures.

NCID staff who took part in the investigation were epidemiologists Linda Han (DVRD), Leslie Tengelsen, Roy Campbell, and Theodore Tsai, and entomologist Harry Savage (DVBID).

To date, 299 cases have been confirmed; 15 patients died. West Nile virus is transmitted by mosquitoes, often carried by infected birds, and usually causes fever, headache, rash, and swollen lymph glands, and more rarely, meningoencephalitis. In the summer of 1996, large populations of Culex pipiens mosquitoes in urban Bucharest led to transmission of the virus, possibly after its introduction by infected migratory birds from Africa. The researchers estimated that more than 94,000 persons became ill.

The results of a case-control study showed that those who were ill were more likely to be older than 70 years, to live in a house rather than an apartment building, to have noticed mosquitoes entering the residence through open windows, and to recall being bitten by mosquitoes more than five times per day.

The investigators hypothesized that West Nile virus, which has a wide geographic distribution in Africa, the Middle East, India, and Pakistan, may persist in a sylvatic cycle in the Danube River Basin, or, at least, that it is reintroduced there by migratory birds. No West Nile fever cases had been confirmed in Romania before this outbreak.

Revised: February 11, 1997

URL: http://www.cdc.gov/ncidod/focus/westnile.htm

-- Stan Faryna (faryna@groupmail.com), September 29, 1999.

CDC answers your questions about WEST NILE ENCEPHALITIS

Q. What is West Nile encephalitis?

A. "Encephalitis" means an inflammation of the brain and can be caused by viral and bacterial infections, including viruses transmitted by mosquitoes. West Nile encephalitis is an infection of the brain caused by West Nile virus, a flavivirus commonly found in Africa, West Asia, and the Middle East. It is closely related to St. Louis encephalitis virus found in the United States.

Q. How do people get West Nile encephalitis?

A. By the bite of a mosquito (primarily the Culex species) that is infected with West Nile virus.

Q. What is the basic transmission cycle?

A. Mosquitoes become infected by feeding on birds infected with the West Nile virus. Infected mosquitoes then transmit the West Nile virus to humans and animals when taking a bloodmeal.

Q. Can you get West Nile encephalitis from another person?

A. No. West Nile encephalitis is NOT transmitted from person-to-person. For example, you cannot get the virus that causes West Nile encephalitis from touching or kissing a person who has the disease, or from a health care worker who has treated someone with the disease.

Q. Can you get West Nile virus directly from birds?

A. There is no evidence that a person can get the virus from handling live or dead infected birds. However, avoid bare-handed contact when handling dead animals, including dead birds. Use gloves or double plastic bags to place the carcass in a garbage can.

Q. Besides mosquitoes, can you get West Nile virus directly from other insects or ticks?

A. Infected mosquitoes are the primary vector for West Nile virus. However, both hard and soft ticks have been found infected with West Nile virus in nature, but their role in the transmission and maintenance of the virus is uncertain. It may be possible for an infected tick to transmit the virus to birds or humans while taking a bloodmeal.

Q. What are the symptoms of West Nile encephalitis?

A. Mild infections are common and include fever, headache, and body aches, often with skin rash and swollen lymph glands. More severe infection is marked by headache, high fever, neck stiffness, stupor, disorientation, coma, tremors, occasional convulsions, paralysis and, rarely, death.

Q. What is the incubation period of West Nile encephalitis?

A. Usually 5 to 15 days.

Q. Where did the West Nile-like virus come from?

A. West Nile virus has been commonly found in humans and birds and other vertebrates in Africa, West Asia, and the Middle East, but has not previously been documented in the Western Hemisphere. It is not known where the U.S. virus came from.

Q. How long has the West Nile-like virus been in the U.S.?

A. It is not known how long it has been in the U.S., but CDC scientists believe the virus has probably been in the eastern U.S. for several months, possibly longer.

Q. When will the current risk of infection end?

A. The risk in the New York City area is greatly reduced due to the effectiveness of mosquito control and public education programs. However, the risk of infection will not be completely over until mosquito activity ceases for the season, i.e., when freezing temperatures are experienced.

Q. What precautions need to be taken to prevent a recurrent outbreak next year?

A. Surveillance for infected mosquitoes and sentinel bird flocks for West Nile virus will greatly enhance state and local government's early detection symptoms.

Q. What is the mortality rate of West Nile encephalitis?

A. Case-fatality rates range from 3% to 15% (higher in elderly than in younger age groups).

Q. How many cases of West Nile encephalitis occur in the U.S.?

A. No cases have previously been reported in the U.S. prior to September 1999 (New York City). No reliable estimates are available for the number of cases of West Nile encephalitis that occur internationally.

Q. Do birds naturally infected with West Nile virus die or become ill?

A. This has not been previously reported, but apparently has occurred in the New York City area epidemic.

Q. How is West Nile encephalitis treated?

A. There is no specific therapy. Intensive supportive therapy is indicated in more severe cases.

Q. Is the disease seasonal in its occurrence?

A. In temperate areas of the world, West Nile encephalitis cases occur primarily in the late summer or early fall. In the southern climates where temperatures are milder, West Nile encephalitis can occur year round.

Q. Who is at risk for getting West Nile encephalitis?

A. All residents of areas where active cases have been identified are at risk of getting West Nile encephalitis, but persons > 50 years of age have the highest risk.

Q. Is a woman's pregnancy at risk if she gets West Nile encephalitis?

A. There is no documented evidence that a pregnancy is at risk due to infection with West Nile virus.

Q. Historically, where has West Nile encephalitis occurred worldwide?

A. See map: http://www.cdc.gov/ncidod/dvbid/arbor/West_Nile_QA.htm

Q. Is there a vaccine against West Nile encephalitis?

A. No.

Q. What can I do to reduce my risk of becoming infected with West Nile virus?

A. Stay indoors at dawn, dusk, and in the early evening. Wear long-sleeved shirts and long pants whenever you are outdoors. Apply insect repellent sparingly to exposed skin. An effective repellent will contain 20% to 30% DEET (N,N-diethyl-meta-toluamide). DEET in high concentrations (greater than 30%) may cause side effects, particularly in children; avoid products containing more than 30% DEET. Repellents may irritate the eyes and mouth, so avoid applying repellent to the hands of children. Insect repellants should not be applied to very young children (< 3 years old). Spray clothing with repellents containing permethrin or DEET, as mosquitoes may bite through thin clothing. Whenever you use an insecticide or insect repellent, be sure to read and follow the manufacturer's DIRECTIONS FOR USE, as printed on the product. Note: Vitamin B and "ultrasonic" devices are NOT effective in preventing mosquito bites.

Q. Where can I get more information on mosquito-borne viral encephalitis?

A. Visit the CDC website http://www.cdc.gov/ncidod/dvbid/arbor/arboinfo.htm

-- Stan Faryna (faryna@groupmail.com), September 29, 1999.

******Spray clothing with repellents containing permethrin or DEET, as mosquitoes may bite through thin clothing. Whenever you use an insecticide or insect repellent, be sure to read and follow the manufacturer's DIRECTIONS FOR USE, as printed on the product. Note: Vitamin B and "ultrasonic" devices are NOT effective in preventing mosquito bites.******

Just an aside, permethrin is not a repellant but an insecticide. Kind of vague in the note from the CDC. Frankly this is not all that big a deal as permethrin is also the best product to protect against ticks which carry Lyme, Erlichosis, Rocky Mountain Spotted Fever. All of which you are more likely to contract than this rare encephalitis. (70 out of how many million people that live in the area?)

Of course you won't encounter many ticks in NY City. But then you will probably die in NY City in 95 days. (Yes Scarlett 95 days, we'll wait untill Monday for the reality to set in and the panic to begin.)

-- LM (latemarch@usa.net), September 29, 1999.

LM,

Your description of symptoms is chillingly similar to how a lot of people in my local area have spent the last few months. Incluyding me. Symptomns most seen as Cory Hamasaki described it a month or so ago; "the flu without the flu". Until those lymph gland inflamations triggerred a case of Bell's Palsy. Oddly, the fourth case locally I've heard of in the last month.

And the CDC says West Nile Encephalitis has only been in the US a month or so? Maybe just it's appearing in a highly populated area for the first time, causing enough ripples on the surface to be noticed by the medical powers that be?

MA

-- MA (Medically Annonymous@thistime.com), September 29, 1999.

This is a good thread. I've learned a lot here for once.

-- (sickofthis@crap.com), September 29, 1999.

MA,

The flu, really flu like symptoms, followed by bell's palsy is a perfect description of Lyme disease. Get to a doctor quick. It can be easily cured with antibiotics at that stage. If you wait you'll regret it, possibly for the rest of your life.

I do not play a doctor on TV, I am a doctor.

-- LM (latemarch@usa.net), September 29, 1999.

With reference to mosquito repellents containing Deet. Consuemr Reports says these are the most effective but DO NOT spray directly on skin; spray on clothes as auggested above. There is a link between Deet and cancer. May as well stock up on Off! now. Heaven knows Off!'s JIT system probably doesn't allow for West Nile encephalitis.

-- Old Git (anon@spamproblems.com), September 29, 1999.