- The Washington Times - Friday, August 9, 2002

Doctors say that people in good health face a very low risk of getting the West Nile virus and that even if they are infected, few will realize they have it.

"The vast majority of the people that would get infected with it don't even know they have it because they have absolutely no symptoms or very mild symptoms," says Dr. Shmuel Shoham, who specializes in infectious diseases at Washington Hospital Center.

"Statistically, for every one person with mild symptoms five others have no symptoms," he said. "For every one person with severe symptoms, 250 people would either have mild or no symptoms at all."

Meanwhile, a 55-year-old District man who contracted the virus fits the profile of those most susceptible to the disease, including a weak immune system, according to the U.S. Centers for Disease Control and Prevention in Atlanta.

The median age of the victims in this year's 113 confirmed cases is 55, and men have made up 60 percent of those who tested positive. The majority of the cases also have involved people whose immune systems were weak before they were infected.

District health officials said the man has a compromised immune system because he has leukemia, which coupled with chemotherapy made him less able to resist West Nile virus.

This year's victims are younger than in years past, when the median age was in the mid-60s, the CDC said in a report released yesterday.

People with chronic illnesses such as cancer, kidney disease, HIV or AIDS may be more susceptible to West Nile virus because of their weakened immune systems.

Flulike symptoms are common in those with West Nile virus and include mild fever, headache and muscle aches. In rare cases, inflammation of the brain can occur.

No drug or vaccine can treat or cure West Nile virus.

"For the vast majority there would be no treatment at all or simply pain relievers, drinking plenty of fluids and resting like treating a common flulike illness," Dr. Shoham said. "The symptoms that people should be looking for are severe headaches, neck stiffness, high fevers, and if people in their family are noticing that they are behaving abnormally that should be a signal to get medical attention."

The virus is carried by birds and transmitted to humans through mosquitoes. There is no evidence to suggest West Nile virus can be transmitted from person to person or from an animal to a person, according to the CDC Web site (www.cdc.gov).

West Nile virus was first discovered in North America in the summer of 1999 in New York City, where it killed seven persons and sickened 55 others.

Since then, cases have been detected in 34 states and the District. Nearly every state east of the Rocky Mountains has found birds that tested positive for West Nile.

From 1999 through 2001, the virus sickened 149 persons and killed 18 in the United States, according to the CDC.

There have been five confirmed deaths this year, all in Louisiana, although Mississippi health officials said yesterday that a resident there is likely to have died from the virus. The death is being investigated, and officials would not release the age or sex of the victim.

The CDC announced yesterday that an additional $10 million will be sent to states to fight infected mosquitoes. About $3.7 million will be earmarked for the hardest-hit states Louisiana and Mississippi where 71 persons and 34 persons, respectively, have become ill. In Texas, 12 persons have contracted the virus, and Illinois, Alabama and the District have each had one confirmed case.

"It's an emerging disease," said Ted Gordon, senior deputy director of the D.C. Department of Health. "It's moving West. From East to Southeast to West. It is endemic to the East Coast."

The D.C. man with the virus was diagnosed at the National Institutes of Health in Bethesda after receiving regular leukemia treatment, said Dr. Michael Richardson, a specialist with the city health department.

The man's condition has stabilized, although he remains hospitalized, health department officials said yesterday.

Mr. Gordon said health officials are going door to door, talking with residents in Ward 3, where the man lives and where the highest number of mosquito pools have been found to be infected with West Nile virus.

"Mosquitoes don't recognize geographical boundary lines or political wards," Mr. Gordon said. "They're in our city. They're everywhere in our city, and you need to take the necessary precautions."

He said the health department has decided against spraying for mosquitoes because of the high rate of asthma among the city's young people.

"We don't want to put those people at risk," he said. "The use of synthetic and organic pesticides can trigger an asthma attack."

Tests of 21 other city residents suspected of having contracted West Nile virus this year all turned out negative. The tests were given to "people who had been hospitalized [for reasons other than West Nile virus]," Dr. Richardson said.

Officials are advising residents and businesses to eliminate pools of water, where mosquitos breed, or treat the water bodies with larvicide. The health department has arranged to test dead crows, blue jays, hawks and eagles.

In the District, 61 birds have tested positive, including a crow found on the White House grounds. Most died in Northwest, and on Monday health officials stopped testing dead birds found in ZIP codes 20007, 20008, 20011 and 20016 in Northwest, where at least 20 birds tested positive.

The department is encouraging residents in other ZIP codes to call 202/535-2323 to report the location of dead birds and to dispose of the bodies themselves or call the Department of Public Works at 202/727-1000.

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