- The Washington Times - Wednesday, September 25, 2002

A vaccine to protect the elderly from West Nile virus could be available in as little as three years, and a way to test the blood supply against the infection might be in place next summer, federal scientists told Congress yesterday.
The mosquito-borne virus has infected about 2,000 people in 32 states so far this year and killed 98. Particularly worrisome are recent discoveries that the virus apparently can be spread through blood transfusions if someone donates blood shortly after becoming infected, and that it occasionally causes a poliolike paralysis.
Still, public health specialists are expressing cautious optimism. While West Nile virus is here to stay, they expect the number of infections to be dramatically lower in coming years possibly as early as next year as more people become immune and communities act quickly each spring to destroy mosquito eggs and breeding grounds.
There even are hints that immunity against cousins of West Nile virus such as yellow fever, dengue fever and St. Louis encephalitis might provide protection against the new virus, too.
Indeed, the yellow-fever connection appears strong enough that the tropical disease forms the backbone of an experimental West Nile vaccine. Genes from the West Nile virus were added to the structure of the yellow-fever vaccine, and proved protective in animal studies, said Dr. Anthony Fauci of the National Institutes of Health.
A biotechnology company, Acambis, plans to begin tests on a few dozen people soon to determine whether the experimental vaccine is safe, and if later testing proves its effectiveness, it could be available in three years, Dr. Fauci said at a Senate hearing.
Also, the NIH this winter will test people vaccinated against yellow fever inoculations required for travel to certain parts of Africa and South America for signs that it provided cross-protection against West Nile virus.
"This is a disease we need to take seriously," Dr. Fauci told senators who wondered why West Nile virus, which first hit the United States in 1999, spread so fast.
But "it's extraordinarily unlikely that West Nile will ever get on the same radar screen" as, say, flu epidemics in terms of the harm it causes, he said.
For one thing, 20 percent of people who become infected with West Nile have mild flulike symptoms; one in 150 to 200 gets seriously ill. Better, if you survive a West Nile infection even if you had no symptoms you are considered immune for life. So today's children and young adults probably will become immune by the time they reach 60, which is important because older people are most at risk of death from the virus, Mr. Fauci said.
West Nile is a member of a family of viruses called flaviviruses that wax and wane from year to year. An outbreak of St. Louis encephalitis in the 1970s, for example, infected more than 1,000 people and killed about 100, but today about 100 cases a year are counted.
West Nile virus, which is common in much of Europe and the Middle East, acts similarly in other countries, with outbreaks cropping up every so often.
If the experimental vaccine works, doctors would be likely to use it during outbreak years to protect the most vulnerable, such as the elderly or people with immune systems weakened from HIV or cancer chemotherapy, Dr. Fauci said.
More immediately, the Food and Drug Administration hopes to have blood banks testing for West Nile virus in donations even if it means using an experimental test next summer, said the FDA's Dr. Jesse Goodman.

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