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States React to West Nile Prediction
Fri Aug 16, 2:36 PM ET
ATLANTA (AP) - Health officials worked Friday to calm public fear of the West Nile virus ( news - web sites) after the government predicted 1,000 people could be infected with the potentially deadly disease this year.
AP Photo
The Centers for Disease Control and Prevention ( news - web sites) said Friday there have been 159 confirmed human cases this year, including nine fatalities. Tests are pending on other cases.
The virus has been found in every state east of the Rocky Mountains, with human cases confirmed in nine states and the District of Columbia.
A CDC West Nile expert, Dr. Lyle Petersen, said the disease's peak may not come for several weeks and that "a lot more cases" could be reported before cooler weather kills the disease-carrying insects.
Petersen said up to 10 percent of people diagnosed with West Nile could die from it - meaning potentially 100 fatalities this year.
In coastal Georgia, mosquito control experts said dozens of people have called with questions about West Nile.
"People are very, very aware of the outbreak, and they're concerned," said Henry Lewandowski, director of Savannah's Chatham County Mosquito Control Commission.
Seven people in Louisiana and two in Mississippi have died of the disease this year.
Public fear heightened Friday when a 13th state reported human West Nile infections. Michigan officers said two elderly men had suspected cases of the virus, though both were expected to recover.
In Texas, one of the hardest-hit states this year with 16 human cases, Houston health officials hope to publicize prevention methods without causing panic.
"We're not trying to alarm people," said Sandy Kachur of the Harris County Public Health Services. "We tell people in the summertime they always need to wear sunscreen when they go outside. Now it looks like it's almost going to be that way with insect repellent, too. It's something we're always going to have to be aware of from now on."
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On the Net:
CDC: http://www.cdc.gov
West Nile Death Toll Reaches 10
Fri Aug 16, 3:34 PM ET
By BRANDON LOOMIS, Associated Press Writer
CHICAGO (AP) - Illinois health officials said Friday that a 67-year-old man had died of the West Nile virus ( news - web sites), the first such death in state history and the 10th nationwide this year.
AP Photo
AP Photo
Slideshow: West Nile Virus
State health director John Lumpkin said the man slipped into a coma after being admitted to the hospital Aug. 4 and died six days later.
The virus has spread rapidly since it was first detected in the United States, in New York in 1999. It has shown up as far west as Colorado and Wyoming, and experts expect it to reach the West Coast.
From 1999 through 2001, the Centers for Disease Control and Prevention ( news - web sites) confirmed 149 human cases and 18 deaths. This year, it had already killed seven people in Louisiana and two more in Mississippi.
Tests are pending on other cases.
A CDC West Nile expert, Dr. Lyle Petersen, said the disease's peak this year may not come for several weeks, and that "a lot more cases" could be reported before cooler weather kills the disease-carrying insects.
Petersen predicted 1,000 people could be infected this year and 100 could die.
In coastal Georgia, mosquito control experts said dozens of people have called with questions about West Nile.
"People are very, very aware of the outbreak, and they're concerned," said Henry Lewandowski, director of Savannah's Chatham County Mosquito Control Commission.
In Texas, one of the hardest-hit states this year with 16 human cases, Houston health officials hope to publicize prevention methods without causing panic.
"We're not trying to alarm people," said Sandy Kachur of the Harris County Public Health Services. "We tell people in the summertime they always need to wear sunscreen when they go outside. Now it looks like it's almost going to be that way with insect repellent, too. It's something we're always going to have to be aware of from now on."
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On the Net:
CDC: http://www.cdc.gov
CDC Team Gauges Risk of West Nile Spread Via Blood
Fri Aug 16, 5:22 PM ET
By Mary Beth Nierengarten
NEW YORK (Reuters Health) - West Nile virus ( news - web sites) infection, the mosquito-borne illness now spreading across the US, could be transmitted through blood transfusions, researchers from the Centers for Disease Control and Prevention ( news - web sites) (CDC) report.
But the risk--while relatively high--would only exist for blood donated during peak times of infection, they conclude.
West Nile virus is carried by certain birds, and can be passed to humans via mosquitoes. The virus--which originated in Africa and was first spotted in the United States in New York in 1999--has quickly spread west and south across the US.
West Nile risk would be highest for blood donated at times and places when the infection was most common--for example the northeastern US in late August, the CDC researchers say. If patients given blood that was donated during such periods exhibit West Nile virus-like symptoms, they add, doctors should consider the possibility that the patient has contracted the infection from the blood donation.
It is particularly important to determine if West Nile could be spread by transfusion, Dr. Brad J. Biggerstaff from the CDC's National Center for Infectious Diseases in Fort Collins, Colorado and Lyle R. Petersen note, because people infected with the virus usually don't have symptoms. But among those who do develop severe illness, fatalities range from 3% to 30%, with the highest death rate among the elderly. There is no cure for the infection.
To investigate the theoretical risk that West Nile virus could be spread by donated blood from infected individuals, Biggerstaff and Petersen conducted a statistical analysis of the 1999 outbreak in Queens, New York. They report the findings in the August issue of the journal Transfusion.
The researchers examined the date of onset for people infected with the West Nile virus during the 1999 epidemic and estimated the number of people who had the virus in their blood throughout the outbreak. To infer the transfusion-transmission risk based on these data, the investigators then estimated the inapparent-to-apparent infection ratio, the proportion of asymptomatic infections, and the size of the population.
The minimum risk of a donor transmitting the West Nile virus through his or her blood during the 1999 outbreak was found to be 1.8 in 10,000 donations, with a maximum risk of 2.7. The risk of transmission was time-limited, peaking during the months of August and September, the period in the northeastern US with the highest rate of infections. Estimates of infection entering the blood supply before August or after September fell to nearly zero.
Elsewhere in the US, the time of highest activity of West Nile virus may start earlier, Biggerstaff noted, "as with the current outbreak in Louisiana. In other parts of the US where West Nile virus is new, we just don't know yet."
Although the estimates indicate a theoretically low risk of transmitting the West Nile virus through transfusion, they are relatively high compared to transfusion-transmitted viruses regularly screened for, such as HIV ( news - web sites). Estimates for HIV, for example, range from 1 per 200,000 to 2 million.
"While the estimates we give are relatively high," explained Biggerstaff, "it's important to remember that the average rate we give is during the outbreak only and for the area of the outbreak only, and that the rate is lower outside this time frame and locale."
Implications of this study suggest that doctors should consider the possibility of transfusion-transmitted West Nile virus in patients with unexplained symptoms suggestive of this virus, particularly if the blood donation was obtained when the activity of the virus is highest. "But they should also be aware of the level of risk or chance of such an occurrence when making a clinical decision," Biggerstaff added.
SOURCE: Transfusion 2002;42:1019-1026.
West Nile Death Toll Reaches 11
Fri Aug 16, 7:37 PM ET
By JANET McCONNAUGHEY, Associated Press Writer
NEW ORLEANS (AP) - The nationwide death toll from the rapidly spreading West Nile virus ( news - web sites) climbed to 11 on Friday as two new victims were reported, one in Louisiana and another in Illinois.
AP Photo
Reuters Photo
Slideshow: West Nile Virus
The death of a 78-year-old man was the eighth in Louisiana, where the mosquito-borne disease has hit hardest. The state also reported 62 new human cases, bringing the total this year to 147 in easily the worst outbreak in U.S. history. Across the country, 251 human cases have been reported, the Centers for Disease Control and Prevention ( news - web sites) said.
"An epidemic this size is like a hurricane. What you need to do is take shelter," said Louisiana state epidemiologist Raoult Ratard. "If you don't take shelter you may be swept away."
Ratard said "taking shelter" meant using mosquito repellent and making sure residents' yards are free of standing water to ward off the virus.
In Illinois, state health director John Lumpkin said a 67-year-old man died of encephalitis Aug. 10 after being admitted to the hospital with the virus. It was the first West Nile death in Illinois history.
The state also reported three non-fatal cases from the Chicago area.
"The results are very serious but we want to remind people that this is still a very rare disease among people bitten by mosquitos," Lumpkin said.
The virus has spread rapidly since it was first detected in the United States, in New York three years ago. The CDC said the virus killed 18 people from 1999 through 2001.
Besides this year's deaths in Louisiana and Illinois, two people have died in Mississippi.
The virus has been found in every state east of the Rocky Mountains, with states as far west as Colorado and Wyoming saying they have confirmed animal cases. It is expected to spread to the West Coast.
A CDC West Nile expert, Dr. Lyle Petersen, said the disease's peak this year may not come for several weeks, and that "a lot more cases" could be reported before cooler weather kills the disease-carrying insects.
Petersen predicted 1,000 people could be infected this year and 100 could die.
In coastal Georgia, mosquito control experts said dozens of people have called with questions about West Nile.
"People are very, very aware of the outbreak, and they're concerned," said Henry Lewandowski, director of Savannah's Chatham County Mosquito Control Commission.
In Texas, one of the hardest-hit states this year with 16 human cases, Houston health officials hope to publicize prevention methods without causing panic.
"We're not trying to alarm people," said Sandy Kachur of the Harris County Public Health Services. "We tell people in the summertime they always need to wear sunscreen when they go outside. Now it looks like it's almost going to be that way with insect repellent, too. It's something we're always going to have to be aware of from now on."
___
On the Net:
CDC: http://www.cdc.gov
New York Hospital to Begin West Nile Drug Trial
Wed Aug 21, 5:44 PM ET
By Elizabeth Wallace
NEW YORK (Reuters Health) - The New York Hospital Queens (NYHQ) said on Wednesday that it has received approval from the US Food and Drug Administration ( news - web sites) to begin the first trial of a drug to treat hospitalized patients infected with West Nile virus ( news - web sites).
The study seeks to determine whether Schering-Plough's Intron-A (interferon alfa-2b) can decrease the duration of illness, decrease severity of symptoms such as brain swelling, and prevent death. Kenilworth, New Jersey-based Schering-Plough will provide the drug free of charge for the trial.
The NYHQ will enroll 40 patients nationally, wherever they are hospitalized, it said. All patients age 50 and over will be eligible, but younger patients will only be enrolled if they have been diagnosed with encephalitis. The trial is expected to begin immediately in Louisiana, Mississippi, and the New York metropolitan area, the hospital said.
Half the patients will receive Intron-A, and the other half will receive basic hospital care, NYHQ Infectious Disease Director and principal study investigator Dr. James Rahal said in a statement. Drug therapy will begin within four days after a patient is admitted, with an initial intravenous dose, then followed by daily injections.
Intron-A has been approved for use in combination with another drug, ribavirin, for treatment of hepatitis C infection. The drug has shown to be effective in laboratory tests against West Nile virus, NYHQ said, and in a study last year, showed possible benefits against St. Louis encephalitis, which is similar to West Nile.
NYHQ is particularly interested in finding treatment options for West Nile virus, hospital spokesman Paul Pickard explained in an interview, because when West Nile first appeared in the US in 1999, it was diagnosed in several patients in Queens. Rahal was one of the first physicians to study the virus and its treatment.
NYHQ noted that the US Centers for Disease Control and Prevention ( news - web sites) has confirmed 11 deaths from West Nile, eight of them in Louisiana. The CDC estimates that 251 people in 12 states have been infected.
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Author Topic: National death toll from West Nile virus reaches 11 with fatalities in La., Ill.
Wise Young
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National death toll from West Nile virus reaches 11 with fatalities in La., Ill.
By Janet Mcconnaughey, Associated Press, 8/17/2002 08:01
NEW ORLEANS (AP) The West Nile virus has claimed two more victims, one in Illinois and another in Louisiana, bringing this year's death toll from the rapidly spreading virus to 11 nationwide.
A 78-year-old man became the eighth fatality in Louisiana, where the mosquito-borne disease has hit hardest. The state also reported 62 new human cases, bringing its total this year to 147 in the worst outbreak since the virus was first detected in the United States three years ago.
Across the country, 251 human cases have been reported, the Centers for Disease Control and Prevention said.
''An epidemic this size is like a hurricane. What you need to do is take shelter,'' said Louisiana state epidemiologist Raoult Ratard. ''If you don't take shelter you may be swept away.''
''Taking shelter'' in the case of mosquito-bourne viruses means using mosquito repellent and making sure residents' yards are free of standing water to ward off the virus, he said.
The virus has spread rapidly since it was first detected in 1999 in New York. The virus killed 18 people from 1999 through 2001, according to the CDC.
This year, two people died in Mississippi, in addition to the deaths in Louisiana and Illinois.
In Illinois' first human death linked to West Nile, a 67-year-old man died of encephalitis Aug. 10 after being admitted to the hospital with the virus, state health director John Lumpkin said. The state also reported three non-fatal cases in the Chicago area.
''The results are very serious, but we want to remind people that this is still a very rare disease among people bitten by mosquitos,'' Lumpkin said.
The virus has been found in every state east of the Rocky Mountains, with states as far west as Colorado and Wyoming saying they have confirmed animal cases.
Michigan reported its first human case of West Nile on Friday, and in Rochester, N.Y., a zoo penguin died from the virus, officials said.
A CDC West Nile expert, Dr. Lyle Petersen, said the disease's peak this year may not come for several weeks, and predicted 1,000 people could be infected this year and 100 could die.
Still, health officials worked to calm public fears. In Texas, one of the hardest-hit states with 16 human cases, Houston health officials hope to publicize prevention methods without causing panic.
''We're not trying to alarm people,'' said Sandy Kachur of the Harris County Public Health Services. ''We tell people in the summertime they always need to wear sunscreen when they go outside. Now it looks like it's almost going to be that way with insect repellent, too.''
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"With every scientific advance, we grow closer to unlocking the mysteries of life and creation. But what have we gained if in the process, we lose our humanity. The most powerful thing we pass along to our children may not reside in the genes, but in the soul."
The Outer Limits(Criminal Nature)
Officials Report Four More West Nile Deaths
Mon Aug 26,10:29 AM ET
By Melissa Goldfine
CHICAGO (Reuters) - Authorities in Illinois, New York, Michigan and Ohio reported four more deaths suspected to be from the mosquito-borne West Nile virus ( news - web sites), possibly adding to the list of 16 confirmed deaths nationally from the virus.
Initial blood tests showed an 81-year-old man from Melville, Long Island, east of New York City, died of the virus last Monday, a spokeswoman for the Suffolk County Health Department said Saturday. If the man did in fact have the virus, he would be the first person in the New York City area to die from the illness this year.
In Cook County outside Chicago, preliminary tests showed a 67-year-old woman is likely the second person in Illinois to die after contracting the disease, according to the Illinois Department of Public Health ( news - web sites). In addition, 16 others have tested positive for the virus, bringing human cases confirmed in the state to 42 this year.
On Friday, state health officials said the virus may be responsible for the deaths of a 65-year-old Michigan man and a 79-year-old Ohio man. The cases are the first apparent deaths from West Nile in both states.
The US Centers for Disease Control and Prevention ( news - web sites) said on Friday 16 people have died this year after contracting the virus.
So far, the CDC also has confirmed 371 human cases of West Nile, which can cause a brain inflammation called encephalitis, in 20 states and the District of Columbia.
A spokesman for the Michigan Department of Community Health said the state has identified 13 probable human cases of the virus, and, according to a news release from the Ohio Department of Health, that state has 14 possible cases.
At least 40 US states have reported some West Nile virus activity this year, with 171 cases and eight deaths in Louisiana alone.
Most people who contract the virus suffer no symptoms and those who do have nothing more than headaches and flu-like illness. But the elderly, chronically ill and those with weak immune systems can develop encephalitis when infected.
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"With every scientific advance, we grow closer to unlocking the mysteries of life and creation. But what have we gained if in the process, we lose our humanity. The most powerful thing we pass along to our children may not reside in the genes, but in the soul."
The Outer Limits(Criminal Nature)
The West Nile Epidemic
he West Nile virus, first detected in New York only three years ago, has now spread more than halfway across the country and deep into the South. Thus far this year it has sickened more than 370 Americans in 20 states and the District of Columbia, killing at least 16 of them. It is the worst outbreak yet in this country, and the peak season for the disease is only just starting. Some experts predict that the number of cases could eventually reach 1,000, with as many as 100 fatalities. There seems little doubt that the disease, which flies on the wings of birds and mosquitoes, has become permanently established in this country. The public is wondering just how bad it will get.
The flaviviruses, which include West Nile virus, fluctuate unpredictably. The West Nile virus itself has been circulating abroad since at least the 1930's, yet it caused only sporadic outbreaks over a period of six decades, most notably in Israel and Africa. That offers hope that this year's outbreak need not be followed by even worse to come.
But there are some worrisome recent developments. Since the mid-1990's, the frequency and severity of the outbreaks abroad have increased. Meanwhile, in this country the virus has been found in some 110 species of birds and some 30 different types of mosquito, giving it numerous pathways to spread far and wide. Disturbingly, this year's epidemic is causing illness in a younger group of people - their median age is in the mid-50's, a decade younger than in past outbreaks. That could reflect a more vigorous search for cases than in previous years, or it could be alarming evidence that the virus has become more virulent and is able to make people sick who would previously have been unaffected.
The odds of getting sick remain small. In any given area, only a small fraction of mosquitoes are apt to be carrying the virus, and only a small fraction of those are apt to transmit it to humans. Even when people do become infected with the virus, only 20 percent develop symptoms, which usually resemble those in a mild case of the flu. The other 80 percent do not even know they harbor the virus.
The real danger is that a small group of people - fewer than 1 percent of those infected - develop an inflammation of the brain or spinal cord that can cause death or permanent injury in some cases. Those over age 50 are most at risk.
Not much can be done for West Nile patients. There is no medicine known to be effective in treating the disease, and no vaccine to prevent it, though research is advancing on both fronts. The most that can be provided is supportive care, like hospitalization and the use of intravenous fluids and machines to aid breathing. Some 3 to 15 percent of the severely affected die, and many of those who survive have lasting symptoms, like fatigue, memory loss, muscle weakness and difficulty walking.
The widening epidemic makes it imperative that health authorities carefully monitor just where and how the virus is spreading, by taking steps like testing dead birds and mosquitoes. When the virus is found, state and local authorities need to suppress mosquitoes by killing both the larvae and the adults.
Individuals can protect themselves by staying inside at peak mosquito hours and by using window screens, long sleeves and mosquito repellant. There is no reason to panic - the odds of getting the disease are very low. But this is not a disease to take lightly. Although it harms relatively few people, it can have life-altering consequences in those most severely affected.
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" They say "Seeing is believing" but the true question is: What do you believe you've seen? Throughout history, the search for faith has lead man to look to the stars and the heavens for answers, but only by looking into ourselves may we truly find it." Outer Limits(Josh)
West Nile Case Suspected in Canada
Fri Aug 30, 2:31 PM ET
By TOM COHEN, Associated Press Writer
TORONTO (AP) - Ontario health officials said Friday they believe three people sick in the province have the West Nile virus ( news - web sites), which would be Canada's first human cases of the mosquito-born illness that has killed 24 people in the United States this year.
Colin D'Cunha, the Ontario chief medical officer, said final confirmation would take another two weeks.
Ontario is Canada's most populous province, and is across the border from U.S. states where the virus has been reported.
If the three have the virus, it would document the continuing spread of West Nile throughout North America. Several U.S. states - including North Dakota, Iowa, Arkansas and South Carolina - have reported their first human cases this week of a virus that can cause fever, body aches, brain swelling, coma, paralysis or death.
Canadian officials have warned in recent years that the virus, which has been detected in birds and animals in Canada, eventually would spread to the human population. It is transmitted to humans by mosquito bites.
Dr. David McKeown, the medical health officer for the Peel region west of Toronto, said two of the probable cases involved people over 65 from the Mississauga area.
One remains hospitalized in serious condition and another was hospitalized and then released to recover at home, McKeown said.
There was little information immediately available about the third case, but D'Cunha said authorities believe the person became sick in the United States.
According to the U.S. Centers for Disease Control and Prevention ( news - web sites), 24 people have died across the country so far this year from the virus, with almost 500 cases reported in more than 20 states.
The virus is most dangerous for children, the elderly and people with weak immune systems. It can cause flu-like symptoms and encephalitis, a potentially fatal brain infection. Most people bitten by an infected bug never get sick.
West Nile is common in Africa and the Middle East. The disease was first detected in the United States in 1999, when seven people died from it in New York.
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" They say "Seeing is believing" but the true question is: What do you believe you've seen? Throughout history, the search for faith has lead man to look to the stars and the heavens for answers, but only by looking into ourselves may we truly find it." Outer Limits(Josh)
West Nile Link in Transplant Probed
Mon Sep 2,10:36 AM ET
By BARNINI CHAKRABORTY, Associated Press Writer
ATLANTA (AP) - Health officials have identified a new possible target in their fight against West Nile virus ( news - web sites) as it spreads across the country.
AP Photo
Reuters
Slideshow: West Nile Virus
They say a woman may have gotten the virus through blood transfusions, and four people possibly became infected after receiving her organs following her death.
One of the organ recipients has died, and three were hospitalized with symptoms associated with West Nile, although tests to determine if they were infected with West Nile through the transplants are still being conducted.
"We've known for some time that there is a theoretical possibility that people can get this through blood or organ transplants," said Tom Skinner, a spokesman for the Centers for Disease Control and Prevention ( news - web sites). "It's highly unusual but it's certainly possible."
American Red Cross ( news - web sites) spokeswoman Trudy Sullivan acknowledged that no test exists to screen blood for West Nile, but she said the blood supply is safer than ever and anyone showing symptoms of the virus would be turned away.
"Yes, the screening process doesn't cover everything, but if you've even got flu-like symptoms, you will be turned away," Sullivan said. "We have a number of different layers of safety."
West Nile infections can be hard to spot, though. Only about 1 percent of those infected show symptoms, with those with weakened immune systems most susceptible, according to the CDC. So far this year, 638 people in 28 states have tested positive for West Nile virus and 31 have died.
All the previous cases had been blamed on mosquito bites, but health officials now fear four people may have been infected with West Nile after receiving the kidneys, heart and liver of a woman who died in Georgia last month after a car accident, the CDC said Sunday.
Officials say the woman may have been infected already or may have gotten West Nile through blood transfusions in the emergency room.
The Atlanta-based CDC is trying to trace donors who contributed the transfused blood, the blood products made from the donations, and any other patients who may have received blood or blood products from the donations.
The Food and Drug Administration ( news - web sites) issued an alert to blood banks two weeks ago to exercise extra caution when screening donors, Dr. Jesse Goodman of the FDA said.
"We have been very active and tried to anticipate the possibility of something like this," Goodman said.
Three of the four patients developed symptoms of encephalitis, the inflammation of the brain and central nervous system, which is the most serious consequence of West Nile virus.
One of the four has died in Atlanta, said Dr. James Hughes, director of the CDC's National Center for Infectious Disease. Standard pathology tests from an autopsy confirmed the recipient had encephalitis. Tests are ongoing to see if the recipient was infected with West Nile, which causes encephalitis.
Another recipient, from Jacksonville, Fla., showed symptoms of encephalitis Sunday, said Dr. John Agwunobi, the Florida Secretary of Health.
CDC officials say they're sure the man didn't contract the disease from a mosquito, said Mary Jo Trepka, epidemiology director with the county health department.
Samples from the four transplant recipients were sent to the CDC's lab in Fort Collins, Colo., Hughes said. Test results are expected within the week.
There is no test yet that can quickly or accurately identify the presence of the West Nile virus. Patients are diagnosed based on their immune response to the virus.
However, researchers at the CDC are trying to find a way that will cut down the time from when infection occurs and when a response to the virus can be measured, the CDC said. It now takes about 15 days.
Officials say they remain optimistic that there is a low chance West Nile can spread through blood because there have been no confirmed cases to date.
There are also no known cases of person-to-person transmission of other diseases in the same family as West Nile called the arboviral encephalitides: St. Louis encephalitis, La Crosse encephalitis and Eastern and Western equine encephalitis.
However, there have been cases of other mosquito-borne diseases being passed by blood transfusion or transplant. Last year, a CDC review of blood-donation problems turned up 93 patients who contracted malaria after blood transfusions.
Cases have also been reported in which dengue, another mosquito-borne disease, was transmitted to a health care worker by a needle-stick and between siblings after a bone-marrow transplant.
Sullivan said the blood supply is safer than it's ever been, and that her organization is "focused on allaying any fears or concerns about the safety of the blood supply for both donors and recipients."
Every unit of blood donated goes through up to 12 tests to ensure patient safety, including tests for HIV ( news - web sites) and hepatitis C, Sullivan said.
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On the Web:
CDC West Nile: http://www.cdc.gov/ncidod/dvbid/westnile/index.htm
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"Experience teaches that, of all the emotions, fear stands alone in its power to move us, or to capture us in its grip forever. In a world of terrors, there is nothing more fearsome that the unknown...especially when what is unknown is ourselves." Outer Limits(Fear Itself)
Experts Aim to Ease W. Nile Worries
Mon Sep 2, 6:11 PM ET
By KRISTEN WYATT, Associated Press Writer
ATLANTA (AP) - Public health officials on Monday sought to assure Americans that the blood supply was safe despite concerns that an organ donor who received a transfusion may have transmitted the disease to four transplant recipients.
Reuters
Slideshow: West Nile Virus
One of the four died of brain swelling that can be caused by the virus, which until now has been blamed solely on mosquito bites.
The three others were hospitalized with symptoms associated with West Nile, although doctors aren't sure they have the virus or whether they got it from a medical procedure.
The organ donor, a Georgia woman, died in a car crash last month. She may already have been infected or may have gotten West Nile through blood transfusions in the emergency room after the crash, the CDC said.
Samples from the four transplant recipients were sent to the CDC's lab in Fort Collins, Colo. Test results are expected within the week. The organ recipient who died was in the Atlanta area. The others are at hospitals in the Atlanta area, in Miami and Jacksonville, Fla., health officials said.
Public health officials spent the weekend assuring people about the national blood supply, despite the lack of a West Nile screening process in donated blood and organs. Any potential blood donor showing symptoms of the virus would be turned away, they said.
"The blood supply is as safe as it's ever been," Trudy Sullivan, an American Red Cross ( news - web sites) spokeswoman in Washington, said Monday.
The Food and Drug Administration ( news - web sites) issued an alert to blood banks two weeks ago to exercise extra caution when screening donors.
"We've known for some time that there is a theoretical possibility that people can get this through blood or organ transplants," said Tom Skinner, a Centers for Disease Control and Prevention ( news - web sites) spokesman, said Sunday.
So far this year, 638 people in 27 states and the District of Columbia have tested positive for West Nile virus ( news - web sites), and 31 have died.
At blood donation centers, officials said people weren't panicky about West Nile and transfusions.
At the Aventis Plasma Center, a blood bank in Tallahassee, Fla., a manager said West Nile hasn't even come up in clients' questions.
"Not even mentioned," manager Gwen Jones said, "not once."
At Atlanta's Centennial Olympic Park, where dozens of parents spent the holiday watching their children with sunblock in one hand and bug spray in the other, word of a new West Nile risk didn't go over well.
"It was prevalent before, and now we hear it's more prevalent," sighed Clinton Orlando of Atlanta.
He said if he needed a transfusion, he wouldn't refuse it. "But I'd probably be very choosy about where I'm being treated and ask a whole bunch of questions about the blood and where it came from. It seems like there's a lot of guesswork involved," he said.
In Chicago, Patty Harty said blood should be screened more carefully for the virus. She said her 8-month-old twins and her 3-year-old son do not go out after dark as a precaution.
"This whole issue with the transplants is scary. I do feel that they should try and test it a little bit better," she said. "It's a scary time."
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On the Net:
CDC West Nile: http://www.cdc.gov/ncidod/dvbid/westnile/index.htm
==============================
"Experience teaches that, of all the emotions, fear stands alone in its power to move us, or to capture us in its grip forever. In a world of terrors, there is nothing more fearsome that the unknown...especially when what is unknown is ourselves." Outer Limits(Fear Itself)
3 Organ Recipients Have West Nile
Wed Sep 4,11:04 AM ET
By KRISTEN WYATT, Associated Press Writer
ATLANTA (AP) - Federal health officials confirmed that at least three of the four people who received transplants from a car crash victim became infected with West Nile virus ( news - web sites), likely through the donated organs.
AP Photo
AP Photo
Slideshow: West Nile Virus
Officials still haven't determined how the organ donor became infected, but as they investigate, they are trying to track down about 60 people who donated blood that was used in transfusions as doctors tried to save the crash victim.
The cases are the first in which humans are believed to have contracted the disease through something other than a bite from an infected mosquito.
Doctors say the possibility of getting West Nile virus through medical procedures is remote, and there are no plans to screen donated blood and organs for the virus.
"We don't even know for sure whether it's possible to transmit West Nile through transfusion or organ donation," said Dr. Jay Epstein, the U.S. Food and Drug Administration ( news - web sites)'s top official for regulating blood products.
Officials at the Centers for Disease Control and Prevention ( news - web sites) said Tuesday that one of the four organ recipients died Aug. 29 in Atlanta. Two others have the virus and have developed encephalitis, an inflammation of the brain. West Nile has not been confirmed in the third person, who is recovering from a milder infection.
The organ donor, a woman from Georgia, could have been infected before the crash, or she may have gotten West Nile through blood transfusions in the emergency room afterward, the CDC said. Health officials have stopped using the donors' blood and said they were searching for about a dozen people who had already received blood from those donors.
Epidemiologists also are trying to detect the virus in the small portion of blood that is routinely kept after each blood transfusion.
So far this year, 32 people have died of West Nile virus, and more than 670 have been infected. Six potential West Nile deaths were reported Tuesday in three states: Tennessee, Illinois and Kentucky.
The CDC said a test to screen all blood and organ donations for the virus is not currently in the works.
"There hopefully will be a test someday, but it's not what we're working on now," CDC spokesman Tom Skinner said.
Patients now can be quickly diagnosed based on their immune response to the virus. Confirming the presence of the virus can take longer, up to about 15 days.
The risk of catching West Nile through a blood transfusion is so remote that some doctors wonder if it's worth screening for. If a test is developed, the FDA will consider it then, Epstein said.
Doctors outside the CDC said people in need of transfusions or donated organs shouldn't be alarmed by the recent infections.
Viruses similar to West Nile have been present in the United States for centuries, but doctors know of no cases where those diseases, such as St. Louis encephalitis, were spread through medical procedures.
The CDC said last year it had documented cases where malaria, which is not a virus, was spread through blood donations, as many as 93 cases in one year. Blood donors, however, already are turned away if they've recently had malaria or visited an area of the world where it's common.
The real danger in blood transfusions often comes from simple bacterial contamination or mishandling, so that's where the resources go in keeping the nation's blood supply safe, said Dr. Louis Katz, president-elect of America's Blood Centers, an association of independent community blood centers.
"On the list of things I'd be worried about going wrong in a blood transfusion, West Nile's way down at the bottom of the list," Katz said.
Donated blood is tested at least 11 times for various diseases, including HIV ( news - web sites) and two kinds of hepatitis. Katz said doctors have debated whether screeners should ask donors whether they've been bitten by mosquitoes lately, but decided against it.
"We can't go there. That's been proposed, but we wouldn't have any blood left if we took out anyone had been bitten by a mosquito. That's crazy," he said.
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On the Net:
http://www.cdc.gov/ncidod/dvbid/westnile/index.htm
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Maryland Reports New West Nile Virus Cases
Thu Sep 5,10:41 AM ET
BALTIMORE (Reuters) - Two more people from Maryland have tested positive for West Nile virus ( news - web sites), which has been blamed for at least 37 deaths in the United States this year, state health officials said on Wednesday.
The two cases bring to four the number of West Nile infections reported in Maryland this year, where three people died from the disease in 2001.
The state Department of Health and Mental Hygiene identified the latest patients as a 69-year-old man from suburban Baltimore who remained hospitalized and 29-year-old woman from Prince George's County who was treated at a hospital and released.
State medical researchers were expected to confirm the cases as West Nile virus within a few days.
The disease, which appeared in North America for the first time in 1999, often causes flu-like symptoms such as fever, headache and body aches. But it can prove deadly, especially for the elderly and people with compromised immune systems.
The virus also has infected at least 359 birds in Maryland this year, and has been found in 33 mosquito pools.
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Officials Consider Test for W. Nile
Thu Sep 5,12:18 PM ET
By LAURA MECKLER, Associated Press Writer
Officials don't yet know if a blood test for West Nile virus ( news - web sites) is even needed - but if it is, it won't be easy to develop.
Health officials were scrambling to determine if West Nile virus can be spread through blood transfusions, even as they emphasized that the blood supply is very safe. The risk of contracting West Nile from blood is significantly lower than the risk of forgoing any procedure that would call for a blood transfusion, they said.
Ultimately, a screening test is probably needed, said Dr. Lester Crawford, acting commissioner of the Food and Drug Administration ( news - web sites). He said government would work with industry to stimulate faster development of a test.
Even so, testing for the virus is complicated. Some of the tests that are used to diagnose West Nile in sick patients won't pick up the virus in donated blood. Other tests are more promising, but they would require significant improvements to be practical on a mass scale, enabling blood banks to screen millions of pints each year.
"I'm reasonably optimistic that if needed, it could be done," said Dr. Jesse Goodman, deputy director of the Center for Biologics, Evaluation and Research at the FDA.
Others are less confident.
"It's going to take several years to have a test suitable for blood donors," said Dr. Harvey G. Klein, chief of the Department of Transfusion Medicine at the National Institutes of Health ( news - web sites) and past president of the American Association of Blood Banks.
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Following material embargoed until 12 noon EDT
West Nile, which emerged in the United States just three years ago, has exploded across much of the country this summer. A total of 737 human cases - including 257 in the last week alone - and 35 deaths have been reported, the Centers for Disease Control and Prevention ( news - web sites) reported Thursday. The median age of patients was 52, with 57 percent of the victims male.
Concern hit new heights Tuesday when officials confirmed that at least three of four people who had received organs from a Georgia woman had contracted the disease. One died.
Officials said they are convinced that these patients contracted the disease through their transplants, though they don't yet know whether the virus can be spread through blood as well. The CDC was advising transplant doctors to be alert for West Nile in their patients, but say current information does not warrant changes to national blood or transplant policies.
End embargoed material
Dozens of epidemiologists at the CDC headquarters in Atlanta and the CDC lab in Fort Collins, Colo., were trying to figure out how the organ donor, a Georgia woman who died in a car crash, got West Nile. She had received blood from more than 60 donors before she died, and they were tracing those blood donors to see if any of them have the virus. They are also tracking down about a dozen other people who had received transfusions from the same donors.
It's possible that the organ donor may have contracted West Nile from a mosquito bite, like others have. And it's possible that the virus can be spread through organ transplants but not through blood. Still, health officials suspect that blood can carry the virus, at least in some cases.
For now, they are reminding blood banks to be sure that no one who has a fever or appears ill donates blood, which could eliminate those with mild West Nile symptoms. They are also urging organ procurement organizations to be aware of the issue.
While scientists are developing a test, Goodman suggested, early versions could be used to screen blood going to patients who are particularly susceptible to West Nile. The FDA could allow use of the test as an experimental product before it is officially proven effective and licensed. That, he said, could give the blood supply some quick added protection.
Still, Klein cautioned, the tests available today would produce a host of false positives, where healthy blood appears to be infected. Using these test could mean throwing away many pints of good blood at a time when the blood supply barely keeps up with demand.
West Nile is currently diagnosed in patients using an antibody test, which looks for signs in the blood that the body is fighting off the disease.
But that test cannot be used to screen donated blood because the virus lingers in the blood for at least a few days - maybe as long as two weeks - before a patient develops symptoms and detectable antibodies, which the body produces to fight off disease. Officials are worried about people who donate blood before they know they are sick.
Furthermore, people with West Nile don't always get sick. Just one in 150 people with the virus gets severely ill with a potentially fatal brain inflammation. An estimated one in five people will get minor symptoms.
More promising, experts say, is a test that looks for the virus itself in the blood. Nucleic acid tests look for genetic material that is present in the blood and have already been successfully licensed to screen blood for HIV ( news - web sites) and hepatitis C.
But it will be difficult to transform this sort of test into reliable mass production, where many different people will use it in many places.
"There are many challenges in taking something that works in a lab and moving it into the field," Goodman said. "Those are challenges that can be met if needed, but they are substantial."
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"Experience teaches that, of all the emotions, fear stands alone in its power to move us, or to capture us in its grip forever. In a world of terrors, there is nothing more fearsome that the unknown...especially when what is unknown is ourselves." Outer Limits(Fear Itself)
West Nile Virus Found in Calif.
Sat Sep 7, 7:50 AM ET
By ANDREW BRIDGES, AP Science Writer
LOS ANGELES (AP) - A West Nile infection in a woman here could mark the virus' cross-country spread, but health officials are baffled at how she might have contracted the illness locally.
AP Photo
AP Photo
Slideshow: West Nile Virus
The woman tested positive for West Nile in preliminary laboratory results, state health officials said Friday.
The results of further tests will not be known for another week. However, county health officials were calling it a "probable case of locally acquired West Nile virus ( news - web sites) infection."
"The virus' arrival in California is anticipated, but unexpected at this time since it is not present in any contiguous states," said Dr. Thomas Garthwaite, director and chief medical officer of the Los Angeles County Department of Health Services.
The woman had a mild case of meningitis, which is associated with the virus, in early August and later recovered.
The unidentified woman had not traveled outside the region, meaning the infection, if confirmed, occurred locally, county Department of Health Services spokeswoman Maria Iacobo said. Officials provided no further information about the woman, including her age or where she lives.
Since West Nile was first detected in New York in 1999, the virus has been found in humans in 27 other states and the District of Columbia.
While its push westward had been expected, there have been no confirmed cases of humans contracting the disease west of the Rocky Mountains.
In two other cases of confirmed or suspected West Nile virus along the Pacific coast, the victims are thought to have been infected in states where the mosquito-borne virus is already known to be present.
In Oregon, doctors in Salem were treating a woman who also has symptoms consistent with West Nile and became sick in Michigan.
A Washington man was diagnosed with the virus, which health officials said he contracted in Louisiana.
Nationwide this year, there have been 954 confirmed human cases of the virus, including 43 deaths, according to the Centers for Disease Control and Prevention ( news - web sites).
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On the Net:
http://www.cdc.gov/od/oc/media/wncount.htm
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111 Species Affected by West Nile
Mon Sep 9, 1:53 AM ET
By ALLISON SCHLESINGER, Associated Press Writer
PITTSBURGH (AP) - The West Nile virus ( news - web sites), first spotted in this country in a sick crow three years ago, has now attacked at least 111 species of birds, including the bald eagle and the endangered Mississippi sandhill crane.
AP Photo
The spread of the virus has surprised and alarmed wildlife researchers because it has happened so quickly. Last year, West Nile had been detected only in about a dozen species of birds.
This year, hundreds of birds of prey, particularly red-tailed hawks and great horned owls, have been found dead in the upper Midwest, said Kathryn Converse, a wildlife disease specialist with the U.S. Geological Survey ( news - web sites)'s National Wildlife Health Center in Madison, Wis.
About 400 owls and hawks died in Ohio alone in what one wildlife official called "a major die-off." The carcasses were being tested for West Nile virus, which has been confirmed in several cases.
West Nile also has killed such birds in the wild as the ruby-throated hummingbird and Canada goose, and exotic and captive species such as the macaw and the Chilean flamingo, according to the Centers for Disease Control and Prevention ( news - web sites) Web site.
Of particular concern are the deaths of any endangered species, like the Mississippi sandhill crane, which numbers only about 120. It is one of six types of sandhill crane.
Since 1999, the virus has also killed at least one bald eagle, a threatened species, according to the CDC Web site.
"We don't know of any birds that can't be affected by the virus," Converse said.
It's impossible to know exactly how many birds have died from the West Nile virus, wildlife officials say, because the only way to confirm the virus in birds is to test them after they die.
Also, federal agencies like the CDC and Geological Survey rely on state and county health officers to report the bird deaths. But those officials are mainly interested in birds only as a tip-off that mosquitoes carrying the virus have shown up in their areas, so that people can be warned.
News that the virus is spreading in bird populations is frustrating for bird caretakers like James Mejeur, curator at the National Aviary in Pittsburgh, because the illness is hard to detect, treat and prevent.
Although veterinarians are experimenting with a vaccine approved for horses, the most effective way to prevent birds from getting sick is to control the mosquito population, Mejeur said.
Some institutions with captive bird populations install mosquito netting.
"It's manageable for us because the majority of our bird population is inside," said Mejeur, whose facility has lost three magpies and a crow this year. "But it is a tough time for zoos and other places that can't control the mosquitoes and have large populations of birds."
The horse vaccine has not been widely tested on birds, but the few facilities that have tested it found the birds were not harmed by it, Mejeur said.
Still, birds must be injected three times over a span of three months, which can be traumatic to wild populations, he said.
At the Raptor Center at the University of Minnesota, caretakers suspect the raptors may have the virus when they develop tremors, a blank stare and confusion. But other illnesses can cause similar symptoms, said Pat Redig, the center's director.
At that point there's not much veterinarians can do but give the animals fluids, antibiotics and special feedings that may help their immune systems.
But many raptors infected by the virus die after symptoms appear, said Redig. The Raptor Center has been studying and caring for eagle, hawk, owl and falcon populations since 1974.
There is hope that hawks, crows and other birds will become resistant to the virus over time.
"But we don't know how long that will take and how many raptors we'll lose in the meantime," Redig said.
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On the Net:
http://www.cdc.gov/ncidod/dvbid/westnile/birdspecies.htm
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CDC Confirms West Nile Organs Link
Thu Sep 12,10:38 PM ET
By KRISTEN WYATT, Associated Press Writer
ATLANTA (AP) - Having confirmed that West Nile virus ( news - web sites) can be spread through organ transplants, federal health officials have found new evidence that it may be transmitted through blood transfusions as well.
Reuters Photo
Slideshow: West Nile Virus
The Centers for Disease Control and Prevention ( news - web sites) said Thursday that it is investigating five cases of people infected with West Nile who also received blood transfusions. That includes a Georgia woman who died and became an organ donor.
In each case, health officials are tracing donated blood to see if the donors had the virus, too. They said Thursday that one of these patients, a woman in Mississippi, did in fact receive blood from three infected donors.
Still, they said it will be very hard to determine whether this patient - or any patient - got West Nile through the blood, or whether it was transmitted by a mosquito bite.
"There is no single laboratory test that's going to tell you the person got it from a mosquito bite or from a transfusion," said Dr. Lyle Petersen, deputy director of the CDC's vector-borne disease division. "So unless something highly unusual happens, like a transfusion recipient in an area where West Nile virus transmission is not occurring ... it's going to be very difficult to sort out natural mosquito infection from transfusion infection."
Officials added that they were testing the blood after it had been processed for transfusion, and it was unclear what effect that may have on the West Nile testing.
Overall, Petersen said, earlier research suggests the chances of a blood transfusion containing the virus is about one in 10,000.
All of five patients who received blood transfusions lived in areas where West Nile is prevalent, he noted. Two are in Mississippi, one in North Dakota and one in Louisiana, plus the Georgia organ donor. Investigations are under way to see if they can prove that blood was the cause of their infection.
Testing is complete on blood donated to one of the patients, and neither of those donors tested positive. Testing is still under way on the three others.
The CDC had already said that four transplant patients who received organs from the infected Georgia donor and then developed West Nile were almost certainly infected by their transplants. On Thursday, they confirmed that this was the route of transmission.
One of these four patients died of West Nile encephalitis, a brain inflammation caused by the virus. The three others are recovering, two after developing encephalitis.
Nationally, the West Nile toll continues to climb, with 1,295 people confirmed with the disease, and 54 dead. Those numbers will continue to climb because the disease is now in its peak transmission period, Petersen said.
Even if officials conclude that West Nile can be transmitted through blood, there is no blood screening test for the disease available. And health authorities have repeatedly said that the benefits of transfusions for sick people far outweigh the risk of catching West Nile.
Most people who get the virus show no symptoms at all, but infection can be deadly in the weak and elderly.
At the Food and Drug Administration ( news - web sites), which regulates the nation's blood supply, Dr. Jesse Goodman said: "In none of these cases is it considered proven that transfusion transmitted the virus, but let me turn that around and say that at FDA we are very concerned about this. So is CDC."
"We regard some of these findings as suspicious but in need of further study," he added.
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On the Net:
CDC: http://www.cdc.gov
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CDC: Ten More Deaths From West Nile
Sun Sep 15, 9:17 AM ET
ATLANTA (AP) - Ten more people have died from the West Nile virus ( news - web sites) this year, bringing the total to 64, the Centers for Disease Control and Prevention ( news - web sites) reported.
Four of the most recently reported deaths were in Michigan and three were in Illinois. Mississippi, Missouri and Nebraska had one death each.
Those figures don't include two deaths in Massachusetts and one in Pennsylvania reported by state health officials Friday.
The CDC on Friday reported 1,438 cases of West Nile infection in 30 states and the District of Columbia.
The virus causes flu-like symptoms and sometimes swelling of the brain, although most people bitten by an infected bug never get sick. The virus is most dangerous for the elderly and people with weak immune systems.
West Nile is common in Africa and the Middle East, but didn't appear in North America until 1999 in New York. The virus this summer spread to the West Coast, with one case in California.
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"It has been said that for the truth to exist, it takes two people - one to speak it...and another to hear it. Mankind will be forever doomed to destruction if we continue to ask for the truth...but then refuse to listen.." Outer Limits( To Tell The Truth )