West Nile Virus Is Discovered In Breast Milk of Mich. Woman

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By David Brown
Washington Post Staff Writer
Saturday, September 28, 2002; Page A11


West Nile virus has been detected in breast milk, raising the possibility that the microbe could be transmitted through nursing as well as by blood transfusion, organ donation and the usual route, mosquito bite, government officials said yesterday.

There have been no known cases of West Nile fever acquired through breast milk, and it's not known whether such transmission is possible, officials from the Centers for Disease Control and Prevention emphasized. However, viruses similar to West Nile can be passed in milk and infect humans, they said.

The agency made no recommendation on whether mothers diagnosed with West Nile virus should stop nursing. Only four of the 2,206 reported cases in the United States this year have been in children younger than 1, suggesting that transmission through nursing is rare, if it occurs at all.

"We need to investigate the potential role of breast milk in transmission," said Lyle R. Petersen, one of the CDC's West Nile experts.

The new finding came in the case of a 40-year-old woman in southeastern Michigan who delivered a baby Sept. 2. She received a transfusion of one unit of blood that day and another unit the following day. She became feverish and ill after returning home, and was readmitted to the hospital Sept. 17. The West Nile diagnosis was made the next day, Michigan state epidemiologist Matthew Boulton said in a telephone news conference.

The woman had been breast-feeding her infant during that two-week period. The child never fell ill, and the woman has recovered, Boulton said, although she has not resumed breast-feeding.

The initial tests of her milk found genetic material from the West Nile virus. Tests are underway to learn whether the virus is whole, live and capable of infecting a person.

Birds have been experimentally infected with West Nile virus orally, Petersen said, although no studies have been done on milk.

Other insect-borne viruses in the same family as West Nile can be transmitted through milk. Tick-borne encephalitis virus, which is confined to Western Europe and the former Soviet Union, has infected people who drank milk from infected goats and cows, Petersen said. Animal-to-animal transmission through milk has also been reported in Kyasanur forest disease virus (found in monkeys in Western India) and louping-ill virus (found in sheep in the British Isles).

The Michigan and CDC investigators say they are certain the nursing mother was infected through blood transfusion, because a 47-year-old man who received blood from one of the same donors also developed West Nile. A stored sample from that donor tested positive for the virus.

Studies done in the 1950s, when West Nile virus was given experimentally to cancer patients to induce fevers thought to be possibly therapeutic, showed that the virus circulated in the bloodstream for only about five days.

Consequently, Petersen said, "we would expect that virus would be present in the breast milk for a very short period of time."

As of Thursday, 2,206 cases of West Nile infection, and 108 deaths, had been reported in 32 states and the District. About three-quarters of those infections caused either encephalitis or meningitis -- severe, life-threatening brain infection. In the other quarter, the patients had fever, headache, weakness and other milder symptoms. And a few patients have developed poliolike paralysis from the infection.


© 2002 The Washington Post Company

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