States React to West Nile Prediction

[Max]

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."

___

On the Net:

CDC: http://www.cdc.gov

[Max]

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."

___

On the Net:

CDC: http://www.cdc.gov

[Max]

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.

[Max]

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

[Max]

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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[Max]

Author Topic: National death toll from West Nile virus reaches 11 with fatalities in La., Ill.
Wise Young

Administrator posted Aug 18, 2002 10:31 AM
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http://www.boston.com/dailynews/229/...m_West_:.shtml


quote:
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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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Posts: 5221 | From: New Brunswick, NJ, USA | Registered: Jul 23, 2001

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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)

[Max]

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)

[Max]

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)

[Max]

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.

==============================
" 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)

[Max]

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.

___

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)