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Utah public health agency shifts into detection mode, expects West Nile virus invasion

By Sun Advocate

On Tuesday, the Utah Department of Health conducted its first electronic news conference involving the agency’s regional divisions and media across the state.
The health department news conference focused on one topic- West Nile virus.
According to the department, the virus will probably officially invade Utah this summer. The disease has been traveling westward after being discovered in the United States in 1999. Authorities indicate that the first case was recorded in Uganda in 1937. The disease has spread into Asia, Europe and the U.S.
“What we are in now is the detection mode,” said Michelle Korth, who heads the agency. “We can’t stop it from coming here but there are things we can do to prevent it from endangering large numbers of people.”
Called an arthropod-borne virus, the disease is transmitted to humans primarily through the bite of an infected mosquito, pointed out public health officials. The virus has taken an increasing toll on people since it was first discovered on the continent. In 1999, 62 cases were reported, mostly in New Jersey and New York. Seven deaths resulted.
In 2000, the disease spread to 12 states and 21 cases were reported. One reported death resulted. However, the virus came back with renewed range and depth of infection in 2001. The disease crossed the borders into every state east of the Mississippi and incurred 66 cases with nine people dying.
The disease is not only a human disease, but also infects certain bird populations as well as horses. Only a few instances of other domestic animals being infected have been detected.
In 2002, the disease spread into every state but four in the lower 48 – Oregon, Nevada, Arizona and Utah. More than 4,000 cases in humans were reported nation wide and 277 people died from the disease, according to compiled data.
Animal deaths also escalated last year, with 14,901 cases found in horses with a 30 percent fatality rate and 15,745 birds were found dead with positive results for the infection.
The virus is minor compared to many other infection diseases. But people should prepare for the eventuality of the infection being found in Utah and use methods to defeat as well as avoid the virus as much as possible, advised health officials.
The disease affects the tissue surrounding the brain, the brain and the general neurological system. The virus is not transmitted from person to person and cannot come from horses or birds. The disease comes only from the bite of mosquitos.
Most people who become infected do not realize they have the virus. One of the ways that health departments across the country have checked for the virus is to look at the antibodies present in people’s blood. A minor infection will cause only slight symptoms like a headache, but will result in antibodies, meaning the person will never get the strain of the disease again.
Other patients may be affected more dramatically. Symptoms may include fever, body aches, rashes and swollen lymph glands. When the infection is severe, a stiff neck, muscle weakness and disorientation result. At this point, the infection becomes West Nile meningitis/encephalitis. People with the condition may have seizures, go into a coma and sometimes die.
“We are learning new things about this disease all the time,” noted Dr. Robert Rolfs, the epidemiologist for the state health department. “One of the things we know is that this disease is age sensitive.”
The risk of the disease becoming severe is much greater for individuals older than the age of 50, pointed out the epidemiologist.
“It grows proportionately with age,” explained Rolfs “For instance, those who are between 50-59 years of age have a tenfold risk of getting the disease in its severe form over those who are 19 years old. For someone over 80, the risk goes up 43 times over the 19 year old.”
The public should not be extremely alarmed about the disease because the chances of incurring severe symptoms are small and only one in 150 infected people will develop neurologic symptoms.
But Carbon County residents should take steps to protect themselves from the virus. People have two areas they can concentrate on to cut the chances of the disease spreading.
First are measures people can take around homes and businesses.
Residents should make sure screen doors and window screens are in good shape and fit properly to keep mosquitos out of buildings.
People should also eliminate standing water on property. That means dump water out of old cans, tires or birdbaths. Drain unmoving water from unkept fountains or swimming pools. Keep weeds and grass cut short. Clean out leaf clogged gutters and repair leaking faucets and sprinklers so as not to provide a breeding ground for the insects.
As for being outdoors there are a number of options. Wearing long pants and shirts with long sleeves and applying mosquito repellent that contains DEET to bare skin. For adults the concentration of DEET should be 30-35percent and for children 2-12 a 10 percent or less solution should be used. Do not apply repellents for children under two.
These measures may sound drastic, but they aren’t as draconian as them may seem due to the type of mosquito that appears to carry the virus.
“There are only two types of mosquitos out of the top 10 that carry this disease in our area,” said Gary Hatch of the Salt Lake City Mosquito Abatement District. “And both of those only feed at dawn and dusk. Otherwise there is a rare chance that bites will take place.”
The public war against these mosquitos is also in place. Since the disease is carried short range by mosquitos the transfer of the disease across the country appears to be taking place by birds that the mosquitos bite. The state health department, along with the mosquito abatement districts and counties are setting up mosquito traps to find out if the disease is in the area. They are also setting up chickens in pens as “sentinel birds” to test for the disease.
Birds, horses and humans are considered accidental or dead end hosts to the disease, meaning they either get over it or die and do not pass it along. Animals like cattle, goats, domestic dogs and cats do not seem to incur the disease.
Scientists are presently working on a vaccine for humans, but have not found a formula that works yet. However, there is a vaccine for horses.
“People ask us why we have developed a vaccine for horses but not for humans quite often,” said Rolfs. “The problem is that making a vaccine for a human is very different than it is for an animal. It is much more complicated.”
Rolfs wasn’t sure what would happen once the disease arrives in Utah..
“It’s impossible to predict what it will do or how things will progress. But we do know the problem will be here to stay and will not go away,” concluded the epidemiologist.

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