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Tuesday, July 06, 2004

Officials change focus on West Nile

No longer an unusual disease, West Nile can be treated as a common summer occurrence, an official said.

By Robert Samuels

Public health officials in the Roanoke region are reducing the amount of research conducted on West Nile virus this summer in order to focus more on community-based prevention.

"In the past, we've been collecting a lot of data and analyzing it, but we realized it was not worth the amount of time we were putting in," said Richard Tabb the environmental health manager for the Roanoke and Alleghany health districts. "So few people actually get the virus."

After more than two years of following mosquito migration patterns and testing birds for West Nile, Tabb said the Roanoke and Alleghany district is equipped to deal effectively with the virus. No longer the unusual disease it once was, officials can treat West Nile as a common summer occurrence, Tabb said.

"It's clear that West Nile is going to be here again," Tabb said. "And it's going to be widespread. But rabies is endemic, and we learned to live with it."

Although Tabb said that residents should be conscious the disease still exists, he also said its presence should not alarm them. Fewer than 1 percent of people bitten by a virus-carrying mosquito will experience anything more than flulike symptoms.

"Most people who get West Nile don't even know they have it," Tabb said.

In its most severe cases, the virus can cause headache, body aches and brain inflammation, a condition that could be fatal.

West Nile virus first showed up in the Western Hemisphere during the summer of 1999, when it killed seven people and brought severe illness to 62 others in New York City.

In 2002, the virus appeared in Virginia, infecting 26 people and killing two others. West Nile re-emerged in 2003, and there were four cases in or around the Roanoke Valley, bringing severe illness to a woman in her 90s and paralyzing Botetourt County farmer Ned Jeter.

Jeter was walking again by Thanksgiving.

The disease's 1999 appearance spurred both state and local health departments to research West Nile and create area-specific prevention techniques. The city now has a "pretty good" idea of what methods can work and what methods probably won't, Tabb said.

"We found that in July, the disease generally presents itself in birds, then mosquitoes, then horses, then large mammals, then people," he said. "Now, we can look at specific habitats where those patterns start and make strategic plans where we can be more effective."

Officials originally conducted random tests to figure out which mosquitoes carried the virus and where their habitats were , Tabb said, which led to the department's current ability to do limited testing.

The district is targeting urban areas, such as Roanoke, and heavily populated counties, Tabb said.

If the department receives a call from a neighborhood that is not in the target area, Tabb said, the health department will send an individual to test for infected mosquitoes.

The person will distribute information to educate the community about the disease. Also, there will be fewer news releases about the disease to minimize fear of the virus, Tabb said.

And although Tabb said that the department knows a number of ways to prevent the virus, there still are patterns about the disease they can't predict.

"We had more rain this June than in previous years," Tabb said. "That could mean the rain would wash away all of the mosquito larvae, or it could mean there'll be more standing water."

Research on West Nile still continues statewide. Dr. Susan Jenkins , an epidemiologist with the Virginia Department of Health, has been collaborating with a task force focusing on West Nile and other viruses.

While the local health district is developing strategic plans on past discoveries, the state task force has noticed an unusual occurrence. The first three in-state incidences of West Nile this year involve horses, breaking the usual pattern of first seeing the disease in birds.

"I don't know what to make of it," Jenkins said. "I wish I had a crystal ball that could tell you if we'll see more cases this year, but we don't have as much experience as we need to make any conclusions."

Despite the break in pattern, Jenkins added that concerned residents should take the same common-sense steps to stop West Nile virus that they take every year.

"Wear light-colored clothing and long sleeves," Jenkins said. "And get rid of all your standing water in containers and tires. Personal surveillance goes a very long way in preventing human cases of the disease."