News in brief - Oct. 2, 2000

West Nile Virus reported in Northeast United States - National conference focuses on children's mental health - Rabies treatment hits wrong targets - Calcium channel blockers blamed for higher rate of heart attacks

West Nile Virus reported in Northeast United States

Since July 20, 12 people have been hospitalized with serious central nervous system infections caused by the West Nile virus, according to the Sept. 15 issue of the Centers for Disease Control and Prevention's MMWR. The patients, who range in age from 40 to 87, lived or spent time in the New York area. Of the victims, seven were men. Eight of the cases were diagnosed as encephalitis, the remaining four as meningitis. There have been no deaths.

The report asserts that the 12 people who have presented with severe symptoms to date probably reflect only a small proportion of the infection rate. Most people who become infected remain asymptomatic or have vague symptoms that do not lead to confirming tests.

Because the West Nile virus primarily circulates between birds and mosquitoes first, only incidentally reaching humans and other mammal populations, the virus' activity in birds and mosquitoes is considered a sentinel event.

The CDC report recommends that physicians and other health care professionals in areas where such epizootic activity has been documented should be aware of the possibility of West Nile virus. Also, though severe West Nile virus central nervous system disease may be more common in older patients, eight of the 12 persons reported this year were younger than 65.

National conference focuses on children's mental health

the Office of the Surgeon General held a major national conference on children's mental health, intended to engage families, professionals and scientists in a meaningful dialogue about issues involved in identifying, referring and treating children with mental health problems. The conference also focused on identifying appropriate, evidence-based treatments and services.

A final report and call to action is expected.

Rabies treatment hits wrong targets

Rabies vaccines are being misused because treatment guidelines are not being followed, according to research published in the Aug. 23/30 JAMA.

The study examined treatment of 2,000 people who, during a two-year period, reported to an emergency department because of animal contact. Of this group, 54 patients received the vaccine who shouldn't have, while 119 didn't receive it when guidelines indicated they should.

"The study translates into a huge number of people nationwide who may be receiving inappropriate treatment for rabies," said Gregory Moran, MD, principal investigator and associate professor of medicine at University of California, Los Angeles, department of emergency medicine, in a statement. Treatment guidelines need to be clarified, and there needs to be a better system to test and observe animals, he said.

Calcium channel blockers blamed for higher rate of heart attacks

Research presented at meetings of the European Society of Cardiology and the International Society of Hypertension last month implicated calcium channel blockers, a family of antihypertensives, in an increased rate of adverse cardiovascular events.

The study presented at the European meeting found a 27% increase in the risk of heart attack, 26% risk of heart failure and an 11% increase in the risk of any major cardiovascular event. "The results add to a growing body of evidence that antihypertensive drugs, despite having equal effect on blood pressure, may vary in their ability to prevent heart attacks and congestive heart failure," said Curt D. Furberg, MD, PhD, professor of public health sciences at Wake Forest University School of Medicine in Winston-Salem, N.C., and a co-researcher of the study presented at the cardiology meeting. He added that calcium channel blockers are also 10 to 15 times more expensive than equally effective diuretics.