Public health is better prepared for West Nile virus

Surprised by the scope of last year's outbreak, health departments are concentrating on awareness campaigns and surveillance systems.

By Victoria Stagg Elliott, AMNews staff. July 14, 2003.

With confirmation of the season's first human case of West Nile virus infection expected any day now, health officials are ready to respond.

For starters, public education campaigns have been fine-tuned to communicate the personal protection message to those who need it most.

In addition, surveillance systems are in place and have been finding infected mosquitoes and animals for months. The blood supply is poised to start screening all blood donations this month And doctors are armed with a greater degree of knowledge than ever about the damage that West Nile virus can do. They also have increased access to the lab tests that can diagnose it.

The big questions now are where will it strike hardest and whom?

Last year's outbreak stunned the public health system with its breadth and depth. No one expected it to sicken more than 4,000 and kill nearly 300 people, touching all but four of the continental United States.

"Everyone was caught blindsided," said Steven Gordon, MD, hospital epidemiologist at the Cleveland Clinic.

At press time, this year's tallies were as follows: At least 26 states were reporting West Nile-positive birds, horses or infected mosquitoes and four states were investigating suspected human cases.

"We have to keep our guard up," said Stephen Sokalski, DO, chief of infectious diseases and epidemiology at Advocate Christ Medical Center in Oak Lawn, Ill. He treated numerous cases last summer.

This year will present new challenges. Most people infected with West Nile virus never get sick, and rapid tests for the disease detect antibodies -- which can remain in the human system for months -- rather than the actual virus. Experts worry that this would confound rapid diagnosis and complicate surveillance.