Probable First Orange County West Nile Virus Case; CA Health Authorities Believe Man Was Bitten By Infected Mosquito During Trip to Nebraska
About dead birds
(October 9, 2002) -- The CA Dept. of Health Services has reported the first probable case of West Nile virus imported to Orange County.
In an October 8 written release, the Orange County Health Care agency indicates "the patient had recently traveled to Nebraska where it is believed that he was bitten by a mosquito infected with the virus." It indicates the case "involves a 70 year-old man who was hospitalized after being diagnosed with aseptic meningitis, an inflammation of the tissues covering the brain and spinal cord that is caused by a viral infection." It adds confirmation of the infection is pending.
"Since this is an imported case, one contracted outside of California, there is no reason for concern among the general public,’ said OC County Health Officer Dr. Mark Horton, M.D. He added, "It does serve as a reminder that we should take precautions to control mosquitoes by eliminating standing water and use mosquito repellents to avoid this and other mosquito-borne diseases."
As reported last month by LBReport.com, CA health officials announced on September 6 they were evaluating (and later confirmed) an L.A. County case of West Nile virus, which was the first reported case of the potentially fatal West Nile virus in CA.
Typically spread to humans by the bite of an infected mosquito, the West Nile virus has claimed an increasing number of lives since arriving in NYC in 1999. It has since spread to 42 states and the District of Columbia.
News of the probable Orange County case came on the same day LB Dept. of Health & Human Services Director Ron Arias told the City Council, "To date, there has been no confirmed presence of West Nile Virus in the City of Long Beach in humans, animals or mosquitos. There have been a couple of human cases detected in California, however the federal government is still investigating the source of those transmissions."
Mr. Arias delivered an agendized Council presentation in response to a request (made in August) by 5th district Councilwoman Jackie Kell for information on LB's West Nile Virus surveillance and prevention program. During his presentation, Mr. Arias discussed the importance of eliminating sources of standing water where mosquitoes breed.
4th district Councilman Dennis Carroll was plainly irked by the report:
"Personally, I would file this report under 'If we don't have enough things to worry about in our life already'. Now we've got the West Nile Virus...This city is replete with County and city drainage ditches, canals...There's no way in the world we could ever address the kinds of public health solutions that you have suggested were critical to dealing with this. I mean, I appreciate what the Health Dept. does, but you have just thrown up an impossible proposed resolution of this problem from my perspective.
I have streets all over Los Altos that never drained right, let alone 50 years later. There's standing water all over the place. I get calls from residents who are tired of the smell of it, the mosquitoes and everything else, so I'm going to forward those complaints to the Health Dept.
I don't know what to do about it. We're in a budget crisis. We can't fix the streets and roads that we have now. So, I just don't know.
The statistic that leaps out at me, and I think should be advertised, is that one out of a hundred [people] gets sick even if you're bitten by the wrong mosquito...I'm very frustrated by hearing this report. It's the kind of thing that, to me, the public certainly needs to know about but is the equivalent of being hit with an asteroid. I'm very frustrated in hearing what I've heard tonight."
Councilwoman Kell, while noting West Nile Virus isn't a problem now in LB, followed up on the standing water issue:
"We [previously] talked about buying a truck that goes around and sucks up standing water. Now I know we're in a budget crisis but [Acting City Manager] Mr. [Jerry] Miller and I discussed this on Monday, the fact that we could maybe rent a truck as needed to go around where we do have standing water...and if we have that kind of problem, it would behoove us to consider renting these trucks that go around and remove the standing water."
In Sept., CA health officials said the L.A. County West Nile Virus case involved a woman who reported no mosquito bites, blood transfusions or organ transplants, or travel to areas where West Nile virus has been confirmed. This left the origin of that case a mystery. Officials said tests of mosquitoes, chickens and dead birds have shown no evidence of the virus in California.
CA health officials say most individuals infected with West Nile virus have only mild symptoms such as fever, headache and body aches. However, the virus can cause severe symptoms in the elderly and individuals with lowered immune systems.
Last month, LB's Health Officer, Dr. Darryl Sexton, told LBReport.com that LB conducts its own surveillance and monitoring (including doing blood tests on four flocks of chickens spread throughout the city and trapping, ID'ing and testing mosquitoes (details below).
Dr. Sexton also noted City Hall takes preventative measures including spraying and LB's Health Dept. maintains a telephone hotline for updated local information (details below).
CA health officials emphasized that the risk of an individual becoming ill from the bite of a mosquito infected with West Nile virus is very low; less than 1 percent of the bites from infected mosquitoes can cause severe disease. "However, the risk of disease is higher for individuals 50 years of age and older," the release said.
CA's Dept. of Health Services has said individuals "can further reduce their risk of mosquito-borne diseases by taking these precautions:
- Avoid activity outside when mosquitoes are most active, especially at dawn and dusk.
- When outdoors, wear long pants, long sleeve shirts and other protective clothing.
- Apply insect repellant according to label instructions.
- Make sure that doors and windows have tight fitting screens. Repair or replace screens that have tears or holes.
- Eliminate all sources of standing water that can support mosquito breeding.
The release notes that many species of birds get infected and die from West Nile virus, and Bontá asked the public to become part of the CA Dept. of Health Services' monitoring effort "by reporting any crows, ravens, magpies and jays that have been dead for less than 24 hours" using a toll-free line: 877-WNV-BIRD.
The CA Dept. of Health Services notes on its web site:
"If you find a dead bird, particularly a crow or other corvid (e.g., jay, magpie, raven, etc.), please call the number above (877-WNV-BIRD) or report the bird on the CA Dept. of Health Services [DHS] web site www.dhs.ca.gov. Do not touch the bird. DHS will record all dead bird reports and will arrange for pickup and laboratory testing for West Nile virus when appropriate."
The CA Dept. of Health Services web site includes the following information:
Most people who are infected with West Nile virus have no symptoms whatsoever. However, of those who become ill, symptoms can include fever, headache, nausea, body aches, mild skin rash, or swollen lymph nodes. In a few cases, the disease will progress to encephalitis. The time between the bite and the onset of illness, known as the incubation period, ranges from 5-15 days in humans.
It is estimated that 1 in 150 people who are infected with West Nile virus will require hospitalization. Of the 66 human cases of West Nile virus in the eastern half of the U.S. in 2001, nine died. The elderly are particularly susceptible to clinical illness caused by West Nile virus. There is no specific treatment for infection with West Nile virus, although supportive care is important.
Wild birds are considered the reservoir of West Nile virus because they are the host from which the mosquito vector primarily acquires the virus. Infection has been reported in more than 70 bird species. Although many birds that are infected with West Nile virus will not appear ill, West Nile virus infection can cause serious illness and death in some birds. The most severe illnesses are seen among the corvid birds, which include crows, jays, ravens, magpies and related birds such as sparrows, finches, and blackbirds. American crows constitute the majority of the bird deaths due to West Nile virus reported in the eastern U.S.
American crows are found throughout California. They have entirely black plumage, black beak, and black feet. Adult size is 17-21 inches from tip of tail to tip of beak. If you find a dead bird, particularly a crow or other corvid (e.g., jay, magpie, raven, etc.), please call the number below promptly, or report the bird on this web site.
Do not touch the bird. DHS will record all dead bird reports and will arrange for pickup and laboratory testing for West Nile virus when appropriate.
The CA Dept. of Health Services has also posted additional information about West Nile virus in CA on its web site: www.dhs.ca.gov".
The information includes a West Nile Virus brochure (from CA Dept. of Health Services) and a link to a Question and answers (link to CDC).
LB Measures Against West Nile Virus
LB's Health Officer, Dr. Darryl Sexton, MD, told LBReport.com that his Dept. is aware of the recent developments and has been preparing for the possible arrival of West Nile virus by conducting surveillance, testing and monitoring for several years.
Dr. Sexton said LB maintains a sentinel flocks of chickens in four parts of LB (east, north, southeast and west) which work like [our phrase] a miner's canary: since mosquitoes bite chickens, the chickens' blood is drawn on a regular basis and tested for West Nile virus (and other serious viruses including St. Louis encephalitis). This live surveillance has been taking place since the late 1980s.
In addition, Dr. Sexton noted that LB also traps and tests mosquitoes weekly in every Council district and has an entomologist who identifies the type of mosquito, its species and the like. To date, none of these have tested positive for West Nile virus.
He said the City of LB also performs proactive vector control with mosquito spraying weekly...and will respond to residents' complaints.
Dr. Sexton also said that on August 20, his department sent an alert to all LB physicians, providing information and directing them to report suspicious cases. He said that if a person has symptoms of meningitis, they should go to a hospital emergency room.
Dr. Sexton said the "best protection is prevention" and includes wearing long clothing, using DEET as a mosquito repellant and getting rid of standing water.
Dr. Sexton noted that LB participates in the CA dead bird surveillance program and can be reached locally at (562) 570-4132 (punch zero to get a live person; see further for after hours contacts). He said the caller will be asked to identify the type of bird (the most frequent carriers are crows and jays).
Dr. Sexton said that on weekends and odd hours, callers should call CA DHS toll free at (877) WNV-BIRD.
Like the CA DHS, Dr. Sexton does not advise touching the dead bird. Although West Nile virus is usually transmitted by mosquito, one could have small breaks in one's skin...so don't touch the dead bird. Use the phone numbers (562 570-4132 and 1-877-WNV-BIRD).
LB recorded information
Dr. Sexton also noted that LB maintains its own 24-hour information hotline which is updated as events warrant: (562) 570-4499.