Doctors on watch for West Nile

Flu-like symptoms scrutinized as virus risk persists.
By Cyndee Fontana / The Fresno Bee
09/04/07 03:52:02
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Information: www.westnile.ca.gov

It usually starts with a mosquito bite.
Then, maybe a fever. Headache. Nausea. Even -- in rare and extreme cases -- tremors, numbness and paralysis.

While those symptoms can signal a range of illnesses, many doctors will test for West Nile virus -- especially if patients remember the bite. Health department and hospital officials in Fresno, Tulare and Madera counties say doctors size up symptoms and patient history in deciding when to screen for the virus.

West Nile virus is a neuroinvasive disease generally spread by mosquitoes as they feed on birds, horses and humans. California is experiencing an upswing in cases as birds and mosquitoes flock to urban areas in search of water.

State and local health officials say it's important to diagnose West Nile to track the disease, focus public education efforts and target mosquito problems. There is no specific treatment for West Nile; doctors treat the symptoms that develop.

"There's nothing magical that you can give" for the virus, said David Luchini, division manager of the communicable disease division in the Fresno County Department of Community Health.

Most people who contract the virus don't show any signs. About 20% display flu-like symptoms that may not require a doctor's care. Fewer than 1% develop an illness such as encephalitis or meningitis that can be fatal.

This year, according to the California Department of Public Health, there have been 172 human cases reported. More than half are from Kern County.

Ten people have died, including a 90-year-old man in Fresno.

The state also tests birds and other animals to track West Nile activity.

State public health guidelines recommend tests for people with encephalitis, aseptic meningitis and certain types of paralysis. Tests also may be given to people who have an illness compatible with West Nile that lasts a week or more.

Krickett Pal, infection control coordinator at Madera Community Hospital, said doctors usually ask about mosquito bites if someone exhibits symptoms that could be West Nile.

"Most people remember the mosquito bite," she said. If symptoms are compatible, doctors screen for West Nile. No cases have been reported in Madera County this year.

Dr. Daniel Boken, an infectious disease practitioner with the Kaweah Delta Health Care District in Visalia, said officials work to promote awareness in case someone has symptoms consistent with West Nile.

Diagnosing the virus helps eliminate other possible causes for an illness, he said. Tulare County hasn't reported any cases this year.

Fresno County's confirmed fatality was Ernest Nave, who died July 23 at Saint Agnes Medical Center.

Kelley Sanchez, a spokeswoman for the medical center, said doctors determine whether to test for the virus based on a patient's symptoms and history. Nave was tested, she said.

An official with Community Medical Centers said they have seen one case this year, compared to none in 2006 and five in 2005.

State and local officials say people older than 50 and those with chronic medical conditions are more likely to suffer serious complications from West Nile.

Luchini said the risk coincides with the summer season. People should continue to take precautions such as wearing mosquito repellent.


The reporter can be reached at cfontana@fresnobee.com or(559) 441-6312.

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