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First Human West Nile Case
Confirmed In California

How LA County Woman Was Infected Is Unknown
By Dorsey Griffith -- Bee Medical Writer
The Sacramento Bee
9-7-2

The West Nile virus has apparently extended its reach to the Golden State -- and skipped over several other Western states on the way.
 
Blood and spinal fluid samples from a Los Angeles County woman tested positive for the virus, state health officials said Friday. The woman had been hospitalized last month with meningitis when the samples were taken.
 
State health officials are calling the Los Angeles case "probable" because one additional test is needed for confirmation.
 
The virus, which has caused 43 deaths in the United States since 1999, apparently has jumped over several states on its migration across the country.
 
Its arrival has baffled health officials, who recently touted extensive virus surveillance programs statewide.
 
The virus has not turned up in any mosquitoes, dead birds, "sentinel" chickens or horses in California. The woman said she had not traveled recently out of state where the virus already is present. And she has not had a blood transfusion or organ transplant, also potential sources of infection.
 
The woman has reportedly fully recovered and is ready to return to work. Officials would not reveal the woman's identity or age, but said she was young and lived in southwestern Los Angeles County.
 
"To date we have no evidence at all across the state of any activity with West Nile virus infection," said Kevin Reilly, deputy director of prevention services for the state Department of Health Services. "The key for us is to look very closely for any mosquito-borne virus activity in the Los Angeles basin, to accelerate that surveillance system and do the basic epidemiological investigation to see if we can identify how this woman contracted the infection."
 
The Centers for Disease Control and Prevention reports that the virus has been found in 42 states and the District of Columbia. It has infected 854 people.
 
But there are no confirmed instances of people contracting the disease in any states west of Montana and New Mexico. West Nile infections in four people who live in Western states, including Arizona and Idaho, are thought to have been contracted in other states where the virus already is present.
 
Dr. Diana Bonta, California Department of Health Services director, said the woman became ill Aug. 10 with viral meningitis and was hospitalized Aug. 12.
 
Doctors apparently suspected the virus, and sent blood and spinal fluid samples to the Los Angeles County laboratory. After the tests proved positive, samples also were sent to a state lab and to the CDC in Atlanta where the positive results were confirmed.
 
On Thursday, the state urged other health care providers to conduct the diagnostic test for West Nile virus when caring for patients with certain illnesses.
 
"We sent a letter to all the physicians in California, the hospitals, health plans and local health departments encouraging them to consider West Nile virus in the differential diagnosis of meningitis, encephalitis or atypical Guillain-Barre syndrome," said Bonta.
 
A month ago, state officials announced an aggressive effort to prepare itself for the arrival of West Nile virus, which they concluded was inevitable.
 
The surveillance effort includes a hotline for reporting any dead birds and the use of 200 flocks of chickens, including 10 in Sacramento and Yolo counties, which serve as sentinels for the virus.
 
On Thursday, Gov. Gray Davis signed a bill to revise an 87-year-old law governing mosquito abatement programs in California. Besides clarifying the government's authority, the measure doubles the maximum penalty for failure to abate a public nuisance -- such as standing water that attracts mosquitoes -- to $1,000 from $500.
 
Mosquitoes pick up the virus by biting infected birds, then pass it on by biting other animals, including humans. Many bird species, including chickens, can serve as hosts for West Nile virus, and scientists believe infected migratory birds are one cause of the rapid spread of the virus.
 
There is no evidence the virus can be passed from person to person, and less than 1 percent of those who become infected will become seriously ill.
 
The virus can cause flulike symptoms and, in rare cases, lead to more serious illnesses such as meningitis or encephalitis.
 
More information on the virus can be found by calling the CDC at (888) 246-2675 (English); (888) 246-2857 (Spanish); or (866) 874-2646 (TTY). To report a dead bird call (877) WNV-BIRD. Also see www.dhs.ca.gov or www.cdc.gov/ncidod/dvbid/ .
 
http://www.sacbee.com/content/news/story/4304605p-5324374c.html






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