Second case of W. Nile hits Md.

Balto. County woman awake, improving in hospital, officials say

September 08, 2001|By Jennifer McMenamin and Frank D. Roylance | Jennifer McMenamin and Frank D. Roylance,SUN STAFF

For the second time in two days, a Baltimore-area resident has tested positive for the mosquito-borne West Nile virus, making a 63-year-old woman the second human case detected in Maryland.

The Eastpoint-area woman, whose name was not made public, was admitted to a city hospital late last month with seizures and was unconscious. By last night, the woman was "awake and improving," said Arlene H. Stephenson, deputy secretary for public health services with the Maryland Department of Health and Mental Hygiene.

The name of the hospital where the woman is a patient was not released.

The diagnosis of West Nile meningoencephalitis - inflammation of the brain and spinal cord - is 98 percent accurate. Further testing by the federal Centers for Disease Control and Prevention will be done to confirm the state's results, state health officials said.

State and county health officials predicted last night that more human West Nile cases will be found - but stressed that people are not at risk.

"We anticipate we will continue to find dead birds, and we have a very aggressive surveillance system," Stephenson said. "We anticipate we will continue to find [infected] mosquitoes. And quite likely, we will see more human cases, unfortunately. ... West Nile is here to stay."

On Thursday evening, Baltimore health officials said a 72-year-old Druid Hill man had been admitted unconscious to Sinai Hospital on Aug. 22. His illness was later diagnosed as encephalitis, and subsequent tests identified the likely cause as West Nile.

The man, whose name has not been made public, had suffered from "a significant number of chronic, debilitating conditions," Baltimore Health Commissioner Peter L. Beilenson said. The man remained in serious but stable condition yesterday at Sinai, where hospital officials said he remained in a coma, breathing with the aid of a respirator.

State health officials did not have information on whether the Baltimore County woman, who lived in the 21224 ZIP code, had pre-existing medical conditions. The area was sprayed Tuesday, and will be sprayed again Sept. 11, state health officials said.

The two Maryland cases of West Nile fever are the 10th and 11th reported this year in the United States. The others have been in Florida (four), New York state (three), New Jersey (one) and Georgia (one). The Georgia case is the sole West Nile fatality in the United States this year.

State health officials said 205 Marylanders have been tested for the virus since May 1. Results on more than 60 of the tests are pending.

"We're not trying to cause people to be panicked," said Dr. Michelle A. Leverett, Baltimore County's health officer. "But we want to remind people to be careful and to be preventative."

Comparing the need for precautions to the water shortages of past summers, when residents were asked to conserve water whenever possible, Stephenson said that there is no need to overreact; people simply need to be similarly conscientious.

"This is our chance, while it's still early in the disease, to make a difference in the spread of the disease by keeping the mosquito counts down," she said. "Look at your neighborhoods and businesses to see if there is any standing water."

The West Nile virus, well-known in Africa, southern Europe and the Middle East, was introduced into the Americas in 1999, probably from Israel.

Primarily a disease of wild birds, it is almost 100 percent fatal to crows. Other species carry the virus without becoming ill, and their migrations are the chief mechanism for its rapid spread.

The virus is transmitted from birds to people and other mammals by the bite of mosquitoes. It becomes a serious threat only when the infection moves into the brain and causes encephalitis or meningitis - inflammation and swelling of the brain or spinal cord.

Most healthy people have little or nothing to fear from the West Nile virus. As many as 80 percent of those infected will show no symptoms, studies have found. Those who do get sick usually have only mild flu-like fever and aches.

But about one in 150 people infected by the virus will experience serious neurological symptoms, including headache, high fever, disorientation, muscle weakness, coma and paralysis.

Most at risk are senior citizens and people with weakened immune systems. Most recover.

Maryland health officials had been watching for the state's first human West Nile cases to turn up. Studies in New York state found that the human infections appeared in communities a few weeks after the number of dead crows found there began to rise rapidly.

In late July, the number of dead crows found in Northeast Baltimore and nearby parts of Baltimore County began to soar, and more than 200 in the two jurisdictions have been found to be infected with the West Nile virus.

Doctors in the area have been alerted to consider and test for West Nile when they encounter patients with encephalitis and meningitis.

There is no human vaccine for the illness, but a new West Nile vaccine for horses was distributed to veterinarians earlier this month.

Public health authorities have focused on urging people to eliminate standing water where mosquitoes breed and treating wetland breeding areas with larvicides.

People are also urged to use mosquito repellent containing DEET and wear long sleeves and pants when outdoors between dawn and dusk.

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