City man may be 1st case of W. Nile

Druid Hill resident, 80, doing fine, doctors say

Further tests planned by CDC

August 15, 2002|By Frank D. Roylance | Frank D. Roylance,SUN STAFF

An 80-year-old Baltimore man stricken by a brain inflammation late last month is Maryland's first probable case of West Nile virus infection this year.

The man, who was not identified, lives in the 2200 block of Linden Ave., near Druid Hill Park. He was admitted to Sinai Hospital on Aug. 1 and sent home the next day.

"One of my colleagues saw him yesterday here at Sinai [Hospital], and reported he is fully recovered, with no lingering neurological or psychiatric" symptoms, said Dr. Andrew R. Mayrer, director of the division of infectious diseases at Sinai.

"He's back home, sitting on the porch, I imagine," Mayrer said.

The patient lives less than a mile from the Gwynns Falls Parkway home of John C. Wood, who became last year's first West Nile victim in Maryland.

Wood survived his initial illness, but died nine months later, after a long struggle with neurological problems attributed to brain damage caused by West Nile encephalitis.

Baltimore Health Commissioner Peter L. Beilenson said he was not surprised to learn of this year's first probable West Nile illness.

The virus is firmly established in the mosquito and bird populations in Maryland. Six Marylanders received a diagnosis of serious West Nile infections last year, and three died.

"I would not at all be surprised if we have a few human cases" this year, he said. "I am a little surprised we have not had more."

In all, 129 infected birds have been found in 11 Maryland jurisdictions this year. Thirteen batches of mosquitoes have tested positive for the virus, including four in the city.

Beilenson said many Marylanders have probably been bitten by West Nile-infected mosquitoes without being aware of it. Ninety-five percent of those infected by a mosquito bite show no symptoms. About 4 percent experience mild, flulike symptoms. Less than 1 percent become seriously ill.

Of those who are hospitalized, most have been elderly or weakened by chronic diseases.

Although the latest victim is 80 years old with a history of heart attack and stroke, Beilenson said, the man is otherwise in good health, which may have aided his recovery.

The man first became ill July 28, the health commissioner said, and went to the emergency room of an unidentified Baltimore hospital with gastrointestinal complaints.

The patient was treated and left the hospital, intending to walk the three miles to his home. Instead, feeling tired, he stopped along the way to rest at the home of relatives, Beilenson said.

Over the next few days, he began to show signs of confusion, fatigue and lethargy, and his family took him to Sinai.

Mayrer said the man's symptoms immediately suggested a possible brain infection.

"This being the summer season, there's always a blip, a spike in the number of cases of viral meningitis and viral encephalitis," he said. Some cases are caused by mosquito bites, but others spread from person to person.

This year, 127 Marylanders with symptoms of brain inflammation have been tested for West Nile virus, according to the state health department. All, until now, tested negative.

Although preliminary tests yesterday showed a 95 percent probability that West Nile was the culprit in the 80-year-old's illness, Beilenson said, confirmation will require further tests by the U.S. Centers for Disease Control and Prevention.

This year, the CDC has counted 156 confirmed or probable human cases of West Nile illness in the nation, with 133 of them in Louisiana and Mississippi. Nine cases have been fatal, including seven in Louisiana and two in Mississippi.

With the new Baltimore case, Maryland becomes the ninth state this year (in addition to the District of Columbia) to report a West Nile illness.

Beilenson said no infected birds or mosquitoes have been found this year in traps set in the Druid Hill Park area. Thanks perhaps to the dry weather, no mosquitoes have been trapped in weeks. So, "spraying doesn't make sense," he said.

Instead, he reminded city residents to avoid going outdoors when mosquitoes are active, to wear long-sleeved, loose clothing with insect repellent, and to eliminate standing water near homes that might permit mosquitoes to breed.

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