Missouri Department of Health & Senior Services
06/23/05

FROM:
Nanci Gonder
751-6062

State's First Confirmed Case of Human West Nile Virus Reported, Missourians Urged to Begin Protecting Themselves, Family, Community

Now that Missouri's first human case of West Nile virus has been reported, the Missouri Department of Health and Senior Services is urging people to step up their efforts to protect themselves, their
families and their communities against the virus. The state's first confirmed case of West Nile virus was reported in a 70 year-old male from Adair County in northeastern Missouri. The man passed away June 14.

While he is reported to have had other medical problems, West Nile virus will likely be listed as a contributing factor in his death. The man is also reported to have regularly traveled to many parts of the state and worked outdoors, so it cannot be determined with certainty where he was infected. The case investigation is on-going.

"This first death related to West Nile virus serves as a solemn reminder that the virus is here to stay, it can be very serious especially in sensitive populations, and that we must all work together to protect ourselves, our families and our communities from mosquitoes that carry the virus," said Dr. Howard Pue, state public health veterinarian.

Pue said that, like many diseases, prevention is the simplest and most effective way to combat the spread of West Nile virus. The most effective ways to prevent infection are using effective insect repellent
containing DEET if going outside in the morning and evening (mosquitoes' most active feeding times), and making sure homes, properties, and communities are protected by cleaning up junk, trash,
and other things that can hold water and serve as breeding grounds for mosquitoes that can carry the virus.

Pue noted that there now are products on the market containing a new repellent called picaridin. Picaridin has been used for some time in Europe and Canada, and was recently approved by the federal Food and Drug Administration (FDA) for use in the United States. Picaridin is a safe, effective alternative to DEET, though it may not last as long as products containing DEET. Repellents containing DEET or picaridin should be applied to clothing and exposed skin, and outside activity minimized during dusk and dawn. These repellents can also be safely used on young children by following directions on the product label.

It also helps to wear long sleeve shirts and pants when outdoors to cover the skin. Pue added that homes should be mosquito-proofed by ensuring doors and windows have screens, and standing water that can serve as mosquito breeding habitat should be eliminated.

The West Nile virus, like most mosquito-borne viruses, is found in wild and domestic birds. When a mosquito feeds on an infected bird, it can pick up the virus and transmit it to other non-infected birds.
Occasionally, infective mosquitoes will feed on mammals such as horses and humans, and transmit the virus to them.

Most people infected with the West Nile virus do not develop any symptoms. Sometimes, though, mild illness results one-to-two weeks after exposure with symptoms such as fever, headache, body aches, skin rash, and swollen lymph nodes. Less than one percent of infected people may develop a serious illness that includes encephalitis (inflammation of the brain). These persons might experience headache, high fever, neck stiffness, disorientation, convulsions, and muscle weakness. Infection may prove fatal, especially among the elderly, in a small number of those who develop encephalitis. West Nile virus is not
transmitted directly from birds to humans or from person to person.

Medical care should be sought as soon as possible for persons who have symptoms suggesting severe illness. There is no specific treatment for West Nile infection or vaccine to prevent it. Treatment of severe
illnesses includes hospitalization, use of intravenous fluids and nutrition, respiratory support, prevention of secondary infections, and good nursing care.

Hunters should follow the usual precautions when handling wild animals. They should wear gloves when handling and cleaning animals to prevent blood exposure to bare hands and meat should be thoroughly cooked.

There are many things that can kill birds besides this virus, and therefore not all dead-bird sightings are investigated. However, some bird species such as crows and blue jays are especially susceptible to
infection by this virus. Pue said that people who observe an unusual number of dead birds, especially crows, blue jays, sparrows, grackles and birds of prey like hawks and owls are encouraged to report the
incident to their city or county health department. Health officials will then determine whether the event should be investigated and whether bird specimens should be submitted to a laboratory for testing. People are also encouraged to report dead birds through the DHSS West Nile virus web site where they will find instructions for using the electronic Dead Bird Reporting Form. While the electronic reporting will
not get the birds tested, the reports will help DHSS track the virus's progression in the state.

DHSS has begun a comprehensive public awareness campaign to help inform and educate people in Missouri about West Nile virus and how to prevent it. The campaign features a statewide radio broadcast program, a large variety of print materials in English and Spanish, informational compact discs, regional training opportunities for public health and medical professionals, and the DHSS West Nile virus web site.

More information about West Nile virus, reporting dead birds, and free awareness campaign materials may be accessed on the DHSS web site at:www.dhss.mo.gov/WestNileVirus.

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