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Should We Worry About West Nile Virus?

What's All The Fuss About?

Driving a car can be dangerous. We probably drive a car or are a passenger in one almost everyday. Thankfully, many of us never get into a car wreck, but there are wrecks every single day nonetheless. All the while experts warn us that driving a car can be dangerous, even deadly. Yes, we venture to work and home again in them. We stop by the cleaners and perhaps the grocery store. We take our kids to their sports games and activities, risking our health by driving in a car. Should you be concerned about driving your car? What if I told you that wearing a seat belt would reduce your risk greatly? Would you wear one? Would you ensure your kids wore one? Of course you would and we do because we know that something so simple as wearing a seat belt can prevent injury and save lives.

West Nile virus is dangerous. It arrived into Contra Costa County in 2004, a mere five years after it first entered the Western Hemisphere into New York in 1999. It's now endemic - established and ingrained into our environment. The carriers of that virus, birds, are endemic. The transmitters of that virus, mosquitoes, are also endemic and therein lies the health problem.

Anyone can contract West Nile virus, a debilitating and possibly fatal disease, from a single bite of an infected mosquito.

Should we be concerned?

As a public health agency, our mission is to protect people from vector-borne diseases. Our mission is specific to every individual. We consider even one person who contracts West Nile virus one person too many.

Protecting people from mosquitoes is a daunting task if you think about the fact that up to 400 mosquitoes can emerge from one egg raft the size of a grain of rice in less than a cup of water. Imagine the vast possible breeding sites. Educating all 1 million people in the 725 square miles of Contra Costa County about the dangers of the virus incorporates extensive communication and best practices, but at the heart of it, we are promoting and requesting teamwork. Our goal is to empower each individual to routinely dump standing water and take the necessary precautions to reduce their risk. Mosquito and vector control technicians can't inspect every backyard and that's often where the threat lies. So we educate people about the risks and try to change their behavior--get people to wear their seatbelts so to speak.

Some people think that concern for contracting West Nile virus in Contra Costa County might not be warranted, considering the statistics:

* Since 2005, 70 people have been diagnosed with the virus in Contra Costa County and two people have died. In the United States, the human toll from 1999-2010 was:

* 30,702 symptomatic cases
* 12,755 (42%) neuroinvasive disease cases
* 1,220 (4%) fatal cases

* About 80% of people won't even know they were bitten by an infected mosquito and will experience no symptoms; 20-30% will get "West Nile fever" and experience flu-like symptoms ranging from mild to severe, including possible paralysis; and less than 1% will experience brain inflammation (encephalitis), meningitis, and/or poliomyelitis (polio-like symptoms such as paralysis); and some of these people die.

But, there's more to the story. Let's consider these facts:

* West Nile virus is grossly under reported. In a recent study, the question "Are Patients with WNV-Compatible Neuroinvasive Disease Being Tested? was raised by the California Department of Public Health. Their conclusions:

Keep West Nile on your raidar

* From April 1-Oct 31, 2010, 80% of patients with a neuroinvasive diagnosis were not tested for West Nile virus
* From April 1-Oct, 2010, only 20% of all encephalitis cases were tested for West Nile virus. This is a decrease from 2009 (27%)

We can't speak for the medical community, but one theory as to why there are few reports of West Nile virus being reported is that flu-like symptoms lead many people to understandably conclude they have the flu, a general catch-all category. Many people don't feel ill enough to see a doctor, but may feel ill enough to miss work or disrupt their activities. When some people do go to the doctor and a diagnosis of a virus is given, seemingly the name of the virus is irrelevant to discover and therefore no need to validate because the treatment of viruses are virtually the same. The specific diagnosis wouldn't change the treatment. People with severe symptoms require investigation into the origin of the illness and therefore, West Nile virus can be revealed, but, in many cases, the test is not performed and/or the case is not reported.

West Nile virus is considered a reportable disease. Knowing where the virus is active is critical to mosquito control efforts.
* Many people are left with permanent disabilities, similar to polio as well as neurological disorders, and there are long recovery times and lost work days associated with even the 'mild' form of the disease. Some people experience life-long lingering and debilitating health issues.

If a picture is worth 1,000 words, surely a video is worth ten times more. Watch videos of local West Nile virus patients as they express their experience with the disease. Byron, 73, an avid outdoor enthusiast required a 15-month hospital stay after enduring a two-week coma. Max, 51, and Lorrie, 42 also recount their experiences after contracting West Nile virus. Recently, we heard the story of Roger Ross, a San Joaquin County court judge who can't breathe with his right lung and whose right arm is still paralyzed due to contracting West Nile virus. He has since returned to work, but with debilitating health issues.

* And some people die.
Surely this fact alone is worth taking very simple precautions toward mosquito control. Each life altered or lost is tragic, regardless of how many or few lives are reflected in the statistics.

Certainly, each and every victim of West Nile virus and their families would say that concern for contracting West Nile virus is warranted. We at the Contra Costa Mosquito & Vector Control District don't want anyone to suffer the ill effects or die from a disease that is largely preventable.

Every health and safety decision we all personally make involves a cost/benefit analysis that is personal to us. Wear a seat belt. Turn off the stove. Dump out standing water. These actions can save lives - so why wouldn't we?

Since West Nile virus is a fairly new disease to the United States, we are still learning about its true effects. For example, not only seniors contract West Nile virus, but anyone can get the disease. Seniors generally have other health issues that weaken their immune symptoms and that's why more seniors tend to succumb to the disease, but West Nile virus does not discriminate against age nor gender.

Any elation the Contra Costa Mosquito & Vector Control District has that there are few people who get the virus is squelched by the fact that some people did get the virus. One case is too many. We continue our mosquito control work proudly because we understand that the mosquito control work we complete is beneficial to everyone. Just like wearing a seat belt or turning off the stove is second nature, our hopes are that dumping out standing water and wearing repellent become second nature, too. We continue our education to the public about mosquitoes and their diseases because our partnership with individuals and the community ensures a healthy environment for everyone. Every. Single. One.

October, 2011