September 2002 • Volume 8 • Number 9 |
There's cause for concern, yes, but by keeping patients informed, you can minimize the public health threat posed by the West Nile virus, say health officials.
FPs should work with their local health departments to stay ahead of the epidemic, says family physician Kathleen Toomey, M.D., M.P.H., director of the Georgia Division of Public Health.
"Education is our best approach," she says. "The more we have a fully informed public, the better off we'll be."
The potentially deadly mosquito-borne pathogen can now be found in 36 states and the District of Columbia. Figures compiled at press time by state health departments cite 251 laboratory-positive human cases of West Nile virus-related illness this year alone, including 11 deaths.
Public health authorities warn that the virus is spreading more rapidly than in past years: From 1999 through 2001, 149 cases of virus-related illness in humans were reported, with 18 deaths.
CDC officials and other infectious disease specialists discussed these and other concerns Aug. 8 in a live satellite broadcast, "CD C Responds: Update on West Nile Virus for Clinicians and Labora-torians." The archived Webcast is available for viewing at http://www.phppo.cdc.gov/PHTN/webcast/westnile/.
Faculty for the program included newly named CDC Director Julie Gerberding, M.D., M.P.H., a former acting deputy director of CDC's National Center for Infectious Diseases. Gerberding was joined by other NCID officials and the state health officer of Mississippi, a state where human viral infection has been documented.
The broadcast addressed disease pathogenesis, epidemiology, and clinical and laboratory diagnosis. What's important, CDC officials urge, is to get the message out to patients to use common-sense precautions to avoid mosquito bites, especially during peak activity hours between dusk and dawn. A thorough history is indispensable during office visits from patients concerned about possible exposure, as are reassurances about the rarity of serious illness.
What can physicians do to head off the disease in their own communities?
Plenty, says Toomey.
Physicians can work with their local health departments to ensure that DEET-containing insect repellent is available to persons who can't afford to buy it, says Toomey. Also, she says, physicians can lobby to have public areas kept free of standing water, where the mosquitoes breed. One's own property shouldn't be overlooked either, she adds. Persons who become infected are usually infected by mosquitoes in close proximity to their homes, she adds.
Spraying is the least effective means of controlling West Nile virus, Toomey says, for a number of reasons. It's expensive, it kills beneficial insects, it's ineffective in wooded and foliated areas, and even if spraying kills adults, new mosquitoes will emerge within days, she says.
CDC maintains a comprehensive Web site devoted to the West Nile virus -- go to http://www.cdc.gov/ncidod/dvbid/westnile/ for the latest surveillance, prevention and control information, as well as for answers to frequently asked questions about the virus.
FP Report is published by the
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Copyright © 2002 by
American Academy of Family Physicians.