New West Nile worries As the U.S. gets ready to face its seventh season of living with the West Nile virus, new research shows that the West Nile family of illnesses (yes, there are more than one) are more threatening than once believed. According to a recent Associated Press report, the West Nile virus is proving to be far more serious than its long-time "nuisance" classification seems to indicate. Since its first recorded presence in the U.S. in 1999, this insect-borne illness has appeared in more than 16,000 Americans, killing more than 650. As you probably already know, West Nile is typically spread to humans by mosquitoes (and tainted blood products), and the effects of infection can run the gamut from completely non-symptomatic to fatigue and weakness, paralysis - and of course, death. The medical establishment has long considered West Nile only a serious threat to the elderly, or those with weakened immune systems. But more and more often in the last few years, West Nile virus has been manifesting itself as a polio-like partial paralysis among hardy, healthy, active folks in their 30s, 40s, and 50s. One source quoted in the AP article (a doctor with the National Institutes of Health) stated that there are currently more annual cases of paralysis in the U.S. caused by West Nile than during many years when polio was at the forefront of American disease worries. The problem may be far worse than even this NIH scientist figures - an accurate count of West Nile paralysis case is nearly impossible, since these symptoms are often likely to be mistaken by doctors for strokes or other paralyzing ailments. Why am I bringing all of this up? Because as time has passed, the West Nile virus (and its cousin, West Nile fever), have seemed to fade somewhat from the public's consciousness - despite the fact that there is to date still no cure, vaccine or even an approved course of treatment for the disease. This lack of headlines could lead to a dangerous lack of awareness about the only course of defense we have against infection: Insect repellants. For years, I've recommended only those containing 100% DEET, but as you read in the Daily Dose a few days ago, the CDC now approves the use of bug sprays made of picaridin and the all-natural oil of eucalyptus. And with a relatively mild, wet winter behind us in much of the United States that could kick mosquito breeding into high gear, analysts are worried that 2005 might prove to be one of the worst seasons yet for the disease. My advice: Stock up on - and for Pete's sake USE - whatever bug sprays you can tolerate (I still think the DEET-based varieties and catnip are best, if you can handle the smell of them) and stay away from wetlands, swamps, and standing water whenever possible. **************************************************** When pigs fry Two months ago, I wrote to you for probably the second or third time in the last two years about the growing epidemic of the H5N1 "Bird Flu" (Daily Dose, 4/11/2005). Specifically, I was sounding the alarm about the disease's possible spread to this country via migrating wild ducks from Asia, which have been shown to be asymptomatic in 40% of infected fowl. But I also mentioned the likelihood of transmission of the H5N1 to ordinary livestock. And now, according to an Associated Press report, these worst fears of mine (and a few others) have been confirmed. Indonesian scientists have now detected a strain of this flu in pigs. According to the article, a full 50% of the porkers tested on the island of Java were found to be infected with the virus, as confirmed by an independent lab in Tokyo. Apparently, none of the pigs showed any outward signs of illness. At present, most human infections with H5N1 have been traced to direct contact with infected poultry or their waste products. It is not know yet whether consumption of meat from infected pigs will transmit the virus. Even if it doesn't, contact with the animals themselves must surely pose a risk - pigs are genetically extremely similar to humans and often carry human influenza viruses. A huge percentage of typical Asian diets use pork as a staple. And whether all pork-eaters or only pig-farmers can catch it, that continent could soon be on the brink of a massive outbreak of H5N1 over a very short time span. Indonesian officials have been convening to discuss their options. Stay tuned. Keeping you "abreast" of matters fowl and fare, William Campbell Douglass II, MD | 
