West Nile: Prepare, Don't Panic

The

big summer scare last year was shark attacks. This year it's West Nile virus — a threat that is in some ways more frightening because you don't have to go near the water to get hurt. Death this summer is being spread by mosquitoes hatched in our backyard. The infestation, first reported in the U.S. in New York City in 1999, has reached nearly every state east of the Rockies. Seven people, all in Louisiana, have died so far this year, and health officials believe that an eighth man, who died in Mississippi last week, was infected. Neighbors have practically come to blows over the pros and cons of spraying against mosquitoes.

Before you decide never to go out again at dawn or dusk, though, it pays to put the latest bulletins about West Nile into perspective. Yes, the West Nile virus has been found in birds and mosquitoes in more than 35 states. Yes, it seems likely to reach the West Coast by the end of the year. And yes, it seems to be striking younger people than it did three years ago; for reasons that are still unclear, the youngest fatality this year was 53, as opposed to 68 in 1999. But the chances of getting infected are still pretty slim, and most people who get sick will develop mild flu-like symptoms. In only a rare few will the infection lead to encephalitis, a potentially deadly inflammation of the brain. One sure sign that you need to see a doctor — unexplained lethargy. (The risk of serious complications, this year's pattern of infection notwithstanding, tends to increase with age or a failing immune system.)

That doesn't mean you should ignore the West Nile virus. And public-health officials definitely need to update some of their long-forgotten plans for mosquito control. But it's not as if we're living in the 18th or 19th century, when mosquito-borne illnesses like yellow fever ravaged New York, Philadelphia and New Orleans. Back then, doctors didn't even know that mosquitoes were to blame, and there was certainly no vaccine — as there is now for yellow fever — to help control the spread of the disease.

Work is progressing on a vaccine for West Nile. (One for horses already exists.) Meanwhile, the best strategy is to use a little common sense. Killing all the birds and mosquitoes that carry the virus is not really an option. "People are going to have to change their habits," says Dr. John Shanley, director of the infectious disease division at the University of Connecticut in Farmington. That means wearing long-sleeved shirts and long pants and using insect repellent during mosquito season. You should also practice mosquito control around your house. Clean out the rain gutters, remove old tires, and drain birdbaths or anything else that collects water where mosquitoes can breed. You can never eliminate risk, but in this case at least, you can control it.

For more on West Nile, visit www.CDC.gov