First West Nile Virus case in Md. re­ported

Mos­quito preven­tion ef­forts al­ready stepped up to stop Zika

Maryland Independent - - Front Page - By RICK BOYD rboyd@somd­news.com

Mary­land health of­fi­cials have con­firmed the first case of West Nile Virus of the sea­son in the state. That an­nounce­ment came

this week as state and lo­cal health of­fi­cials con­tinue their work to fore­stall an out­break of an­other mos­quito-borne virus, Zika.

West Nile Virus was first de­tected in the United States in 1999, and its pres­ence in Mary­land is not new. Last year, there were 46 hu­man cases of West Nile in­fec­tion in the state, ac­cord­ing to the Mary­land De­part­ment of Health and Men­tal Hy­giene. The peak years of hu­man in­fec­tion in the state were be­tween 2003 and 2012, the state health de­part­ment said. There were 73 cases re­ported in 2003.

The state’s first West Nile pa­tient this year was an adult in Western Mary­land who sur­vived the in­fec­tion, ac­cord­ing to the state health de­part­ment. In ad­di­tion, West Nile has been de­tected in mos­qui­toes col­lected at trap sites in Mont­gomery and Prince Ge­orge’s coun­ties.

A spokesper­son for the Mary­land De­part­ment of Agri­cul­ture said Thurs­day no mos­qui­toes car­ry­ing West Nile Virus have been trapped in South­ern Mary­land. St. Mary’s County health of­fi­cials said that agency has not been told of any dead bird con­cerns that may be an in­di­ca­tor of West Nile Virus cir­cu­lat­ing in the lo­cal mos­quito and bird pop­u­la­tion.

{span}As for Zika, that virus has been found in 77 peo­ple in Mary­land as of Aug. 24, ac­cord­ing to the state health de­part­ment. But none of those re­ported in­fec­tions were caused by mos­qui­toes in the state. All 77 were travel-re­lated, mean­ing the peo­ple in­fected had vis­ited, or had sex with peo­ple who vis­ited, ar­eas with con­firmed Zika out­breaks car­ried by mos­qui­toes. As of last month those ar­eas in­clude Mi­ami in ad­di­tion to much of Latin Amer­ica and the Caribbean.{/span}

Zika is of great­est risk to preg­nant women, as it has been linked to fe­tal ab­nor­mal­i­ties, in­clud­ing mi­cro­cephaly, a birth de­fect in which a baby’s head is smaller than ex­pected.

West Nile Virus can in rare in­stances be fa­tal, ac­cord­ing to the state health de­part­ment, ad­ding that fewer than 1 per­cent of peo­ple ex­posed to it de­velop se­vere in­fec­tions that can lead to headaches, high fever, neck stiff­ness, stu­por, dis­ori­en­ta­tion, coma, tremors, con­vul­sions, mus­cle weak­ness and paral­y­sis. In ad­di­tion to headaches and fever, milder symp­toms that ap­pear two to 14 days af­ter the bite of an in­fected mos­quito in­clude body aches, skin rash and swollen lymph glands.

Symp­toms of Zika may in­clude fever, con­junc­tivi­tis (red eyes), joint pain and rash, which oc­cur about 10 days af­ter in­fec­tion.

Most peo­ple in­fected with Zika or West Nile Virus suf­fer no symp­toms at all, which lim­its the health haz­ards to hu­mans but makes de­tect­ing the pres­ence of the two viruses in any com­mu­nity more dif­fi­cult.

In re­sponse to the Zika threat, St. Mary’s and state health of­fi­cials, in co­op­er­a­tion with mos­quito con­trol work­ers, ear­lier this sea­son stepped up preven­tion ef­forts that aim to elim­i­nate mos­qui­toes and guard against mos­quito bites.

St. Mary’s health of­fi­cials, cit­ing pa­tient pri­vacy, have de­clined to say if any of the state’s Zika cases have been found in South­ern Mary­land.

But St. Mary’s health and mos­quito con­trol of­fi­cials have been going door to door in some neigh­bor­hoods to pass out lit­er­a­ture and even help res­i­dents check for stand­ing wa­ter on their prop­erty where mos­qui­toes can breed.

“The key re­ally is preven­tion, hav­ing peo­ple look at their own yards,” Terry Prochnow, the St. Mary’s health de­part­ment’s di­vi­sion di­rec­tor of pub­lic health and pre­pared­ness, said ear­lier this month of the ef­fort to pre­vent a Zika out­break.

“These neigh­bor­hood vis­its are fo­cused on re­duc­ing the lo­cal mos­quito pop­u­la­tion that can trans­mit Zika and other in­fec­tions,” Dr. Meena Brew­ster, St. Mary’s County health of­fi­cer, said this week. “We are also en­cour­ag­ing neigh­bor­hoods and home­own­ers’ as­so­ci­a­tions to launch their own ef­forts via our Neigh­bor­hood Mos­quito Source Re­duc­tion Cam­paign Toolkit on the SMCHD web­site at www.smchd.org/mos­quito-con­trol.”

Zika and West Nile Virus are car­ried by dif­fer­ent mos­qui­toes.

Un­like the Aedes mos­quito that trans­mits Zika, the Culex mos­quito that trans­mits West Nile Virus is pri­mar­ily a per­ma­nent sur­face-wa­ter mos­quito, not a con­tainer

mos­quito, but it is pos­si­ble that it will use con­tainer wa­ter to re­pro­duce, ac­cord­ing to Brew­ster.

“Many of the mos­quito con­trol mea­sures (e.g., wear in­sect re­pel­lent, re­duce stand­ing wa­ter, mos­quito proof­ing the home, etc) will also be help­ful to ad­dress the Culex mos­quito ...” Brew­ster said in an email re­sponse to ques­tions. “The Culex mos­quito prefers stag­nant sur­face-wa­ters (such as marshes, bogs, pas­tures, pud­dles, pools, wa­ter-filled ditches, etc.), how­ever [it] may also lay eggs in con­tain­ers that have stag­nant wa­ter.”

The Aedes mos­quito pri­mar­ily is a day­time biter though it can also bite at night, Brew­ster said. The Culex mos­quito pri­mar­ily bites be­tween dusk and dawn. The Culex mos­quito that can trans­mit West Nile virus may also fly much far­ther than the Aedes mos­quito, typ­i­cally up to 1 to 2 miles. The Aedes mos­quito that car­ries Zika has a much smaller range.

State health of­fi­cials also an­nounced Mon­day that East­ern equine en­cephali­tis has been de­tected in mos­qui­toes trapped on the East­ern Shore.

East­ern equine en­cephali­tis virus can be trans­mit­ted to hu­mans through the bite of an in­fected mos­quito, though it is a rare ill­ness in hu­mans. It is one of the most se­vere mos­quito-borne dis­eases in the United States, Brew­ster said.

To stop mos­qui­toes from breed­ing, state health of­fi­cials sug­gest clean­ing rain gut­ters to al­low wa­ter to flow freely; emp­ty­ing or screen­ing cor­ru­gated drain pipes, re­mov­ing old tires or drilling drainage holes in those used as play­ground equip­ment; turn­ing over wad­ing pools, wheel­bar­rows, wag­ons and carts when they are not be­ing used; re­plac­ing wa­ter in bird­baths or plant hold­ers at least twice a week; and mak­ing sure trash re­cep­ta­cles are empty of wa­ter and fix­ing drip­ping faucets.

To pre­vent mos­quito bites, peo­ple are en­cour­aged to wear long pants, long-sleeved shirts and hats in ar­eas where mos­qui­toes are ac­tive, and to use use an EPA-reg­is­tered in­sect re­pel­lent with DEET, pi­caridin, IR3535, or oil of lemon eu­ca­lyp­tus or para-men­thane-diol. For a list of such in­sect re­pel­lents, visit www.epa.gov.

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