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    Slumbering Virus to Awaken Again, Experts Say

    By Ori Twersky
    WebMD Health News

    April 25, 2000 (Washington) -- Infections by the West Nile virus are likely to occur again this summer in New York and possibly 17 other states, where the virus may have spread by migrating birds and mosquitoes, federal officials confirmed Tuesday. But the majority of these cases are unlikely to result in severe complications, they added, noting that the greatest danger basically is limited to high-risk populations such as older Americans.

    First reported last summer in New York City, the West Nile virus is commonly found in Africa, West Asia, and the Middle East and causes encephalitis, or inflammation of the brain. Spread by mosquitoes that became infected after feeding on infected birds, it is closely related to the St. Louis encephalitis virus found in the U.S., common symptoms of which include fever, headaches, and body aches.

    But unlike the St. Louis version, the effects of the West Nile virus can be far more severe, resulting in neck stiffness, disorientation, coma, tremors, convulsions, muscle weakness, paralysis, and even death. During the outbreak in New York last summer, West Nile virus caused seven deaths and 62 cases of severe illness.

    While initially hoping that this more severe version would not survive the winter months in America, the CDC last month detected live West Nile virus in hibernating adult mosquitoes, increasing fears of a possible second outbreak. Now, federal officials also say that it might have found a new home in America despite efforts taken last summer in New York and neighboring states to eradicating the virus altogether.

    "We may see some cases here and there over the years," said Stephen Ostroff, MD, associate director for epidemiologic sciences at the CDC. Putting it in context, the West Nile virus is an example of the emerging infectious disease threat facing the U.S. in the age of international travel, he said.

    How the West Nile virus made its way to the U.S. remains a mystery. But federal officials suspect that it may have traveled to New York from Israel (where a similar outbreak occurred in 1998) through either an infected bird, mosquito, or human. There are also anecdotal reports of similar cases reported during a 1996 Romanian epidemic.

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