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Another West Nile Virus Summer?

Eyes are turning to California as encephalitis season starts.

Hot Spots: California, Colorado

This pattern bodes ill for California. Already this year, a dead crow and two live house finches in Southern California tested positive for West Nile virus.

"We worry about Southern California. By that theory, California should light up this year -- but it all depends on climate and mosquito control and luck," Campbell says. "If California is going to be a problem, you might see human cases very early. Cases in May or June or early July are very unusual and could be a sign of something big. Just a lot of dying birds and horses could suggest something big coming."

The pattern also suggests that Colorado -- last year's hardest hit state -- may see fewer cases this year.

"The big question is, what will happen in Colorado this summer," Campbell says. "If we continue to have a hot, dry summer, we could have activity again this year. If you start seeing cases in early July rather than late July in Colorado, it might portend a big epidemic."

It's too soon to tell whether this year's first probable human case of West Nile virus -- seen in a 79-year-old man from southern Ohio with severe viral encephalitis -- is an unusual aberration or a sign of things to come. Ohio reported 108 cases of West Nile virus infection in 2003 -- down from 441 cases in 2002.


"We know very little about treatment of West Nile virus disease," says Carlos del Rio, MD, chief of medicine at Atlanta's Grady Memorial Hospital. "Once it's diagnosed, treatment usually consists of just managing symptoms and preventing other diseases from happening to people in a weakened condition. With the encephalitis and meningitis, it is a very slow recovery. Physical therapy and rehab are all-important for recovery."

Researchers are racing to come up with treatments that are more active.

"There's a lot of interest from the National Institutes of Health in clinical trials of antiviral drugs, such as ribavirin and interferons, to see if we can decrease the symptoms of severe disease," del Rio says. "Passive immunity [treating patients with serum from people who have recovered from infection] is an area of significant interest."

Also being tried is an unusual treatment from a St. Louis firm called GenoMed Inc. The patent-pending protocol, developed by GenoMed CEO David W. Moskowitz, MD, involves the use of a common blood-pressure lowering drug: either an ACE inhibitor or one of a class of drugs called angiotensin-receptor blockers, such as Cozaar and Avapro. The idea is to slow down overreactive immune responses and speed recovery.

So far, 10 patients -- including this year's first case, the 79-year-old encephalitis patient from Ohio -- have received the experimental treatment. Nine of them, GenoMed says in a news release, got better. He thinks the same treatment may work for people with autoimmune disease, SARS, severe flu, and even the common cold.

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