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    Another West Nile Virus Summer?

    Eyes are turning to California as encephalitis season starts.


    "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.

    Preventing Infection

    Work is under way on a West Nile vaccine. The vaccine farthest along uses the backbone of the existing live-virus yellow fever vaccine. That, however, may be a problem.

    "The yellow fever vaccine backbone has been associated with severe adverse events in elderly patients -- multisystem organ failure," Campbell says. "That will be a thorny issue. Because now you are talking about taking that backbone and putting it into thousands of elderly Americans."

    Other types of West Nile vaccine are in the early stages of development.

    Meanwhile, there's a good way to make sure you don't get the West Nile virus: Avoid mosquito bites. When the blood-sucking varmints appear, limit your out-of-doors time in the early evening. When you do go out, wear long sleeves and use a DEET-containing mosquito repellent on exposed skin.

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