For Immediate Release:
September 19, 2007

Contact:
Nanci Gonder
Office of Public Information
573-751-6062

Dr. Howard Pue, DVM
State Public Health Veterinarian, or

Karen Yates
DHSS Vector-Borne Disease Coordinator
573-751-6113

Missouri’s first West Nile virus-related death of the year reported

The Missouri Department of Health and Senior Services (DHSS) confirmed today Missouri’s first West Nile virus-related death this year.  A 51-year-old woman from St. Louis City died September 14, 2007.  As of Tuesday, September 18, DHSS reports 30 human WNV cases.  Eight of this year’s cases are from the St. Louis area; five from the county and three from the city.

“We always regret having to announce disease-related deaths. Our condolences go out to the family and loved-ones of this person,” said Dr. Howard Pue, state public health veterinarian. “But we also hope that by announcing WNV-related deaths we can get people’s attention and help prevent other WNV illness and death. Our message is that, even though it is getting cooler, mosquitoes that can cause West Nile virus are still out there, and people should continue taking precautions to prevent WNV infection.”

According to the Centers for Disease Control and Prevention (CDC), the top risk factors for serious cases of WNV are for people over the age of 50 and anyone who has had an organ transplant. Organ transplant patients and others who have suppressed immune systems often must take medications that make them more susceptible to infections, including WNV.  These people may also have longer incubation periods, delayed development of infection antibodies and an increased likelihood of severe WNV disease.  CDC also says about 20% of infections lead to a flu-like West Nile fever and that severe West Nile disease, where the virus is found in the nervous system, occurs in less than 1% of infected people. 

“The risk of serious WNV illness to most people is low, but a death like this serves as a solemn reminder of the importance of avoiding mosquito bites,” said Pue.  “While serious complications from WNV infection tend to occur in people who have suppressed immune systems and people over the age of 50, people of all ages can become ill, so it’s important to remember that avoiding mosquito bites reduces your risk of getting this disease.”

“People need to realize that we’re not out of the woods yet with WNV,” Pue said.  “We have cases each year where people become infected in September and October, so we still have at least another month of WNV risk, and maybe longer if temperatures stay moderate.  It will take a prolonged period of repeated hard freezes before these persistent pests give up for the season, not just a few frosty mornings.  People need to continue following the very simple precautions that are so vital to preventing WNV infection.”

Missouri’s state and local public health officials have urged Missouri residents to use insect repellents that contain DEET during the late summer and early fall season of peak virus transmission.  According to Pue, products containing DEET and picaridin are very safe when used according to the label directions.  “Mosquitoes tend to be most active at dawn and dusk, and sometimes during midday, if the wind is still or the humidity high.  Using an effective insect repellent, one that contains DEET, reduces the risk of being bitten and allows people to carry out their outdoor activities with less fear of WNV infection,” said Pue.
  
To reduce the risk of being bitten by mosquitoes that carry WNV, the state public health department recommends the following protective measures:

• Apply an EPA-registered insect repellent such as those containing DEET or picaridin on clothing and exposed skin when you go outdoors.  Upon returning indoors, wash exposed skin with soap and water. 
• Choose a repellent that provides protection for the amount of time that you will be outdoors.  A product with a higher percentage of active ingredient is a good choice if you will be outdoors for several hours while a product with a lower concentration can be used for a shorter period.  Reapply if you start to be bitten by mosquitoes again.  (For details on where and when to apply repellent, go to www.cdc.gov/westnile).
• Apply insect repellent when doing outdoor activities, especially around dawn and dusk, when mosquitoes are most active.
• Use just enough insect repellent to cover exposed skin – it is not necessary to use a heavy application.  You can also apply it to clothing, such as shirtsleeves and trouser legs.
• Permethrin is an effective pesticide designed to be sprayed only on clothing and allowed to dry before wearing.  Closely follow label directions for use. 
• Fix or install door and window screens to keep mosquitoes out.
• Seek out and eliminate places in your yard where mosquitoes can lay their eggs – look under shrubs and into tall flowerbeds for forgotten toys or containers that may hold water.  Clean birdbaths and pet dishes once a week.
• Fall is a good time to check and clean rain gutters so that water will not collect there.

Though DHSS no longer tests dead birds for the presence of WNV, citizens can still help with tracking WNV activity in their area by reporting dead birds they see. Although birds die from many different infectious diseases as well as exposure to toxins, DHSS’ Internet dead bird reporting form is being used to track reports of certain types of dead birds that may be an early sign of WNV activity in an area. 

Crows and blue jays are likely to die when infected with WNV and therefore serve as effective sentinel species warning that there is increased risk of WNV infection in an area. Other types of birds that may also indicate an increase in WNV activity include grackles, sparrows, finches, cardinals, robins and some birds of prey like hawks and owls. Citizens are encouraged to use the DHSS Internet Dead Bird Reporting Form so that state and local public health officials can track possible WNV activity.

Citizens and public health departments are cautioned that reports from the public are not authenticated or confirmed in any way and are subject to inaccuracies.  The web address of the Dead Bird Reporting Form is: https://webapp03.dhss.mo.gov/DeadBird/Index.aspx

DHSS lists all new human cases, as well as non-human indicators of WNV activity on its web site (www.dhss.mo.gov/WestNileVirus/index.html).  Human case data posted on the web site represent cases that are under investigation, and are therefore provisional and subject to change.

For more information on WNV, contact your local health department or the Department of Health and Senior Services at 1-866-628-9891 or 573-751-6113, or visit the DHSS WNV web site above.