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Citing Malaria, Natalie Gulbis withdraws from Founders Cup

In Malaria, Uncategorized on March 24, 2013 at 12:29 pm
Natalie Gulbis

Natalie Gulbis withdrew from the RR Donnelley LPGA Founders Cup in Phoenix Tuesday night with her management team confirming that she contracted malaria while on the tour’s Asian swing.

Gulbis first became ill playing the HSBC Women’s Champions in Singapore two weeks ago. She withdrew after the first round with her team reporting she was being medically treated for flu-like symptoms, but had not been diagnosed with malaria.


“Natalie originally became ill in Singapore and she was treated and medically cleared to fly home,” according to a statement released jointly by the LPGA and IMG, Gulbis’ management company. “Natalie continues to be treated at home and is expected to be at full strength in three weeks. Natalie’s well-being is a top priority for both the LPGA and IMG, and steps continue to be taken to ensure the well-being of Natalie and all the players on the LPGA Tour now and for future events. LPGA doctors have been consulted and believe she is on appropriate medications, under great care, and her prognosis is excellent.”

According to the Center for Disease Control, malaria is a “serious and sometimes fatal disease,” if not treated properly. It’s caused by a parasite that infects a certain kind of mosquito that feeds on human beings. The CDC reports that about 1,500 cases of malaria are diagnosed in the United States each year with the vast majority among travelers and immigrants returning from parts of the world where malaria transmission occurs, including South Asia.

The LPGA reports that tournament founding partner Scottsdale Healthcare will be on-site in Phoenix Wednesday to provide a blood draw for players, caddies and family members wishing to be screened.


Dengue, aka “Breakbone Fever,” Is Back in Florida

In Dengue Fever, Uncategorized on December 31, 2012 at 9:28 am
The vicious virus has re-established itself in the South, and mosquitoes are carrying it north.

By |Posted Friday, Dec. 21, 2012, at 11:14 AM ET

Tiger mosquito.

Asian tiger mosquitos, like the one seen above, can carry dengue fever and have been seen as far north as Chicago

Photo by Roger De Marfé/iStockphoto/Thinkstock.

In the autumn of 1885, people in Austin, Texas, began to feel sick. One after another, they developed a chill and then a soaring fever. They vomited and broke out in rashes. Their most distinctive symptom was agonizing pain behind their eyes and in the bones of their arms and legs. And when the fever subsided, lack of appetite and deep exhaustion left them unable to work for weeks or months.

Austin had been founded only 46 years before, and it was still small, with just 22,000 people. By the time the epidemic was over, 16,000 of them had fallen ill. A local doctor who described the outbreak in the Journal of the American Medical Association the following year added: “I am informed that other cities … had as many cases in proportion to the population as did Austin.”

The illness that took out Texas that fall had already devastated Charleston, S.C., in 1828and Savannah, Ga., in 1850, and it would go on to sicken half the population of Galveston, Texas, in 1897; one-quarter of Monroe, La., in 1922; and one out of every nine people in Miami in 1934. It was dengue—a mosquito-borne virus popularly known as “breakbone fever” for the pain it caused. From the 1820s to the 1940s, it caused recurring epidemics roughly every 10 years.

World War II mosquito-eradication programs broke the chain of transmission between humans and insects, and by the time the war ended, dengue had retreated to the tropics and was no longer a problem in the United States.

That may be about to change. At the annual meeting of the American Society of Tropical Medicine and Hygiene last month, researchers from the University of Florida revealed thatdengue has reappeared in Key West, Fla. The virus they found was not a one-time visitor imported by a tourist or a stray mosquito; it has been on the island long enough to become a genetically distinct, local strain.

The Florida researchers didn’t want to talk about their presentation because they hope to get it published soon in a medical journal. But it turns out other tropical-disease experts have been watching dengue’s return to the United States for a while and wondering what it will mean.

“It really is just a matter of time until dengue re-establishes itself in certain areas here,” says Amesh Adalja of the Center for Biosecurity of the University of Pittsburgh Medical Center. “The U.S. has been lucky that it has escaped so far.”

Dengue is already a pandemic elsewhere. Among insect-borne diseases, malaria gets the headlines: It causes about 219 million cases per year and about 660,000 deaths. But dengue is right behind it, racking up potentially 100 million infections per year around the world and putting about 500,000 people in the hospital, most of them children. It causes fewer deaths—25,000 per year—than malaria, but its prolonged illness keeps people from working and depresses both personal incomes and gross national product.

Dengue is also becoming more common. Between World War II and about 1970, severe dengue epidemics were recorded in only nine tropical countries; now the disease occurs routinely in more than 100. The primary driver has been the growth of slums as people leave rural areas to search for work. When migrants settle at the fringes of a city, they are beyond the reach of its infrastructure—water lines, sewer systems, and trash disposal—and they cope by digging latrines, storing water in jugs and barrels, and consigning trash to open dumps. All of those strategies create small pools of stagnant liquid, exactly the kind of habitat that the main dengue-carrying mosquitoes prefer. (The pools can be very small, less than an ounce.)

Dengue infects only humans and other primates—there is no intermediate host that harbors it, such as birds for West Nile virus—and people are its main vehicle for moving around the globe. After a bite, the virus replicates in the blood for four to seven days; once the fever starts, there are at least two and up to 10 days when the victim can cause an infection in the next mosquito that bites him or her. In the two weeks between the initial bite and the end of the infectious stage, a traveler can unknowingly transport the virus from an area where it is common—a marketplace in Singapore, a river terrace in Thailand, a beach in the Caribbean—to somewhere it has never been before.

The Centers for Disease Control and Prevention estimates that more than 2,700 peoplebetween 1977 and 1995, and more than 360 between 2001 and 2004, had that experience: being bitten somewhere, coming home, and getting sick afterward. In most cases, the disease went no further, but sometimes it kept spreading. There was a 122-person outbreak in Hawaii in 2001, the first time the virus had been seen in the islands since 1944. There were 25 cases in Brownsville, Texas, in 2005 and 90 cases in Key West between 2009 and 2010. In the last case, the outbreak extended over the winter, when cooler temperatures should have knocked out local mosquitoes.

“That was the winter when the H1N1 pandemic flu was circulating, and whatever dengue cases we had would have been masked by that and went unrecognized,” says Danielle Stanek of the Florida Department of Health. “When the flu settled down and we realized there were still dengue cases, that was a wake-up call for us.”

Local spread of dengue is still happening in Florida. On Key West, 5 percent of people show immunologic evidence of having had a dengue infection, and the disease is found farther north as well. This year, four residents caught “locally acquired” dengue, two in Miami and two near Orlando, Fla. Another 112 were diagnosed with dengue they had caught somewhere else and brought there.

The CDC’s experts assume there are more cases that haven’t been counted, and not just in Florida. “When you’re seeing a patient early on, dengue looks like a lot of other acute (fever-causing) illnesses,” says Kay Tomashek, chief of epidemiology in the agency’s dengue branch. “If you are a physician in New York and you see a patient with fever, headache, and muscle pain, you might not be thinking about that.”

Detecting imported cases is important because the more frequently the disease comes across the border, the more risks from it increase. And not just the risk of catching the disease. There are four types of dengue, distributed unevenly across the tropics and subtropical zone. Becoming infected with any one causes the classic breakbone fever. But if you acquire and recover from one type and then contract a different type even years later, you are more likely to develop the disease’s worst version, dengue hemorrhagic fever. DHF disrupts the circulation, sends patients into shock, and kills up to 1 in 5.

The U.S. outbreaks to date, as well as the locally adapted Key West strain, are all caused by the first type, known as DEN-1. But 10 of the imported cases in Florida this year were in tourists from Central and South America, where DEN-2, DEN-3, and DEN-4 circulate as well.

Could more dengue outbreaks happen? To spark one, you need three things. First, imported virus: check. Second, a population with no immunity. The United States has that, since dengue was last widespread in the 1940s. And third, mosquitoes that can transmit it. Those are already widespread.

The spraying campaigns that ended U.S. epidemics of malaria and dengue in the 1940s turned out to be only a temporary solution. National eradication programs petered out in 1972, and the main dengue vector, Aedes aegyptiquickly returned; it is now in 23 states and ranges as far north as New York City. In 1985, a second species that can spread dengue—Aedes albopictus, better known as the Asian tiger mosquito—arrived in Texas in a shipment of used tires from the Pacific Rim that had been stored outdoors and held puddles of rainwater. It is now in 26 states and has been found as far north as Chicago.A. albopictus is what entomologists call a “less competent” vector; it doesn’t spread the disease as efficiently as A. aegypti does. But it has other abilities that have huge significance for disease transmission: It bites all day long, not just at dawn and dusk, and it can survive both winter temperatures and drought.

Because there is no vaccine for dengue, the best hope of stopping its advance relies on individual action, such as getting people to wear repellent and persuading them to scour their homes and properties for small puddles—underneath a planter, inside a tiki torch—after every rain. Or convincing them to stay inside. Researchers theorize the 2005 Brownsville outbreak was smaller than the 2009 Key West because of the “Texas lifestyle” of sealed, air-conditioned houses—so different from the patio culture of Hawaii and Key West.

It’s impossible to say, at this point, if climate change will move the risks of dengue farther north. Researchers disagree on whether higher temperatures automatically mean bigger mosquito populations, since the insects are also affected by unpredictable changes in rainfall, humidity, and wind. But barring some other factor that no one can foresee, the experts agree: Dengue is coming.

“It may not swamp the entire U.S.,” Adalja acknowledged. “But the entire South already harbors those mosquitoes, and that is bad enough. Dengue shouldn’t have to swamp the entire country for us to make it a priority.”

Mosquito-Borne Disease Alert Issued in Walton County. Florida

In West Nile Virus on December 2, 2012 at 8:12 am

The Walton County Health Department continues its mosquito-borne illness alert for Walton County, Florida. The fourth human case of West Nile Virus (WNV) has been confirmed in Walton County.

The possibility that others may become infected with the virus remains extremely high, and the health department strongly encourages the public to continue to take precautions to avoid being bitten by mosquitoes.

Mosquitoes infected with WNV can bite and infect humans. About one in 150 people infected with WNV will develop serious illness. Symptoms of West Nile Virus may include headache, fever, fatigue, dizziness, weakness and confusion. Those individuals who develop a fever or other signs of illness following a mosquito bite should consult with their health care provider. Health care providers should contact either health department if they suspect an individual may be infected with a mosquito-borne illness.

The easiest and best way to avoid WNV is to prevent mosquito bites. The best preventive measure for residents living in areas infested with mosquitoes is to eliminate the places where the mosquito lays her eggs, primarily artificial containers that hold water.

US West Nile outbreak second-worst at more than 4,500 cases

In Uncategorized, West Nile Virus on October 21, 2012 at 7:40 pm

By Marice Richter

DALLAS Oct 17 (Reuters) – The number of West Nile virus cases across the United States has topped 4,500, with another 282 cases reported last week, making 2012 the nation’s second-worst year on record for the mosquito-borne disease, government figures showed on Wednesday.

The Centers for Disease Control and Prevention said 4,531 cases have been reported this year, the highest number since the record outbreak of 2003, when 9,862 cases were reported.

Another 15 deaths from the disease were reported last week, bringing the total to 183, the CDC said.

Almost 70 percent of the cases have been reported in eight states: Texas, California, Louisiana, Mississippi, Illinois, South Dakota, Michigan and Oklahoma. More than one-third were in Texas, with Dallas-Fort Worth at the center of the outbreak.

Just over half of the cases reported to the CDC this year have been of the severe neuroinvasive form of the disease, which can lead to meningitis and encephalitis.

The milder form of the disease causes flu-like symptoms and is rarely lethal.

West Nile Virus Leaves Man Disabled Years after Bite

In Uncategorized, West Nile Virus on October 2, 2012 at 2:08 pm



In northwest Indiana, where I have raised vegetables for 20-odd years, mosquitoes flourish when rain fills the swamp pools in the backwaters of the Kankakee River.

In August 2004, those pools spawned a particularly righteous throng. One afternoon, they found me. I had unzipped my bug-protection hood to write some notes about what I was planting. Bitten sharply on the chest, I slapped and missed. Then I was lanced on the left temple. That was her last act. The gangly bug lay flat on my palm — and so began my odyssey into the world of West Nile that even eight years later is not entirely concluded.

The Centers for Disease Control and Prevention says this year is the worst summer for West Nile virus since the disease arrived in the United States, probably in 1999. If so, my tale is a cautionary one.

A week after being bit by that mosquito, I was at a cooking conference in Vermont, working 10-hour days cutting vegetables, joking around the kitchen, making new friends. The third day, I woke with a fever and ached deeply in my bones. I figured it was a bizarrely ferocious flu.

Two days later, I had a temperature of 104, was losing the ability to walk and suddenly realized that I could not move my left arm. The friends who drove me to the hospital had to all but carry me into the emergency room. Within two hours, I had been X-rayed, CT-scanned, MRI’ed, and spinal-tapped. The tests showed extremely high white blood cell counts. There were lesions on my spinal cord, and the virus had caused my brain to swell: I had encephalitis.

As the doctors theorized about Lyme disease or a rampant herpes virus, I remembered that vicious bite of 10 days earlier and placed my bet that it was West Nile. Sure enough, there were West Nile antibodies in my spinal fluid, and the doctors put me on a serious regimen of steroids and antibiotics. Within a few days, both arms were flaccid and my legs began to fail me.

My wife and friends were at my side, but I recall little of those first days other than being stunned by this new life situation. I’d had sports injuries in the past but had never been in a hospital, rarely visited doctors and secretly applauded myself on my innate good health. Now, I could barely move. I was a spry 47 year old and could barely move. Adding to that, the medical community seemed to share the same sense of bewilderment I felt. There was no regimen of pills, no shot, no miracle cure.

The nurses became my heroes. I lived in a new world of urinals and wheelchairs, sleeplessness and a slide into more paralysis. All I had to rely on to deal with my new condition was my sense of humor and truisms that my father had cheerfully passed on to me and my siblings from his Kansas childhood during the Depresssion: “Nobody ever said life was fair” and “A little rain must fall.”

Doing me in

The virus, or my own immune system’s punch-drunk response — the doctors weren’t certain — was still killing nerve cells. Pain was rarely a big problem, but the illness was doing me in quietly and stealthily.

My physical therapy was canceled because I could no longer walk. My farm muscles were melting away. As bones settled and ligaments let go, my hospital bed became a rack where I found no comfort. Sleep came a few hours at night, medication useless.

The lowest moment came during an attempt at showering a few weeks into my illness. A sweet and tough older nurse was trying to spray me down when I slumped off the shower chair, feeling so weak that I asked to return to bed. As I passed a mirror, supported in her arms, I saw the shrunken person I was now. I remembered my father’s body ravaged by cancer: spindles for limbs, a pathetic little belly, eyes shrunken and dull. I lay there and cried off and on for the next few days.

I lost 40 pounds during that first month, though they fed me double rations. I began to feel real fear.

The anterior horn nerve cells at the top of the spinal cord that controlled my muscles — the same cells attacked in polio and Lou Gehrig’s disease — were dying. My body was so unsupported by tissue and muscle that my shoulders threatened to dislocate. My arms flopped over the side of the bed. I could barely speak. My lungs struggled in my sallow chest.

It seemed incredible: A persistent mosquito had followed nature’s prerogative and brought me to this. According to the CDC, the disease first identified in Uganda in the 1930s had traveled thousands of miles within a bug and alighted in New York 13 years ago. Birds became the vector for the virus, migrating and spreading disease throughout the country. This summer, the virus has sickened people innearly every state.

Feeling as if I had failed my caregivers, my family and myself, I focused my hopes on getting to Chicago and its world-renowned rehabilitation hospital. Chicago was home when I was not on the farm, and I had all the resources of family and friends there to count on. By mid-September, after five weeks of treatment brought no improvement, I was flown out of Vermont by air ambulance and started rehab the morning after my arrival.

A therapist strapped my hands to a sort of elevated bicycle wheel that I was supposed to crank, and she moved on to other patients. I still recall the look of surprise and muted frustration on her face when she returned a few minutes later to find my arms fallen uselessly out of the contraption, the flaccid muscles hopeless for this mode of therapy.

I was in the post-polio division, tended to by neurologists as famous as world-class athletes and by nurse’s aides who fed me, cleaned me from stem to stern and taught me not to buzz too often, especially at night. My siblings flew in to visit, sit by my bedside, read to me and roll my wheelchair to the park down the street. My son, 11 at the time, and my wife bravely endured, willing me to keep my spirits up, feeding me on little doses of love, salted with humor.

I fended off the psychiatrist obsessed with putting me on antidepressants and overruled proposed 3 a.m. shots of blood thinner that was supposed to keep me from dying from a blood clot. There was no real therapy, just visits from young and shiny residents intrigued by my strange, slowly deteriorating condition. My doctors were stymied and began planning to discharge me — in theory, to somehow gain the strength at home to return for therapy.

Then my older sister, a scientist and Internet bloodhound, found a new source for information and guidance: a doctor in Jackson, Miss. Neurologist Arturo Leis of the Methodist Rehabilitation Centerhad treated as many cases of West Nile as anyone in the country. She persuaded my reluctant doctors to consult him.

And then I heard Leis’s voice on the speakerphone explaining that I should no longer be getting weaker as a result of the virus alone and that my symptoms suggested that some secondary, dangerous process was killing more nerve cells. He advised massive doses of IV steroids. My doctors quickly agreed, wordlessly forgetting their plan to send me home.

Going home in a wheelchair

It was autumn when I finally left rehab and saw Lake Shore Drive again, sitting in my wheelchair aboard the ambulance taking me home. The lake was bluer than I remembered amid the sere of late summer, with yellowed grass and tumbling leaves. My wife and son were waiting, soon joined by Bouma, a towering man from Mongolia who for months would be my caretaker.

The steroids brought the first, timid signs of recovery. Faint nerve signals moved muscles even as I called myself “baloney on a slab” and knighted my useless left hand “the claw.” I still could not sleep, overspilled my urinal nightly and came to understand more plainly the value of an enema.

My son said a soft goodbye each day on his way out to school. I would cry sometimes when he left, trying instead to think about my father’s homespun admonitions, my wife’s constant efforts to help me heal and the underpaid heroes who had tended to me in Vermont and Chicago.

I started outpatient therapy and saw an acupuncturist whose needles and herbs rallied my hope. And then one December night at home, in a foul mood, I demanded that someone help me out of my wheelchair — and jerked myself up and tottered a few feet to the table. I started to be able to walk again.

As uncalled and silent as the virus when it crept in, so my recovery began.

West Nile’s aftereffects

The mosquitoes are still multiplying in the heat out in the country. Hurricane Isaac’s remnants provided them with one final birthing bonanza before their demise in the season’s first hard frost.

The CDC, meanwhile, advises that immunity to West Nile for those who have been exposed to the virus should, in most cases, be lifelong.

Although I have regained fairly robust health and returned to farming, my left arm has little strength and my shoulders and upper back have only half the muscle they had before 2004.

I visited Art Leis in Mississippi about five years ago. He tested my nerves and muscles, evaluated my whole history, and stated that my case of West Nile was one out of 30,000: I had been too healthy to get so sick, I had been too sick to recover so well. There was still no certainty as to whether the virus alone ravaged me or whether my own immune system had joined the attack.

Of the more than 3,500 cases of West Nile reported to CDC in this record-setting year, a little more than half developed into encephalitis, meningitis or another disease classified as “neuroinvasive” such as mine. All these years later, I continue to recover, feeling my shoulder blade reattach and surprising myself by sprouting a miniature triceps on my left arm.

Strange as it might seem, because of all that I have learned about myself and my place in the world — where I have been carried by strangers who became heroes and by family and friends — I would not trade these lessons even to be made whole again.

When he’s not working on his organic farm, Shane is a chef in Chicago

Disease-Spreading Ticks on the Move as Climate Changes

In Lyme Disease, Uncategorized on September 9, 2012 at 11:15 am
Posted by David Braun of National Geographic in Tales of the Weird on September 7, 2012
A female blacklegged tick converting its blood-meal into thousands of eggs. Credit: NSF/Graham Hickling, University of Tennessee

A female blacklegged tick converting its blood-meal into thousands of eggs. Credit: NSF/Graham Hickling, University of Tennessee

One more reason to be nervous about climate change: Tick species are on the march.

The blood-sucking, disease-spreading parasites are expanding into new territories as wildlife populations, forest habitats and weather patterns change across North America, biologists have found.

“This year’s mild winter and early spring were a bonanza for tick populations in the eastern United States,” the National Science Foundation said today. “Reports of tick-borne disease rose fast.”

While Lyme disease is the most common tick-borne disease in the Northeast and Upper Midwest, new research finds that it is not the greatest cause for concern in most Southeastern states, the NSF said in a news statement about a research paper in the journal Zoonoses and Public Health.

“The majority of human-biting ticks in the North–members of the blacklegged tick species–cause Lyme disease, but these same ticks do not commonly bite humans south of mid-Virginia,” the NSF explained.

Biologist Graham Hickling of the University of Tennessee, co-author of the Zoonoses and Public Health paper, says many patients in Southeastern states, who become sick from a tick-bite, assume they have Lyme disease, but the odds of that being the case are low.

“Ticks in the eastern U.S. collectively carry more than a dozen agents that can cause human disease,” says Hickling.

“Here in Tennessee we regularly collect lone star ticks that test positive for Ehrlichia, [a tick-borne bacterial infection]. Lone stars are an aggressive species that account for most of the human bites that we see in this region. So ehrlichiosis has to be a big concern, yet most people have never heard of it.”

In contrast, explains Hickling, there have been no confirmed reports to date of the Lyme disease pathogen among the sparse populations of blacklegged ticks found in Tennessee.

Spotted Fever Rickettsiosis and Ehrlichiosis

“The Southeast is dominated by different tick species than the ones that attack humans in the North,” says Ellen Stromdahl, an entomologist at the U.S. Army Public Health Command and lead author of the paper.

“The lone star tick is by far the most abundant tick in the Southeast, and which species of tick bites you is critical because different ticks carry different diseases. In the Southeast you are unlikely to be bitten by the blacklegged ticks that spread Lyme disease,” Stromdahl says.

Most bites in the Southeast are from the tick species that spread spotted fever rickettsiosis and ehrlichiosis, but not Lyme disease, the NSF said. “A complicating factor for public health officials is that tick species are on the move, as wildlife populations, forest habitats and weather patterns change across the continent. This spring the Tennessee Department of Health, for example, reported a 500 percent increase in tick-borne rickettsiosis.”

“Identifying health risks in the face of changing climates will be critical in coming years.”

“Identifying health risks in the face of changing climates will be critical in coming years,” says Sam Scheiner, National Science Foundation program director for the joint NSF-National Institutes of Health Ecology and Evolution of Infectious Diseases (EEID) program, which funds Hickling’s research. This study will inform public health officials about what diseases are found in which areas, so they can minimize human health problems.”

Hickling’s work is also in collaboration with scientist Jean Tsao of Michigan State University and is part of an EEID project to identify the ecological factors leading to distributions of tick species and pathogens–in particular, where the Lyme disease tick and pathogen are found.

Lyme-infected blacklegged ticks are expanding south through Virginia, and lone star ticks are moving north, the NSF said in its statement. “The bite of the lone star tick can create a bulls-eye rash that appears like that of Lyme disease, but the rash isn’t caused by the Lyme bacteria. The scientists say that this almost certainly leads to misdiagnosis of some patients in mid-Atlantic states, where both tick species are common.”

The best way to distinguish Lyme from other tick-borne diseases is to be vigilant for tick bites, and whenever possible save any tick that manages to bite you. “Store the tick in your freezer or in a vial of alcohol so it can be identified if you become ill,” the NSF recommends.

Nymphal Blacklegged Ticks of the Northeast

In the Northeast, the NSF release explained, Lyme disease awareness campaigns have focused public attention on the nymphal blacklegged tick–which is responsible for most disease transmission and which is tinier than the adult form. “While nymphal blacklegged ticks and nymphal lone star ticks–which also bite humans–can be distinguished, the two are often confused by the public. In one study, 13 of 20 patients reporting tick bites to physicians were given antibiotics on the assumption that they were at risk for Lyme disease, yet 53 of the 54 ticks removed from those same patients were lone star ticks, which do not spread Lyme disease.”

“Where you live determines which tick species is likely to bite you.”

“Where you live determines which tick species is likely to bite you,” says Tsao, “and therefore which diseases you’re most likely to contract.”

The NSF says biologists are happy that recent treatment recommendations have begun to emphasize the importance of considering the tick species and its infection status as part of the diagnostic process. “Their advice: Stay open-minded about which tick-borne diseases are most common in your area–and save the tick that bites you.”

This blog post was based on publicity material provided by the National Science Foundation, an independent federal agency that supports fundamental research and education across all fields of science and engineering.

Lyme Disease

(From the Centers for Disease Control and Prevention)

The Lyme disease bacterium, Borrelia burgdorferi, is spread through the bite of infected ticks. The blacklegged tick (or deer tick, Ixodes scapularis) spreads the disease in the northeastern, mid-Atlantic, and north-central United States, and the western blacklegged tick (Ixodes pacificus) spreads the disease on the Pacific Coast.

Ticks can attach to any part of the human body but are often found in hard-to-see areas such as the groin, armpits, and scalp. In most cases, the tick must be attached for 36-48 hours or more before the Lyme disease bacterium can be transmitted.

Most humans are infected through the bites of immature ticks called nymphs. Nymphs are tiny (less than 2 mm) and difficult to see; they feed during the spring and summer months. Adult ticks can also transmit Lyme disease bacteria, but they are much larger and may be more likely to be discovered and removed before they have had time to transmit the bacteria. Adult Ixodes ticks are most active during the cooler months of the year.

A Run on Bug Spray Amid Fears of West Nile Virus

In Uncategorized, West Nile Virus on August 26, 2012 at 9:25 am

One bottle of mosquito repellent was all that remained at a Dougherty’s Pharmacy in Dallas.


Published: August 24, 2012

DALLAS — If there was an aroma that defined life in this city, maybe it was the scent of chicken-fried bacon and other exotic deep-fried specialties at the annual State Fair of Texas. Maybe the city smelled like football, or steakhouses, or money, or some combination thereof.

Mark Graham for The New York Times

Katharyn DeVille, who was hospitalized after being bitten by a mosquito, said, “I have migraines, and this was worse.”

But these days, there is something new in the air, and it is everywhere: the sweetly pungent odor of spray-on mosquito repellent.

As the city and its nearby suburbs cope with a deadly outbreak of West Nile virus, the bug-spray shelves of convenience stores and pharmacies are emptying out. In the upscale neighborhood of Preston Hollow, a section of Aisle 3A at Dougherty’s Pharmacy was nearly bare: 87 out of a stock of 88 bottles of OFF! had sold.

“OFF! is the new Chanel No. 5 around here,” said Carol Reed, a longtime political consultant whom D Magazine once dubbed the No. 1 Dallas insider. “I now put on insect repellent the same way I do sunblock. But we are Texans, so we fight something every summer.”

State health officials confirmed that since June 1, 640 people have been infected with West Nile, 23 of whom have died. Dallas County is the epicenter of the mosquito-borne illness that has spread across Texas and other parts of the country. Ten people have died in Dallas County and more than 200 others have been sickened, the highest number of West Nile-related deaths and infections of any county in the United States.

In addition, state officials are investigating but have not yet confirmed three other possible West Nile-related deaths, including one in Dallas County.

In response, the mayor of Dallas has declared a state of emergency, low-flying planes have waged an aerial pesticide assault and slow-moving trucks have sprayed on the ground.

One day last week, the Texas Poison Center Network experienced a spike in calls statewide, receiving the most calls in a single day since a 2007 peanut butter recall. Out of 1,491 calls, 716 were from people concerned about West Nile virus and the pesticide spraying.

“We have had calls from people saying, ‘O.K., I have a bunch of mosquito bites and I’m nauseous, what does this mean?’ “ said Melody Gardner, director of the North Texas Poison Center at Parkland Memorial Hospital in Dallas, which handled most of the 716 calls.

At another hospital, Methodist Dallas Medical Center, there have been a couple of cases of people who were bitten by mosquitoes rushing to the emergency room and bringing the suspected culprits with them, in the hopes of getting the insects tested for West Nile, a hospital spokeswoman said.

And yet, despite the fatalities and the nearly $3 million countywide spraying operation, the outbreak has not caused widespread panic. Many of those who have died were elderly men and women who had underlying conditions, a fact that many residents recite as the reason for only mild alarm.

People still sit outdoors at cafes and restaurants in shorts and T-shirts, and joggers still huff down the sidewalks before dusk, fearing neither mosquito nor chemical agent. Two days after declaring a state of emergency, Mayor Michael S. Rawlings was in downtown Dallas to see the musical “Chicago.”

Amid the sunshine on Thursday afternoon, many of those running and walking along the popular Katy Trail here were doing so without the aid of bug spray.

“I could care less,” said Josh Tucker, 36, a financial analyst for a real estate company who was deep into a three-mile-plus jog. “For the most part, I think it’s overblown.”

The Dallas-Fort Worth area is a sprawling 12-county region that is home to more than six million people and is known by its labyrinth-sounding nickname, the Metroplex. If any good has come of the outbreak, then perhaps it has succeeded in shrinking the Metroplex to a more small-town scale, uniting residents of different cities and incomes the way blizzards and blackouts often unite New Yorkers.

In Dallas, many people know someone who has gotten ill or has died, and many more know someone who knows someone.

“I was getting my hair cut last week,” said Roy W. Bailey, the chief executive of a private equity firm who lives in Preston Hollow. “My barber has two customers who have died. That really just slaps you in the face. This is real. This is not something that people are just blowing off.”

Jacqueline DeVille, 8, knows someone affected by the virus, too: her mother, Katharyn DeVille, who spent eight days in a hospital after getting bitten by a mosquito in the family’s backyard in the suburb of DeSoto. Mrs. DeVille, 42, was not sure what she was doing the moment she was bitten.

“I was just doing regular stuff, swimming and probably cooking out,” Mrs. DeVille said. ”There were some days when we would all notice that we would start slapping ourselves, because something was biting.”

It all started July 30, when Mrs. DeVille felt as if she had the flu. Then her fever climbed and she got the chills. She went to a clinic, which sent her to a hospital emergency room in Dallas. The doctor there told her not to worry, and blood tests came up negative, she said.

But nobody knew what was wrong with her, and by that time she had broken out in a rash. By Aug. 8, she kept getting worse, and a severe headache crept up. “It was like an ax in my head,” she said. “I was miserable. I have migraines, and this was worse.”

The next day, Mrs. DeVille went to the emergency room at Methodist Dallas Medical Center, where she was admitted and told she had West Nile and other complications.

“Oddly, I was kind of relieved,” she said, tears welling up in her eyes. “A, it had a name. And B, I knew I wasn’t contagious to any of my family members, and that was really important to me.”

Mrs. DeVille had lost, in a sense, a month of her life, celebrating her birthday in bed, missing her daughter’s first day of school. She does not venture much into her backyard since being released last Friday, and worries that too many people have an ‘It wouldn’t happen to me’ attitude.

“I think that if we’re all cavalier like that, when people around us are getting sick, if you don’t at least get a can of OFF! and keep it handy, just give yourself that chance not to get sick,” she said. “Because, believe me, you don’t want this.”

On Thursday evening, Mrs. DeVille relaxed at home on the sofa, her daughter by her side. Her phone was in arm’s reach, as was a bottle of mosquito repellent.

NYT: West Nile Hits Hard Around Dallas, With Fear of Its Spread

In West Nile Virus on August 18, 2012 at 12:45 pm

By  and 

DALLAS — An outbreak of West Nile virus has engulfed Dallas County, with nearly 200 cases of human infection and 10 deaths, leading the mayor of Dallas to declare a state of emergency and to authorize the first aerial spraying of a pesticide in the city since 1966.

The high number of infections and deaths from the mosquito-borne disease marks the nation’s worst outbreak of West Nile in a year that has already logged a record number of cases across the country. The virus has become endemic in the United States since the first outbreak in 1999.

An official with the federal Centers for Disease Control and Prevention said the Dallas-area outbreak was probably a harbinger of a larger spread of the virus into other parts of the country. In Cook County, Ill., which includes Chicago, human cases of infection rose steadily this week, from 5 on Monday to 8 on Wednesday to 10 on Thursday, though no deaths had been reported, the authorities said.

Texas officials say the statewide death toll so far is 17, the most West Nile-related fatalities of any state.

In a report, the C.D.C. said that as of Tuesday, 693 cases of infection had been reported nationwide. Louisiana had six deaths, according to the report, and no other state had more than one.

“With this huge outbreak in Texas, the jury is still out on what’s going to happen with the rest of the country,” said the official, Dr. Lyle R. Petersen, director of the C.D.C.’s Division of Vector-borne Infectious Diseases. “But in Chicago, we’ve already observed high numbers of West Nile virus-infected mosquitoes. This is looking like a large regional event. We don’t know if the number of cases is going to drastically increase, but we do expect more cases.”

And yet, as local and state officials have stepped up their efforts to fight West Nile in the Dallas area, there has been a kind of backlash, with many residents growing more concerned about the aerial spraying than the virus itself.

More than 1,700 people signed an online petition on calling on Dallas officials to stop the spraying, describing it as ineffective, unsafe and harmful to insects like honeybees and ladybugs. A number of other cities in Texas and around the country do aerial spraying to reduce their mosquito populations — including New York, which recently sprayed over uninhabited wetlands on Staten Island — but this is the first time Dallas is doing so in more than 45 years.

Though officials in Dallas describe the procedure as safe and effective, they have added to some residents’ worries by advising those concerned about exposure to avoid being outside, close their windows and keep their pets inside while spraying occurs. “I think residents need to take the precautions that they’re comfortable with,” said Frank Librio, a city spokesman.

The aerial spraying was to begin Thursday at 10 p.m. in a 106,000-acre section of the city and county, including the wealthy areas of University Park and Highland Park. Twin-engine planes flying about 300 feet above the ground will spread a pesticide called Duet to kill the adult mosquito population.

Duet has been approved by the federal Environmental Protection Agency for ground and aerial use in outdoor residential and recreational areas, and it is similar to the pesticide the city has been using as part of a truck-mounted spraying operation it began in June. The last time Dallas conducted aerial spraying was in the summer of 1966, to combat an outbreak of St. Louis encephalitis, a mosquito-borne infection. That outbreak killed 14 people in the county.

The spraying operation this time is being led — and paid for — by the state. More than half of the human cases of infection in the United States this year are in Texas, which has confirmed more than 400 cases statewide.

More planes are scheduled to spray Friday night and possibly over the weekend. “The disease poses an immediate public health threat to Dallas County,” Dr. David Lakey, the commissioner of the Texas Department of State Health Services, said in a statement. “We need to use all possible tools, including aerial spraying, to fight this outbreak.”

Five of the 10 deaths in the county occurred in Dallas, the third-largest city in Texas, with a population of 1.2 million. Mayor Michael S. Rawlings declared the state of emergency on Wednesday, one week after officials issued a similar declaration for Dallas County. Dallas officials have asked the state to spray the entire city.

Dr. Petersen with the C.D.C. said it was difficult to say why the Dallas area has had such a severe outbreak, but he said that the early spring and the hot summer were likely culprits, because heat affects factors like mosquito abundance. Hot weather both increases the mosquito population and causes more of the virus to build up in their salivary glands.

“That summer in New York City when it was discovered in this country — 1999 — was a very hot summer,” Dr. Petersen said. “In 2002, 2003, when it was all over the U.S., it was abnormally hot. We had an early spring and abnormally hot weather this year, so that could be a factor.”

A spokeswoman for the New York City health department, Alexandra Waldhorn, said the city had only 3 cases so far, with only 11 in all of last season.

At 10:16 p.m. in University Park, a low-flying plane with two misty trails streaming behind it flew over James Smith, 41, who stood with his girlfriend on a shop-lined street near Southern Methodist University. He had no reservations about being outside.

“I think whatever the risk may be, if there’s any, it’s outweighed by the risk of the mosquitoes that are infecting people,” he said. “There’s a lot of things out there that can kill you. I don’t think this is one of them.”

Manny Fernandez reported from Dallas, and Donald G. McNeil Jr. from New York.

This article has been revised to reflect the following correction:

Correction: August 17, 2012

An earlier version of this story referred imprecisely to mosquito-control efforts on Staten Island. The city sprayed in some uninhabited wetlands, not in residential areas

West Nile Outbreak Grows, nearly 700 cases reported

In Uncategorized, West Nile Virus on August 18, 2012 at 12:41 pm
Posted: Aug 15, 2012 4:40 PM EDT
Updated: Aug 18, 2012 7:00 AM EDT
(NBC) – West Nile virus is spreading faster than it has in previous summers.

The number of cases now nears 700, with nearly 30 deaths reported.

Jordan Connor, 14, of Texas is home from the hospital, recovering from a severe West Nile infection that led to encephalitis – inflammation of the brain.

She’s young and strong enough to recover.

Others, especially elderly patients, have not been as lucky.

Betty West’s husband of 65 years was the first one in North Carolina to die of the mosquito-borne disease this season.

“He had gotten so weak, we could barely get him out of the house,” she said.

Climate experts say the mild winter and rainy spring became the perfect breeding ground for mosquitoes, who get the virus from birds.

Although mosquitoes thrive on standing water, the drought has added to the problem.

“With fewer water sources, mosquitoes and birds find themselves closer together,” said Vanderbilt University’s Dr. William Schaffner.

So it’s been easier for mosquitoes to get infected, then transmit the virus to people.

Experts recommend using insect repellent outdoors, draining areas of standing water, and wearing long sleeves and pants when outside at dawn and dusk, when mosquitoes are most active.

Most West Nile victims have no symptoms and recover quickly.

‘Robo-mosquitoes’ in Margaritaville?

In Dengue Fever, Lyme Disease, Uncategorized on August 13, 2012 at 8:43 am


Most Europeans see the United States as the land that embraces genetic engineering. So imagine the surprise when a British firm — Oxitec — ran into the buzz saw of public opinion trying to introduce a genetically modified (GM) mosquito in Key West to eradicate the dreaded Dengue virus.

Within a few weeks of a public meeting to discuss the mosquito release, a petition against the initiative had more than 100,000 signatories. [The entire population of Monroe County, which encompasses The Keys, is only about 75,000.] Key West inhabitants have branded Oxitec mosquitoes with names like “Robo-Frankenstein mosquitoes,” “mutant mosquitoes,” and “Super bugs,” using rhetoric lifted from movies like Jurassic Park and The Hunger Games.

Are people overreacting? Maybe. But a closer read of many of the comments posted on the petition website provide a deeper insight into the resistance and some key lessons for future technologies dependent on genetic engineering.

•  Trust. Whether the public trusts new technologies often depends on whether the public trusts their developers or those responsible for ensuring public safety. The comments contain numerous references not just to Oxitec, but to agriculture giant Monsanto, the Food and Drug Administration (FDA), and British Petroleum: “I am fed up with Monsanto and other biotech companies,” said one.

Given the complexity of most emerging technologies, many people will fall back on this simple trust test, and most corporations, and increasingly, government organizations, will lose.

•  Nature. Many people saw the GM mosquitoes as a violation of nature’s order, commenting, “Why do all these big companies all seem to think that they know what’s better than Mother Nature?” “You can’t mess with Mother Nature and not have something bad happen; they don’t know what they’re doing!”

Commenters pointed to a number of examples, including invasive species common in Florida, such as the melaleuca plant (originally introduced to dry out swampy land) and giant pythons, and other unwelcome visitors like Africanized honeybees, the Mediterranean fruit fly (a scourge in California) and Asian beetles and carp. People emphasized that a true “test release” is impossible. “Once living organisms are released into the environment they cannot be recalled, nor do we know what results and impacts may occur,” one commenter said.

•  Permission. Decades of research on risk perceptions have shown that people differentiate between “voluntary” risks, which we willfully undertake, and “non-voluntary” risks, which are imposed upon us. People will smoke themselves to death while fighting against a nearby factory emitting pollutants.

In this case, Key West inhabitants clearly saw the government and the company imposing their will on the population. “We were never asked if we wanted GMOs released into our environment . . . there is very little democracy left if we have no voice,” one commenter said. Another asked, “Who wants to be a human Guinea pig?” Another added, “We are not lab rats!”

Interestingly, the other side of the risk equation, Dengue fever, was never mentioned. This may be because the actual number of cases in Florida totaled seven in 2011 and 58 in 2010, according to the Centers for Disease Control and Prevention. In the tropics and subtropics, as many as 100 million people are infected yearly, but for many people in Florida, Dengue fever is an abstraction; Oxitec and their mosquitoes pose the risk.

Clearly, there was a significant lack of information about impacts and uncertainties in the Key West case. Some people asked: “Where is the unbiased, third-party, peer-reviewed research on effectiveness and safety of GM mosquitoes?” But given the biases, trust deficit, and dynamics of the situation, it is doubtful whether more information would have reduced public opposition.

As scientists work on more dramatic modifications of organisms in areas like synthetic biology, the Key West case should serve as a lesson, as should the growing public opposition to GM foods in states like California, Michigan, Oregon, Washington and Vermont.

Getting the science right won’t help if we get the public engagement wrong.

David Rejeski is the director of the Woodrow Wilson International Center for Scholar’s Science & Technology Innovation Program. Eleonore Pauwels is a research scholar with the program.

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