According to the Nassau County Health Department, at least one dead crow found in the Village of Garden City was among a number of birds found throughout the county that tested positive for West Nile Encephalitis. As the number of humans diagnosed with the disease in the NY metropolitan area looms toward 40, residents' concerns and questions about the disease increase. Garden City Life spent the weekend researching materials on the subject through the Centers for Disease Control, Kids Health Organization, and Medical Reference Library Online. (Information from the search follows news on the spraying issue within this story.)

Last weekend, attorney Thomas Liotti pushed for an injunction against the planned aerial spraying of Anvil, a pesticide substitute for Malathion, a neuro-toxin. State Supreme Court Justice Leonard Austin ordered the county to prove its spraying efforts were legal Monday at 2 p.m. and stopped the county from conducting spraying before that time.

Plans to spray at press time were for between 5 p.m. and 11 p.m. in central Nassau on Tuesday, southern Nassau on Wednesday, and northern Nassau on Thursday (as weather on Monday prevented spraying). Rain, wind, and fog for example prevent pilots from being able to spray, so the schedule, if allowed to go forward by the judge, can be altered because of nature.

As of press time the judge had still not returned with a verdict either allowing or prohibiting the County to spray. News reports on the radio as this paper was going to press were already announcing the spray schedule, demonstrating the county's confidence that the judge would rule in their favor. Caroline Smith of the county press office did say Monday afternoon, "We are confident that we will win and commence aerial spraying Tuesday night as planned."

The county had planned to spray Anvil at .62 ounces per acre. According to the Environmental Defense Fund Scorecard, Hexaconazole (Anvil) is suspect, but not a recognized carcinogen and there are data gaps in subjects like inhalation non-cancer risk value. There are gaps in the regulatory coverage in terms of the National Ambient Air Quality Standard and National Water Quality Standard.

Superintendent of Schools Dr. Stephen Leitman in Garden City says that all playground equipment will be washed down after any and all spraying to ensure the safety of children on school playgrounds. Garden City Recreation Commissioner Paul Blake spoke with Garden City Life and said that Village playgrounds would be closed at 4 p.m. on the day of spraying and remain closed the following day while staff members soap, wash and hose down all of the playground equipment at all Village playgrounds. The county has advised the Village to keep sand areas closed for 48 hours after spraying, which means all equipment in or on sand, as well as sand box areas will be closed for 48 hours following spraying.

According to the Centers for Disease Control and Prevention, West Nile Encephalitis is a flavivirus commonly found in Africa, West Asia and the Middle East and is transmitted by the bite of a mosquito, primarily the Culex species. The CDC website states, "Mosquitoes become infected by feeding on birds infected with the West Nile virus. Infected mosquitoes then transmit the West Nile virus to humans and animals when taking a bloodmeal. West Nile Encephalitis is not transmitted from person-to-person. There is no evidence that a person can get the virus from handling live or dead infected birds. However, avoid bare-handed contact when handling dead animals, including dead birds. Use gloves or double plastic bags to place the carcass in a garbage can." Anyone who finds a dead bird that does not appear to have been injured is urged to contact the Nassau County Health Department at 571-8707.

The CDC also reports, "Infected mosquitoes are the primary vector for West Nile virus and the source of this outbreak. Ticks have been found infected with West Nile virus in Asia and Africa. Their role in the transmission and maintenance of the virus is uncertain. However, as it relates to the New York area outbreak, ticks have not been implicated as vectors of West Nile virus. It is not known how long West Nile virus has been in the U.S., but CDC scientists believe the virus has probably been in the eastern U.S. for several months, possibly longer. The virus found in NY is genetically related to West Nile virus, but because of genetic differences, it may be a new subtype of West Nile virus. Laboratory testing to confirm this continues. No cases have previously been reported in the U.S. prior to September 1999. No reliable estimates are available for the number of cases of West Nile Encephalitis that occur internationally."

Previously, in other areas of the world, birds reportedly infected did not die from the disease, but here in NY the link between the deaths of birds and the disease seems clear. Until a freezing temperatures can kill off the mosquitoes, the threat of infection continues, despite efforts to spray and ward off mosquitoes with DEET. As all residents are at risk for becoming infected, concern remains high.

According to Marjorie Lazoff, M.D., medical editor for Medical Computing Today, Encephalitis is "an inflammation of the brain parenchyma." encephalitis "presents as a diffuse and/or focal neuropsychological dysfunction. From an epidemiological and pathophysiological perspective, it is distinct from meningitis although clinically the two often coexist with signs and symptoms of meningeal inflammation" she explains. Lazoff also explains, "Once across the blood brain barrier, the virus enters neural cells, with the resultant disruption in cell functioning, perivascular congestion, hemorrhage and inflammatory response diffusely affecting gray matter disproportionate to white matter."

Lazoff states, "The classic presentation is encephalopathy with diffuse or focal neurological symptoms including the following: behavioral and personality changes, decreased consciousness; stiff neck; photophobia; lethargy; generalized or localized seizures; acute confusion or amnestic states; less common and dramatic symptoms include headache and other complaints of meningismyms."

According to Kids Health Organization, "In infants it is harder to detect some of these symptoms, but there are still some important signs to look for: vomiting; a full or bulging 'soft spot' (fontanelle); and crying that doesn't stop (intractable crying)." They also explain that in addition to mosquito-borne forms of the virus, "Milder forms of encephalitis can follow or accompany common childhood illnesses, including mumps, measles, chicken pox, and mononucleosis. For example, about one out of every 1,000 persons with measles will develop a measles encephalitis, which begins four to seven days after the measles rash appears."

KHO also reports, "Since antibiotics are not effective against viruses, they are not used to treat encephalitis. However, antiviral drugs, like acylovir, can be used to treat some forms of encephalitis, especially the type caused by the herpes simplex virus. Corticosteroids may also be used to reduce brain swelling. If your child has severe symptoms of encephalitis, your doctor will probably order blood tests and a lumbar puncture (spinal tap) to remove some spinal fluid for testing. A special brain scan (an MRI or a CT scan) may also be necessary. After treatment for severe encephalitis, physical therapy or speech therapy is sometimes needed to help a child fully recover from the illness."

Parents should call their pediatricians, according to the Kids Health Organization, when "your child has any of the following symptoms: severe headache, convulsions (seizures), stiff neck, inability to look at bright lights, double vision, difficulty walking, problems with speech or hearing, difficulty moving an arm or leg, loss of sensation anywhere in the body, personality changes, problems in memory, extreme drowsiness, and loss of consciousness."

According to the CDC, "Case fatality rates" for West Nile virus specifically, "range from 3 percent to 15 percent (higher in elderly than in younger age groups). There is no specific therapy. Intensive support therapy is indicated for more severe cases. There is no documented evidence that a pregnancy is at risk due to infection with West Nile virus." The CDC reports that the incubation period is usually 5 to 15 days and the Kids Health Organization reports that the acute phase of the illness usually lasts from a few days to one week. Recovery usually takes about three weeks. Some cases require hospitalization.

Residents can call the Nassau County Health Department at 571-8707, 571-8708, or 573-7055 for more information or the State Health Department at 1-888-697-4234.