NKS WESSMAN

Since a “depressed horse” tipped the Mississippi State Department of Health (MSDH) to the presence of West Nile virus (WNV) in Mississippi in 2001, the state has consistently — except for 2003 — reported two or three times the national case rate.

Interim state health officer Dr. Ed Thompson said the number of cases per 100,000 population soared in 2002, dipped the following year, increased to about twice the national case rate in 2004 and 2005, then skyrocketed in 2006. MSDH reported 70 cases in 2005, 184 cases in 2006, and 100 cases by Oct. 1, 2007, including three deaths.

Interim state epidemiologist Dr. Mary Currier recalled that then staff epidemiologist Dr. Sally Slavinski learned in 2001 from state veterinarian Dr. Jim Watson about a “depressed horse” he had tested for the mosquito-borne illness. Awaiting confirmation that the test for WNV was positive, he alerted public health epidemiologists.

A positive test confirmed the infection — the first evidence of the now resident-year-round mosquito-borne illness in Mississippi. The virus first appeared in the United States in New York in 1999.

Thompson told Joint Legislative Budget Committee members in September that “mosquito season never ends in Mississippi. West Nile virus will continue to be a part of our lives.”

Currier echoed the prediction: “Our climate is warm enough for us to have infections occur throughout the year. We have even had a case occur in January.”

But before Thompson and Currier returned to MSDH in July 2007, public health officials were widely accused and critically questioned about disease reporting practices. Clarion-Ledger Reporter Jerry Mitchell wrote for the Dec. 13, 2006, edition: “Mississippi’s Health Department learned of its first West Nile case in January what CDC officials called a possible predictor of a severe West Nile season. But Health Department officials didn’t warn the public in a news release until July.”

Mitchell reported, “Although West Nile usually strikes in late summer or early fall, officials from the Centers for Disease Control and Prevention say the disease can be transmitted year-round in milder climates.”

During 2006, in Senate Public Health Committee hearings prompted by a 2005 Performance Evaluation and Expenditure Review (PEER) Committee report critical of public health, a Jackson doctor testified that 29 cases of West Nile — most if not all of them in the Hattiesburg area — had gone unreported because MSDH did not follow the necessary procedures to detect the disease.
In 2007, MSDH first reported two WNV cases in March — both in Southwest Public Health District VII, headquartered in McComb. By Oct. 1, the agency had reported cases from some 30 counties, most in central and southern Mississippi.

An Oct. 1 agency news release announced 15 new WNV cases in Adams, Coahoma, Copiah, Hinds (3), Jones, Lamar (2), Lauderdale, Madison (2), Neshoba, Rankin and Scott counties.
Other cases reported earlier occurred in Adams (3), Coahoma, Copiah (2), Covington, Forrest (4), Harrison (4), Hinds (11), Jackson, Jones (4), Lamar (5), Lawrence, Lauderdale (4), Leake, Leflore (4), Lincoln, Madison (20), Neshoba (4), Oktibbeha, Panola, Pearl River (2), Perry, Rankin (10), Scott (4), Smith, Stone, Walthall, Warren (2), Washington, Wayne (2) and Yazoo (2) counties.

Symptoms of WNV infection are often mild or flu-like and may include fever, headache, nausea, vomiting, a rash, muscle weakness or swollen lymph nodes. In a small number of people, infection can result in encephalitis or meningitis, which can lead to paralysis, coma and possibly death.

Public health officials encourage all Mississippians to reduce the risk of contracting WNV and other mosquito-borne illnesses: remove sources of standing water, avoid mosquito-prone areas, especially between dusk and dawn when mosquitoes are most active; wear protective clothing (such as long-sleeved shirts and pants) when in mosquito-prone areas; and apply a mosquito repellent according to the manufacturer’s instructions.


November 2007