Hawaii is getting ready
to battle West Nile virus

By Helen Altonn

After battling to control dengue fever and murine typhus cases in Hawaii, state health officials are not waiting for the West Nile virus to arrive here.

They are planning a surveillance program that involves testing dead birds for the virus, as some other states are doing.

"We're in the process of getting prepared," Dr. Paul Effler, chief of the state Communicable Disease Division, said yesterday.

The virus jumped to New York from West Africa or some other continent in 1999 and began spreading west across the United States, he said. It has been found in birds and people in 34 states and Washington.

Although Hawaii is geographically remote, the risk of it reaching here will go up significantly if it reaches California, Effler said.

West Nile virus, isolated in the West Nile District of Uganda in 1937, is spread to people by infected mosquitoes, according to the Centers for Disease Control and Prevention. They also spread the disease to horses, birds and some other animals.

The disease is not transmitted from animals to animals or by human-to-human contact, but by mosquitoes that become infected by feeding on infected birds.

It is believed that migratory birds might have transported the virus to New York, Effler said.

Travelers carrying the virus could be another source, he said, noting that is how the recent dengue fever outbreak began here.

State and public health officials met this week with colleagues in the state Department of Agriculture, Honolulu Zoo and University of Hawaii Medical School to discuss a surveillance program, Effler said.

He said the Health Department already is spraying to control mosquitoes and avoid an overlap with infected birds.

Most people bitten by a mosquito carrying the virus do not become noticeably ill, although some develop flulike symptoms, the Centers on Disease Control said. Occasionally, the virus causes encephalitis, a potentially fatal inflammation of the brain.

With increased travelers and mosquitoes hitchhiking on airplanes, Effler said: "Never say never in medicine. We just don't know what we're going to get. Our world is changing, and people need to get to grips with it."

Effler also stressed the need to "move beyond Band-Aids" for every health issue that arises and improve the state's underlying structure to deal with threatening pests and diseases.

This includes increasing laboratory capacity and investigators "so we can be prepared," he said.

Department of Health

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