The Heat Is Online

First Cases of Encephalitis Strike New York City

New York battles encephalitis outbreak

By Deepti Hajela, The Boston Globe, Associated Press, Sept. 10. 1999

NEW YORK - New York is dealing with a deadly new menace: mosquitoes.

Three people have died in the last few weeks in an outbreak of mosquito-borne encephalitis, an inflammation of the brain. Nine other people have been infected, and 56 other possible cases are being investigated.

Health officials in helicopters and on foot began spraying pesticide around the city last weekend to prevent the spread of the disease. Mayor Rudolph Giuliani said yesterday that forested or swampy areas in the entire city will be sprayed during the next several days. The spraying is aimed at stagnant pools of water where the bugs breed. ''The more dead mosquitoes, the better,'' Giuliani said.

Roger Nasci, an entomologist with the federal Centers for Disease Control and Prevention, said it is ''exceedingly rare'' for the disease to hit a Northeastern city, and blamed the outbreak on ''bad luck.''

It was New York's first confirmed outbreak of the disease, a strain known as St. Louis encephalitis. One of the confirmed cases was in Brooklyn. All of the rest have been in Queens.

Although there have been few confirmed cases, Nasci expressed concern that ''a very large population'' is at risk among New York City's 7.3 million people. Children, the elderly, and anyone with immune system problems can die from the disease.

But people relaxing in Flushing Meadow Park in Queens seemed unconcerned yesterday afternoon, even though the park was one of the first areas targeted as a possible mosquito breeding ground.

''If I was meant to die by a mosquito, I would have died already,'' said sunbather Anthony Ferro, 35. St. Louis encephalitis, named for the city where the first cases were identified in 1933, is often treatable.

Doctors at Flushing Hospital reported the outbreak on Aug. 24 after identifying four patients with symptoms. The symptoms, which generally appear five to 15 days after a bite, include fever and headaches.

This story ran on page A28 of the Boston Globe on 09/10/99.

Health officials fight encephalitis spread

Boston Globe, Sept. 7, 1999

NEW YORK -- (AP) -- Armed with pesticide-filled canisters, city health officials continued spraying stagnant pools of water yesterday as the number of suspected cases of St. Louis encephalitis climbed to 37. Since the outbreak was reported last week, two elderly people in Queens have died from the mosquito-borne disease, and three other cases have been confirmed, Mullin said.

Encephalitis Strikes 3 People, 1 Fatally, in Queens, City Says

By Abby Goodnough, The New York Times, Sept. 4, 1999

An elderly resident of Queens died this week from a mosquito-borne viral disease known as St. Louis encephalitis, and city health officials fear that at least nine other people have been infected, Mayor Rudolph W. Giuliani said on Friday.

At a hastily called news conference in Whitestone, Queens, Giuliani said three victims of the disease had been identified in northern Queens in recent days: an 80-year-old man who died at Flushing Hospital Medical Center on Tuesday and two middle-aged men who were being treated Friday.

Health officials believe that an 87-year-old woman who died at Flushing Hospital on Thursday also had St. Louis encephalitis, Giuliani said. The disease is most common in Southern states, and the three confirmed cases are believed to be the first ever contracted in New York City, he added.

The disease, which starts as a flulike illness in humans but can progress to a fatal inflammation of the brain, is usually transmitted to mosquitoes from migratory birds.

Most people infected with the virus never exhibit symptoms, but some -- mainly children and the elderly -- develop muscle weakness, tremors, confusion and paralysis that can lead to permanent neurological damage or death. Death rates in previous outbreaks have varied from 3 percent to 20 percent.

City officials would not give the names or addresses of the two people who died, but Neal L. Cohen, the Health Commissioner, said all of the confirmed and most of the suspected cases had originated in the Whitestone, Flushing and Auburndale neighborhoods of Queens. About two dozen people are being tested for the disease, including four who live in the South Bronx and one who lives in Manhattan but works in Queens, Cohen said.

Health officials passed out insect repellent and brochures about the disease in the three Queens neighborhoods last night, and the Mayor's Office of Emergency Management dispatched helicopters to spray pesticide over those areas, focusing on Powell's Cove Park, on the East River between Whitestone and College Point; the Flushing Airport, and several other bodies of water where the infected mosquitoes are likely to breed. The helicopters sprayed malathion, a pesticide, last night, and city officials said trucks would spray it on the streets in the affected neighborhoods several times today and tomorrow.

Jerome M. Hauer, director of the Office of Emergency Management, said the spraying would be done in the evening and around dawn, when mosquitoes are most active. He added that the pesticide would not harm people or their pets but advised residents to stay indoors during the spraying.

"We would ask people to understand why we are doing this and to cooperate with us," Giuliani said at the afternoon news conference, held on 11th Avenue near Powell's Cove Park, as a group of bewildered-looking Whitestone residents looked on.

"We will do everything that we can to try to wipe out the mosquito population and deal with and treat the people who may be bitten and may be affected by it."

While the city moved aggressively to prevent more cases of the disease, Cohen said a person's chances of becoming infected were remote. Only 1 out of 300 bites from the mosquito species that carries St. Louis encephalitis actually transmit the disease, he said.

"The probability of infection is very, very low," Cohen said, adding that the disease cannot be transmitted between people. "Essentially, because somebody gets a mosquito bite there is no reason to panic."

Cohen said that until the mosquito eradication effort is completed, city residents, especially the elderly, should try to stay indoors, and should wear long pants, socks and long-sleeved shirts when going outside.

He urged residents of the affected neighborhoods to use insect repellent and to rid their homes and yards of any sources of stagnant water, where mosquitoes might breed. People with questions about the disease can call a city information line at (888) 663-6692.

There is no vaccine or specific drug therapy for St. Louis encephalitis, named for the city where the first cases were recognized in 1933. But people with serious symptoms usually receive supportive therapy, like respiratory care, to prevent pneumonia.

Since 1964 there have been 4,437 confirmed cases of St. Louis encephalitis in the United States, with an annual average of 193, according to the Federal Centers for Disease Control and Prevention in Atlanta. But studies show that the vast majority of cases go undiagnosed.

The Queens cases come only weeks after two 11-year-old boys contracted malaria at a Boy Scout camp near Calverton on Long Island. But city health officials said yesterday that there were actually fewer mosquitoes in the New York region this year because of the summertime drought.

They added, however, that the area's relatively wet spring and hot, dry summer had been ideal for the mosquito species that carries St. Louis encephalitis in the Northeast, Culex pipiens.

The City Health Department has ordered every hospital in the city to look out for the disease, and has warned that some of the symptoms -- like muscle aches and fever -- can be similar to those of meningitis. Health officials began to suspect an outbreak of St. Louis encephalitis about 10 days ago, but the C.D.C. did not confirm the three cases until Friday afternoon, said Annie Fine, a medical epidemiologist with the Health Department.

On Friday, several frightened Whitestone residents at the news conference complained that they should have been alerted as soon as city officials suspected a serious problem. The residents said their neighborhood had been inundated with mosquitoes for decades and the city in recent years stopped spraying pesticides over Powell's Cove Park and other badly infested areas.

"At night you sleep with the air- conditioner cranked up and the covers up to your eyeballs," said Dave Morales, 33, who was watching as city officials prepared for the spraying in Powell's Cove Park.

"I always hoped they would spray down there, but they never did. I would rather take my chances with the cancer from the insecticide than deal with nine million mosquito bites."

Kathy Reiter, 46, said her yard was so infested with mosquitoes that she planned to get rid of her swimming pool next year. "I run my air- conditioner day and night, April through October," she said. "Otherwise my home is full of mosquitoes. "I think everyone here is genuinely concerned."

Mosquito Disease in New York City

By The Associated Press, Sept. 4, 1999

NEW YORK (AP) -- An outbreak of St. Louis encephalitis, a viral infection transmitted by mosquitos, has been blamed for at least one death here and could be responsible for several illnesses over the last two weeks.

It is believed to be the first time the infection, usually found in the South, has spread to New York City. Workers have started spraying affected areas of the borough of Queens to prevent further outbreaks.

The viral infection is transmitted by a species of mosquito, and most people recover from it. But it can be fatal to those with weakened immune systems, such as the elderly, authorities said.

Encephalitis symptoms usually manifest five to 15 days after a bite from a carrier mosquito. They can be as minor as a slight fever or headache, but some experience muscle weakness or paralysis that can trigger permanent neurological damage or death.

In the area where the outbreak occurred, residents were advised to wear insect repellent and to cover themselves while outside.

Besides a confirmed encephalitis death of an 80-year-old man on Tuesday, officials believe the infection may also be responsible for the death of an 87-year-old woman on Wednesday, said Dr. Annie Fine of the city's Department of Health.

Two middle-age men are being treated for the virus, and 20 other people may be infected, officials said.