The New York Times, Sept. 23, 2002
NEW ROADS, La., Sept. 22 — First came Jimmy Bonaventure, a beefy 31-year-old tractor salesman who showed up at the public hospital covered in red spots.
Next was Ervin Padgett, a 48-year-old golfer with a headache so bad it felt as if someone were driving a 9-iron right between his eyes.
Then came LaVerne Tyson, a 77-year-old woman who had been living by herself for years in a mobile home along the river. She was wheeled into the emergency room in a cloud of confusion, talking about her papa, his cotton gin and the drought of 1933.
"All of a sudden, our emergency room was overwhelmed with these people with strange symptoms," said Dr. Brian LeBlanc, a family practitioner at the hospital. "It was an outbreak."
If the West Nile virus works like a tornado, skipping over some communities while descending to wreak havoc on others, this little area of southeastern Louisiana has been the hardest hit in the country.
The town of New Roads and the surrounding parish of Pointe Coupee (rhymes with toupee), a jungly, wet, mosquito paradise, have reported the highest concentration of the deadly virus, with 11 verified cases, none fatal, among a rural population of 22,000.
State scientists have rushed in, slathered in insect repellent, of course. But the high rate of disease transmission remains a mystery.
The virus, spread by mosquito, has felled strong men, made horses run goofy, sent firefighters down to the Piggly Wiggly to pass out buckets of larvicide and exhausted the resources of a parish where nearly a third of the children live below the poverty line.
"That place is under attack" said Dr. Ed Thompson, the Mississippi health officer. "We've been watching it closely."
Nationwide, it has been a frightening summer for West Nile. The death toll stood at 89 today, with 1,852 verified cases. There are fears the blood supply may be tainted, with scientists confirming that the virus can be transmitted through transfusions.
Last week the Centers for Disease Control and Prevention released a study on a rare form of the disease that paralyzes the limbs — "the polio of the 21st century," as one neurologist put it.
Fast as a mosquito can fly, the virus has spread to 42 states, with Illinois leading the nation in deaths.
The 11 sick in Pointe Coupee might not seem like a lot compared with the dozens ill in Chicago, New Orleans and other big cities. But it is the concentration of the cases that interests scientists. With its kudzu-covered road signs and fields of towering sugar cane, Pointe Coupee is something of an enigma. How did the disease spread so fast? Why here?
Scientists say a mosquito-borne disease like West Nile is bound to be somewhat random. Dr. Raoult Ratard, a Louisiana epidemiologist, takes a metaphysical approach.
"The universe is lumpy, right?" Dr. Ratard said. "It's the same with Pointe Coupee. Everyone is trying to understand why there's so much virus in this one little place and absolutely nothing 10 miles down the road. We just don't know. That's the way things are."
This slice of Cajun country, 50 miles north of Baton Rouge, looks like many other parts of lower Louisiana — parts that have not reported a single West Nile case.
It is lush, rural and very wet.
There are countless swampy bayous, a nice wide stretch of the Mississippi River running along the eastern edge of the parish, and the 14-mile-long root-beer-colored False River.
Mosquitoes love water, and there are loads of them here — real and imaginary.
"When you walk into somebody's yard and you hit that grass, you can feel them," said Bernadine St. Cyr, a New Roads councilwoman.
Cpl. Don Ramagos of the Pointe Coupee sheriff's office remembers hunting in the woods one day and feeling as if somebody had jabbed him in the neck with a hypodermic needle.
"This skeeter was so big you could mount it," Mr. Ramagos said, holding his fingers inches apart.
Local officials have been besieged trying to deal with the problem.
Their nightmare started on July 29 when Mr. Bonaventure checked himself into Point Coupee General Hospital, freckled with rash. Mr. Bonaventure, 6 feet 3 and 280 pounds, also had a monster headache and a low pulse.
"People had warned me about bug spray, but I didn't use it," he said. "I guess I was hardheaded."
Then a few horses got the virus and "ran around like they were drunk," said Miles Brashier, a state agricultural expert.
A few days later Mr. Padgett staggered into his doctor's office. "I couldn't hardly see," he recalled.
West Nile virus, discovered 65 year ago in Uganda, can infect people, horses and birds. Most people who catch it do not know it. On rare occasions, it causes headaches, fever, severe brain swelling and even death, especially among the elderly.
That is why there was such concern when Ms. Tyson showed up at the hospital on Aug. 3, barely conscious and mumbling about her past.
Her daughter thought it was a reaction to some new medicine.
Ms. Tyson spends her afternoons on her porch along the False River, and Dr. LeBlanc, her physician, immediately suspected she had been bitten by an infected mosquito.
"I thought we were going to lose her," he said.
While Ms. Tyson began to slip into a fog, dozens of other Pointe Coupee residents streamed into the hospital. They complained of fever, headaches and confusion. Over the next few weeks, the nine-bed emergency room was full. August happens to be peak mosquito season because of hot, muggy weather.
Pointe Coupee is one of those sweetly distilled places where many people never move away and most know each other. People here have not lost the fine art of leisure, or gossip. Even before several West Nile patients left the hospital, word was out that they had the disease. There were even rumors that the high school football coach had caught it. (He hadn't.)
Parish officials had few resources to combat the outbreak. They sent firefighters to grocery stores to pass out pellets that kill mosquito larvae. They borrowed money to rig three old pickups with rudimentary spraying equipment.
The West Nile epidemic seems to be subsiding, with no reported cases in Point Coupee in the last two weeks.
But there is a new problem, whirling up the Gulf of Mexico.
Isidore, a Category 4 hurricane, is pounding the Caribbean and may hit Louisiana this week. Its drenching rains will bring more mosquitoes and probably more virus.
Ms. Tyson, who is recovering well in a nursing home, is not too worried — at least not about the mosquitoes.
West Nile is like chickenpox. Once you have had it, you are immune for life.
"I just want to go back to my porch and watch the boats go by," Ms. Tyson said today. "It's heavenly."