NPM12: Surviving Disaster – Texas Style

 

 

# 6532

 

September is National Preparedness Month, and along with thousands of others across the country, AFD blog is part of this year’s NPM coalition. All this month, in addition to my regular infectious disease blogging, I’ll be running preparedness articles as well. 

 

Some will be new, like today’s entry, and some will be reposts (often updated) of earlier preparedness essays.

 

Today, from Texasprepares.org (part of the Texas Department of State Health Services) we’ve a series of preparedness videos (available in both English and En Español) that highlight how Texans – who are hardly strangers to natural disasters – prepare for and cope with emergencies.

 

The 7 videos are:

 

Introduction from Dr. David Lakey, Commissioner – 1:20

Surviving Hurricanes: Grab it and Go – 9:50

A Community Rebuilds: Recovering from Wildfires – 9:46

Back to Business: Planning for Disasters – 7:35

Ready for Anything: Preparing for the Next Flood – 8:02

Winds of Destruction: A County's Lessons – 8:45

Facing Disasters: A Plan for Work and Home – 8:17

 

You can click the image below to watch the videos, or follow the link below it to the download page, where you can access, and download, all of their videos.

 

 

Surviving Disaster: How Texans Prepare - Download and Accessible Videos

 

Beyond the videos, you’ll find plenty of emergency preparedness resources on the Texasprepares.org page, including:

 

 

You needn’t be one of the 25 million residents of Texas to find these videos, and resources useful. But you can also find emergency preparedness resources at the FEMA and Ready.gov websites.

 

Regardless of where you go, today would be an excellent day to to take a hard look at your family’s emergency plans, and begin taking steps to improve them.

»» Read More

CDC Telebriefing on West Nile Virus

 

 

# 6510

 

A public health situation we’ve been following here for the past several weeks (see here, here, here, and here) was the subject of a CDC telebriefing today; the unusually high incidence of West Nile infections across the country, but most noticeably in Texas.

 

According to the CDC’s Dr. Lyle R. Petersen, director of the DVBID at the CDC, 2012 may be on track to be the worst yet in the 13 year history of the virus in the United States.

 

Yesterday, the CDC’s DVBID division updated their numbers through August 21st, indicating:

 

2012 West Nile virus update: as of August 21

Thus far in 2012, 47 states have reported West Nile virus infections in people, birds, or mosquitoes. A total of 1118 cases of West Nile virus disease in people, including 41 deaths, have been reported to CDC. Of these, 629 (56%) were classified as neuroinvasive disease (such as meningitis or encephalitis) and 489 (44%) were classified as non-neuroinvasive disease.

 

The 1118 cases reported thus far in 2012 is the highest number of West Nile virus disease cases reported to CDC through the third week in August since West Nile virus was first detected in the United States in 1999. Approximately 75 percent of the cases have been reported from 5 states (Texas, Mississippi, Louisiana, South Dakota, and Oklahoma) and almost half of all cases have been reported from Texas.

 

 

Of the 1118 cases, nearly half (n=537) are from Texas, and 26 deaths so far this year have been recorded in the Lone Star State. Hard hit Dallas county reported their 11th fatality yesterday.

 

Elsewhere across the nation, 38 other states have reported West Nile infections in humans, and deaths have been reported across 16 states.

 

Of note, Louisiana has reported 6 fatalities and Oklahoma has reported 3.

 

Today’s telebriefing featured Lyle R. Petersen, M.D. and the transcript should be posted on the CDC’s media site tonight or tomorrow (now available at this link).

 

Lisa Schnirring writing for CIDRAP NEWS has an excellent summary of today’s briefing:

 

CDC reports surge in US West Nile virus activity

Lisa Schnirring Staff Writer

Aug 22, 2012 (CIDRAP News) – The United States is experiencing a dramatic rise in the cases of West Nile virus (WNV) infections over the past month, with record-setting numbers expected over the next several weeks and the US Centers for Disease Control and Prevention (CDC) warning people to take key preventive steps.

 

So far, 38 states have reported human cases, but the epicenter is Texas, which has reported half of the WNV infections. The CDC said so far it has received reports of 1,118 cases, including 629 people with the neuroinvasive form of the disease. Nationally, 41 deaths have been reported.

(Continue . . .)

 

 

 

Given that the WNV season doesn’t usually peak until mid-August, and it can take 2 to 3 weeks for symptoms to develop, many more cases are expected over the next few months.

 

While 80% of those infected don’t show symptoms, last week WEBMD carried a report (see New West Nile Threat: Kidney Disease) about research conducted by Baylor University West Nile expert Kristy O. Murray, PhD, DVM.

 

Dr. Murray’s research (see Persistent Infection with West Nile Virus Years after Initial Infection) suggests long-term sequelae may develop among a significant percentage of those who are infected with the West Nile Virus – even among those infected asymptomatically.

 

Dr. Murray was awarded an NIH grant in 2011 to study the effects of chronic WNV infection on the kidneys and central nervous system.

 

Reason enough to take seriously the recommendations from health departments across the nation that urge people to follow the `5 D’s’ of mosquito protection:

To find out about the West Nile threat in your area, you can visit the DVBID website below:

Links to State and Local Government West Nile Virus Web Sites

 

And as a final note, the CDC recently updated their information on mosquito repellants.

Updated Information regarding Insect Repellents

»» Read More

Updating the Texas West Nile Outbreak

Credit DVBID  Nearly half of all cases this year are out of Texas

# 6495

 

In 2011 there were only 2 fatalities linked to the West Nile virus across Texas. This year 16 deaths have already been recorded, and several hundred people have been seriously sickened.

 

Yesterday Dallas County, Tx confirmed their 10th fatality of the year, and announced that they plan to begin aerial spraying for mosquitoes on Thursday night. Cities and municipalities have until the end of day today to opt out of the plan.

 

According to the State health department:

Texas has more than 380 state-confirmed cases of West Nile illness for 2012, including 16 related deaths. Texas is on track to have the most cases of West Nile illness since the disease first emerged in the state in 2002. (cite)

Despite these grim statistics, opposition to aerial spraying exists, with online letter writing and petition signings campaigns underway urging the city not to spray (see KDAF-TV report)

 

The plan is to use two small twin-engine aircrafts, flying at roughly 300 feet, to spray a chemical called DUET, which is EPA approved for use in outdoor and residential areas.

 

Application rates will average less than 1 ounce per acre, and this spray is chemically similar to the ones used for ground spraying operations.

 

Aware of concerns over aerial spraying, the State of Texas released this statement on the safety of the program, stating:

 

Aerial spraying is a very effective and safe way to kill adult mosquitoes in large, densely populated areas. For people concerned about exposure during aerial spraying, health officials suggest the following precautions:

• Minimize exposure. Avoid being outside, close windows and consider keeping pets inside while spraying occurs.
• If skin or clothes are exposed, wash them with soap and water.
• Rinse homegrown fruits and vegetables with water as a general precautionary measure.
• Cover small ornamental fish ponds.
• Because the chemical breaks down quickly in sunlight and water, no special precautions are suggested for outdoor swimming areas.

 

While only about 20% of the people who are infected with WNV ever develop symptoms – and most only experience a mild flu-like illness –a very small percentage will develop the the more severe, and sometimes deadly, `neuroinvasive’ form of WNV.

 

Although Texas is seeing the brunt of this year’s outbreak, the virus is showing up from coast-to-coast.

 

Six deaths have been reported in Louisiana, and another half dozen are scattered across  Arizona, California, Mississippi, Missouri, South Dakota, and Pennsylvania.

Neuroinvasive West Nile Disease  has been reported in 27 states so far this year; Alabama, Arizona, Arkansas, California, Colorado, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan, Minnesota, Mississippi, Missouri, Nebraska, New York, North Dakota, Ohio, Oklahoma, Pennsylvania, South Dakota, Tennessee and Texas.

 

 

Reason enough for health departments across the nation to urge people to follow the `5 D’s’ of mosquito protection:

To find out about the West Nile threat in your area, you can visit the DVBID website below:

Links to State and Local Government West Nile Virus Web Sites

Click on a state to link directly to their West Nile virus Web page.

See list below for additional city-level and main State Health Department Web sites.

 

And as a final note, the CDC recently updated their information on mosquito repellants.

Updated Information regarding Insect Repellents

Download PDF version formatted for print (32 KB/3 pages)

Repellents are an important tool to assist people in protecting themselves from mosquito-borne diseases.

CDC recommends the use of products containing active ingredients which have been registered by the U.S. Environmental Protection Agency (EPA) for use as repellents applied to skin and clothing. EPA registration of repellent active ingredients indicates the materials have been reviewed and approved for efficacy and human safety when applied according to the instructions on the label.

Repellents for use on skin and clothing:

CDC evaluation of information contained in peer-reviewed scientific literature and data available from EPA has identified several EPA registered products that provide repellent activity sufficient to help people avoid the bites of disease carrying mosquitoes. Products containing these active ingredients typically provide reasonably long-lasting protection:

• DEET (Chemical Name: N,N-diethyl-m-toluamide or N,N-diethly-3-methyl-benzamide)
• Picaridin (KBR 3023, Chemical Name: 2-(2-hydroxyethyl)-1-piperidinecarboxylic acid 1-methylpropyl ester )
• Oil of Lemon Eucalyptus* or PMD (Chemical Name: para-Menthane-3,8-diol) the synthesized version of oil of lemon eucalyptus
• IR3535 (Chemical Name: 3-[N-Butyl-N-acetyl]-aminopropionic acid, ethyl ester)

(Continue . . . )

»» Read More

Dallas West Nile Update

 

 

# 6483

 

While we await today’s MMWR and a briefing this afternoon from the CDC on the H3N2v outbreak in Ohio and Indiana, we’ve three more West Nile Virus (WNV) deaths to report in Dallas County, Texas this week (see Ninth West Nile Virus Related Death in Dallas County August 8, 2012). 

 

Nationally, as of August 7th, 253 neuroinvasive cases of WNV have been reported to ArboNET, along with 137 non-neuroinvasive WNV infections. 

 

Of those, roughly half have been reported out of the state of Texas (see CHART).

 

 

It is estimated that only about 20% of the people who are infected with WNV develop symptoms, and the vast majority of those only experience a mild flu-like illness. Accordingly, mild, asymptomatic, or non-neuroinvasive infections are likely vastly undercounted.

 

The more severe `neuroinvasive’ form of WNV can produce symptoms that include headache, stiff neck, confusion, coma, convulsions, and even paralysis.

 

According to the CDC’s  WEST NILE SYMPTOMS Q&A page.

 

It is estimated that approximately 1 in 150 persons infected with the West Nile virus will develop a more severe form of disease. Serious illness can occur in people of any age, however people over age 50 and some immunocompromised persons (for example, transplant patients) are at the highest risk for getting severely ill when infected with WNV.

<SNIP>

When someone is infected with West Nile virus (WNV) they will typically have one of three outcomes: No symptoms (most likely), West Nile fever (WNF in about 20% of people) or severe West Nile disease, such as meningitis or encephalitis (less than 1% of those who get infected).

If you develop a high fever with severe headache, consult your health care provider.

 

While many are concerned this week over an emerging swine flu virus, so far we are not aware of any deaths or serious illness from that flu strain.

 

The same, sadly, cannot be said about mosquito borne illnesses this summer. 

 

Reason enough for health departments across the nation to urge people to follow the `5 D’s’ of mosquito protection:

To find out about the West Nile threat in your area, you can visit the DVBID website below:

 

Links to State and Local Government West Nile Virus Web Sites

Click on a state to link directly to their West Nile virus Web page.

See list below for additional city-level and main State Health Department Web sites.

»» Read More

Update & Video On The Texas West Nile Outbreak

 

 
Map credit – DVBID

 

# 6476

 

 

A week ago, in Texas: West Nile Cases Rising I wrote about the high number of West Nile infections being reported in, and around, Dallas County Texas.  At the time, the DCHHS was reporting three local fatalities from WNV neuroinvasive disease (WNND).

 

That number has now doubled to six fatalities, according to this press release from the Dallas County Health Department. WNV related deaths have also been reported in Travis County (1) and McLennan County (1).

 

To put this into some kind of perspective, in previous years the entire state of Texas reported:

• 2 West Nile human fatalities in 2011
• 7 West Nile human fatalities in 2010
• 9 West Nile human fatalities in 2009
• 1 West Nile human fatalities in 2008
• 17 West Nile human fatalities in 2007

 

The latest edition of West Nile Watch indicates 115 human infections in Dallas County Alone – an increase of roughly 40% over last week’s total. Zachary Thompson -director of Dallas County Health and Human Services – is quoted on the department’s website about the seriousness of this outbreak:

 

 

Last week Baylor Health Care System sponsored a webinar called West Nile in North Texas: What you need to know, and that video is available on Youtube.  Participating in this 23 minute program were:

 

• Janet St. James, local Medical reporter with WFAA-TV, Channel 8
• William Sutker, M.D., chief of infectious disease, Baylor University Medical Center at Dallas
• Charles Perkins, D.O., medical director, Dallas County Department of Health and Human Services
• Roger Khetan, M.D., Internal Medicine physician on the medical staff at Baylor University Medical Center at Dallas

 

 

While Northern Texas, Oklahoma, and Mississippi are currently reporting the most West Nile Virus activity, the CDC noted last week that 42 states across the nation have reported WNV activity this year.

 

West Nile virus disease cases up this year

 

Take steps to protect yourself and your family

The Centers for Disease Control and Prevention is urging people to take steps to prevent West Nile virus infections.  Outbreaks of West Nile virus disease occur each summer in the United States.  This year, some areas of the country are experiencing earlier and greater activity.

 

Thus far in 2012, 42 states have reported West Nile virus infections in people, birds, or mosquitoes. A total of 241 cases of West Nile virus disease, including four deaths, have been reported to CDC. This is the highest number of cases reported through the end of July since 2004. Almost 80 percent of the cases have been reported from three states, Texas, Mississippi, and Oklahoma.

 

West Nile virus is transmitted to people by infected mosquitoes.  In the United States, most people are infected from June through September, and the number of these infections usually peaks in mid-August.  Seasonal outbreaks often occur in local areas that can vary from year to year.  Many factors impact when and where outbreaks occur, such as weather, numbers of mosquitoes that spread the virus, and human behavior.

 

“It is not clear why we are seeing more activity than in recent years,” said Marc Fischer, M.D., M.P.H., medical epidemiologist with CDC’s Arboviral Diseases Branch.  “Regardless of the reasons for the increase, people should be aware of the West Nile virus activity in their area and take action to protect themselves and their family.”

 

The best way to prevent West Nile virus disease is to avoid mosquito bites:

• Use insect repellents when you go outdoors. 
• Wear long sleeves and pants during dawn and dusk.
• Install or repair screens on windows and doors.  Use air conditioning, if you have it.
• Empty standing water from items outside your home such as flowerpots, buckets, and kiddie pools.

(Continue . . .)

 

To find out about the West Nile threat in your area, you can visit the DVBID website below:

Links to State and Local Government West Nile Virus Web Sites

 

Click on a state to link directly to their West Nile virus Web page.

See list below for additional city-level and main State Health Department Web sites.

»» Read More