Monthly Archives: June 2014

West Nile Virus: What is it? Where is it? How to prevent it?

It’s become a yearly tradition- the first confirmed report of West Nile Virus in a mosquito.  The winner in New York State this year is Rockland County!!  They found their first positive mosquito just last week! So far this year there have not been any reported human cases, but it’s still early in the season.  Last year NY had 33 cases.  (Source)

I’ve written before about my not-so-illustrious research career, specifically the summer I spent working for my local county health department doing West Nile Virus (WNV) surveillance, here.  Back then, 2001, West Nile was an emerging disease.  The first cases had been reported in New York City in 1999, and each year subsequent had seen an increase in cases as the virus spread.  More than once that summer, I answered panicked phone calls from residents who found dead birds on their property and were fearful of disease.

As I did then, I hope this post will help allay fears, and educate readers about West Nile, what it is, how it spreads, how it’s monitored, and how you can help prevent it!

What is West Nile Virus?

The structure of the West Nile Virus, solved by a group at Purdue. (Source)

The structure of the West Nile Virus, solved by a group at Purdue. (Source)

As the name implies, West Nile is a virus, of the genus flaviviruses (Dengue virus is in the same genus).  WNV can infect certain birds and mosquitoes as well as many mammals including humans and horses.  The virus is spread by mosquitoes the feed on infected animals and transmit it by feeding on uninfected animals.  WNV was first identified in Uguanda in the 1930s.  How it came to New York City in 1999 is unknown, however, “international travel of infected persons to New York, importation of infected birds or mosquitoes, or migration  of infected birds are all possibilities.” (Source, CDC) Since arriving in North America, WNV has spread over all of North America and Mexico.

How is it detected?

The virus can be detected in samples from infected animals (blood, tissues, etc), including mosquitoes.  The summer I worked for the health department, one of my primary tasks was to collect dead birds and send them to a state lab for testing to detect WNV.  Another was to trap mosquitoes (you can see the type of trap we used below), sort them by species (and gender, only females bite!), and pool them so they can be sent for testing.  Research conducted when WNV first emerged in the US showed that the density of dead crows correlated with the risk of WNV infecting humans (Source).  Thus, our collection and reporting on the species and location of dead birds was crucial.

Mosquito trap:  the bucket contains fetid water, attractive to a gravid female mosquito looking for a place to lay her eggs, some dry ice

Mosquito trap: the bucket contains fetid water (attractive to a gravid female mosquito looking for a place to lay her eggs), some dry ice (mimicking a the CO2 mammals exhale), a net, and a battery-operated fan.  The mosquitoes fly towards the water, the fan sucks them up into the net and keeps them there.  (Image Source)

What are the symptoms of WNV infection?

The vast majority of people (70-80%) who are infected with WNV will show no symptoms at all.  So, you may have already had it and your immune system fought it off without you even knowing you were sick.  The remaining ~20% may have flu-like symptoms- headache, body aches, joint pain, vomiting, diarrhea, or rash– and recover completely.  A very small percentage of people (less than 1%) will develop neurological condition- encephalitis or meningitis (the inflammation of the brain or its surrounding tissue).  The symptoms of the encephalitis/meningitis include headache, high fever, stiff neck, disorientation, coma, seizure, etc.  The neurological condition will prove fatal in about 10% of cases.

What are the treatments?

There is no vaccine against WNV for people (there is one for horses).  There is also no specific treatment for WNV, just over-the-counter pain relievers/fever reducers, and other supportive care (fluids, pain relief).

Who is at risk?

The elderly are most at risk, with most cases of WNV occurring in people over 60 years of age (Source).  Certain illness can make people more vulnerable to complications from WNV infection- those who are immune suppressed (organ transplant recipients, cancer patients, etc.).

Is West Nile Virus in my area?

So far this year, it’s still early in the season.  As I said above, NY just had their first positive mosquito. To view the CDC’s current map of West Nile Virus activity per state, click here.

West Nile Virus Activity by State – United States, 2014 (as of June 10, 2014) (Source)

West Nile Virus Activity by State – United States, 2014 (as of June 10, 2014) (Source)

As our climate continues to change, and warm, data show West Nile will continue to spread.

How does it spread?

The West Nile Virus is primarily spread through mosquito bites.  WNV is endemic in birds and spread vie mosquitoes in that population. Occasionally an infected mosquito bites a human and transmits the virus.  There have been reported cases of human to human transmission, but only through organ donation and blood transfusions.

Transmission cycle of West Nile Virus. (Source)

Transmission cycle of West Nile Virus. (Source)

What can I do keep from getting WNV?

Clatsop County Oregon's approach. (Source)

Clatsop County Oregon’s approach. (Source)

Long sleeves/pants/socks, insect repellent, and window screens can keep you from getting bitten.  You can also make it harder for mosquitoes to breed near you- avoid having ANY STANDING WATER on your property.  That includes birth baths, old tires (there are prime breeding grounds), wheel barrows, sand boxes, water tables, flower pots, tarps, any place water can accumulate, mosquitoes can lay their eggs.

When I worked for my local health department, we routinely kept our eyes out for sources of standing water and encouraged the public to notify us if they found a source.  We’d get calls about abandoned properties (with swimming pools, bird baths, etc) and go out to try and get homeowners and business owners to fix the problems. If you see a problem area, I’d encourage you to call your local health department. Also, if you find a dead bird- give them a call, they may want to send it for testing.

Washtenaw County Michigan's approach. (Source)

Washtenaw County Michigan’s approach. (Source)

The bottom line.

Chances of you or your kids getting sick from WNV are pretty slim.  That said, avoiding mosquito bites is the best way to keep yourself safe.  Keep yourself covered, keep mosquitoes out of your house, remove any sources of standing water on your property.

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Not a humblebrag- why I hide the fact that I went to elite schools

I recently read this article on Slate by LV Anderson on why people who attend(ed) elite colleges shouldn’t hide it by saying “I went to college in [Boston/New Jersey/New Haven, etc].”

I wish she had experimented by telling people in social situations that she went to an Ivy League school and seen the reactions first hand.  And by reactions, I mean how people reacted to her, and how their reactions made her feel.

People do make assumptions based on this kind of information- some of them are flattering, others of them are unflattering- all of them make me uncomfortable, all of them are detrimental.

In high school, I didn’t even tell people I was applying to an Ivy League school.  I had a first choice, Mt. Holyoke, and I didn’t want people thinking of it as my second choice because I didn’t get into my reach school.  When the guidance department announced over the loud speaker that I would be attending Yale, all of the heads in the room whipped around and looked at me, shocked.  It was awkward.  I was wearing my Yale sweatshirt- the one full of holes that I’d had since 6th grade when my best friend’s older brother started attending.  I had always loved the school- loved the environment, loved everything he told me about learning there. I had the shirt long before I even applied to the school.  I wore it enough (because it was super comfy and I loved the paisley fabric of the letters) that it got holes.  I wore it after I had applied and before I knew if I’d gotten in- including on picture day (which I had forgotten about).  My application was a lotto ticket, and I was lucky enough to win.  Nobody had batted an eyelash at the sweatshirt until that announcement.  After that, the high school rumor mill churned out reports daily about who thought I was bragging by wearing the shirt, who though I didn’t deserve it, who thought it unfair I hadn’t told people I was applying, etc.

That was my first experience sharing what would become my alma mater.  Of course there were accolades, my friends cheered me on and were genuinely happy for me, but it was tinged by those negative reactions.  That is how the stage is set for people to hide that information.

As we all know, high school is an unhealthy and miserable microcosm of society.

When I was applying to grad school, I went on a bunch of interview weekends.  I distinctly remember one weekend (at Johns Hopkins of all places), another prospective student, upon learning I was from Yale said, “So you’re the one from Yale!  But you don’t seem snooty at all.”  Apparently the assembled group of prospectives, as they got to know each other, had wondered who was the Yale student that weekend.  At that moment I was glad that our name tags hadn’t included our undergrad institutions.  I have enough trouble meeting new people without having to overcome hurdles put in place by their stereotypes. This was the reaction of people smart enough and hard working enough to be brought in from all over the country to interview at Johns Hopkins- you’d think they’d know better.

When we were first dating in grad school, my husband didn’t believe me that this kind of information would make all manner of people act weird and make embarrassing (to both parties) comments. Then he took me to his high school reunion and his jaw dropped at the reactions of his former classmates. People instantly used self-deprecating humor to put themselves down and adopted ‘we’re not worthy’ types of body language.  Instead of discussing the weather or the Eagles, conversation revolved around how dumb they were and what I was studying.  It was so uncomfortable I asked him to please stop telling people where I was going to school, and he obliged.

Years later, we were out to dinner with friends of friends, people we barely knew.  Our friend, who was hosting the event, introduced me as the smartest person he knew, and rattled of my undergrad, grad, and post-doc institutions.  It was the end of the evening as far as I was concerned.  I felt super awkward, my husband knew how I felt.  It didn’t even matter whether the other people gave a shit or not (most likely they couldn’t have cared less)- I couldn’t say if it changed how they interacted with me, I changed, I was uncomfortable and felt conspicuous.

This is why I consciously withhold this information from people until they get to know me. On several occasions, upon revealing the info people have said, “I never would have guessed! You are so [opposite of whatever stereotype they had in mind]!” While that’s not a reaction I like to get, I at least am glad that they were able to get to know me without that sterotype interfering.

Quite frankly, it’s the same reason I don’t go by “Doctor”- I don’t need people’s assumptions getting in the way of getting to know me.

For the past two years I’ve been invited to speak to a group of girls interested in STEM– at a struggling high school, in a struggling city, in a socioeconomically disadvantaged area.  When I sent in my biographical info for the program, I specifically did not use “Doctor” or “PhD” in it.  My work email signature does include the “PhD” but I left it up to the organizers how my name should appear.  After the event, which was great- one of the other panelists (who has a PhD in education and goes by “Doctor”) pulled me aside and asked, “Why don’t you use doctor?” I replied, “Because people see that and make assumptions about me. I find it gets in the way.” (If she hadn’t gone by “Doctor” I might have added that I think it’s pretty pretentious when PhDs do that.)

What this geographical lie of omission comes down to is this: It’s hard enough to get to know new people and their prejudices (good or bad) can make it a lot harder.  It can be harder because of how they react (put themselves down).  It can be harder because of how you think they’ll react (unnecessarily impressed).  It can be harder because of how they think you want them to react (impressed).  It can be harder because of how you react to their reaction (awkwardly).

I’m not asking anyone to play the world’s smallest violin on my behalf, as if I have this cross of education to bear, I’m just pointing out that it makes me uncomfortable when people react to by alma maters as anything other than factoids of information.  (Unless you are a potential employer, in which case- be impressed!!!) And, since they often do react strongly to learning of my educational background, making one or both of us feel awkward, I choose to avoid sharing that info when possible.

And for the record, I don’t think the geographic option is ‘code’ for the in-crowd.  When people tell me they went to school in Boston, I don’t automatically assume Harvard. And when I’ve said I went to school in New Haven, I’ve never been insulted when people ask about UNH or Quinnipiac- I’m usually chagrined because it means I have to clarify and ‘fess up to the truth.

 

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