West Nile 2012

Here are statistics for several states cases reported for these years.

State	Total Cases 2002	Total Cases 2003	Total Cases 2004	Total Cases 2005	Total Cases 2006	Total Cases 2007	Total Cases 2008	Total Cases 2009	Total cases 2010	Total Cases 2011	Total Cases 2012	Total Cases 2013	Total Cases 2014	Population	RatePerMil.
														Millions
Arizona		13	391	113	150	97	114	20	167	69	124	62	107	6.48	19.1
California	1	3	779	880	278	380	445	112	111	158	424	379	801	37.69	11.2
Colorado	14	2947	291	106	345	576	71	103	81	7	129	322	118	5.11	31.1
Illinois	884	54	60	252	215	101	20	5	61	34	249	117	44	12.87	19.3
Louisiana	329	124	109	171	180	40	49	21	27	10	311	54	125	4.57	68.1
Minnesota	48	148	34	45	65	101	10	4	8	2	70	79	21	5.34	13.1
Mississippi	192	87	51	70	183	136	65	53	8	52	242	45	43	2.98	81.2
New Jersey	24	34	1	6	5	1	6	3	30	7	46	12	8	8.82	5.21
New Mexico		209	88	33	8	60	5	5	25	4	40	38	24	2.08	19.2
New York	82	71	10	38	24	22	46	7	128	44	106	32	26	19.46	5.4
Texas	202	720	176	195	354	260	64	115	89	27	1707	183	379	25.67	66.5
Washington		0	0	0	3	13	3	38	2	0	4	1	12

The final total cases for years:

• 2003                       2866

• 2004                       1142

• 2005                       3000

• 2006                       2269

• 2007                       3630

• 2008                       1356

• 2009                       723

• 2010                        1029

• 2012                        5207   45% of these were in Texas.

• 2013                        2469  and only 183 in Texas

• 2014                        2,205 with 379 in Texas.

CDC quote:

"One thing to remember is that the virus is endemic, at this point, throughout most of the United States. Certain areas high in the Rocky Mountains may not have it. But most of the country has endemic virus, it circulates every year. It's just a matter of how much. And so, what we have observed is a very high rate of transmission in certain states this year. Less transmission in other states, but it doesn't mean that people aren't at risk in other areas. There's a risk almost everywhere in the U.S. We're certainly, in areas where they had outbreaks or having high number of cases, we're certainly emphasizing that people follow the recommended precautions. In other areas, the risk may be lower but it's still not zero. And West Nile virus isn't the only mosquito-borne virus out there as well. So, I think it's prudent to follow the precautions no matter where you are. "

Why the outbreak has occurred there in the north Texas area in 2012? I don't think we have a full understanding of that yet. but probably an increase is susceptible people and increase in mosquitoes. ,

In 2012:
79 years old a rate of 6.3
for those 80 and above, 7.3.
for 10 to 19 years old, we’ve had an incidence rate of .3 per 100,000.
For 20 to 29, a .6.
From 30 to 39 year old individuals, a 1.2.
For 40 to 49, an incidence rate of 1.6.
From 50 to 59, of 2.9.
And from 60 to 69, 3.2.
We have had cases in all age ranges. "

The number of cases especially in children is way underestimated since many cases are milder and do not get tested and diagnosed.  If you look at these numbers in the chart above.. you will see many states vary the cases reported year after year.  Texas has an average of 218 cases over the last 11 years.  We saw a big number in 2012.  But look at the numbers from these states and you will see different states have had big out breaks in different years in the past. Look at the "Rate" per million population and two other states that I sampled were as high or higher than Texas.

Colorado almost had 3000 cases in 2003.  We had 720 cases in 2003.  California had the highest number of cases in 2011.  It is hard to say why there are years we have more cases  of West Nile in different states. It may be from Doctors looking for cases more when the news media goes crazy and that results in more reporting of cases or if there are factors that allow more mosquitoes or more mosquitoes with the virus. There are more cases in the South Eastern United states with more mosquitoes.  Also if there are a large number of people susceptible then there is a big outbreak.  Eventually many people become immune to the West Nile and then we will see a big decrease.

Before we had the chicken pox vaccine, we had many cases of Chicken Pox.  We had "chicken pox parties" to have the kids get it over with since they were going to get it any way.  But just as many kids got encephalitis from chicken pox as there are from West Nile, so we came up with a vaccine against it. We need to get a vaccine against West Nile... and Mononucleosis ... and Dengue Fever.  Dengue Fever will be exploited by the press some day.  It is in South America, Central America, Mexico, and now South Texas and Florida.  And 2% had Encephalitis.... It is coming up here some day and the news will go crazy over it.  There are a lot of diseases out there that cause death and damage... and we will never get rid of all the mosquitoes and diseases in the world.  Life has risks.... !!  Vaccines are the only real protection.

We see many cases of Encephalitis in children but it is milder in kids.  Most cases do not get diagnosed since it is just fever and mild headache in most kids.  Most parents are not anxious to do some expensive tests or do a spinal tap to diagnose a virus we cannot treat.  There are also many cases of Enterovirus illnesses in the summer as well causing fever.   So like chicken pox.... get West Nile as a kid since the mortality is very rare.  If the child gets West Nile, the illness is mild and the risk of death or damage microscopically small.

It is a bad disease and you need to use precautions to cut your mosquito bites down. Especially the elderly.   But no hysteria here.  Be careful but don't get crazy like the news media.

Like I said in 2012:  "I predict less cases this summer of 2013 since many will be immune to it but we shall see.   The news will give credit to mosquito control... like we could really make a dent in the number of them!"

Dr. Knapp
www.rogerknapp.com