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West Nile virus, a virus known to be hosted by 18 species of native wild birds and spread by mosquitoes, was first confirmed in the United States last August. An outbreak of West Nile encephalitis was contained within the New York City and Long Island regions between August 5, 1999 and September 16, 1999. Since then, the virus has been found in Connecticut, Maryland and Eastern Upstate New York. In July of this year dead birds in the Boston area have been confirmed as having the disease. West Nile encephalitis is an infection of the brain caused by the virus and can be fatal to humans.

The disease is transmitted to humans when a mosquito feeds on an infected bird and then feeds on a human during the virus incubation period, which is 10 to 14 days. Most infections are mild and symptoms of West Nile encephalitis include fever, headache, body aches, skin rash and swollen lymph glands. More severe infections may be marked by high fever, neck stiffness, stupor, disorientation, coma, tremors, convulsions, muscle weakness, paralysis, and in some cases, death. The Centers for Disease Control and Prevention (CDC) recommends that immediate medical care should be sought if you believe you may have contracted West Nile encephalitis.

According to the CDC case fatality rates range from 3% to 15% and are highest in the elderly population. In the New York epidemic of 1999 seven deaths occurred in sixty-two cases of severe disease. People who are most at risk for contracting severe symptoms, in addition to the elderly, are young children and those with weakened immune systems. The CDC recommends reducing the risk of becoming infected by:
limiting time outdoors during dawn, dusk and early evening
wearing long-sleeved shirts and long pants when outdoors
using an effective insect repellent

David Kern of DAK Pharmaceuticals, maker of GreenHead repellent adds that "because mosquitoes will bite through thin clothing, repellent should be applied to clothing as well as to exposed skin." The choice of insect repellent should be based on three factors; the level of mosquito infestation, the length of time one will be exposed to them and the age of the person. Using a 20 30% concentration of a DEET-based repellent will provide effective protection for up to 4 hours exposure to heavy infestations. Higher concentrations of DEET will give longer-lasting protection according to Kern whose company markets GreenHead Tick and Insect Repellent in a formula of 30% DEET.

Plant-derived formulas, such asthose with a 5 or 10% citronella concentration, will provide effective mosquito repellency for short periods of time and need to be reapplied to maintain protection. Studies show that citronella can be an effective repellent, but it provides much shorter protection time than most DEET-based products. Frequent reapplication of the repellent can partially compensate for this. but Deet-based products are by far and away the most effective repellent.

Because the West Nile virus had never been reported in the United States before last year, and the migration of the disease from the New York area to Boston, Kern emphasized the importance of protection against mosquito bites. He especially recommends that people who could be most seriously affected by West Nile encephalitis, keep insect repellent in their automobiles, recreation vehicles, and with the tools and other items they use outdoors during mosquito season.

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