Notes: Epidemiology, Clinical Observations, Misc.

ec01 "A clinical case [of WNV encephalitis] is defined as a presumptive diagnosis of viral encephalitis with or without muscle weakness or acute flaccid paralysis, Guillain-Barre syndrome, aseptic meningitis, or presence of the clinical syndrome characterizing the initial cluster of cases in a patient presenting after August 1." MMWR Weekly www.cdc.gov/epo/mmwr/preview/mmwrhtml/mm4838a1.htm
Note: Associating WNV with any of the above symptoms defines West Nile virus encephalitis. There is a legal precedence for interpreting "or" as "and". This could be important in interpreting the phrase, "or presence of the clinical syndrome... after August 1."
ec02 "As New Yorkers endure one of the hottest summers on record, they are also suffering a curse that compounds their lethargy and sense of ill-being: the worst smog in more than a decade. [para] Levels of ozone, a toxic chemical that burns the lungs, stings the eyes and can dim vistas with a brown haze, are the highest since the late 1980's, records kept by the State Department of Environmental Conservation show, and as usual, the worst of it has blanketed New York City and its suburbs. [para] The state has already exceeded the Federal standard for ozone pollution more times this year than it did in each of the last seven years, and there are still two months to go in the May-to-September smog season. [...] Put simply, ozone makes it hard to breathe, particularly for the elderly, small children, people who are exerting themselves and those with lung diseases. It burns the lungs much the way sun burns the skin. [...] 'It impairs the ability to fight off infection, in kids especially, and it can aggravate the trouble that heart and lung patients already have breathing, which can be fatal.' [...] Ozone is not the only form of air pollution..." -- The New York Times, 8/1/1999 Note: NYT gives the impression that photochemical smog is a respiratory hazard, while not mentioning neurological dangers.
ec03 Clinical description of Bronx Zoo birds: "Autopsies of the birds revealed streaking in the heart and brain hemorrhages." -- The New York Times, 9/25/99

Regarding Fort Totten crows: "...Mr. Carrasko, who said he began noticing brown, bumpy growths on the heads of many crows last month." -- The New York Times, 8/22/99

"But a Queens veterinarian, John Charos, who has treated more than two dozen sick crows, said that some of the birds he treated showed symptoms similar to encephalitis, including high fever and a dazed demeanor." -- The New York Times, 9/11/99

Note: Gastro-intestinal disease was also apparent.~
ec04 "And health officials in New Jersey urged doctors to be on the alert for symptoms of the disease, which range from high fevers to severe headaches, slurred speech, blurred vision and nervous tics." -- The New York Times, 9/11/99
ec05 www.epa.gov/oar/oaqps/gooduphigh ; www.epa.gov/airnow/health/smog1.html#9 ; www.oxybusters.org
ec06 NOAA, National Climatic Data Center, Summer of 1999
ec07 Summary review of NYSDEC Pathology log, 1992-1999
ec08 EIDTEXT.DOC, CDC/NYSDOH (12/18/1999)
ec09 NYSDEC "West Nile Virus Database", 2/23/2000; See my graphic representation of NYSDEC Result Ratios.
ec10 Interviews with: Dr. Charos, Veterinarian, Bayside, Queens; Joe Pane, Chief Biologist NYCDEC; Ward Stone, Chief Pathologist, NYSDEC; Personal observations. See my graphic representation of NYSDEC Results.
ec11 1) "But they [the crows] are, and not just in Fort Totten. They have also been found dead in Flushing, Kings Point in Great Neck and Throgs Neck in the Bronx... [...] For two weeks we've been getting reports on a daily basis about dead and dying crows around there,' Mr. Lieblein [NYSDEC] said. Eight dead crows, several from each area, were frozen and sent to state laboratories in Albany for autopsies, he said. Results are expected this week." [...] "Crows, which are hearty scavengers, are affected much less frequently than other birds by spoiled food and bacteria. 'This is a bird that can live on road kill,' he [Dr. Charos, Bayside veterinarian] said, 'so the amount you have dying now, you have to wonder if they're being poisoned." The New York Times, 8/22/1999

2) "An unusual increase in crow deaths, first noticed last month [August, 1999] near Fort Totten (N. Queens), has spread to other parts of the city, according to the state's Department of Environmental Conservation. The agency has concluded that the deaths are most likely linked to the region's water shortage, although the final test results are not in." [...] "The affected birds are American crows and, more recently, fish crows, which are slightly smaller and live near waterways, where they feed on the eggs of other birds." [...] "'As the ground dries up, there aren't as many seeds and insects around, and water and fruits are not as available. The crows are more pressed than usual and may be eating other things and digging deeper into the ground for food and access old toxins." -- The New York Times, 9/5/1999

3) "We thought that they [crows] might have been poisoned from chemicals in the ground, dumps, etc." -- Interview with Joe Pane, Chief Biologist NYCDEC; Ward Stone, Chief Pathologist, NYSDEC (5/8/00)
ec12 1) "WASHINGTON, July 26 -- The Environmental Protection Agency will propose that Congress no longer require oil companies to add an ingredient to gasoline that is meant to make the air cleaner, because it pollutes water. A panel appointed by the E.P.A. is set to report on Tuesday that use of the much-debated ingredient, M.T.B.E., a possible carcinogen, should be 'reduced substantially' because it dissolves easily in water and turns up in tap water when gasoline has leaked or spilled." -- The New York Times 7/27/1999

Note: Not mentioned in NYT: A major concern is MTBE's characteristics as a neurotoxin and as a catalyst for ozone production in the atmosphere. See studies by Dr. Joseph, downloadable from
ec13 "ALBANY, Aug. 27 -- After years of battling over smokestack pollution that blows from the Midwest and the South, Northeastern states, led by New York, have signaled for the first time a willingness to retreat from their demands that other states significantly reduce their emissions. [...] Environmentalists are furious at the apparent retreat. 'Anyone concerned with clean air and health would have huge reason to be outraged by this,' said Peter Iwanowicz, director of environmental health for the American Lung Association of New York State. [...] About one-third of atmospheric nitrogen oxides, the main chemicals that contribute to ozone, come from electric power plants. Environmentalists say this summer's ozone problem provides more evidence that New York State and the Federal Government should make old power plants meet the same emissions standards as new ones." -- The New York Times, 8/28/1999
ec14 1) Joe Pane, Principal Fish and Wildlife biologist for NYCDEC, quoted in Newsday, Queens Edition, 9/14/1999: He referred to presumed toxic-caused death for the crows with the phrase "the miner's canary."

2) Jay Gould, Low Level Radiation, High Level Deceit (1996), "Silent Summer", p37-38. Excerpt: “'Older birds are generally a little bit dominant over younger birds, more experienced, better able to find shelter, and they usually have the best territories,' DeSante explained.'' [...] DeSante suggested that these puzzling results may all agree with the hypothesis that [atmospheric, neurotoxic] radiation from Chernobyl was the culprit. He said, 'I believe that if low-level radiation is working through the immune system, it would preferentially affect the very young...' [...] Ornithologists are generally in agreement that birds can be regarded as early warning systems for man because they are extremely sensitive to the environment—like the canary in the coal mine. The miner never knew when poisonous gases were accumulating to dangerous levels. When the canary died, the miner hastened to get out. Did birds send a similar message to humanity in the summer of 1986, this time about the dangers of low-level radiation, particularly to especially sensitive members of the human race, such as infants and ailing adults?" Note: Dr. David DeSante is the Executive Director of The Institute for Bird Populations, Point Reyes Station, CA. In reply to my inquiry regarding atmospheric pollution, Dr. DeSante responded, "...these kind of environmental contaminants likely will work synergistically with other stressors (like high ozone levels) to negatively affect immune responses which generally are weakest in both the very old and very young.'"
ec15 Ann Dunn, in the New York State Conservationist, 4/1/1999
ec16 June/July Crow Deaths (1999)
1) After searching Nexus (All news journals, domestic and international), wire services, news, business, and legal magazines), I found that the earliest article which mentioned crow deaths was the August 22, 1999 article in The New York Times, which refers to approximately August 1st ("three weeks ago") as the first mention of crow deaths. That was in reference to Dr. Charos of Bayside receiving dead crows. NYT 9/11/1999 places Dr. Charos receiving crows at about 9/5/1999 ("last week"). The first NYT article to use the words "crow" and "July" is September 29, 1999. The NYT views pervaded the media with two exceptions, which occurred several months later, in December, 1999. See NandoTimes, and The New Yorker, below.

2) An NYSDOH/CDC document, EIDTEXT.DOC refers to over 3,000-6,000 crow deaths reported to the NYSDOH.

3) Searching the internet proved fruitless, but for one exceptional article, which mentioned June crow deaths. This was found in the online news service,
www.NandoTimes.com (NandoTimes/Associated Press), in an article written by Matt Crenson and Joseph B. Verenga, entitled "Unraveling The Mystery Of A Deadly Virus". Excerpt: "NEW YORK (December 5, 1999) William Carrasco chose a spot between two oak trees and started digging. Two dead crows, their eyes sunk into their heads, lay near his feet. [para] Crows were dying all over Fort Totten, the Civil War fort where Carrasco works as a security guard. He was finding them at the front gate, behind the old officers' club, by the murky pond behind the buildings. [para] The dying started in late June when the weather turned hot. From his post at the gate, Carrasco watched birds stumble drunkenly around the grounds. Some had growths on their heads. [para] Within weeks, it was the same all over the New York City area - in Brooklyn's Prospect Park, by Long Island roadsides, on golf courses in Westchester County. Dead crows were everywhere; and sick birds, listless and disoriented, shuffled about aimlessly. [para] On Long Island, a man saw one fall right out of a tree...." Note: This article is apparently no longer online. Bolding is mine.

4) Day Starr, of Queens: "In June, my sister said she saw a number of dead crows near the swimming pool in Harlem."

5) "In late June or early July, the virus apparently showed up in birds in the Whitestone area of northern Queens and in the South Bronx." -- The New Yorker, 10/18/99 and 10/25/99
ec17 "Once the local Health Department and the CDC decided the cause was the West Nile virus, all other concerns were dropped." -- Joe Pane (Interview, 5/8/2000).
ec18 1) "In early August, the city announced that scores of people were suspected to have contracted St. Louis encephalitis, an illness that had never been in New York City before and is more often found in the South [SLE rather than WNV was first stated as causal in The New York Times, 9/4/99]. At the same time, wildlife experts in Albany and at the Bronx Zoo, as well as bird-watchers and other people, began to notice the deaths of large numbers of crows around the state and in New Jersey." -- The New York Times, 9/28/99

2) "In late summer 1999, an outbreak of human encephalitis occurred in the northeastern United States that was concurrent with extensive mortality in crows (Corvus species)..." -- R. S. Lanciotti, et al, "Origin of the West Nile Virus Responsible for an Outbreak of Encephalitis in the Northeastern United States", Science, 10/25/99
ec19 Personal observation, and common knowledge in New York City.
ec20 Ward Stone, Chief Pathologist, NYSDEC (Interview, 3/27/00).
ec21 1) "WNV can infect a wide range of vertebrates, but in humans it usually produces either asymptomatic infection or mild febrile disease. Within its normal geographic distribution of Africa, the Middle East, western Asia, and Europe, WNV has not been documented to cause epizootics in birds; crows with antibodies to WNV are common, suggesting that asymptomatic or mild infection usually occurs among crows in those regions. Similarly, substantial bird virulence of SLE virus has not been reported. Therefore, an epizootic producing high mortality in crows and other bird species is unusual for either WNV or SLE virus and may represent introduction to a native bird population or a new virulent strain." MMWR 10/1/99, www.cdc.gov/epo/mmwr/preview/mmwrhtml/mm4838a1.htm Note: "Therefore" WNV may not have produced high mortality in crows in NYC either, and the cause might be something else. There appears to be no evidence that WN virus is new to the Western Hemisphere. New, is the search itself. New is the mosquito/virus surveillance program. New is the CDC's growing interest in this methodology. Thus there is not even a prior association with crow death to bring as evidence against WNV regarding its ability to cause disease in crows.

2) "In a final twist, it is possible that West Nile was already part of the American landscape, and has been discerned only because of the current outbreak... It's an extremely complicated issue. We just have no idea what might be going on here." Regarding the dangers of the WN virus, 'I would hesitate to assign risk." The New York Times editors, in the same article, contradicts Dr. Spielman's concern, with a crude editorial presumption, "No one really knows, for instance, how long this region's birds, which have never been exposed to the disease..." -- The New York Times, 9/29/1999. Note: Dr. Spielman is a professor of tropical public health at Harvard's School of Public Health whose expertise is mosquito-borne diseases.
ec22 1) "In its effort to eradicate mosquitoes, the city said, it had concentrated since Friday night on the sections of northern Queens lying south of the Bronx-Whitestone Bridge and the Throgs Neck Bridge..." -- The New York Times, 9/5/1999, (see N. Qns map)

2) "Eight of the earliest case-patients were residents of a 2-by-2-mile area in northern Queens. On the basis of these findings, aerial and ground applications of mosquito adulticides and larvacides were instituted in northern Queens and South Bronx on September 3." -- MMWR 10/1/99,
ec23 "No one diagnoses HIV infection on a single ELISA. [The NYC aerial pesticide spray program was initiated within hours of the 2nd ELISA seropositive and no genetic identification.] [...]"

"...now it's accepted that endogenous retroviral DNA forms about 1% of human DNA... that's about 3,000 times larger that what the experts claim is the size of the HIV genome. And what’s more, new retroviral genomes can arise by rearrangements and recombination of existing retroviral genomes. [...] Retrovirologists themselves have argued that retroviruses may arise as the result of a disease and not vice versa. [...] Endogenously produced retroviruses are morphologically and biochemically indistinguishable from exogenous retroviruses."

-- Christine Johnson, "An interview with Eleni Papadopulos-Eleopulos", Continuum, Autumn 1997, see
ec24 1) "For both viruses, migratory birds may play an important role in the natural transmission cycles." -- MMWR 10/1/99, www.cdc.gov/epo/mmwr/preview/mmwrhtml/mm4838a1.htm

2) "Collectively, these data suggest that control measures, combined with cooler temperatures, have been effective in reducing the transmission cycle in nature and limiting further illnesses in humans." -- MMWR 10/22/99,
ec25 "Clinically they didn't [see enterovirus encephalitis]. Sometimes there's some initial confusion, but... and that's again where the other branch of epidemiology, the investigative branch, where we can go out and collect mosquitoes, we see birds... you know in the enterovirus, we wouldn't see mosquitoes... with the virus, we wouldn't see birds dying... we were seeing the natural transmission cycle of a flavivirus in New York. We were seeing birds dying." -- Interview (paraphrased from notes) with Robert Lanciotti, Section Chief of the Diagnostic Laboratory, CDC, Ft. Collins, CO.
Note: Clearly the death of the crows was used to determined the suspected virus to be an avian/mosquito virus, which then indicated the types of viruses that would be specifically tested for in the laboratory. Lanciotti knew of no testing for enteroviruses. There is no indication from Lanciotti or in the literature of the epidemic, that other viruses were tested for in human patients or birds or the contradictions such findings would pose if they were found. Also, mosquito/virus surveillance didn't detect and wasn't testing for any West Nile virus or SLE virus until after the last human disease onset. NYC did not have mosquito/virus surveillance at that time.
ec26 "Bird deaths help track West Nile virus" -- Ward Stone, Chief Pathologist, NYSDEC, as quoted in Daily News (4/30/2000).
ec27 1) "The correlation between the activity and abundance of microbes in disease is very clear. They have to exceed a certain threshold number before they can cause a disease." -- Peter Duesberg, Ph.D., molecular biologist, as quoted by Gary Null in "AIDS: A Second Opinion", Townsend Letter for Doctors and Patients, June, 2000.

2) Question to Fort Collins, CDC: "I didn't see the number of reactions or a mention of quantitative data. I am probably mis-reading the article. Have I overlooked the quantitative data in the article?" Reply from CDC (3/13/2000): ...the answer to your question is not known at this time. The data are being analyzed and will be reported in the published literature when available." -- James Herrington, MPH, CHES, PhD (candidate), Public Health Education Specialist, Office of the Director, Division of Vector-Borne Infectious Diseases, CDC, Fort Collins, CO.

3) Loose usage of the word "isolation" is admittedly common among virologists according to WNV virologist Zdenek Hubálek. Although WNV has not been isolated as a purified virus when cytopathic effects are noticed in vero cells or chick eggs, isolation is claimed retrospectively after identification of the unknown "isolate" or "isolates" by highly specific tests. These tests are dependent upon the vague clinical data
(ec28) and epidemiology to specify the virus testing. It seems that purified WNV has never existed, because none of the photomicrographs show a purified virus, free of surrounding tissue cells, which, if any quantity existed, could easily have been obtained with a high-speed centrifuge. Without a purified isolate, virologists are admitting in effect that no tangible quantity of WNV has been found since 1937, when the WNV was claimed to have been discovered, and thus a sure identification of a virus, isolated from free nucleic acid and other viruses has not ever been attained. This brings into question the overall status of WNV as an active pathogenic virus, and specifically, regarding the NYC epidemic: Is WNV active, dormant, quantitative? More than an anecdote? Or is it a normal part of the cell structure? Thus, the question was asked if there are photos of purified WNV. An expert in the field of WNV, Zdenek Hubálek, wrote in response (4/14/2000): "I am not aware of better photos. You will always have some cells or cell debris in these electron micrographs." When Robert Lanciotti at Ft. Collins was queried, he replied (4/12/2000), "Unfortunately, I do not have any such photos and I am not aware of where there would be any."

4) Question to viropathologist John F. Anderson
Anderson re the existence of quantitative data for WNV. "Could you inform me as to the results of quantitative analysis regarding WNV in human patients and crows during the summer of 1999, New York? And the obvious next question, is there a standard threshold for WNV quantitative presence in order to label it as causal for WNV encephalitis?" Anderson's reply (6/14/2000): "I cannot answer your first question. You will need to talk with the people in New York. We reported culturing WNV from 28 of 31 crows tested in Connecticut. I believe the culturing of this virus from birds is a good indication that the bird died from the virus. In humans, clinical symptoms and positive serology's were used to identify cases in New York." Anderson would not respond to a further email. Note that serology was limited to arboviruses. Note Anderson is contradicted by items herein, regarding clinical symptoms: "symptoms were not identical" (ec28) and "not well documented". (ec48)

5) David Crowe attempted to understand how virologist John F.
Anderson identified WNV as the single causal disease agent:
"From: John F. Anderson, To: David Crowe, Subject: West Nile Virus (WNV), Date: Fri, 5 May 2000
Dear Mr. Crowe: Viruses can only be isolated in cells. We isolated WNV in Vero cells. WNV killed our cells, caused disease in laboratory animals, and we published a photograph of the virus in our Science article. In serology tests, our virus reacted with antisera to WNV and to St. Louis encephalitis virus. [para] After extracting RNA from our isolates, we ran RT-PCR. We then sequenced a portion of the genome and compared this sequence with those of other flaviviruses including WNV. We had a close match with WNV. [para] Vero cell cultures without WNV did not die from an infectious agent and they did not produce a 921 nucleotide band by RT-PCR. John F. Anderson" Note: I inquired of Anderson what he meant by the statement "Viruses can only be isolated in cells", and received no reply. In some articles, Anderson is described as an entomologist. Perhaps he is not the appropriate person for these questions.
ec28 NYCDOH epidemiologist Marcelle Layton stated in The New York Times (9/9/99), upon hearing of the 6th SLE [WNV] case, "The six patients' symptoms were not identical." Symptoms are vaguely defined: See NYCDOH description and CDC description. It has been stated that West Nile virus symptoms are "not well documented."
ec29 Interview with Dr. Charos, Bayside veterinarian on 2/9/00.
ec30 No Mosquitoes During the Summer of 1999

1) "That silence is the sound of a mosquito-free summer... Martin Chomsky, superintendent of the Monmouth County Mosquito Extermination Commission [said,] '...this is a record year in terms of the lack of freshwater mosquitoes' [...] 'I was very prepared with the itchy stuff, the calamine and Caladryl, and we haven't had to use it,' said Clara D'Angelo, the nurse at Camp Waneeshi in Salt Point, N.Y., where 90 Girl Scouts pitch tents each night.
'I'm well prepared for mosquitoes that don't exist.'" -- The New York Times, 8/7/99 Note: The first onset of WNV encephalitis was 8/5/99.

2) "I didn't see any mosquitoes until after the spray program finished." -- Jennifer Jager, NYC

3) "I also did not encounter a single mosquito last summer. This year, I have had more mosquito bites than I have had since childhood. Do I believe the prediction that spraying produces a rebound of the mosquito population? It sure looks that way." -- Richard Janniccio, Bayside, Queens. Note: It is believed that mosquitoes rebound after pesticide spraying because their natural predators [bats, birds, dragonflies, spiders] are killed off, and because the mosquitoes of year 2000 are the survivors, the less-sensitive to pesticides, and the adapted.

4) "I had not seen a mosquito during the entire hot, dry summer. Near the end of the summer, I endured six weeks of dramatic, dangerous aerial pesticide spray programs, carelessly done, without accurate scheduling. Mayor Giuliani and other politicos grossly misinformed the entire citizenry regarding the dangers of pesticides
(ref). When the spray program was finally called off and the government was announcing its victorious reduction in mosquito populations (without quoting sources), I laid down on my back, staring peacefully at the ceiling, and saw a resting mosquito -- a comic reassurance. I reflexively got up, swatted at the mosquito and thankfully, missed." -- Jim West, NYC
ec31 "A short 5' noncoding region of 96 nucleotides is followed by an ATG initiation codon at position 97 and a single open reading frame of 10,302 nucleotides coding for three structural proteins--capsid, premembrane (prM), and envelope (E)--and five nonstructural proteins (NS1, NS2a/NS2b, NS3, NS4a/NS4b, and NS5)." -- Robert Lanciotti, et al., "Origin of the West Nile Virus Responsible for an Outbreak of Encephalitis in the Northeastern United States", Science, 10/25/1999.
ec32 "In late summer 1999, an outbreak of human encephalitis occurred in the northeastern United States that was concurrent with extensive mortality in crows (Corvus species) as well as the deaths of several exotic birds at a zoological park in the same area." -- Robert Lanciotti, et al., "Origin of the West Nile Virus Responsible for an Outbreak of Encephalitis in the Northeastern United States", Science, 10/25/1999. Note: An impression is given that the WNV encephalitis epidemic could have occurred in the middle of a nature preserve, rather than one of the most polluted industrial areas of the U.S. Wouldn't it have been proper to present a technical summary of existing environmental poisons which were capable of causing encephalitis?
ec33 Jay Gould, "Coverup", Low Level Radiation, High Level Deceit (1996)
ec34 Dan Fagin and Marianne Lavelle, Toxic Deception (1996) found that 18 of 20 government environmental executives move on to work for private industry. They state that the chemical industry shapes the way chemicals are perceived through a domination of the media, courts, legislature, and science. They quote the chairman of Dupont, "Science is what Dupont says it is."
ec35 "Although government agencies and industry have been slow in their reevaluation..., reassessment often comes in the wake of or concomitant with some recently disclosed adverse environmental or health effect." -- Casarett and Doull's Toxicology, The Basic Science of Poisons, 5th ed. (1996), p650.
ec36 Commonalities of the WNV patients: "The six [encephalitis] patients' symptoms were not identical. Nevertheless, Dr. Layton and Dr. Fine said they were struck by certain similarities of clinical and laboratory findings among the patients. [1] All had been active and healthy with only [2] minor medical problems before developing this new illness. [3] Now muscle weakness was a striking feature. [4] Fever and mental confusion were also present, but in varying degrees. [...] That Saturday, Dr. Layton and Dr. Fine interviewed patients' families. But there were no common threads [except:] -- [5] no other illnesses in the same household or among their friends, [6] no recent travel, trips to the same beaches, or [7] shopping, eating or socializing at the same place. [and:] '...The only common thread was [8] they spent time outdoors in their backyards,' Dr. Layton said." -- The New York Times (9/9/99)  Note:  Layton is an E.I.S. Officer (Epidemic Intelligence Service, i.e., "Medical CIA", as found in writings of Dr. Peter Duesberg).
ec37 CJ: Antibodies are too imprecise? EPE: Antibodies are imprecise but that's not the issue here. Antibodies are irrelevant. You prove proteins come from a virus particle by isolating the particle and then doing a dissection. You don’t prove proteins are constituents of a viral particle by performing chemical reactions on what is essentially a culture soup. It has nothing to do with it. So what if some proteins and antibodies react? There's many reasons why these reactions might take place. -- Christine Johnson, "An interview with Eleni Papadopulos-Eleopulos", Continuum, Autumn 1997, see www.virusmyth.com/aids/data/cjinterviewep.htm
Note: This critique of antibody reaction tests regards HIV, however, this critique can apply to the WNV testing.
ec38 "URGENT UPDATE: [...] REPORTING SUSPECT CASES OF SLE [diagnoses similar to WNV, which was later determined to be the virus]: The location of laboratory-confirmed cases suggests that transmission of SLE is occurring in at least three boroughs in the city. To determine the full geographic extent of this outbreak, and to target mosquito control measures as effectively as possible, the NYCDOH continues to request that you report immediately any patients with the following syndromes with onset since August 1, 1999:

1.Any adult or pediatric patient with the clinical syndrome that characterized most of the laboratory-confirmed cases in Queens: a) Fever > or = 38.0oC or 100oF; b) Altered mental status (altered level of consciousness, agitation, lethargy, or change in personality); c) CSF pleocytosis with predominant lymphocytes and/or elevated protein d) Muscle weakness (especially flaccid paralysis) confirmed by neurologic exam or by EMG.

2.Any adult or pediatric patient admitted to your hospital with a presumed diagnosis of viral encephalitis, or with focal CNS findings and fever

3.Any adult or pediatric patient admitted with presumed Guillain-Barre Syndrome or acute flaccid paralysis since August 1, 1999.

4.Any adult or pediatric patient admitted with presumed aseptic meningitis (fever, headache, stiff neck and/or other meningeal signs, with CSF pleocytosis with predominant lymphocytes and moderately elevated protein, and a negative gram stain and culture to date). Please be advised that since aseptic meningitis due to enteroviruses (such as ECHO and Coxsackie) is common in the late Summer and early Fall, especially among young children, most of these cases are likely not due to SLE [later named WNV]."

-- Excerpt from:
www.ci.nyc.ny.us/html/doh/html/cd/cdsten2.html, September 13, 1999

Note: Bolding is mine. The first bolded phrase discourages the reporting of pre-August cases as WNV. Apparently, a bias exists in the epidemiology which allows children and post-pollution cases to be categorized as non-WNV, as follows: The second statement specifies clinical description. If the suspect is young then WNV will not be suspected and other germ culprits, such as enteroviruses, will be sought. If the suspect is old, then WNV tests will occur first, and not continue after findings of WNV seropositive. Similarly, if enterovirus positives are found in a young person, then WNV will not be sought. Thus a goal is achieved: no mention of cases of mixed virus family disease (no flavivirus/enterovirus cases), although the mix, SLE/enterovirus, has been reported re encephalitis epidemics in Microbiology, by Dulbecco (1973), and generally, mixed pathogens are historically common in viral encephalitis.
ec39 The EPA office which handles the issues of MTBE and air pollution is entitled "The Office Of Air And Radiation", perhaps allowing this office to be privy to the security measures given to the nuclear industry, which are described by Dr. Jay Gould as extending to manipulations of the Vital Statistics.
ec40 New Jersey, General Description
"'That's an extraordinary number of bird carcasses to see in Bergen County,' said William Schuber, the Bergen County Executive, about the 80 dead crows found in his region over the last few days. 'We do have concern. Finding one dead crow is unusual. To find so many is very unusual.' New Jersey's Department of Health has asked eight northern counties to continue spraying insecticide until further notice." -- The New York Times, 9/29/99.

"New York, New Jersey and Connecticut are studying samples from dead birds, some of which have already tested positive for a West Nile-like virus." -- The New York Times, 9/30/99.
ec41 Connecticutt, General Description
"Although no Connecticut residents have been diagnosed with the disease, the virus has been detected in mosquitoes and crows in New York, New Jersey and Connecticut. Connecticut, for several years, has been trapping and testing mosquitoes for Eastern Equine Encephalitis, a potentially fatal virus that has surfaced in neighboring states. The state Department of Environmental Protection on Tuesday released results of mosquito testing in Fairfield County, which showed no signs of either virus." -- The New York Times, 10/14/99.

"Infected Mosquitoes Spread Scientists in Connecticut said that they had found encephalitis in a crow and in mosquitoes." -- The New York Times, 9/22/99.

"No one in Connecticut has been found to have the disease. But today's discoveries of the virus led officials of the State Department of Environmental Protection to prepare for widespread aerial spraying of insecticide in Fairfield County next week. As a first step, street-by-street spraying from trucks is to begin at sunset Thursday in the Old Greenwich area, weather permitting. The insecticide, called Scourge..." -- The New York Times, 9/22/99.

"Connecticut officials said that as of the middle of last week no one in the state is known to have contracted the virus. Hundreds of birds, most of them crows, have dropped dead in Fairfield County since Sept. 24, and scientists suspect many of them have been felled by the new virus. They have confirmed that one crow from Westport found Sept. 13 had the new virus." -- The New York Times, 10/3/99.

"And in Connecticut, officials in Hartford reported on Monday that seven dead crows collected in Fairfield County from Sept. 22 to Sept. 24 had tested positive for the virus. However, they said tests from mosquitoes collected in a trapping program indicated that the virus was not present at a significant level." -- The New York Times, 10/5/99.
ec42 Though the West Nile Virus was never tested for previously in the U.S., it is commonly claimed to have recently arrived in the United States, thus accounting for the massive bird deaths as due to immunologically naive birds. On May 4, 2000, the Mayo Clinic summarized WNV with the following dogmatism: "Origins of the Virus... West Nile virus made its first appearance in the Americas in August 1999 when an outbreak occurred in the New York City area."
ec43 "The case fatality among 59 hospitalized patients was 12%; the seven deaths occurred among person aged 68 to 87 years. (Increased severity of illness and higher case fatality among older patients characterizes both West Nile and St. Louis virus encephalitis viruses.) One patient was infected with HIV but had not been diagnosed with AIDS; 3 patients were receiving immunosuppressant drugs for cancer."
ec44 "Daily News 7/27/2000 Plan to Block Skeeter Spraying Squashed: 'You have to virtually, you know, drink this stuff in order to have those side effects", [Mayor Giuliani] said of the pesticide Anvil. "There's no risk of fatalities.'" -- via Robert Lederman. Note: Mayor Giuliani, having been sprayed with malathion several times, now has prostrate cancer. Malathion has been shown to greatly increase risk for prostate cancer. The Mayor's solution? To have 90 radioactive pellets implanted, producing levels of radioactivity that require him not within close vicinity of children or pregnant women.

"'I have three kids, and I have no problem leaving my windows open when they are spraying. [Brooklyn News]' - City Council member Angel Rodriguez, Brooklyn, Sunset Park / Red Hook / Carroll Gardens" -- via NoSpray News 9/19/99
ec45 "Queens Courier, February 17, 2000, Attorney General To City Officials: Stop Claiming Malathion Is Safe, By Howard Girsky, Senior Editor: City officials including Mayor Rudy Giuliani and Health Commissioner Neal L. Cohen have repeatedly violated federal and state regulations by offering public assurances that the pesticide malathion is safe, The Queens Courier has learned from the New York State Attorney General’s office. Judith Enck, a spokesperson for Attorney General Eliot Spitzer confirmed officials of her agency have notified the city’s corporation counsel to "cease and desist" this practice. [para] Peter Lehner, chief of the Attorney General’s environmental protection bureau, notified the city’s corporation counsel, Michael Hess, that safety claims about pesticides are in violation of U.S. Environmental Protection Agency and the New York State Department of Environmental Conservation Law.'" -- via Elizabeth Shanklin, Riverdale Greens
ec46 "WNV can infect a wide range of vertebrates, but in humans it usually produces either asymptomatic infection or mild febrile disease. Within its normal geographic distribution of Africa, the Middle East, western Asia, and Europe, WNV has not been documented to cause epizootics in birds; crows with antibodies to WNV are common, suggesting that asymptomatic or mild infection usually occurs among crows in those regions. Similarly, substantial bird virulence of SLE virus has not been reported. Therefore, an epizootic producing high mortality in crows and other bird species is unusual for either WNV or SLE virus and may represent introduction to a native bird population or a new virulent strain. For both viruses, migratory birds may play an important role in the natural transmission cycles." -- MMWR 10/1/99
ec47 "Birds not only know no political boundaries... they also ignore ecological barriers of any kind. They are able to fly over all the global oceans, the broadest deserts and the highest mountain ranges, as well as fields of ice and expanses of rain forest. When crossing ecological barriers they routinely ascend to altitudes of 10,000 m or even a little more." -- Peter Berthold, "Bird Migration: Introductory Remarks and Overall Perspective", Max Planck Institute Vogelwarte Radolfzell, Germany,
ec48 "One should note that clinical signs have not been well documented for West Nile..." [...] "West Nile virus, Northeastern US October 1999 Impact Worksheet" [...] "Prepared by: Center for Emerging Issues, Centers for Epidemiology and Animal Health Animal and Plant Health Inspection Service, USDA" -- http://www.aphis.usda.gov/vs/ceah/cei/westnile.htm Note: Epidemiology depends upon virus/clinical descriptions, in order to target suspected specific viruses or specific types for lab testing.
ec49 Contributed by Meg Feeley
ec50 Robert Lanciotti, CDC, Fort Collins (Personal communication)