Toxicology and WNV Encephalitis
New York City Region - 1999
The epidemic epicenter could have happened anywhere. It occurred, however, in one of the most congested, polluted areas of the United States, during a summer of record-high air toxics levels for that area.
Toxicological epidemiology is difficult due to a carefully maintained unavailability of data. So, in an effort to put the picture together piece-by-piece, public literature has been reviewed. The human epidemic first occurred, and mainly occurred in northern Queens, e.g., Whitestone, College Point, and Bayside (this is the order usually stated). The epidemic began in northern Queens zipcode 11357 (represented by the red cross) and then "spread" to the secondary epicenter, across the bay, to the SE Bronx rather than to adjacent land areas. Secondary areas for human cases and crow deaths were in the SE Bronx.
During the summer, beginning late- to mid-June, unconfirmed reports of crow deaths indicated that the peak of crow deaths occurred before August, 1999, before the human epidemic began.
During late July and early August some officials noticed and were notified of large numbers of dead crows. Many of these were reported to the NYSDEC from northern Queens. The areas south of the Whitestone Bridge and south of the Throgs Neck Bridge were mentioned, and Fort Totten (on the point just to the east of the Throgs Neck Bridge) were mentioned as sites of numerous crow deaths. Throgs Neck in the Bronx was also mentioned.
About a week later, August 12, the first human cases began to file into Flushing Hospital from the Whitestone area (see 3 red crosses below). The epidemic is summarized by borough:
NYC Patient Statistics as of 10/7/99 (ref) Status Age Location Hospitalized 5 60 or more 29 Queens 27 Deceased 4 50's 4 Bronx 9 Discharged 30 40 or less 6 Manhattan 2 Brooklyn 1 Totals 39 39 39
As of May, 2000, the figures have been slightly revised by the NYCDOH:
NYC Patient Statistics as of May, 2000 (ref) Location Queens 32 Bronx 10 Manhattan 3 Brooklyn 1 Totals 46
From the literature, descriptions of the epidemic epicenters have been approximated in the map below. The major human epicenters, as described, are circled in black and the major crow epidemic centers are squared in blue. Each of the 3 red crosses represent a middle point of 3 zipcode areas (ref) described by NYSDOH as the areas of the outbreak epicenter. Generally, winds come from the north and from the west. The following represents northern Queens (College Point, Whitestone, and Bayside) in 1999:
As of 1999, the entire borough of Queens contained only 3 EPA air toxics station monitors, represented by black squares. College Point had 2, and Bayside had 1. A sudden increase in the number of monitors is being completed for the end of the summer of 2000.
All boroughs are represented in the following table:
|EPA Station Monitors In New York City (All Boroughs)|
|Existing Monitors: 1999||New Monitors: By End of Summer, 2000|
|Queens||3||2 in College Pt., 1 in Bayside||2||Maspeth, Sunnyside|
|Bronx||4||3 in SE Bronx, and 1 north of the Bronx Zoo, near the Botanical Gardens||-1||470 Jackson Ave. monitor shut down|
|Manhattan||3||Mabel Dean HS; 288 E. 57th St.; 350 Canal;||4||600 E. 6th St., 2351 1st Ave., 511 W. 102 St., Madison and 47th-48th St.|
|Brooklyn||2||Greenpoint, Park Slope||2-3||800 Bushwick; Sunset Park District|
|Staten Island||2||Susan Wagner HS, Port Richmond HS||2||By the Landfill (Freshkills); PS 44|
|High Air Pollution Sources
At The Epicenter of the Epidemic
Pollutants that contribute to photochemical smog/ozone production
|College Point, Whitestone, Bayside||4 expressways border to the south and east. 1 other expressway a few miles to the east.||Automobile emissions, e.g., MTBE, VOCs such as benzene, NOx, CO.||WhtStnExpwy|
|College Point, Whitestone, Bayside||2 interborough bridges to the north.||Automobile emissions, e.g., MTBE, VOCs such as benzene, NOx, CO.||WhtStnBrgEntryS|
|College Point, Whitestone||La Guardia Airport: 3,000 ft away. Jets and piston aircraft will be blowing exhaust downward on takeoff. Large, low-flying turbine-aircraft are landing (and taking off) directly over the epidemic center. Landings and take-offs occur approximately every 2 minutes during the day and evening)||Aircraft and ground support engines emissions, e.g., MTBE (gasoline fueled engines (piston)), VOCs such as benzene, NOx, CO from all aircraft and ground support engines. (MTBE banned in 1999 and took several years for ban to take effect.)||BigJet1OverWhtStnExp
|College Point||College Point Corporate Park: An industrial park on the west waterfront, i.e., the area west of College Point Blvd., heavy and light industry. (Variety of emissions). A major NYC sewage treatment plant near Powell's Cove, at the tip of College Point emits volatile organochlorines and VOCs, and discharges waste into the bay.||Asphalt distribution center produces particulate matter, organochlorines, and VOCs.||CPindPark1
|Fort Totten||U.S. Army dump site. Cleanup is long overdue, according to Richard Janaccio, Bayside.||VOCs.|
|SE Bronx||3,500 NW and generally upwind of N Queens. Nation's highest high asthma rates (26 times the national average, NYCDOH blames roach feces). Heavy and light industry, and several expressways. "Hunts Point is home to the nation's largest food distribution center, nine waste transfer stations, dozens of manufacturing firms, salvage yards and auto-repair shops. Residents say that much of the pollution is caused by traffic and cite Community Board statistics that show 60,000 trucks per month come in and out of Hunts Point. Local environmental groups have rallied against facilities in the area, including a medical waste incinerator that had racked up more than 500 pollution violations." --http://www.oxybusters.org/asthma/asthma8.htm.||Automobile and truck emissions, e.g., MTBE, VOCs such as benzene, NOx, CO. Industrial emissions, e.g., organochlorines, organofluorines, organic solvents. Incinerator emissions.||Factory Stacks
|Bronx Zoo||Site of extensive crow and zoo bird deaths. Heavy expressway traffic on 3 sides. Large apartment complexes and incinerators. (I should have waited for heavy traffic to build up on the right lane too., but I was out of film!)||Automobile emissions, incinerator particulates and gas emissions.||Botanical Gardens (North of Bronx Zoo)|
It is interesting to note that mosquito-virus surveillance systems are now being established in New York City and that there is a parallel increase (time and place) in the number of pollution monitor stations. It is also interesting, possibly from a political viewpoint, that much of the highly polluted SE Bronx has no station monitors.
The SE Bronx community has relatively little political power to resist a severe encroachment from industrial sources of pollution, according to my interview of community board leaders who expressed frustration and ire. Ash and fiber pollution can be seen in SE Bronx window screens and air fans, if they are not frequently cleaned, the evidence of incinerator emissions. Such material is seen much less in Manhattan where an ever-settling fine, black carbon settles daily on floors and window sills, the evidence of diesel and powerplant emissions.
For a wider perspective, refer below to a map of New York City (not showing the two southern boroughs of Brooklyn and Staten Island). New Jersey is in the very NW corner, Manhattan to the west, being just south of the Bronx, and the large borough of Queens to the east (1999):
|White circles||College Point, Whitestone, Bayside (Queens)|
|Dark circles||Vaguely described areas of cases in Manhattan, and SE Bronx|
|Blue Squares||Crow deaths|
|EPA monitor stations|
|Center of zipcode areas of epidemic epicenter (ref)|
Dead crows were found throughout the New York region, including Long Island, but the first, prominent, and the most numerous findings, which were brought to the attention of the NYSDEC and deemed worthy of media attention, are represented above with blue-squares.
The exceptional concentrations of human and crow deaths correlate well with areas of highest levels of ozone and MTBE pollution -- near pollution monitors, multiple expressways, downwind from La Guardia Airport, and the toll gates of the bridges. According to the EPA Region #2 office (NYC region) the College Point monitors were installed to monitor the airport. Take-offs and landings occur from both runways.
The following is derived from the EPA's "Final Report: Evaluation of Air Pollutant Emissions from Subsonic Commercial Jet Aircraft", April 1999.
LTOs are "landing and take-off cycles", used to evaluate emissions from airports. New York City region is second in the nation to Chicago in total LTOs per year. The greatest number of LTOs/airport in the New York City area occur at La Guardia Airport, about 3,000 feet from the epidemic center, close to residential neighborhoods.
NYC leads the nation in aircraft NOx emissions (NO1, NO2).
"NO2 is an important precursor to both ozone and acidic precipitation, which harms both terrestrial and aquatic systems. Emitted from hydrocarbon combustion at high temperatures, NO and NO2 (collectively called NOx) react with gaseous hydrocarbons to form ozone.The mixture of NOx and urban air is commonly called 'smog'."
The following two tables include years 1990 and 2010:
By interpolating EPA data from the two tables and comparing with regional data,
it can be estimated that in 1999, approximately 3% of total New York City mobile sources of NOx were from aircraft, and about 1% came from La Guardia airport.
For La Guardia Airport, 1999, we can interpolate the first two tables giving 156,455 LTOs, and a total aircraft emissions of over 19 tons per day.
"The analytical results of the study confirm that commercial aircraft emissions have the potential to significantly contribute to air pollution."
Apparently MTBE is not added to turbine fuel, nevertheless, the components listed above are the basis for photochemical smog and ozone.
Most of the emissions come from take-offs, when the engines are running at full throttle. La Guardia has short runways and aircraft must ascend at a steep angle, driving their exhaust downward until they reach beyond the ground air "default mixing height" of 3,000 feet.
There are 4 possible take-off directions from La Guardia and direction 130 (SE), near Whitestone, is the most frequently used, representing 40% of all take-offs. Direction 220 is rarely used for take-offs (possibly to abate noise), and thus, whenever the wind is blowing from SW, S, or SE, runway direction 130 would be preferred. Many of these wind directions could move exhaust towards the epidemic area.
The composition of the aircraft emissions, VOC, NOx, SO2, and CO, combine and react in sunlight to form neurotoxic photochemical smog (ozone and aromatic nitros/sulfides).
An excellent summary of pollution in Queens is online at Queens College School of Earth and Environmental Science where it is stated:
"Airports create smog; a single 747 arriving and departing... produces as much smog as a car driven more that 5,600 miles, and as much NOx as a car driven almost 26,500 miles (source: Natural Resources Defense Council)."
Queens College provides a map showing La Guardia arrivals and departures and aircraft heading changes. I have included a modified version, showing the total number of departures (most pollution) and exhaust plumes on runway 13. I left out departures on runway 22 because they were relatively insignificant. Perhaps departures on 22 were deemed an avoidable source of noise pollution.
Queens College School of Earth and Environmental Science Modified to Show Departures and Exhaust
Runway 13 has by far the most departure traffic. These numbers include all traffic, turbine and piston, making MTBE also relevant for consideration. The EPA states that gasoline formulations using up to 100% MTBE have been tested successfully for piston-powered aircraft.
Departing aircraft that bank to the right, away from the epidemic area, to perhaps avoid noise pollution over that area, ironically would be pointing their high velocity exhaust down and into the epidemic area. Additionally, winds from S, SSW, SE or E would necessitate departures on runway 13 so that planes can depart into the wind. Any winds from the southern directions could blow the exhaust plumes further into the epidemic epicenter of Whitestone and College Point, ensuring high levels of ozone during year 1999, and acting synergistically with MTBE gasoline formulations to produce an unprecedented smog characteristic.
Two Maps Superimposed Showing LGA Exhaust/Wind
From the beginning and throughout the main part of the epidemic, just preceding the early acute and fatal cases, during haze (pollution) days, the LGA weather station shows wind directions to be primarily from the southern directions.
Minute amounts of volatile organochlorines have been found to act in combination with ether (MTBE), VOCs, and oxygen to concurrently cause both fatal encephalitis and virus proliferation. (See Middlesex Study) There are numerous sources of organochlorines near the epidemic epicenter:
Reformatted data from the Queens College website:
Other High-Output Sources in Queens (1997) Source Emission Amount Abbott Industries, Inc., 95-25 149th St, Jamaica Tetrachloroethylene 25,700 lbs Tudor Handle Corp., 43-02 38th St, LIC Toluene 12,341 lbs Volkert Precision Products, Inc., 222-40 96th Ave, Queens Village Trichloroethylene 3,750 lbs Standard Motor Products, Inc., 37-18 Northern Blvd, LIC Copper 50 lbs
The EPA report describes ozone poisoning:
"Acute health effects of ozone are defined as those effects induced by short-term and prolonged exposures to ozone... Acute health effects have been observed following prolonged exposures during moderate exertion at concentrations of ozone as low as 0.08ppm... Furthermore it is recognized that some individuals are unusually responsive to ozone and may experience much greater functional and symptomatic effects..."
This descriptions of ozone on the EPA sites do not emphasize the combined effects of VOC, NOx, SO2, CO, and particulate matter, i.e., their synergistic neurotoxic effects when combined with ozone in photochemical smog. Nor do they describe extra-pulmonary dysfunction, such as microscopic destruction of the involuntary nerve system that controls breathing, coordination, thought, and gastro-intestinal functions.
The levels of ozone at College Point were often in the range of 0.08ppm for a duration of months. (see Hourly Ozone Charts)
The upper New York City region appears to have its own capability to produce substantial air toxics. The following is an EPA AirNow ozone map (downloaded 2/19/2000), where the epidemic epicenter (northern Queens, the Bronx, and Bergen County) show an independent ability to produce high levels of ozone on 7/14/99:
EPA AirNow (7/14/99) dnld:2000.02.19
The next day, 7/15/99, the entire region showed high levels of ozone, with an "unhealthy" dark red accent across the epidemic areas:
EPA AirNow (7/15/99) dnld:2000.02.19
As of at least July 2000, when I attempted to again access these maps, I found them grossly revised by the EPA. In the new versions, the 7/14/99 map is completely green. The 7/15/99 map has been attenuated across the epidemic area. See Map Changes.
For more maps, see MapMuse (400KB) and RoadDensity/DeadBirds
A study is proposed to examine historically (before 1999) the epidemiology of northern Queens and Bronx, in terms of neurological diseases, and comparing them to the surrounding areas. I would predict findings of higher incidence of non-WNV encephalitis within the WNV epidemic areas, thus demonstrating that something other than the WNV was responsible for the epidemic, and possibly all neurological diseases in the region. Historically, New York City in general has been a region of record-high incidence for neurological disease epidemics.
|eg01||"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." -- The New York Times , 8/22/99|
|eg02||"Dr. John Charos, a veterinarian who has an office in Bayside, said that clients had brought in many sick crows...." -- The New York Times , 8/22/99|
|eg03||"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." -- NandoTimes/Associated Press 12/5/99|
|eg04||"But they [the crows] are [dying], 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 said, "so the amount you have dying now, you have to wonder if they're being poisoned." -- Dr. Charos, Bayside vetanarian, interview in The New York Times 8/22/99|
|eg05||"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." -- NandoTimes/Associated Press 12/5/99|
|eg06||"Testing of these initial cases by IgM-capture ELISA for antibodies to the common North American arboviruses was positive for SLE virus on September 3 at CDC. 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." -- NandoTimes/Associated Press 12/5/99|
|eg07||"Last fall, the NY DOH, in collaboration with CDC, conducted a door-to-door survey to determine how many people had been infected with West Nile virus in northern Queens. In the survey, which was anonymous, information was collected about recent illness and different types of exposure to mosquitoes, and a blood specimen was collected to look for evidence of a West Nile virus immune response. City blocks were selected at random from a 9 km2 area that encompassed parts of the neighborhoods of Auburndale, Linden Hill, Murray Hill, and Whitestone (mostly within Community Board 7), where the highest rates of West Nile encephalitis had been found." [http://nyclink.org/html/doh/html/wnv/wnvqa.html]|
|eg08||"UPDATE ON WEST
NILE-LIKE VIRUS IN NEW YORK CITY: 39 laboratory confirmed
cases of West Nile-like virus (including 4 deaths); 168
case reports are under investigation."
"The New York City Department of Health (DOH) today provided an update on the outbreak of a West Nile-like virus in New York City. The Centers for Diseaseand Prevention (CDC) reclassified 1 previously investigated illness as a laboratory positive case of West Nile-like virus. Control Specimens from 39 individuals have now been classified as laboratory positive cases of a West Nile-like virus in New York City, including 4 deaths, all of whom were Queens residents. 168 cases are under investigation."
"The case confirmed today is of a 56 year-old woman from Glen Oaks, Queens, who has been discharged from the hospital. Of the 39 laboratory positive cases of West Nile-like virus, 30 were discharged from hospitals, 5 are hospitalized, and 4 are deceased. Of the 39 laboratory positive cases, 29 are age 60 or over, and 4 are in their 50s. The other 6 cases are among people age 40 years old and under. Of the 39 laboratory positive cases, 27 are from Queens, 9 are from the Bronx, 2 are from Manhattan, and 1 is from Brooklyn."
"The survey was conducted by DOH teams in parts of the northern Queens neighborhoods of Auburndale, Linden Hill, Murray Hill, and Whitestone (parts of areas with zipcodes 11354, 11357, and 11358)." -- http://www.ci.nyc.ny.us/html/doh/html/public/press99/pr751007.html, 10/7/99
|eg09||"The major expansion in the spraying campaign came the day after an 80-year-old resident of Sunset Park, Brooklyn, died from the virus, and three other cases were confirmed in eastern and central Queens, several miles from the original epicenter of the epidemic, near Whitestone and College Point." -- The New York Times, 9/10/99|
area [College Point], a center of last years West
Nile virus outbreak in northern Queens, includes
the area between Flushing Bay and the East River west of
the Whitestone Expressway and the Whitestone Bridge.
Environment types contain a variety of single-family
homes on large and small lots, low-rise multi-family
housing, parks, natural resources, including
Powells Cove, a variety of tidal wetlands, and the
former Flushing airport, which contains substantial open
water and wetland areas. Also included in this
representative area is College Point Industrial Park,
several office buildings, and a major new installation of
retail uses along 20th Avenue."
"More specifically, the residential uses in the area are largely 2- and 3-story single family and multi-family residences. There are detached and attached houses in the area. Most of the houses have front and rear yards and driveways. The Riverview Condominium Complex in the northwestern portion of the study area has townhouses and villas. A low-rise apartment complex and a townhouse complex under construction are located in the north central portion of the study area. The Malba neighborhood in the northeastern portion of the study area contains large homes."
"The industrial uses in the study area are concentrated in the College Point Industrial Park and on the waterfront west of College Point Boulevard. These areas contain a mixture of light and heavy manufacturing, warehouse and distribution facilities, utilities, auto-related uses and mixed commercial and industrial operations. Some of the major industrial uses in the area are Con Edison, Queens Surface Corporation, a New York City Department of Sanitation (NYCDQS7J Marine Transfer Station, and the NYCDEP Tallman Island Water Pollution Control Plant. Industrial uses on portions adjacent to the former Flushing airport area include a post office facility and a New York Times printing and distribution facility." -- NYCDOH, "Mosquito-Brone Disease Control Plan for Adult Mosquitoes EIS", 5/18/00
Note: Additionally, New York Asphalt, storage and loading facility, is just west of the epidemic center. This contributes particulate matter in the form of dust plumes during loading operations.
|eg11||"Active surveillance in the New York City area confirmed 62 cases of West Nile viral disease during the 1999 outbreak. Among New York City cases, 32 lived in Queens, 10 in the Bronx, 3 in Brooklyn, and 1 in Manhattan. Illness onsets ranged from August 2 to September 22; most patients became ill during the 3rd and 4th weeks of August. Most cases occurred among persons aged 50 and older (median age, 68 years); only 3 cases occurred among children aged 16 years or younger. 46 in New York City, 9 in Westchester County, and 6 in Nassau County." -- NYCDOH, CHI, May, 2000 Vol. 19, No. 1|
|eg12||"Yesterday, two elderly women were added to the list of confirmed cases of the mosquito-borne illness. One of the women, who is 90 years old and in critical condition, was the first case to be confirmed in Manhattan since the outbreak began in August. Officials said the woman, who lived near Central Park, apparently contracted the virus in Manhattan, but it was not clear where." -- The New York Times , 9/25/99|
|eg13||"MINEOLA, N.Y., Oct. 7 -- A 76-year-old Mineola woman has become the first Long Island resident to die of the West Nile-like encephalitis virus, Nassau County health officials announced today. [para] The woman, whose name was withheld because of patient confidentiality, was one of two new cases of the virus reported today by Nassau County officials, bringing the total to six. There were also additional cases reported today in New York City and Westchester County, and New Jersey officials reported the first suspected case of the illness there. [para] Officials could not say whether the Nassau woman, who died on Oct. 4, contracted the virus here or in Queens, where most of the cases have been reported. County Health Commissioner Kathleen A. Gaffney said the new cases and the death of the Mineola resident demonstrated the urgency with which the county needed to go forward with its long-delayed plans to spray pesticide by helicopter. [para] The aerial spraying was to have begun last Friday, but it was delayed by rain, cold, too much wind and a lawsuit. The suit was rejected by the courts, but the rain, wind and cold have persisted, blocking spraying efforts not only in Nassau County, but in Suffolk and Westchester Counties and Connecticut. [para] Health officials in New York City, where four people have died of the virus, reported today that an additional case had been confirmed, bringing the total for the city to 39, of which 27 were in Queens, 9 in the Bronx, 2 in Manhattan and 1 in Brooklyn. That latest case of the virus in the city was a 56-year-old woman from Glen Oaks, Queens, who was said to had been released from a hospital in good condition. [para] An additional case, a woman in her 40's, was also reported today in Westchester, where one person has died of the virus, bringing the total number of cases in the county to nine, officials said. As in other areas, officials said they hoped to resume spraying on Friday and to continue through the weekend, weather permitting. [para] In New Jersey, health officials said they were awaiting the results of tests by the Centers For Disease Control and Prevention to determine whether a resident of Lakewood had contracted the West Nile-like encephalitis virus. The man is a patient at the Jersey Shore Medical Center in Neptune, where a spokeswoman, Christine Scott, said his condition was critical." -- The New York Times, 10/8/99|