Epidemiologists are predicting that the upcoming season will bring increasing concerns about West Nile Virus (WNV). They expect that the virus will continue its westward movement and be detected in all 48 contiguous states in 2003. Physicians and health departments are preparing for ways to alleviate people's concerns and anxieties. The first year WNV was seen in the United States was 1999 when the season began in August and most illnesses and deaths were in New York state. In 2002 the season started in June and was much more widespread. Questions about transmission and about the virus itself still remain. Researchers are investigating why the virus hardly fazes most people, but does kill a few. Another concern this year will be that there are many people that will have antibodies from exposure to the virus that did not make them sick previous years. If they become sick this year, false positive test results will confuse tracking of and research on the disease. Health officials say that they are having a hard time convincing people to prepare for uncertain danger. Even in endemic areas, mosquito control, the most basic method of controlling transmission, is often not done. New tests for the virus are being developed, but it may be the end of summer before they are available.

COMMENTARY: The situation for veterinarians will be very similar to that facing physIcians. Although dogs are resistant to WNV, last year some became ill and died. Testing is difficult because a positive antibody titer does not mean that WNV is the cause of disease. We still don't know why some dogs get sick and others don't, so veterinarians will be asked to provide advice and protection for all dogs.

Get ready for a new-and nastier-West Nile season. Elliott VS. AMNews. www.ama-assn.org/sci-pubs/amnews, March 10, 2003.