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CNN Sunday Morning
Weekend House Call: West Nile Virus
Aired June 01, 2003 - 08:30 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
ARTHEL NEVILLE, CNN ANCHOR: We were talking about SARS and that, of course, has been a huge story in Canada, as well as in Asia, but the big story here in the U.S. is another virus. As summer heats up, so does the West Nile season.
On today's "Weekend House Call," Elizabeth Cohen joins us with some information you need to know to protect yourself -- Elizabeth.
ELIZABETH COHEN, CNN MEDICAL CORRESPONDENT: Anderson, that's right. Summer, I think, is officially here, almost, and when it does start it brings in the mosquito season, as well. Infecting mosquitoes are the most common carrier of the West Nile virus.
Experts are concerned that this year could be a particularly bad one.
(BEGIN VIDEOTAPE)
COHEN (voice-over): They're back, and so is West Nile virus.
Last year, according to the Centers for Disease Control, 284 people died in the U.S. of the disease and some 4,000 people were diagnosed with West Nile in 39 states.
One official says he's concerned this year could be worse. There's been so much rain this spring in many parts of the United States and mosquitoes lay their eggs in water.
Already this year, animals with West Nile virus have been found in nine states. Although animals can't pass the virus to people, you can get it from mosquitoes or tainted blood transfusions.
The CDC recommends get rid of standing water in your yard. Organize a mosquito control program in your neighborhood if there has isn't one already. Use a repellent containing the chemical DEET. Wear long pants and sleeves and spray your clothing with a spray containing DEET or permethrin.
(on camera): And perhaps the most important advice of all, don't panic.
While the 4,000 cases of West Nile virus last year may sound like a lot, think about how many millions of people are bit by mosquitoes.
(voice-over): And keep this in mind: according to the CDC, 80 percent of people who get West Nile don't get sick at all; they're perfectly fine. Twenty percent have mild symptoms such as fever and headache. Less than 1 percent become severely ill.
(END VIDEOTAPE)
COHEN: Now the most vulnerable to becoming very sick from West Nile are the elderly and those with immune problems.
Here are some of the symptoms of West Nile virus: severe headaches, fever, muscle weakness, stiff neck, confusion and the sudden sensitivity to light as well as a slight rash on the trunk of body. Those symptoms of West Nile will usually appear within two to 15 days. Now remember, these can be early symptoms of the virus or of many other illnesses. So seek medical attention to find out the cause.
Now we want to answer your questions about West Nile, so please e-mail us your questions at Housecall@CNN.com or you can call us at 1- 800-807-2620, international charges do apply if you're calling from not within the United States.
I want to bring in our guest to help answer some of our questions. Dr. Daniel Blumenthal joins us this morning. He's an infectious disease expert at the Moorehouse School of Medicine.
Dr. Blumenthal, thank you for joining us. Let's get started with our question. It's an e-mail from Misti in North Dakota.
Misti asks, "Has the threat of West Nile increased, decreased, stayed the same since it was first found in the United States?"
DR. DANIEL BLUMENTHAL, INFECTIOUS DISEASE EXPERT: Well, you'd have to say that it's increased because each year since 1999 we've seen more cases. And last year, of course, was the big year with over 4,000 cases.
But it's hard to predict. I think the smart money would say we're going to have another heavy season of West Nile virus this summer because of the wet spring, a lot of mosquitoes. And we've seen the virus spread across the United States and you sort of think it's going to continue to spread the way that it has, at least for another season.
COHEN: Thank you, Dr. Blumenthal, and Anderson...
ANDERSON COOPER, CNN ANCHOR: Yes, we have a phone call. I want to start answering some of your phone call questions. This is from Doris in Bridge City, Texas. Go ahead, Doris.
CALLER: OK. I had West Nile in August of 2000. And I'm really concerned. Can I get it again because I've had it one time?
BLUMENTHAL: No. We would think that you're probably permanently immune to the virus after having the disease. So at least from this condition, you can relax, I think.
COOPER: Doris, what was your experience like when you realized you had it? CALLER: Well, I got sick on a Monday with just severe back pain. I felt like I was running fever. Within less than a week I was completely paralyzed.
COOPER: But you feel better? I mean, that has gone away?
CALLER: No, I'm still having some of the problems. I'm not completely recovered from the paralysis. I have some existing conditions that just seem to want to stay on. My right hand, I have constant tremors, and I do not have my abdominal muscles back. I don't cough, sneeze or, you know, do the normal things that I could with my abdominal muscles.
COOPER: Just terrible. Doris, we appreciate you. Dr. Blumenthal?
BLUMENTHAL: So, Doris had one of the rare complications of West Nile virus infection, and that is a paralysis that's very much like polio, at least that's what it sounds that she had.
COOPER: But that's pretty rare, you said.
BLUMENTHAL: It is rare. We heard from the story at the beginning of the show how unusual it is to get very sick from this, anyway. It's less than 1 percent of cases, and in that 1 percent of cases she had a fairly rare syndrome with the paralysis and then, of course, the after effects hang on for a long time.
COOPER: Well, Doris, we are sorry for your experience and we appreciate your call this morning -- Elizabeth.
COHEN: One of the things that's most interesting about West Nile is that the vast majority of people, they get it and you don't even know it. You or I could have had West Nile last summer...
BLUMENTHAL: That's true.
COHEN: ... and we wouldn't have known it.
BLUMENTHAL: It's true.
COHEN: People forget that.
All right. Let's talk to Nicole from Ohio. She asked, "What happens if you get the West Nile virus?" This is an e-mail from Nicole. I think what she's asking is we hear a lot about the symptoms, but what happens if you have a severe case? What's the mortality rate? If you do get sick, what's the chances you're going to die from it?
BLUMENTHAL: It's less than one in a thousand. So fewer than 1 percent have a severe illness from the disease and less than 10 percent of those actually wind up dying, so it's about one in a thousand.
COHEN: And if you do become severely ill, what can doctors do for you?
BLUMENTHAL: There's no specific treatment for the infection. Antibiotics don't help, for instance, so we try to just support the patient as best we can. Keep fluids in balance, make sure the respirations continue, do good nursing care, that sort of thing.
COOPER: Rick from Washington joins us on the phone with a question. Rick, good morning.
CALLER: Good morning. Doctor, I'm looking at elective knee surgery. I understand West Nile can be transmitted by blood transfusions and if so, should I wait until after mosquito season or should I build up my own blood supply?
BLUMENTHAL: Well, that's an interesting question. It is true that West Nile, on occasion, can be transmitted by blood transfusion. There is a test now and they're going to start screening blood this season, I understand, for West Nile so you're probably safer. And you may want to check before you go to surgery to find out whether, in fact, the blood supply in your area is being screened for West Nile.
COOPER: But have there been many cases of...?
BLUMENTHAL: No. It's very rare. And that's not something I would go to the hospital worrying about. I think the blood supply overall is very safe.
COOPER: So if you were having a procedure or operation you'd go ahead.
BLUMENTHAL: I'd personally go ahead.
COOPER: You would go ahead?
BLUMENTHAL: Yes.
COOPER: All right. Rick, appreciate your call from Washington. Thank you very much.
We need to take a short break. When we come back, what are the best mosquito repellents and how do they work, exactly? You can e- mail us your other questions, if you'd like, here at Housecall@CNN.com or call us directly, 1-800-807-2620. We'll be right back.
(COMMERCIAL BREAK)
(BEGIN VIDEO CLIP)
UNIDENTIFIED MALE: Have you heard the buzz about West Nile virus? Protect yourself and your family.
(END VIDEO CLIP)
COOPER: That's a clip from the CDC's latest public service announcement to warn the public about West Nile virus. And that is our topic today on "Weekend House Call." Call us now with your West Nile questions, 1-800-807-2620, or simply e-mail us at Housecall@CNN.com. We'll be right back.
(COMMERCIAL BREAK)
COOPER: Welcome back to WEEKEND HOUSE CALL. That graphic, which I don't think you could read, it's so tiny I couldn't, it shows animals with West Nile virus. It shows the states they've been found in, nine states. A big concern, of course, as it gets warmer.
COHEN: That's right, Anderson. Mosquitoes are already out in force this year and here are some good tips to avoid getting bitten.
First of all, use insect repellent containing DEET. Look at the label and make sure that it contains DEET.
Also cover up, wearing long sleeve shirts and long pants when you're outdoors.
Minimize the time spent outdoors during dusk and dawn. That's when mosquitoes are out in their fullest force.
Remove any standing water around your home. That's where mosquitoes like to breed.
And take care of your yard; don't leave clippings around or piles of leaves, where mosquitoes can breed.
And we have an e-mail from Steve in Illinois. Steve asked, "What I can use on the lawn to kill the thousands of mosquitoes that I see fly out when I walk through the grass? I have pets and I worry about toxicity."
Dr. Blumenthal, this seems to be a struggle a lot of people have. They don't want mosquitoes but they also don't want the toxicity of the spray.
BLUMENTHAL: That's right. And I would say to Steve that he ought to do the things that you just talked about in terms of personal protection, and if he's worried about toxicity for his pets, then don't spray. But I don't think there's anything that will give him -- any approach that will give him all of the things that he wants, which is no toxicity for his pets, no chance of toxicity, no mosquitoes. I think he's just going to have to try to protect himself and his pets.
COHEN: What about children? If you -- Let's say your municipality sprays and your children play in that area. What kind of worry should parents have?
BLUMENTHAL: This is the classic public health paradox. The question of individual rights, versus what's best for the health of the public. And the spraying that takes place these days is very careful, very contained. We use ultra-low volume techniques and when I say "we," I'm talking about the public health infrastructure. Small amounts of insecticide and we think that the way it's being done is safe. But people may still say it's my right not to be sprayed on. I don't want to take any chances on exposing myself to insecticide, and arguably, that's their individual right. On the other hand we have to worry about West Nile and other conditions that are carried by mosquitoes, and so the health of the public may be best protected if we spray for mosquitoes.
But I think with the techniques that are being used these days, you'll find that spraying is not being done in people's yards and in many places, such as the county where I live, spraying isn't being done anymore. We use logiciding (ph) instead and put little pellets or briquettes in places where there's standing water like storm drains and kill the larvae, rather than spraying insecticide around.
COHEN: We've been talking a lot about repellents and wearing repellent. Can babies and small children, can they put on repellent that contains DEET?
BLUMENTHAL: I'm a pediatrician, and I like to recommend that kids under 2 have not repellent applied. Over 2, I think it's safe as long as you use it in a rational fashion, wash it off at night and that sort of thing.
COHEN: What about...
COOPER: Forgive my ignorance, but why is it under 2 not safe?
BLUMENTHAL: Why is it...?
COOPER: Yes, why would under 2-year-olds...
BLUMENTHAL: Well, kids are developing nervous systems. We worry about some nervous system toxicity with the DEET that's in the insect repellent for the very small children. Others think you can go down to two months, but I like to be conservative...
NEVILLE: So what do you do if your 18 month-year-old who's running around outside, and you don't want her to get bitten by mosquitoes?
BLUMENTHAL: Long sleeves, long pants, mosquito netting if they're in a contained area where you can use that. The sorts of things that you recommended at the beginning.
COOPER: We also have a call from Suzanne in Ontario. Suzanne, good morning, what's your question?
CALLER: Good morning, Anderson. I wanted to ask the doctor. I see at Shopper StruckMart (ph), they sell mosquito jackets and they said that they could protect you against the West Nile virus. I wondered if it was possible that it could happen, that they could protect you.
BLUMENTHAL: Mosquito jackets.
CALLER: Right. BLUMENTHAL: If this is the sort of clothing we've been talking about, long sleeves and that sort of thing, then yes, that would protect you against mosquito bites.
COOPER: But it sounds almost like some product like DEET that's sort of infused in the material or something. If they're calling it a mosquito jacket it would indicate something beyond just a long sleeve. Unless it's some new marketing technique.
COHEN: Yes.
BLUMENTHAL: It sounds like it is, but that's something you could do yourself, of course. And if you're wearing a long-sleeved shirt that's has a thin fabric that a mosquito might bite through, you can apply the insect repellent directly to the fabric.
COOPER: Really? That would be OK.
BLUMENTHAL: Yes. And that helps. Yes, sure.
COOPER: OK. Suzanne, I hope that helps. Appreciate you calling us.
We're going to take a short break. When we come back, more answers to your questions.
But first, let's check our "Daily Dose Heath Quiz." Today's question, can your pet contract the West Nile virus? What do you think? The answer when we return.
(COMMERCIAL BREAK)
COHEN: Let's check the "Daily Dose Quiz." We asked, can your pet contract the West Nile virus? Well, while it's not common it has happened. In terms of who mosquitoes want to bite, cats and dogs are very low on the list. But if you're concerned, practice caution like keeping your animal in during the areas during dusk and dawn. Keep dogs away from ravines and ponds. And insect repellent is not recommended for household pets. Some vets say feeding your pooch a B vitamin or garlic can work, and there's also a dog mosquito repellent on the market.
COOPER: We also have a call from Sylvia in North Carolina. It kind of relates to the whole question of West Nile in pets. Sylvia, good morning.
CALLER: Good morning.
COOPER: What's your question, Sylvia?
CALLER: Yes, I was concerned whether or not, if your pet, your small pet, cat or dog, should contact the West Nile virus, is it transmittable to humans.
COOPER: From the pet?
CALLER: Yes. Yes.
COOPER: Doctor?
BLUMENTHAL: It's not transmissible directly from the pet. If the mosquito bites the pet and then bites the human, it is transmissible that way.
COOPER: But if -- I think her question is more from the mosquito bite to the pet and then the pet somehow bites you or something like that.
BLUMENTHAL: And the answer is no you can't get the disease that way.
COOPER: All right. Sylvia, appreciate your call. Thank you very much.
COHEN: So the way that West Nile is transmitted, Doctor, is mosquitoes biting humans is the big number one.
BLUMENTHAL: That's right. Absolutely.
COHEN: And that's the big one.
BLUMENTHAL: That's right.
COHEN: But also, organ donation and blood transfusions have, also, although rare.
BLUMENTHAL: A few instances, a few cases of organ donation, breast milk and blood transfusion, needle sticking the lab worker. So there are these rare cases get reported, but for most of us it's not an issue.
COHEN: And the breast milk one, I don't want to scare women away from nursing their children, which is obviously the best thing they can do.
BLUMENTHAL: And they absolutely should not be scared away. The transmission is documented but the babies didn't get sick.
COHEN: Right. So the baby -- the breast milk had West Nile in it, but the baby was fine and there's only one case in five years -- four summers of having West Nile.
BLUMENTHAL: That's right.
COOPER: Got another call. Lynn in Great Neck, New York. Lynne, good morning, what's your question?
Let's try it again. Lynn, are you there?
CALLER: Yes.
COOPER: Lynn, OK, you are there. Good morning, Lynn, what's your question? CALLER: I'm not from New York, I'm from Hudson, North Carolina.
COOPER: Oh, I'm sorry about that.
CALLER: That's OK. We have a pretty big development in our area that has an old rock quarry in it, and the rock quarry is filled with water. I think there might be a natural spring underneath it, I don't know. But it's filled with tires that have been there for years and years and years and probably, like, refrigerators and I don't know if there's old cars in it or whatever. And we have mosquitoes the size of 50 cent pieces all of the time. And we've contacted all of the local people, but nobody seems to know what to do about it.
COOPER: So you're wondering if there's anything you can do or...
CALLER: Right, or if there's a government area that we can contact for something. These people that they own the -- they call it a lake, because they didn't want lay docks on it (ph), but the people, those people are the ones that own this development or started this development so we have a problem right there with that.
COOPER: It's on private property. I see, yes. It's a difficult thing to do. I mean, obviously, standing water or anything like that is going to attract mosquitoes.
Is there a government agency that she can call, I guess?
BLUMENTHAL: She should call her local health department, if she hasn't done that already. And I know in North Carolina they have very good local health departments -- excuse me -- so if she hasn't done that already that's the way she should go.
COOPER: And theoretically, what could they do? I mean, make these people clean it up or spray?
BLUMENTHAL: It depends on local circumstances. I don't know if it's feasible to drain that quarry and get rid of the water that way. There are larvicides that you can put in the water that would kill the larvae that are breeding in the water.
So there's more than one approach.
COOPER: But a health department. I mean, it's enough of a concern that the health department would theoretically try to do something?
BLUMENTHAL: It certainly sounds like it is, from what she says.
COHEN: And as you said this, it's sort of with West Nile, there's this struggle between private and public. A private person might say, no, I want my water to stand there. I don't want to do any...
BLUMENTHAL: I want my water in the quarry.
COHEN: Right. Exactly. And then public health people would have to move in.
BLUMENTHAL: That's true.
COHEN: That would continue.
COOPER: We've got a lot still ahead of us. Some other thoughts, some final thoughts when we return. We'll be right back.
(COMMERCIAL BREAK)
COHEN: Welcome back to "Weekend House Call." I'm medical correspondent Elizabeth Cohen and we've been talking about West Nile virus with Dr. Daniel Blumenthal.
Dr. Blumenthal, do you have any final thoughts about West Nile virus?
BLUMENTHAL: I think my final thought would be to reassure people. Tell them not to panic. There were 284 deaths from West Nile virus last year, 30,000 deaths from pneumonia and influenza, and those are diseases that we can immunize against. So his is still a quite rare condition and not something that people should be overly concerned about.
COHEN: I remember last summer people were coming up to me, just at work and saying, oh, my gosh, I'm so scared about West Nile. I'm going to play out in the backyard.
What do you tell healthy patients who come to you and say, "Doctor, I'm just so paranoid about this. What about if I get bit by a mosquito?"
BLUMENTHAL: I tell them all the things that we've been talking about this morning: insect repellent, long sleeves, try to stay inside at dusk and dawn, just try to take care of yourself and clean up all the standing water outside your house.
COHEN: And if someone came in and said, "Doctor, you know, I haven't been feeling great, I've been feeling a little bit sick. Could I have West Nile? Could you give me a blood test?" What would you tell them?
BLUMENTHAL: Well, it's possible that most people who come in feeling a little sick with something that resembles a cold or flu, probably have a cold or flu. And so unless it seems to be something more serious or unless the patient is just desperately concerned, I don't think it's worthwhile doing the blood test. But if it seems like it might be West Nile and a blood test is in order and CDC wants us to report cases so we can keep track of what's going on.
COHEN: Great. Dr. Blumenthal, thank you so much for joining us this morning...
BLUMENTHAL: My pleasure.
COHEN: ... to talk about West Nile virus. That's all we have time for today. Make sure you join us next weekend. That's Saturday and Sunday at 8:30 in the morning. This is WEEKEND HOUSE CALL, the place for the answers to your medical questions. Thanks for watching.
I'm Elizabeth Cohen. "CNN SUNDAY MORNING" continues now.
TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com
Aired June 1, 2003 - 08:30 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
ARTHEL NEVILLE, CNN ANCHOR: We were talking about SARS and that, of course, has been a huge story in Canada, as well as in Asia, but the big story here in the U.S. is another virus. As summer heats up, so does the West Nile season.
On today's "Weekend House Call," Elizabeth Cohen joins us with some information you need to know to protect yourself -- Elizabeth.
ELIZABETH COHEN, CNN MEDICAL CORRESPONDENT: Anderson, that's right. Summer, I think, is officially here, almost, and when it does start it brings in the mosquito season, as well. Infecting mosquitoes are the most common carrier of the West Nile virus.
Experts are concerned that this year could be a particularly bad one.
(BEGIN VIDEOTAPE)
COHEN (voice-over): They're back, and so is West Nile virus.
Last year, according to the Centers for Disease Control, 284 people died in the U.S. of the disease and some 4,000 people were diagnosed with West Nile in 39 states.
One official says he's concerned this year could be worse. There's been so much rain this spring in many parts of the United States and mosquitoes lay their eggs in water.
Already this year, animals with West Nile virus have been found in nine states. Although animals can't pass the virus to people, you can get it from mosquitoes or tainted blood transfusions.
The CDC recommends get rid of standing water in your yard. Organize a mosquito control program in your neighborhood if there has isn't one already. Use a repellent containing the chemical DEET. Wear long pants and sleeves and spray your clothing with a spray containing DEET or permethrin.
(on camera): And perhaps the most important advice of all, don't panic.
While the 4,000 cases of West Nile virus last year may sound like a lot, think about how many millions of people are bit by mosquitoes.
(voice-over): And keep this in mind: according to the CDC, 80 percent of people who get West Nile don't get sick at all; they're perfectly fine. Twenty percent have mild symptoms such as fever and headache. Less than 1 percent become severely ill.
(END VIDEOTAPE)
COHEN: Now the most vulnerable to becoming very sick from West Nile are the elderly and those with immune problems.
Here are some of the symptoms of West Nile virus: severe headaches, fever, muscle weakness, stiff neck, confusion and the sudden sensitivity to light as well as a slight rash on the trunk of body. Those symptoms of West Nile will usually appear within two to 15 days. Now remember, these can be early symptoms of the virus or of many other illnesses. So seek medical attention to find out the cause.
Now we want to answer your questions about West Nile, so please e-mail us your questions at Housecall@CNN.com or you can call us at 1- 800-807-2620, international charges do apply if you're calling from not within the United States.
I want to bring in our guest to help answer some of our questions. Dr. Daniel Blumenthal joins us this morning. He's an infectious disease expert at the Moorehouse School of Medicine.
Dr. Blumenthal, thank you for joining us. Let's get started with our question. It's an e-mail from Misti in North Dakota.
Misti asks, "Has the threat of West Nile increased, decreased, stayed the same since it was first found in the United States?"
DR. DANIEL BLUMENTHAL, INFECTIOUS DISEASE EXPERT: Well, you'd have to say that it's increased because each year since 1999 we've seen more cases. And last year, of course, was the big year with over 4,000 cases.
But it's hard to predict. I think the smart money would say we're going to have another heavy season of West Nile virus this summer because of the wet spring, a lot of mosquitoes. And we've seen the virus spread across the United States and you sort of think it's going to continue to spread the way that it has, at least for another season.
COHEN: Thank you, Dr. Blumenthal, and Anderson...
ANDERSON COOPER, CNN ANCHOR: Yes, we have a phone call. I want to start answering some of your phone call questions. This is from Doris in Bridge City, Texas. Go ahead, Doris.
CALLER: OK. I had West Nile in August of 2000. And I'm really concerned. Can I get it again because I've had it one time?
BLUMENTHAL: No. We would think that you're probably permanently immune to the virus after having the disease. So at least from this condition, you can relax, I think.
COOPER: Doris, what was your experience like when you realized you had it? CALLER: Well, I got sick on a Monday with just severe back pain. I felt like I was running fever. Within less than a week I was completely paralyzed.
COOPER: But you feel better? I mean, that has gone away?
CALLER: No, I'm still having some of the problems. I'm not completely recovered from the paralysis. I have some existing conditions that just seem to want to stay on. My right hand, I have constant tremors, and I do not have my abdominal muscles back. I don't cough, sneeze or, you know, do the normal things that I could with my abdominal muscles.
COOPER: Just terrible. Doris, we appreciate you. Dr. Blumenthal?
BLUMENTHAL: So, Doris had one of the rare complications of West Nile virus infection, and that is a paralysis that's very much like polio, at least that's what it sounds that she had.
COOPER: But that's pretty rare, you said.
BLUMENTHAL: It is rare. We heard from the story at the beginning of the show how unusual it is to get very sick from this, anyway. It's less than 1 percent of cases, and in that 1 percent of cases she had a fairly rare syndrome with the paralysis and then, of course, the after effects hang on for a long time.
COOPER: Well, Doris, we are sorry for your experience and we appreciate your call this morning -- Elizabeth.
COHEN: One of the things that's most interesting about West Nile is that the vast majority of people, they get it and you don't even know it. You or I could have had West Nile last summer...
BLUMENTHAL: That's true.
COHEN: ... and we wouldn't have known it.
BLUMENTHAL: It's true.
COHEN: People forget that.
All right. Let's talk to Nicole from Ohio. She asked, "What happens if you get the West Nile virus?" This is an e-mail from Nicole. I think what she's asking is we hear a lot about the symptoms, but what happens if you have a severe case? What's the mortality rate? If you do get sick, what's the chances you're going to die from it?
BLUMENTHAL: It's less than one in a thousand. So fewer than 1 percent have a severe illness from the disease and less than 10 percent of those actually wind up dying, so it's about one in a thousand.
COHEN: And if you do become severely ill, what can doctors do for you?
BLUMENTHAL: There's no specific treatment for the infection. Antibiotics don't help, for instance, so we try to just support the patient as best we can. Keep fluids in balance, make sure the respirations continue, do good nursing care, that sort of thing.
COOPER: Rick from Washington joins us on the phone with a question. Rick, good morning.
CALLER: Good morning. Doctor, I'm looking at elective knee surgery. I understand West Nile can be transmitted by blood transfusions and if so, should I wait until after mosquito season or should I build up my own blood supply?
BLUMENTHAL: Well, that's an interesting question. It is true that West Nile, on occasion, can be transmitted by blood transfusion. There is a test now and they're going to start screening blood this season, I understand, for West Nile so you're probably safer. And you may want to check before you go to surgery to find out whether, in fact, the blood supply in your area is being screened for West Nile.
COOPER: But have there been many cases of...?
BLUMENTHAL: No. It's very rare. And that's not something I would go to the hospital worrying about. I think the blood supply overall is very safe.
COOPER: So if you were having a procedure or operation you'd go ahead.
BLUMENTHAL: I'd personally go ahead.
COOPER: You would go ahead?
BLUMENTHAL: Yes.
COOPER: All right. Rick, appreciate your call from Washington. Thank you very much.
We need to take a short break. When we come back, what are the best mosquito repellents and how do they work, exactly? You can e- mail us your other questions, if you'd like, here at Housecall@CNN.com or call us directly, 1-800-807-2620. We'll be right back.
(COMMERCIAL BREAK)
(BEGIN VIDEO CLIP)
UNIDENTIFIED MALE: Have you heard the buzz about West Nile virus? Protect yourself and your family.
(END VIDEO CLIP)
COOPER: That's a clip from the CDC's latest public service announcement to warn the public about West Nile virus. And that is our topic today on "Weekend House Call." Call us now with your West Nile questions, 1-800-807-2620, or simply e-mail us at Housecall@CNN.com. We'll be right back.
(COMMERCIAL BREAK)
COOPER: Welcome back to WEEKEND HOUSE CALL. That graphic, which I don't think you could read, it's so tiny I couldn't, it shows animals with West Nile virus. It shows the states they've been found in, nine states. A big concern, of course, as it gets warmer.
COHEN: That's right, Anderson. Mosquitoes are already out in force this year and here are some good tips to avoid getting bitten.
First of all, use insect repellent containing DEET. Look at the label and make sure that it contains DEET.
Also cover up, wearing long sleeve shirts and long pants when you're outdoors.
Minimize the time spent outdoors during dusk and dawn. That's when mosquitoes are out in their fullest force.
Remove any standing water around your home. That's where mosquitoes like to breed.
And take care of your yard; don't leave clippings around or piles of leaves, where mosquitoes can breed.
And we have an e-mail from Steve in Illinois. Steve asked, "What I can use on the lawn to kill the thousands of mosquitoes that I see fly out when I walk through the grass? I have pets and I worry about toxicity."
Dr. Blumenthal, this seems to be a struggle a lot of people have. They don't want mosquitoes but they also don't want the toxicity of the spray.
BLUMENTHAL: That's right. And I would say to Steve that he ought to do the things that you just talked about in terms of personal protection, and if he's worried about toxicity for his pets, then don't spray. But I don't think there's anything that will give him -- any approach that will give him all of the things that he wants, which is no toxicity for his pets, no chance of toxicity, no mosquitoes. I think he's just going to have to try to protect himself and his pets.
COHEN: What about children? If you -- Let's say your municipality sprays and your children play in that area. What kind of worry should parents have?
BLUMENTHAL: This is the classic public health paradox. The question of individual rights, versus what's best for the health of the public. And the spraying that takes place these days is very careful, very contained. We use ultra-low volume techniques and when I say "we," I'm talking about the public health infrastructure. Small amounts of insecticide and we think that the way it's being done is safe. But people may still say it's my right not to be sprayed on. I don't want to take any chances on exposing myself to insecticide, and arguably, that's their individual right. On the other hand we have to worry about West Nile and other conditions that are carried by mosquitoes, and so the health of the public may be best protected if we spray for mosquitoes.
But I think with the techniques that are being used these days, you'll find that spraying is not being done in people's yards and in many places, such as the county where I live, spraying isn't being done anymore. We use logiciding (ph) instead and put little pellets or briquettes in places where there's standing water like storm drains and kill the larvae, rather than spraying insecticide around.
COHEN: We've been talking a lot about repellents and wearing repellent. Can babies and small children, can they put on repellent that contains DEET?
BLUMENTHAL: I'm a pediatrician, and I like to recommend that kids under 2 have not repellent applied. Over 2, I think it's safe as long as you use it in a rational fashion, wash it off at night and that sort of thing.
COHEN: What about...
COOPER: Forgive my ignorance, but why is it under 2 not safe?
BLUMENTHAL: Why is it...?
COOPER: Yes, why would under 2-year-olds...
BLUMENTHAL: Well, kids are developing nervous systems. We worry about some nervous system toxicity with the DEET that's in the insect repellent for the very small children. Others think you can go down to two months, but I like to be conservative...
NEVILLE: So what do you do if your 18 month-year-old who's running around outside, and you don't want her to get bitten by mosquitoes?
BLUMENTHAL: Long sleeves, long pants, mosquito netting if they're in a contained area where you can use that. The sorts of things that you recommended at the beginning.
COOPER: We also have a call from Suzanne in Ontario. Suzanne, good morning, what's your question?
CALLER: Good morning, Anderson. I wanted to ask the doctor. I see at Shopper StruckMart (ph), they sell mosquito jackets and they said that they could protect you against the West Nile virus. I wondered if it was possible that it could happen, that they could protect you.
BLUMENTHAL: Mosquito jackets.
CALLER: Right. BLUMENTHAL: If this is the sort of clothing we've been talking about, long sleeves and that sort of thing, then yes, that would protect you against mosquito bites.
COOPER: But it sounds almost like some product like DEET that's sort of infused in the material or something. If they're calling it a mosquito jacket it would indicate something beyond just a long sleeve. Unless it's some new marketing technique.
COHEN: Yes.
BLUMENTHAL: It sounds like it is, but that's something you could do yourself, of course. And if you're wearing a long-sleeved shirt that's has a thin fabric that a mosquito might bite through, you can apply the insect repellent directly to the fabric.
COOPER: Really? That would be OK.
BLUMENTHAL: Yes. And that helps. Yes, sure.
COOPER: OK. Suzanne, I hope that helps. Appreciate you calling us.
We're going to take a short break. When we come back, more answers to your questions.
But first, let's check our "Daily Dose Heath Quiz." Today's question, can your pet contract the West Nile virus? What do you think? The answer when we return.
(COMMERCIAL BREAK)
COHEN: Let's check the "Daily Dose Quiz." We asked, can your pet contract the West Nile virus? Well, while it's not common it has happened. In terms of who mosquitoes want to bite, cats and dogs are very low on the list. But if you're concerned, practice caution like keeping your animal in during the areas during dusk and dawn. Keep dogs away from ravines and ponds. And insect repellent is not recommended for household pets. Some vets say feeding your pooch a B vitamin or garlic can work, and there's also a dog mosquito repellent on the market.
COOPER: We also have a call from Sylvia in North Carolina. It kind of relates to the whole question of West Nile in pets. Sylvia, good morning.
CALLER: Good morning.
COOPER: What's your question, Sylvia?
CALLER: Yes, I was concerned whether or not, if your pet, your small pet, cat or dog, should contact the West Nile virus, is it transmittable to humans.
COOPER: From the pet?
CALLER: Yes. Yes.
COOPER: Doctor?
BLUMENTHAL: It's not transmissible directly from the pet. If the mosquito bites the pet and then bites the human, it is transmissible that way.
COOPER: But if -- I think her question is more from the mosquito bite to the pet and then the pet somehow bites you or something like that.
BLUMENTHAL: And the answer is no you can't get the disease that way.
COOPER: All right. Sylvia, appreciate your call. Thank you very much.
COHEN: So the way that West Nile is transmitted, Doctor, is mosquitoes biting humans is the big number one.
BLUMENTHAL: That's right. Absolutely.
COHEN: And that's the big one.
BLUMENTHAL: That's right.
COHEN: But also, organ donation and blood transfusions have, also, although rare.
BLUMENTHAL: A few instances, a few cases of organ donation, breast milk and blood transfusion, needle sticking the lab worker. So there are these rare cases get reported, but for most of us it's not an issue.
COHEN: And the breast milk one, I don't want to scare women away from nursing their children, which is obviously the best thing they can do.
BLUMENTHAL: And they absolutely should not be scared away. The transmission is documented but the babies didn't get sick.
COHEN: Right. So the baby -- the breast milk had West Nile in it, but the baby was fine and there's only one case in five years -- four summers of having West Nile.
BLUMENTHAL: That's right.
COOPER: Got another call. Lynn in Great Neck, New York. Lynne, good morning, what's your question?
Let's try it again. Lynn, are you there?
CALLER: Yes.
COOPER: Lynn, OK, you are there. Good morning, Lynn, what's your question? CALLER: I'm not from New York, I'm from Hudson, North Carolina.
COOPER: Oh, I'm sorry about that.
CALLER: That's OK. We have a pretty big development in our area that has an old rock quarry in it, and the rock quarry is filled with water. I think there might be a natural spring underneath it, I don't know. But it's filled with tires that have been there for years and years and years and probably, like, refrigerators and I don't know if there's old cars in it or whatever. And we have mosquitoes the size of 50 cent pieces all of the time. And we've contacted all of the local people, but nobody seems to know what to do about it.
COOPER: So you're wondering if there's anything you can do or...
CALLER: Right, or if there's a government area that we can contact for something. These people that they own the -- they call it a lake, because they didn't want lay docks on it (ph), but the people, those people are the ones that own this development or started this development so we have a problem right there with that.
COOPER: It's on private property. I see, yes. It's a difficult thing to do. I mean, obviously, standing water or anything like that is going to attract mosquitoes.
Is there a government agency that she can call, I guess?
BLUMENTHAL: She should call her local health department, if she hasn't done that already. And I know in North Carolina they have very good local health departments -- excuse me -- so if she hasn't done that already that's the way she should go.
COOPER: And theoretically, what could they do? I mean, make these people clean it up or spray?
BLUMENTHAL: It depends on local circumstances. I don't know if it's feasible to drain that quarry and get rid of the water that way. There are larvicides that you can put in the water that would kill the larvae that are breeding in the water.
So there's more than one approach.
COOPER: But a health department. I mean, it's enough of a concern that the health department would theoretically try to do something?
BLUMENTHAL: It certainly sounds like it is, from what she says.
COHEN: And as you said this, it's sort of with West Nile, there's this struggle between private and public. A private person might say, no, I want my water to stand there. I don't want to do any...
BLUMENTHAL: I want my water in the quarry.
COHEN: Right. Exactly. And then public health people would have to move in.
BLUMENTHAL: That's true.
COHEN: That would continue.
COOPER: We've got a lot still ahead of us. Some other thoughts, some final thoughts when we return. We'll be right back.
(COMMERCIAL BREAK)
COHEN: Welcome back to "Weekend House Call." I'm medical correspondent Elizabeth Cohen and we've been talking about West Nile virus with Dr. Daniel Blumenthal.
Dr. Blumenthal, do you have any final thoughts about West Nile virus?
BLUMENTHAL: I think my final thought would be to reassure people. Tell them not to panic. There were 284 deaths from West Nile virus last year, 30,000 deaths from pneumonia and influenza, and those are diseases that we can immunize against. So his is still a quite rare condition and not something that people should be overly concerned about.
COHEN: I remember last summer people were coming up to me, just at work and saying, oh, my gosh, I'm so scared about West Nile. I'm going to play out in the backyard.
What do you tell healthy patients who come to you and say, "Doctor, I'm just so paranoid about this. What about if I get bit by a mosquito?"
BLUMENTHAL: I tell them all the things that we've been talking about this morning: insect repellent, long sleeves, try to stay inside at dusk and dawn, just try to take care of yourself and clean up all the standing water outside your house.
COHEN: And if someone came in and said, "Doctor, you know, I haven't been feeling great, I've been feeling a little bit sick. Could I have West Nile? Could you give me a blood test?" What would you tell them?
BLUMENTHAL: Well, it's possible that most people who come in feeling a little sick with something that resembles a cold or flu, probably have a cold or flu. And so unless it seems to be something more serious or unless the patient is just desperately concerned, I don't think it's worthwhile doing the blood test. But if it seems like it might be West Nile and a blood test is in order and CDC wants us to report cases so we can keep track of what's going on.
COHEN: Great. Dr. Blumenthal, thank you so much for joining us this morning...
BLUMENTHAL: My pleasure.
COHEN: ... to talk about West Nile virus. That's all we have time for today. Make sure you join us next weekend. That's Saturday and Sunday at 8:30 in the morning. This is WEEKEND HOUSE CALL, the place for the answers to your medical questions. Thanks for watching.
I'm Elizabeth Cohen. "CNN SUNDAY MORNING" continues now.
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