Big Apple Able to Take Bite out of Virus

Article excerpt

Some bioterrorism experts say that New York City's response to the West Nile Virus outbreak this past summer shows it is better prepared for a bioterrorism attack than almost any other city in the United States.

"Probably the most advanced planning for bioterrorism has been done by New York City," said Dr. Donald Henderson, director of the Johns Hopkins Center for Civilian Biodefense Studies in Baltimore.

Despite concerns that it took three weeks for the Centers for Disease Control and Prevention (CDC) to diagnose the disease that killed seven, Dr. Henderson said the city's overall public health response was a model for responding to a bioterrorism attack.

"The detection of the disease and the speed with which New York moved was highly commendable. They have good people who have been building good relationships with emergency-room doctors," he said.

Others disagree.

"West Nile fever was a wake-up call for us," said Dr. Alan Zelicoff, a physician and senior scientist at the Federal Center for National Security and Arms Control at Sandia National Laboratories in Albuquerque, N.M.

If the relatively benign West Nile virus had been a more serious virus like smallpox, it would have "dispersed and spread across the country to hundreds of thousands of people before it was detected," Dr. Zelicoff told Scripps Howard News Service.

New York City's response was coordinated by Mayor Rudolph W. Giuliani's Office of Emergency Management, but it was the city's Department of Public Health that led the response.

Dr. Annie Fine, director of the health department's Division of Infectious Diseases and Bioterrorism, said the city's response to the West Nile Virus was similar to the response had it been an attack from terrorists.

"Preparing for bioterrorism is a chance to strengthen public health in addition to preparing for the real thing," said Dr. Fine, speaking recently at a convention of infectious-disease specialists in Philadelphia.

"What we need to do to prepare for any of these situations is build up the public health structure," she said.

On Aug. 23, Dr. Deborah Asnis in Queens, N.Y., called the Department of Public Health to report two cases she could not diagnose. Her patients, age 60 and 75, had become sick in early August with nausea, fever and lethargy.

"If the cases had not been clustered in one hospital and the physicians did not recognize something unusual, this could have gone undetected," said Dr. Fine.

On Aug. 28, two more cases came in to Dr. Asnis' hospital, and a total of eight cases were uncovered.

All were "clustered" in a 2-square-mile area and all the patients had spent time outdoors, near mosquito-breeding areas. The neighborhood residents also reported large numbers of crows staggering around and then dying, but at first no one put the two together.

By Sept. 3, the CDC had made its initial identification of the virus, the mosquito-borne St. Louis encephalitis. But the diagnosis proved wrong, and it would be three more weeks before it was correctly identified. …