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Complacency Boosts West Nile Peril

September 06, 2004|Laurie Garrett | Pulitzer Prize winner Laurie Garrett is the senior fellow for global health at the Council on Foreign Relations.

California is officially the epicenter of the 2004 West Nile virus epidemic in North America, giving the state a decidedly dubious distinction once held by weary New York City. I salute you, California.

In 1999, we New Yorkers thought the emergence of an African savanna virus in our concrete jungle was about the scariest thing imaginable. Now terrorism-traumatized New Yorkers look back with fond nostalgia on our days of mosquito paranoia, and most residents of Gotham shrug off insecticide spraying notices and West Nile virus alerts with a good deal more nonchalance than they exhibit in the face of a Yankee loss.

Complacency has set in on the East Coast: West Nile virus has lost its novelty, and with that could come a slacking off in mosquito-control efforts. That is, of course, what happened in California. Complacency is why you now have a mess on your hands, with more than 425 cases of the viral disease and 11 deaths. And it's going to be tough for your budget-strapped health departments to carry out the insect-control programs that once made California a model for the whole world.

After World War II, California benefited from the collective wisdom of insect specialists who had fought great battles in the Pacific theater -- not against the Japanese but the mosquitoes that carried malaria, dengue fever and encephalitis viruses.

Early in the Pacific conflict, far more GIs succumbed to insect-carried diseases than bullets and bombs, and stopping the infectious carnage required the brain power of a unique set of arbovirologists. Chief among them was William C. Reeves, who returned from Okinawa and Guadalcanal to wage war on the insects of California from his shared posts at UC Berkeley and the state health department. He quickly figured out that pesticides worked, but only if the ecology of the insects was fully understood and the chemicals were used in the right places at the right times.

Reeves inspired a vast network of research and activity from Eureka to Coronado, yielding vital information about where the mosquito populations spent their winters, where they spawned their larva in the spring and how the disease-carrying adults moved about the state, potentially infecting the citizenry, during the summer months. That sort of ecological understanding, he insisted, was essential because "every time people have tried to use some shortcut to get around that sort of detailed knowledge, the program has failed."

During the 1950s and '60s, California faced wave after wave of deadly, mosquito-borne encephalitis viruses, usually starting during the spring Sierra thaws, when mosquitoes would lay their eggs in the fresh water streams and pools of the eastern part of the state. Spotted early, the insects could be controlled swiftly in the mountains with larvicides harmless to humans.

What then seemed a very remote Sierra ecology is now a heavily populated region. Mosquitoes that once were forced to feed on wild animals, birds and backpackers can now get their nightly blood feed in bedrooms from Riverside to Kern County, Stockton to Fresno. The ecology has changed -- to the decided advantage of the insects. But there is little research underway to study those changes.

Today, most insect abatement in California is carried out at the county level by private contractors. The patchwork of roughly $70 million worth of uncoordinated programs throughout the state are financed by local governments, most of which are starving for cash. In August, Gov. Arnold Schwarzenegger authorized spending $750,000 to control mosquitoes in wetlands, and a bill now sits on his desk awaiting his signature that would pony up $977,000 more for West Nile virus control.

The state is in reactive mode, having allowed its insect control efforts to slack off amid budget constraints. Florida faced a similar conundrum a decade ago when elimination of control efforts allowed the state to be overrun by mosquitoes carrying encephalitis viruses, spawning an outbreak so severe that Walt Disney World, all Little League baseball and Kennedy Space Center were shut down.

A paucity of ecological information and paid mosquito abatement personnel puts environmentally conscious Californians in the awkward position of having to accept widespread insecticide spraying that may or may not be directed in the most effective manner.

As Reeves learned decades ago, if you don't know the bugs and their ecology, you don't know when and where to spray. In the early 1960s, environmentalists opposed pesticide use to stop encephalitis outbreaks, and Reeves told them: "This is the only thing we know that will abate an epidemic. We have to decrease the risk of further exposure to disease. If you want to take the responsibility of saying it can't be done and making a stand, you take the responsibility for an epidemic and for further cases. Don't ask us to."

Four decades later, state and county officials, lacking the long-term understanding of the region's insects and inadequately staffed to execute targeted programs, have no option but to repeat to pesticide opponents those words uttered long ago by Reeves.

West Nile virus has been spreading steadily across North America since 1999. Politicians ought to pay a price for ignoring the threat all that time, watching one state after another fall victim to the African virus out of sheer complacency.

Sadly, the price will be paid by the people of the state and the environment in which they live. It didn't have to be this way.

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