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Researchers probing mysteries of West Nile virus

JACKSON — As neurologists at Mississippi Methodist Rehabilitation Center were making news with their discovery as to the cause of some severe West Nile symptoms in certain patients, a student working at the state veterinary lab was successfully testing award-winning research on the West Nile virus (WNV) in birds.

And with the heat of summer rising, Mississippi’s research facilities are working even harder to build on all that was learned during the past year to effectively combat the disease in years to come.

Gay Henson, a student in the School of Health-Related Professions at the University Medical Center, was doing a special rotation in 2002 an the state vet lab as part of her coursework in clinical laboratory science. Already holding an undergraduate degree in animal science and a certified veterinary technician designation, Henson had set her sights on vet school at Mississippi State University.

While at the state vet lab, however, Henson began working with colleagues documenting the spread of West Nile virus in birds.

“We were just getting bombarded with birds,” said Henson.

With the spread of the virus last summer, the Mississippi State Department of Health (MSDH) was seeing increases in dead birds, sick horses, mosquito samples — and sick humans.

Dr. Sally Slavinsky, an MSDH epidemiologist, said that the test being used to check for the presence of West Nile in birds in 2002 was a cumbersome virus isolation mechanism, with each test often taking more than two weeks to show results.

The federal Centers for Disease Control (CDC), on the other hand, had developed a much faster test for the presence of West Nile called the VecTest WNV Antigen Assay, but there was a catch — researchers had only used it successfully on mosquitoes.

“We acquired the test for the vet lab and asked them to use the test in parallel (with the virus isolation),” said Slavinsky.

Henson became interested in the research, and she decided to conduct her own set of tests on blue jays and crows to comply with research requirements for her degree program. She contacted the company that made the test kits and set up her own set of birds to test — first with VecTest, then the conventional way to test the accuracy of her results.

Henson’s research confirmed that the VecTest was accurate in birds as well as mosquitoes.

“What I was able to do with the test was set up a protocol to test the birds,” said Henson.

Dr. David Fowler, chairman of the UMC Department of Clinical Laboratory Sciences, said, “She did a correlation study of the adapted test to the PCR (polymerase chain reaction) testing that is currently used and found 100% correlation. This makes testing for the West Nile virus significantly easier.”

Henson’s paper on her research — “Rapid Detection of West Nile Virus in Birds Using the VecTest WNV Antigen Assay” — won first place among competition in the department. She’ll also accept the Best Research Paper award by the American Society for Clinical Laboratory Science’s (ASCLS) Education Scientific Assembly during the society’s 2003 Clinical Laboratory Expo in late July.

Education was also the name of the game at a recent seminar for Mississippi health professionals at MMRC this past April. Much has been learned about the virus in the three years since New York physicians were taught to be on the alert for a mosquito-borne, flu-like illness that seemed to target the elderly or people with weakened immune systems.

A top priority on health care professionals’ list of concerns was how to diagnose, treat and prevent the disease that killed a dozen Mississippians last year.

“Our patients had lots of questions last year, and I wanted to get answers,” said Dr. Michael Gordon, a physician at Alliance-Laird Medical Clinic in Union. “One of the things of interest to me is which patients would you want to draw a West Nile virus test on. Last fall we had a lot of people come in to the clinic, certain they had West Nile virus and demanding the test.”

“Mothers were very concerned,” said Carol Terrell, a nurse practitioner at North Sunflower County Hospital. “They wanted to find out how to protect their kids.”

Dr. Arthur Leis, a neurologist and senior scientist at the Methodist Rehab’s Center for Neuroscience and Neurological Recovery, said that a lot had been learned by Mississippi researchers concerning disease transmission and likely complications during last year’s outbreak.

“We’ve seen evidence that the virus can be transmitted by blood transfusions, organ transplants and possibly breast milk,” said Leis.

Leis said physicians need to be aware of all the manifestations of West Nile virus because a misdiagnosis can affect a patient’s chance for a full recovery.

“Because physicians were initially unaware of West Nile’s association with paralysis, cases have been misdiagnosed as stroke or Guillain-Barre syndrome,” Leis said. “And treatments for those conditions are completely ineffective for West Nile virus and can cause injurious side effects.”

This year, MMRC is conducting follow-up studies with the patients they saw with the most severe symptoms last summer. There is no cure for West Nile infection, but supportive care can help minimize the most severe symptoms. The MMRC study is designed to evaluate the long-term effects of infection and treatment.

Other studies being conducted in Mississippi include a MSDH/CDC case control project that surveyed 300 Mississippians to determine if there are risk factors that increase the likelihood of infection or complications from infection, said Slavinsky. Those results are still being analyzed.

And birds are the topic of research at the University of Southern Mississippi, where researchers have been considering the migratory patterns of birds, which are believed to spread the virus through their seasonal flight patterns. The principal question was whether a bird infected with West Nile virus has the ability and motivation to fly.

According to Slavinsky, all the research has one main goal: finding out as much as possible about the disease and how to prevent the spread of infection.

While the VecTest study and the migratory bird study helps document the methods of transmission, the MMRC research will likely have the most effect of patient care.

“It really was groundbreaking work,” Slavinsky said. “It helps to better directly apply treatment for those folks.”

Contact MBJ contributing writer at Julie Whitehead at mbj@msbusiness.com.

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