West Nile Virus Mounts Deadly Attack in Louisiana

MANDEVILLE, La. — As dusk fell on St. Tammany Parish, Sam Costanza cast a line for croaker from the banks of Lake Pontchartrain--and counted on an occasional breeze to keep the mosquitoes at bay.

“You can’t tell which mosquitoes are infected with West Nile,” he said, flicking away the bugs that hovered near his bare arms. “But you can’t run away from them, either. When you’re around mosquitoes as much as we are, you learn to take your chances.”

But as an insect-borne epidemic worsens, the nonchalance of residents like Costanza has health officials on edge. A 76-year-old woman became the fifth Louisiana resident to die of West Nile virus, the state’s epidemiologist said Tuesday, and 14 more people have fallen ill across the state.

The fresh cases bring Louisiana’s sick toll to 71 and make this the worst outbreak of West Nile since the disease came to the United States three years ago. This summer, the Southern rite of bug bites can be a deadly affliction--and the virus shows no sign of abating.

“This is only the beginning,” Louisiana epidemiologist Raoult Ratard said. “It won’t be surprising if we get 200 or 300 cases before it’s over.”

West Nile virus is carried by migratory birds and spread by mosquitoes. Mississippi has confirmed 22 cases of the disease this year. Texas health officials suspect they’ve had 10 residents fall ill with the virus. And earlier this week, another suspected West Nile victim turned up in Arkansas, near the Louisiana line. The virus is expected to spread to California this year or next.

East Baton Rouge Parish has lost two people to the disease. A resident of Calcasieu Parish, near the Texas border, died of West Nile virus. Here in St. Tammany Parish, across the watery stretch of Lake Pontchartrain from New Orleans, two people have died, and 18 more were infected.

Even 8-year-old Jocelyn Rojas knows those numbers by heart--along with the warning that this year’s mosquitoes “have a disease.” Before she and her brothers step into the afternoon to walk the family dog along their heavily wooded street, they slather every inch of exposed skin with insect repellent. Nevertheless, the kids end up swatting bugs from their legs.

“You protect yourself with bug spray as best you can,” said their 36-year-old father, Eric Rojas. “We don’t stay out very long, just long enough to get in a short walk after work. When we go back to the house, we won’t come out until morning. We don’t take unnecessary risks, but you have to live your life.”

When darkness falls, the mosquito trucks come rumbling through the streets, yellow lights flashing, to spray a fine mist of pesticides over the lawns. From dusk to midnight, low-flying planes blanket the 910-square-mile parish with bug poison.

“Oh, it stinks,” said Jennifer Bonnell, 26. “You hate to think what’s in the stuff. But I think it’s working. I’m not noticing as many mosquitoes out there.”

It wasn’t enough to save Steven Theall, a former jockey who died last month of the virus. Weakened by emphysema, the 53-year-old Theall spent his days among the puddles and manure of a horse stable in nearby Folsom. “That’s probably where that mosquito came from,” said his father, Edgar Theall.

For weeks, the elder Theall watched his son waste away. Steven thought he’d caught a bad case of the flu. He’d knock it out with Coke and aspirin, he told his father.

“But he didn’t get any better,” Edgar Theall said. “He just got worse. The boy was in real misery. He got weaker and weaker.”

By the time a friend drove Theall to the hospital, it was too late. The onetime athlete spent five weeks in intensive care. By the time he died July 26, his frame had dwindled from 106 to 70 pounds. “His immune system was so weak that he couldn’t recover,” his father said.

At its worst, West Nile can bring on encephalitis, a fatal swelling of the brain. Most of the victims killed in Louisiana were elderly people whose immune systems were weakened by other health problems, said Charlie Anderson, Louisiana’s West Nile virus coordinator.

But more often than not, the virus is a relatively mild malady. Most of those stricken with West Nile don’t get sick at all, or they suffer flu-like symptoms. The improbability of a serious infection has fueled a cavalier outlook among many residents, said Dawn Wesson, a mosquito specialist at Tulane University Health Sciences Center in New Orleans.

“There’s the attitude that we’ve always had mosquitoes and they’re not going to make me sick anyway,” she said. “But you wouldn’t want to be the one who gets sick. It’s not worth the gamble.”

Until this summer’s outbreak, the worst epidemic was the United States’ first brush with the disease, when 62 residents of New York state fell ill in 1999. Seven people died that summer.

Louisiana’s West Nile epidemic is most likely a function of its geography. This swamp state of lush greenery and stagnant waters makes for a buggy pit stop in the path of migrating birds. The virus is carried from one state to the next by birds, then transmitted by mosquitoes.

“Some of the things that make our state so beautiful also supports mosquito development,” Wesson said.

The trick is to find a balance between caution and common sense, said Susan Costanza, who wore a sleeveless sundress as she fished alongside her husband. When mosquito larvae speckled her grandchildren’s plastic swimming pool, Costanza dumped out the water and packed away the pool for the rest of the summer. When bugs swarmed a neighbor’s water-filled tire swing, she called the city to complain.

Costanza pointed a fish hook in the direction of the couple’s pickup. Inside, the pair keep a duffel bag stuffed with emergency supplies: bug spray, long-sleeved shirts and slow-burning coils of repellant.

“Unless it gets like the plague or something, I’m not going to let myself get paranoid,” she said. “But I want to be safe just in case.”

But beneath the towering pines, tallows and stately oaks of Mandeville’s sleepy streets, fear of mosquitoes is still evident. Flowerpots and wheelbarrows are overturned in the grass--officials have urged residents to throw out standing water where mosquitoes breed.

Having spent one sweltering summer after the next in Mandeville, Bonnell never gave the prick of a mosquito a second thought. “You just whack at it,” she said.

Not this year. These days, Bonnell is arming herself with citronella candles and bug spray.

“To tell you the truth, I’m paranoid now,” she said. “It’s scary to think a little mosquito bite could kill you.”