West Nile Virus The West Nile virus (WNv), originally from the West Nile region of Africa, has been spreading across North America since 1999. In the last few years it has been steadily moving north along the Pacific mountain ranges. This disease is spread by mosquitoes, which become infected with the West Nile virus by biting infected birds. BC has seen many cases of disease in people who had travelled to other parts of North America. In late August 2009, for the first time in BC, two human cases tested positive for West Nile virus. These individuals from the Okanagan had no history of travel outside of the region. Interior Health, the British Columbia Center for Disease Control and Health Canada websites have regularly update information on WNv and it presence in Canada. Mosquito Life Cycle There are four stages to the mosquito life cycle: egg, larva, pupa, and adult (Figure 1). Eggs are laid on the surface of standing or still water. Larvae hatch from the eggs (1) and develop in standing water (2). Larvae go through four growth stages called instars. They feed on organic matter by filtering the water and they must come to the surface of the water to breath. At the end of the fourth instar, the larvae transform into a pupae (3) which must also come to the water’s surface to breathe but do not feed. The adult mosquitoes emerge from the pupae (4), rest on the water’s surface to dry their wings and then they fly away in search of a mate or a blood meal (5). Female mosquitoes require a blood meal (6) in order to mature a new batch of eggs, and they will bite before laying each batch. Male mosquitoes do not bite; instead they feed on flower pollens.

Figure 1. Mosquito Life Cycle - Provided by the Florida Medical Entomology Lab.

Figure 2. A 300ml Dipper loaded with mosquito larvae! It does not take much water to product thousands of larvae. West Nile Virus Cycle Mosquitoes are called WNv vectors, which means that they are responsible for transmitting the virus. Mosquitoes suck in the virus when they bite an infected bird and then when the mosquito bites another bird or a mammal (including humans), they pass on the virus. Mammals, including humans, are considered “dead-end hosts” meaning that they are unable to pass the virus on to other mammals or back to mosquitoes (Figure 3). Figure 3. West Nile Virus Cycle Not all mosquito species are vectors of WNv. In the Interior Health Authority there are approximately 30 species of mosquitoes, and only two species are considered to be significant vectors of WNv. The scientific names of these two mosquitoes are Culex tarsalis and Culex pipiens. In the Okanagan, these species have been found in very high numbers in many locations.

Ministry of Health WNv Assistance Grants Since the spring of 2004 the Ministry of Health Services has offered grant funding for all municipalities, First Nations bands and Regional Districts in the province. Regional Districts throughout the Okanagan have been applying for and receiving this grant. The funding has been used for mosquito surveillance, mosquito larval control, larval habitat mapping and public education. Adult mosquito surveillance is used to monitor mosquito abundance and determine which species of mosquitoes are present in an area. Mosquitoes are trapped using a mosquito light trap baited with dry ice (Figure 6). Mosquitoes are attracted to the light and the CO2 from the dry ice and they are sucked into a collecting container. The Regional Districts and the Interior Health Authority have participated in adult mosquito trapping throughout the Okanagan. All mosquitoes trapped by the Interior Health Authority are shipped to the British Columbia Centre for Disease Control where they are ground up and tested for the presence of West Nile virus. Tens of thousands of mosquitoes have been tested from the Okanagan and non have tested positive for virus.

Figure 6. Mosquito Light Trap Known mosquito larval development sites are monitored throughout the summer in the Okanagan, and when mosquito larvae are present, the Regional Districts consider the use of larvicides. The larvicide product(s) that are being used are called Vectobac and/or Aquabac whichever is more readily available at the time. These essentially identical products contain the active ingredient Bacillus thuringiensis israelensis (Bti)(Figure 7). Bti is a bacterium which occurs

naturally in soils and aquatic environments and although kills mosquito larvae, it is safe for other insects, mammals, fish and amphibians. Bti is certified for organic gardening. Catch basins in urban areas of the Okanagan often contain larvae of Culex pipiens. The larvicide VectoLex with the active ingredient Bacillus sphaericus is used to control larvae in catch basins. This product contains live bacteria that reproduce in the gut of mosquito larvae and kill them. This product will kill larvae for up to 30 days and is safe for all other organisms. Figure 7. Aquabac- Bacillus thuringiensis israelensis formulated on corn-cob Frequently Asked Questions What attracts mosquitoes? Mosquitoes are attracted by body odour, perspiration, heat, light, and carbon dioxide. Why do mosquitoes bite? Only female mosquitoes bite and they use the blood to obtain protein for egg development. How do people become infected with WNv? People become infected with WNv when they are bit by an infected mosquito. What are the chances of getting infected with WNv? The chances of getting WNv are very low. Approximately 80% of people infected with WNv will not get sick at all; the remaining 20% will experience flu-like symptoms (fatigue, fever, headache, body aches) that last about a week or less. In very rare cases (less than 1%), infected people can develop encephalitis, inflammation of the brain, or meningitis, inflammation of the lining of the brain, which can result in death. Does WNv only infect humans? No. There have been cases of horses, birds, cats, chipmunks, domestic rabbits, squirrels, and skunks being infected by WNv. These animals cannot infect other animals or humans. Can my pet get West Nile virus?

• West Nile virus can infect domestic dogs and cats however, these infections very rarely develop into serious illness. These animals usually fully recover without treatment and usually show no symptoms whatsoever.

• Domestic birds such as parrots can be infected and may become very ill or die from the virus.

• Horses are the most susceptible domestic animals to serious West Nile virus illness and up to 40% of infected horses will die. There is a vaccine available for horses.

• All domestic animals acquire the virus through the bite of a mosquito and none are able to pass on the virus to other animals or humans once they are infected. Please contact your local veterinarian for more information about protecting domestic animals from West Nile virus infection.

Why should I report a dead bird? Members of the corvid family (crows, ravens, magpies, blue jays, and Steller’s jays) are particularly sensitive to the virus causing high death rates if infected and are therefore good indicator species of WNv activity. Who do I call if I find a dead bird? Birds of the corvid family which include crows, ravens, magpies, blue jays and Steller’s jays that are dead but not decayed should be reported to the Interior Health Authority (IHA) at 1-866-300-

0520. Efforts will be made to collect the bird and send it for testing at the provincial Animal Health Lab in Abbotsford, BC. If at all possible, place the bird in a double bag and store in the freezer until a representative from the IHA can collect the bird. Can I get WNv directly from birds? No. Precautions should be taken when handling dead birds due to the fact that you don’t know the bird’s cause of death. Avoid bare-handed contact; use gloves or double plastic bags when handling dead birds and wash your hands after disposal. How can I protect myself from WNv? The best way to protect yourself from WNv is to minimize your exposure to mosquitoes and to reduce mosquito larvae development sites. The following are ways to accomplish this:

• reduce mosquito larvae development sites around your home by draining standing water on a regular basis

o change the water frequently in bird baths, pet dishes and children’s wading pools o keep gutters clear so they will drain properly o empty or turn over anything that holds standing water such as buckets, wheel

barrows, old tires, and toys o drill holes in tire swings o empty water out of plant saucers

• keep a fine mesh screen over rain water barrels so female mosquitoes cannot land on the water and lay eggs

• aerate ornamental ponds or stock with fish • repair holes in screens on windows and doors • wear tightly woven clothing with long sleeves, and long pants. Try to wear light-coloured

clothing (Mosquitoes are attracted to dark clothing because it absorbs heat) • use insect repellent that contain DEET (important: read the product label for proper use)

or Oil of Lemon Eucalyptus products such as OFF! Botanicals® What product is being used to kill mosquito larvae in stagnant water? Aquabac 200G or Vectobac 200G. These are larvicides that contain the bacterium Bacillus thuringiensis var israelensis which is certified for organic gardening. The bacteria is attached to ground corn cob and spread on the surface of standing water containing larvae. Mosquito larvae eat the bacteria and it causes their death. Other insects, amphibians, fish, birds and mammals are unharmed by this naturally occurring bacteria. Is Aquabac/Vectobac safe for the environment? Aquabac and Vectobac are two of the least toxic insecticides used today. Bacillus thuringiensis var israelensis, the active ingredient in these products, is a naturally occurring bacterium found in soil and aquatic environments. How does Aquabac/Vectobac work? Aquabac and Vectobac are applied to standing water that contains larvae in their third and fourth instar. Once in the water, the Bacillus thuringiensis var israelensis is eaten by the larva which causes death within 4 to 24 hours. For more information, refer to the British Columbia Center for Disease Control website at www.bccdc.org, the Interior Health Authority website at www.interiorhealth.ca or call the Interior Health West Nile Virus information line at 1-866-300-0520

Fight the

Bite!

West Nile VirusProtection Information

What You Can Do to ProtectYourself and Your Family

Wear light coloured long sleeves andpants when outdoors,especially around dusk anddawn when mosquitoes thatcan carry West Nile virus aremost active. Use mosquitorepellent containing DEET,PMD or lemon eucalyptus oilas directed on the bottle.

Contact Information

Dead Bird pickup hotline

1-866-300-0520

•

Interior Health AuthorityWest Nile Information

1-866-300-0520

www.interiorhealth.ca

•

BC Centre for Disease Control

www.bccdc.org

•

BC NurseLine – For Health questions

1-866-215-4700

•

Regional District of North OkanaganWest Nile Prevention Program

(250) 550-3700

info@rdno.ca

www.rdno.ca

Regional District ofNorth Okanagan

9848 Aberdeen RoadColdstream, BC V1B 2K9

REDUCE MOSQUITO BREEDING INCOMMERCIAL /I NDUSTRIAL AREASAND DEVELOPMENT S ITES

Image courtesy BCCDC

What are the symptoms?

Around 80% of people show no symptomswhen infected. About 20% of people developa milder form of the illness. Less than 1%get seriously ill and approximately 0.1% ofcases can be fatal.

Symptoms may include: headache, rash,high fever, sensitive eyes, fatigue, neckstiffness, gastrointestinal distress, stupor,disorientation, tremors, convulsions, muscleweakness, paralysis and coma.

Anyone suspected of having West Nilevirus should see a doctor. For generalhealth questions related to West Nile viruscontact the BC NurseLine toll-free:

1-866-215-4700

What You Can Do To ReduceMosquitoes Around Your Home or Business

From Spring to Fall look for any standingwater. Mosquitoes only need a teaspoonof stagnant water to breed in.

Remove standing water from items suchas flower pots, wheelbarrows, old tires,barrels, tin cans, bird baths, swimmingpool covers, tarps and wading poolsevery two days. Check that holes, smalldepressions, roofs, catch basins, eaves anddrains are not collecting stagnant water.

Install screens on your windows anddoors and make sure they are secureand have no holes.

What is West Nile Virus?

West Nile virus is spread to people

by mosquitoes. The mosquitoes

bite infected hosts and transfer the virus

to the next animal or person they bite.

Birds are especially sensitive to the

virus. Dead birds often act as an

indicator that West Nile virus is present.

If you find a newly dead crow, magpie

or jay please contact the Interior Health

Authority at:

1-866-300-0520

Who is at risk?

Anyone can become infected. People

over 50 years old or who have

compromised immune systems are at

highest risk of serious illness.REDUCE MOSQUITO BREEDING INRESIDENTIAL AREAS

Image courtesy BCCDC

West Nile Virus Communication Action Plan

June, 2007 1. WEST NILE VIRUS COMMUNICATION ACTION PLAN PURPOSE To outline a local plan of action for community and media communications prior to and once WNV is detected in mosquito, bird, horse, or human in Interior Health.

• To ensure clear and consistent messages are delivered by established spokespersons • To ensure partner agencies and local governments are apprised of IH communication

and action plans prior to release to public • To involve partner agencies and local governments in any media release or news

conference • To reassure staff and public and to further educate on personal protection, source

reduction, and surveillance • To provide information and education to other key audiences, such as physicians

2. BACKGROUND • Interior Health (IH) will work with the BCCDC, PHO, and the appropriate RD and

municipalities to deliver the initial message to the public via the media. • IH Medical Health Officers (MHO), Director of Health Protection and Program Leader

should be prepared to speak to the issue as required. • Locally, key stakeholders and program partners will also need to be informed and may

need to respond to public and media inquiries regarding their area of responsibility and/or interest.

• BCCDC reports out on positive crow and mosquito results, and on probable human cases (preliminary test is positive – then has to wait for a few weeks for confirmatory testing results). They report on West Nile Fever or more serious WNv complications (West Nile Neurological Syndrome).

• Note: if a horse or a bird, then the Animal Health Centre and Canadian Food Inspection Agency (CFIA) will also be involved via BCCDC.

• IH program leader will meet with RD or municipalities in areas likely to see the first IH cases, to determine a communications protocol.

3. OVERVIEW

• BCCDC test shows WNV in IH region - first positive mosquito pool, bird, horse, or locally acquired human case in IH

• BCCDC will notify IH MHO, who will fan out to IH MHOs, IH Health Protection, IH PH Communications and the affected RD/municipality

• IH will issue a news release in consultation with the BCCDC, PHO, and the affected RD or municipality. Interior Health MHO will hold a news conference in the affected community with participation from the affected RD or municipality.

• Local MHO or Health Protection or program lead will be available to respond to media in their respective HSAs.

• Follow up public open house and meetings as deemed necessary will be held in the affected communities to address local concerns. Meetings will be coordinated between the affected RD/Municipality and IH. This open house/public meeting will also be announced at the time of initial news conference.

• Advance notice of IH Action Plan provided to local government partners for their information and subsequent participation.

• BCCDC may also run additional radio and newspaper ads to emphasize personal protection message.

• Subsequent cases to be handled locally, without direct involvement of BCCDC. The need for further press conferences or community meetings will be determined on a case by case basis.

4. IH ACTION PLAN

Public Education Plans Date Target

Audiences Message Communication

Tools

Mid June General public Source reduction Surveillance Personal Protection

News release Backgrounder Website MHO Update

July/August/Sept as required based on appearance of and degree of WN

General public Event related communications

News release Website MHO Update

August Personal protection Continued source reduction Continued surveillance, especially in southern most communities in IH

News release Website

Oct/Nov General public Physicians

Wrap up if events occur News release Web site MHO Physicians Update

Notes • If WN virus discovered, public education messages will change accordingly

4.1 PRE EVENT COMMUNICATIONS Local Governments and Key Stakeholders • West Nile Virus Update #1 - in conjunction with public education plans (see below

chart) produced and distributed electronically by West Nile Program Lead to all Chief Administrative Officers, City Administrators, as well as Mayors, MLAs, Bands, Tribal Councils, and Nations.

o Provides a ‘heads up’ on IH Action plan, information on surveillance, source reduction, and personal protection

• West Nile Virus Update #2 - in conjunction with public education plans (see below chart) produced and distributed electronically by West Nile Program Lead to all Chief Administrative Officers, City Administrators, as well as Mayors, MLAs, Bands, Tribal Councils, and Nations.

o Provides a reminder of above and reports on number of crows etc. • More updates as required.

4.2 EVENT COMMUNICATIONS Immediate Notification • BCCDC contacts MHO on call with test results at 1-866-851-7311. Available 24/7 • MHO on call initiates fan out. Communications and emergency numbers are listed in the

contacts section at the end of this plan. o Public Health: Dr. Paul Hasselback, Senior MHO; all MHOs; Ken Christian,

Director of Health Protection; Ken Cooper, WNV Program Lead; Mary Bates, Director of Prevention Services; Public Health Leadership Team, local PH contact

o Communications: Alison Paine, IH Communications; Deanna Wadstein, for Public Health; Ryan Kuhn, for KB; Darshan Lindsay, for Thompson Cariboo, Shuswap; Cathy Renkas, Okanagan; and Jennifer Henkes, for EK.

o IH Senior Executive: Murray Ramsden, CEO; Alan Dolman, Board Chair; and Senior Executive Team

o Local IH Contact: COO, Community Administrators o First Nations Inuit Health Branch: Dr. David Martin and Ian McLean (Ken

Christian and Ken Cooper have contact information)

Preparations for Announcement • Determine time, locations for news conference based on location of source of WNv • IH locations for local web cast news conference will vary according to the location of the

source of the virus. At a minimum the following will be held: o Main IH news conference held in affected community

• Prior to where possible, consult with key local government contact on news conference plans. Note that local community may or may not want to host media conference in their community.

• Establish time, date, and location for follow up public information session (open house/meetings) for announcement. West Nile Virus Program Lead and area Senior Public Health Inspector will coordinate.

Pre-Announcement Notification • Local area MHO and area Senior Public Health Inspector initiates local internal rollout

with materials provided by IH and BCCDC Communications. • Local roll out consists of providing key stakeholders with information prior to public

release and ensures governments and agencies aware of and included in communicating to broader publics and media.

• Local stakeholders to be previously identified with contact information and may include: o IH Contacts (COO, Community Administrators) o MLA o Mayor and Council o RD Chair and Board of Directors o Regional Hospital District o Band, Tribal Council, Nation contact o Person/agency responsible for local mosquito control o Local tourism association (e.g.: Chamber of Commerce) o Economic Development Commission o BC Nurseline o Canadian Blood Services

• At time of announcement, provide information to other contacts:

o Other key stakeholders as identified by local community o Physicians o Front line staff

Announcement • In consultation with IH Communications and BCCDC Communications, and key

stakeholders, participate in news conference as determined above • Develop and circulate media and information packages that include:

o News Release o BC Health Files Fact sheets on West Nile virus #88 o Information on source reduction, personal protection, and surveillance o Links to BCCDC site with FAQs

(http://www.bccdc.org/content.php?item=183&PHPSESSID=66a74da12f792f3732e72925c8a32382)

• Update IH Web site and Inside Net home page. If outside of regular business hours contact Public Health Communications Officer or Director of Communications to coordinate posting.

• MHO Update to Physicians, include links to CDC website with information for Physicians (http://www.bccdc.org/content.php?item=184)

• Provide speaking notes for front line staff • Provide information to IH staff though @IH newsletter, HSA email bulletins or separate

notices as required • In the event of a case(s), the official numbers to be used in reporting to the media and

the public are those posted on the BCCDC web site at http://www.bccdc.org/content.php?item=183

4.3 FOLLOW UP COMMUNICATIONS

• Host a local public information session (meeting or open house) in community affected where people can ask health professionals and other available partners (e.g. local gov’ts) more detailed questions. Note that an open house format may be a more effective way to transmit information over a longer period of the day. Area Senior Public Health Inspector will coordinate.

• Leverage media coverage with more in-depth interviews to promote degree of health risk, personal protection, and source reduction.

• Update websiteand InsideNet home pages. • Consider update in @IH Newsletter and HSA email bulletins as required.

5. RISK COMMUNICATION OBJECTIVES • Provide details on what is being done to address the situation; address public’s concerns • Recommend specific steps people can take to protect themselves and their families

(e.g., surveillance, source reduction, personal protection) • Avoid issuance of statements or information that conflicts with other agencies (e.g.,

BCCDC web site as source for case numbers) • Avoid speculation, comparisons, negative words, personal opinions • Build trust and credibility for all involved by taking an open and honest approach

6. MESSAGES 6.1 ABOUT WEST NILE • West Nile Virus has been detected in almost all other areas of North America since it

was first identified in New York in 1999. Its spread into British Columbia is not unexpected.

• WNV is normally passed between mosquitoes and birds. While the risk is low, humans

can become infected if bitten by an infected mosquito. Most infected people will have a mild illness or no symptoms. The elderly and people with compromised immune systems may develop more severe illness in response to WNV exposure.

• If you have been bitten by a mosquito, you do not have to be tested for WNv. Less than

1% of people who are bitten by an infected mosquito will get severely ill. Most people who become infected with the virus will have no symptoms or ill effects at all. In a minority of cases some people may experience mild flu like symptoms such as headache, fever body aches, swollen glands, and muscle weakness before fully recovering. If you have mild health symptoms that you think might be from the West Nile Virus, you should get plenty of rest, drink fluids, and avoid alcohol. If your symptoms persist and seem like they are getting more severe, call your doctor. If you have a high fever, neck stiffness, disorientation, tremors, muscle weakness or convulsions you should seek immediate medical attention. In some individuals, especially those over 50, WNv can cause more severe illness such as meningitis and/or encephalitis.

6.2 EMPHASIZE PERSONAL PROTECTION • While the risk of anyone becoming seriously ill from WNv infection is low, it is important

to remember the preventative steps that everyone can take in order to ensure the lowest risk of infection possible. Any activity that either prevents mosquitoes from biting or prevents them from breeding will help to further reduce the risk of infection. Here are some simple things you can do:

To protect yourself and your family from mosquito bites: • Wear baggy, long-sleeved shirts and pants. • Wear light-coloured clothing since dark colours attract mosquitoes. • Use mosquito repellents that contain DEET. The percentage of DEET in repellents

should not exceed 30% for adults or 10% for children. DEET should not be used on children under 6 months of age. Ensure you read the instructions before application.

• You may also try "Oil of Lemon Eucalyptus" in "Off Botanicals" as an alternative for those who don't want to wear DEET, but it is not long lasting. DEET is considered by authorities to be safe when used according to the label. Be sure to read all labels.

• If you live in an area with lots of mosquitoes install screens on your doors and windows. Make sure they fit tightly and have no holes in them.

• Make sure your lawn is mowed to decrease the area where mosquitoes can rest during the hot part of the day.

• Avoid or protect yourself, in or near woodland, forests, creeks, marshes, and any other places where mosquitoes may bite during the day.

• Try to avoid spending time outdoors at dawn and at dusk when mosquitoes are most active.

6.3 REDUCE BREEDING GROUNDS • It doesn’t take much time, or water, for mosquitoes to develop from eggs into adults.

They can breed in as little as a teaspoon of water. Keeping your home free from mosquito breeding grounds is the best defence. We can all reduce risk by doing the following:

o Dispose of tin cans, plastic containers, ceramic pots or similar water-holding containers, including pet food dishes

o Empty standing water from used or discarded tires (e.g. tire swings) o Drill holes in bottom of recycling containers o Clean clogged roof gutters o Turn over plastic wading pools when not in use/change water weekly o Turn over wheelbarrows o Change water in birdbaths weekly o Aerate ornamental pools, stock them with fish, or change water weekly o Clean and chlorinate swimming pools o Use landscaping to eliminate water that collects on private and public property

• If there is a large area of stagnant water near your house, but not on your property, that

you are concerned about, please contact your local government or highways contractor. Where appropriate, arrangements may be made to drain it or prevent mosquitoes from breeding in it. In some municipalities, local by-laws may provide City staff or Regional District staff with the power to order remedial action.

• Interior Health has also worked closely with the media to encourage the public to protect

themselves from WNV and reduce breeding grounds for mosquitoes, including presentations to local governments and local groups.

6.4 REPORT CORVIDS • If questions are received from the public, they can contact 1 866-300-0520 for information.

Active solicitation will not take place until/unless WNv is reported in surrounding communities.

6.5 FOR NUMBER OF CASES • Use CDC website for official source

(http://www.bccdc.org/content.php?item=183&PHPSESSID=66a74da12f792f3732e72925c8a323820)

6.6 MORE INFORMATION • For more information call the BC Health Guide Nurse Line - available 24 Hours Toll Free 1-

866-215-4700. For deaf and hearing impaired - 1 866 TTY 4700. • For more information visit our web site at www.interiorhealth.ca or visit Health Canada’s

West Nile Surveillance web site at West Nile Virus Monitor - West Nile Virus Surveillance Information - PPHB - Health Canada (http://www.hc-sc.gc.ca/pphb-dgspsp/wnv-vwn/mon_e.html)

6.7 PRE EVENT MESSAGES

• West Nile virus has not yet been seen in BC, however with 24 cases in Alberta last year, 805 cases in Idaho, and 3 cases in Washington State, there is a good chance we will experience West Nile in BC this year.

• See general messages from sections 6.1 – 6.6 listed above.

6.8 FOR FIRST POSITIVE BIRD or MOSQUITO

• BC has now experienced its first bird/mosquito positive for WNv which was expected this year.

• While the likelihood of human infection is still low, the recent detection of WNv in BC means individuals must be diligent in protecting themselves from this serious illness.

• BC public health and local communities have carried out mosquito control activities on breeding sites to reduce the risk of human exposure, but it is impossible to eliminate the risk from a mosquito source, as we cannot “eliminate” mosquitoes.

• Surveillance and prevention activities will increase to protect the health of BC residents.

• People should watch for and report dead corvids in areas where West Nile has not been found, reduce mosquito breeding areas around their homes, and exercise caution to avoid mosquito bites.

• Provide information on West Nile Virus hotline number – 1-866 – 300 – 0520 (Note: may

also have Nurseline Or other Province-wide number available)

• Emphasize Personal Protection: See WNV Personal Prevention (below) • Until BCCDC and your Regional Health Authority give the “all clear” and/or your region

experiences its first hard frost of the season, please continue implementing these personal protective measures to reduce your risk of contracting WNv.

• See general messages from sections 6.1 – 6.6 listed above. 6.9 FIRST HUMAN CASE IN IH • Currently, this is a probable, not a confirmed human case of WNv. This diagnosis was

made based on the patient’s clinical symptoms, patient history, and a simple blood test. It will take several weeks of laboratory testing to confirm this as the first human case of WNv is BC. This testing is conducted by the National Medical Laboratory in Winnipeg.

• This is BC’s first local human case of WNv. Although it is important for all British Columbian’s to take precautions to protect themselves against mosquito bites, additional protective measures should be considered in the regional area(s) affected.

• It is not yet clear whether this person contracted WNv at their primary residence or from

a nearby adjoining community or local area they have traveled to recently. Again, this illustrates the need for increased personal protective measures both in BC and when visiting surrounding areas.

• If you have been bitten by a mosquito, you do not have to be tested for WNv. Less than

1% of people who are bitten by an infected mosquito will get severely ill. Most people who become infected with the virus will have no symptoms or ill effects at all. In a minority of cases some people may experience mild flu like symptoms such as headache, fever body aches, swollen glands, and muscle weakness before fully recovering. If you have mild health symptoms that you think might be from the West Nile Virus, you should get plenty of rest, drink fluids, and avoid alcohol. If your symptoms

persist and seem like they are getting more severe, call your doctor. If you have a high fever, neck stiffness, disorientation, tremors, muscle weakness or convulsions you should seek immediate medical attention. In some individuals, especially those over 50, WNv can cause more severe illness such as meningitis and/or encephalitis.

• WNv cannot be transmitted from person to person; it is caused by being bitten by an

infected mosquito. Birds and other animals cannot transmit WNV to people.

• It is important to use personal protective measures to guard against mosquito bites and WNv transmission. Until BCCDC and your Regional Health Authority give the “all clear” and/or your region experiences its first hard frost of the season, please continue implementing these personal protective measures to reduce your risk of contracting WNv.

• FOR BLOOD DONOR POSITIVES: This is a probable human case. Canadian Blood

Services alerted BCCDC to a BC blood donor in the [NAME] health region whose blood donation tested positive for the virus. The test result is now being confirmed at Canadian Blood Services National Testing Laboratory in Ottawa. Confirmation is expected within 48 hours. In the meantime, the blood donation has been withdrawn from the Canadian Blood Services’ inventory of blood.

• FOR BLOOD DONOR POSITIVES: Canadian Blood Services reminds BC residents to

please continue to donate blood. Remember, you cannot get WNV by giving blood. While you should take precautions to protect yourself, most mosquitoes do not carry WNV. Mosquito bites do not disqualify people from giving blood and every blood donation is tested for WNV.

• See general messages from sections 6.1 – 6.6 listed above.