IT helps NYC medics battle fever

It sounds like a Hollywood thriller: A few cases of an unfamiliar illness appear in New York City around Labor Day weekend. At first city health officials think it's a domestic form of encephalitis.

By Trudy Walsh

GCN Staff

It sounds like a Hollywood thriller: A few cases of an unfamiliar illness appear in New York City around Labor Day weekend. At first city health officials think it's a domestic form of encephalitis.

A few weeks later, researchers identify the disease, which has killed five people and sickened more than 30, as a virus never before found in this hemisphere.

The outbreak was fact, not fiction. The illness was West Nile virus, a mosquito-borne disease in the same class of viruses as dengue fever and yellow fever, researchers said.

By October, New York City health officials, working with U.S. Centers for Disease Control and Prevention researchers, had to switch epidemiological gears. What they originally thought was St. Louis encephalitis was reclassified.

The logistics of updating researchers and epidemiologists about the changing nature of the outbreak was daunting, said David Haddow, assistant director of the New York City Health Department's Communicable Disease Program.

Haddow and his team worked with CDC's Epidemic Intelligence Service to create a database using information gathered in Microsoft Excel 97 spreadsheets to track the virus. Analysts imported the Excel data into two statistical software packages'SAS software from SAS Institute of Cary, N.C., and SPSS Version 8 from SPSS Inc. of Chicago'to analyze the data.

Haddow used WinFax Pro Version 9 from Symantec Corp. of Cupertino, Calif., over a high-speed modem to transmit breaking news simultaneously to emergency rooms, infectious-disease researchers, medical and commercial laboratories, and health departments in surrounding communities.

'You can't predict an outbreak like this,' Haddow said. 'That we had our computer systems ready, even if it was more than we needed for basic surveillance, proved invaluable.' The department had to mobilize a lot of resources fast. 'Without computers, it would have been impossible,' he said.

City health officials also leaned on geographic information system software to track the geographic distribution of the illness.

Using MapInfo and ArcView software from Environmental Systems Research Institute of Redlands, Calif., on Pentium II notebook PCs, city health officials determined that the initial outbreak was clustered in northern Queens.

The GIS showed the distribution of the disease spreading into the Bronx, Brooklyn, Manhattan, Westchester County, Nassau County and Connecticut.

Officials also could indicate on the GIS which cases were confirmed, probable, possible or suspect.

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