COUNTY OF MERCER DEPARTMENT OF HUMAN SERVICES DIVISION OF PUBLIC HEALTH MCDADE ADMINISTRATION BUILDING 640 SOUTH BROAD STREET P.O. BOX 8068 TRENTON, NEW JERSEY 08650-0068 (609) 278-7165 (609) 396-8014 FAX

BRIAN M. HUGHES County Executive KELVIN S. GANGES ANDREW A. MAIR Chief of Staff County Administrator

KRISTIN REED MARYGRACE BILLEK Health Officer Director West Nile Virus

Update: August 2018: A 74-year-old Hunterdon County man tested positive for West Nile after displaying symptoms late last month, according to the New Jersey Department of Health. This is the first case of West Nile Virus in New Jersey this year. In 2016 New Jersey had 11 cases and 2 deaths.

What is it? West Nile Virus (WNV) is a disease that is usually spread to people through the bite of an infected mosquito. Identified in the United States in 1999, West Nile virus is seen most often during the summer and early fall months. Anyone can get infected with West Nile virus. People over age 50 and people with weak immune systems are at greater risk of developing severe illness. Mosquitoes become infected when they feed on infected birds. Infected mosquitoes then spread West Nile virus to people and other animals by biting them. In rare cases, the virus has been spread through blood transfusions, organ transplants, breastfeeding and during pregnancy from mother to baby. West Nile virus is not spread:  Through coughing, sneezing, or touching  By touching live animals  From handling live or dead infected birds. Avoid bare-handed contact when handling any dead animal. If you are disposing of a dead bird, use gloves or double plastic bags to place the carcass in a garbage can.  Through eating infected birds or animals. Always follow instructions for fully cooking meat from either birds or mammals.

How can I protect myself? The most effective way to avoid West Nile virus disease is to prevent mosquito bites.

To prevent mosquito bites:  Use Insect Repellent Use Environmental Protection Agency (EPA)-registered insect repellents with one of the active ingredients below. When used as directed, EPA-registered insect repellents are proven safe and effective, even for pregnant and breastfeeding women.  DEET  Picaridin (known as KBR 3023 and icaridin outside the US)  IR3535  Oil of lemon eucalyptus (OLE) or para-menthane-diol (PMD)  2-undecanone

Remember to:  Always follow the product label instructions.  Reapply insect repellent as directed.  Do not spray repellent on the skin under clothing.  If you are also using sunscreen, apply sunscreen first and insect repellent second.  Always follow instructions when applying insect repellent to children.  Do not use insect repellent on babies younger than 2 months old.  Do not apply insect repellent onto a child’s hands, eyes, mouth, and cut or irritated skin. Spray insect repellent onto your hands and then apply to the child’s face.  Do not use products containing oil of lemon eucalyptus (OLE) or para-menthane-diol (PMD) on children under 3 years old.  We do not know the effectiveness of non-EPA registered insect repellents, including some natural repellents.  Choosing an EPA-registered repellent ensures the EPA has evaluated the product for effectiveness.

ALSO Try To:  Dress your child in clothing that covers arms and legs.  Cover crib, stroller, and baby carrier with mosquito netting.  Wear long-sleeved shirts and long pants  Treat items, such as boots, pants, socks, and tents, with permethrin* or buy permethrin-treated clothing and gear.  If treating items yourself, follow the product instructions.  Do not use permethrin products directly on skin.  Take steps to control mosquitoes inside and outside your home  Make sure all windows and doors have screens and that all screens are in good condition.

ALSO Try To:  Use air conditioning when available.  Mosquitoes begin to breed in any puddle or standing water that lasts for more than four days. Get rid of mosquito breeding sites around your home. Empty and scrub, turn over, cover, or throw out items that hold water, such as tires, buckets, planters, toys, pools, birdbaths, flowerpots, or trash containers. Clean out gutters and drains. Symptoms No symptoms in most people. Most people (8 out of 10) infected with West Nile virus do not develop any symptoms. Fever: only in some people. About 1 in 5 people who are infected develop a fever with other symptoms such as headache, body aches, joint pains, vomiting, diarrhea, or rash. Most people with this type of West Nile virus disease recover completely, but fatigue and weakness can last for weeks or months. Serious symptoms in a few people. About 1 in 150 people who are infected develop a severe illness affecting the central nervous system such as encephalitis (inflammation of the brain) or meningitis (inflammation of the membranes that surround the brain and spinal cord).  Symptoms of severe illness include high fever, headache, neck stiffness, stupor, disorientation, coma, tremors, convulsions, muscle weakness, vision loss, numbness and paralysis.  Severe illness can occur in people of any age; however, people over 60 years of age are at greater risk. People with certain medical conditions, such as cancer, diabetes, hypertension, kidney disease, and people who have received organ transplants, are also at greater risk.  Recovery from severe illness might take several weeks or months. Some effects to the central nervous system might be permanent.  About 1 out of 10 people who develop severe illness affecting the central nervous system die.  See your healthcare provider if you develop the symptoms described above.  Your healthcare provider can order tests to look for West Nile virus infection.

Treatment  No vaccine or specific antiviral treatments for West Nile virus infection are available. Antibiotics are not effective against viral illnesses and anti-viral drugs have not shown to be effective for treating West Nile virus.  Over-the-counter pain relievers can be used to reduce fever and relieve some symptoms  In severe cases, patients often need to be hospitalized to receive supportive treatment, such as intravenous fluids, pain medication, and nursing care.  If you think you or a family member might have West Nile virus disease, talk with your health care provider.