Advertisement The numbers mean something different to the Centers for Disease Control and the Wisconsin Division of Health, and something else to local health departments and the public.
You probably remember the 70-year-old West Salem, Wis., man, who was positive in initial tests for West Nile virus. I reported he was the first human West Nile case in La Crosse County since the virus was confirmed in Wisconsin in 2001.
I also wrote that the man was probably the first case in Wisconsin this summer. But state health officials knew it wasn’t the first case this season.
Dave Geske, a vector control officer for the county’s Health Department, considered the West Salem man a case for his purposes. It’s his duty as a public health officer to treat the report as a case and investigate it. Pending confirmation, he suspected this was a case although he knew it wouldn’t officially count.
The CDC and state health officials won’t count the West Salem man as the first case this season because they only count West Nile cases with a positive test and symptoms. The man reported no symptoms, but it was suspected he was bitten by an infected mosquito — and we know his positive status was discovered only after he gave blood at a Red Cross drive.
So he would have been discounted even if the final tests had confirmed West Nile virus.
State health officials and local health departments compare apples to oranges when they talk about things such as Lyme disease, La Crosse encephalitis and West Nile.
Partly because their mission is different.
When a physician reports an initial positive test for La Crosse encephalitis, Geske considers it a case pending final tests. “I assume it is a case because I need to follow up with it, and we know other family members and neighbors could be at risk for the disease,” Geske said. “We want to know where the person picked up the virus and clean up the environment.”
A physician’s report on a person who tested positive for Lyme and has symptoms is enough to get Geske’s attention. But state and federal officials have specific criteria, including the largeness of the rash, which help determine an official case.
“For my purposes, the physician report is enough,” Geske said. “The important thing is physicians treat it like Lyme. We know there are more cases of Lyme which are not counted as Lyme.”
So what’s in a case? It depends on the definition and your point of view.
My point of view is health promotion and prevention.
I’ll still report initial tests are positive pending confirmation, so the public will be more aware of Lyme, encephalitis and West Nile in a timely manner. I’ll also report the official data, often later when I get that press release.
Terry Rindfleisch can be reached at trindfleisch@lacrossetribune.com or (608) 791-8227.
