Thursday, August 22, 2002
Putting West Nile into perspective

By Dr. Anthony Policastro
Nanticoke Memorial Hospital

About two years ago, West Nile virus made its appearance in New York City. At that time I wrote an article about it. Given the recent events in the news, it made sense to dig that article out and give everyone a chance to review it. People sometimes behave in an illogical way. We see examples of this in many different areas. However, there are many of them in medicine. West Nile virus is a disease that is common in many parts of the world. It only recently has been introduced to the Untied States. Most people that get infected with the virus get minor symptoms. A very small number develop an infection of the brain called encephalitis. Many viruses cause encephalitis. West Nile virus is not the only one. Measles used to do it. Chickenpox used to do it. Herpes can do it in the newborn. The one thing they all have in common is that most people with the disease do not get encephalitis. Some older patients will not survive the encephalitis. A lot of people have gotten concerned about this virus for that reason. However, older individuals are much more at risk from pneumonia. They are so much at risk that we recommend that they take a pneumonia vaccine. Very few of them do. Why do they worry about West Nile virus and not get protected against pneumonia? A few years ago a drug company came out with Lyme vaccine to protect against Lyme disease. Many people rushed to their doctors to get their dose of Lyme vaccine. They were upset when they found that it was not covered by their insurance. This did not seem fair to them. Later we found that about 12 percent of the people that got the new vaccine developed chronic joint pain. Most people did not even know about that side effect. Now few physicians are giving the vaccine. In the meantime, influenza is a very common disease. It affects millions of more people every year than Lyme disease. There is a vaccine for it also. So many doses have been given that we know about the side effects. They are much less than the side effects from Lyme vaccine. However, many of the people that should get flu vaccine do not. Why do they worry about Lyme vaccine and not flu vaccine? There have been stories about bacteria in undercooked beef causing illness. In some cases the illness is serious. That has led to concern about making sure that beef is cooked very well so that the rare case of disease from undercooked beef is prevented.
However, too much beef is bad for us because of the high fat content. Cutting down on the fat content of our foods is important. Perhaps we should not even eat that much beef to begin with. That is a more healthy approach. That does not happen. We continue to eat large quantities of high fat foods and just make sure they are cooked well. Why do we do that? Airplane accidents are unusual. They are frequently fatal when they occur. The result is that some people do not like to fly. However, deaths from auto accidents are much more common than aircraft accidents. Not only are people not afraid to drive, but they also refuse to wear their life saving seat belts. Why do they behave in this illogical fashion? You might wonder what these items all have in common. There is one thing. It is the media. West Nile virus is news. Lyme disease is news. Food-borne illnesses are news. Airplane accidents are news. The media projects these items as a great problem. They do not take the time to show how unusual they are. Television has one purpose. It is to sell time to sponsors. Sponsors will not buy time unless viewers watch. Viewers watch sensational items. These items are sensational. The result is that television has to blow them up out of proportion to get an audience. The audience assures money from the sponsors. The actual reporting of the news is far less important. Television viewers have encouraged this for years. The success of sensationalistic news shows like 60 Minutes is a good example. I always cringe when I see 60 Minutes do a medical story. I know that they are going to show the audience their side of the story. I know that they will edit the facts from the other side of the story to make their position look better. I can depend upon the audience not getting the full information. The key point here is that much of what the media reports in the way of medicine is based upon facts. However, there is usually more to the story. Many times that means that what they are reporting on is a relatively rare disease that they make look common. Sometimes, it means that there is indeed another side to the story that is not shown.