CDC: West Nile death toll reaches 20

Officials say they fear virus soon will reach West Coast

ATLANTA, Georgia (CNN) -- The confirmed death toll from this year's outbreak of the West Nile virus rose to 20 Monday, as the Centers for Disease Control and Prevention attributed four more fatalities to the mosquito-borne disease.

The number of confirmed or probable human West Nile cases rose to 425 in 20 states and the District of Columbia. That number includes the 20 deaths.

According to the CDC, two deaths in Ohio and one each in Michigan and Illinois were confirmed to have been West Nile-related. In addition to those three states, deaths have been confirmed in five other states -- Georgia, Kentucky, Louisiana, Mississippi and Texas.

More than half of the cases and deaths have been reported in Louisiana and Mississippi, the two states hardest hit by this year's outbreak.

As the virus continues its westward march across the United States, there are now only nine states where neither human nor animal cases have been confirmed this year: Washington, Oregon, Idaho, California, Nevada, Utah, Arizona, Alaska and Hawaii.

In New York, a 81-year-old Long Island resident died of the virus August 19 and two others have been infected, local health officials said.

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The New York State Health Department and the Centers for Disease Control and Prevention have confirmed three human cases of West Nile in Suffolk County, but they have not confirmed the virus caused the man's death. The other two cases involve a 77-year-old woman from Babylon and a 55-year-old man from East Setauket.

In response to the New York cases, the Suffolk County Department of Public Works said it will do two aerial applications of Scourge, a pesticide used to kill mosquitoes that carry the disease.

The virus has been spreading quickly westward, with officials saying they fear it will soon reach the West Coast. The CDC confirmed West Nile has been found in horses and birds in Montana, Wyoming, Colorado and New Mexico.

Concern in Louisiana

So far, Louisiana has been the hardest hit, with eight people dying as a result of the outbreak. The CDC confirmed 24 new human cases in that state, raising the total human caseload to 171.

Virginia's first case was a 33-year-old Richmond man from an area where West Nile virus-positive birds and mosquitoes have been found, a news release from the Virginia Department of Health said. He was not hospitalized and is recovering.

"We expected to see a human case of West Nile virus in Virginia this year due to the level of virus activity being detected in birds and mosquitoes," said the commonwealth's health commissioner, Dr. Robert B. Stroube.

Nebraska officials also announced the state's first human case Friday, saying the person infected is not seriously ill and not hospitalized.

CDC warns hunters

With hunting season beginning in September in several states, health officials are concerned the virus, which is carried by many birds, would be transferred to humans who handle infected animals, particularly during butchering.

"The CDC has recommended that hunters shooting game birds use gloves to pick up the animals," said Butch Kinerney, spokesman for the U.S. Geological Survey.

"There's no evidence just by handling a dead bird or touching a dead bird you can contract" West Nile, he said.

But CDC epidemiologist Dr. Lyle Petersen said last week that hunters should practice "the normal precautions they would take to prevent infection from butchering these animals."

In many Southern states, public health departments are fogging nightly for mosquitoes.

Though West Nile does not kill game birds, they can carry the virus in their blood, Kinerney said. Doves, ducks, geese, grouse, pigeons, wild turkeys and ring-necked pheasants have tested positive for the disease.

Kinerney said mosquitoes continue to pose the major risk for humans, but the Geological Survey advises that any dead bird -- even one killed by a hunter -- be handled using plastic.