ANOTHER W. NILE DEATH VICTIM IS L.A. COUNTY'S 3RD.

Byline: Troy Anderson Staff Writer

A sixth Californian - the third in Los Angeles County - has died of the West Nile virus and officials warned Thursday that most victims of the disease have developed other, more serious illnesses, including encephalitis and meningitis.

Health officials also said the threat of the disease will remain high into October.

``We're still fairly early,'' said Ken August, spokesman for the state Department of Health Services. ``Mosquito activity remains high through September and October so we know that we still have not seen the worst of it.''

Los Angeles County health officials reported that 25 - or more than two-thirds - of the 35 human cases diagnosed in July developed into more serious diseases, including eight cases of encephalitis, 16 cases of meningitis and one case of acute flaccid paralysis, a polio-like syndrome that leaves some people unable to walk.

Of eight cases reported so far this month, one led to encephalitis and three to meningitis.

By comparison, in Arizona - the epicenter of the outbreak this year - and statewide, a little more than one-third of the cases have developed into the more serious illnesses that can lead to comas, convulsions and paralysis.

Of the 162 cases in California as of Aug. 17, 64 were neuroinvasive. Of Arizona's 291 cases, 112 were neuroinvasive.

``We are looking at this with great interest,'' said Llewellyn Grant, a spokesman for the Centers for Disease Control and Prevention in Atlanta, Ga. ``If you are asking if we are concerned, yes; we are seeing something where significant numbers of neuroinvasive activity is being reported (in Los Angeles County).''

But CDC medical epidemiologist Roy Campbell said officials have seen other jurisdictions with similarly high proportions of the more serious forms of the disease and explained that officials in some areas are discouraging the testing of mildly ill patients.

``Some states go aggressively after West Nile cases in outpatient settings whereas California and Arizona are mainly looking at hospitalized cases,'' Campbell said. ``It's not indicative of the virus changing or becoming more aggressive.''

For every West Nile case diagnosed, Campbell estimates, 15 to 30 people have contracted West Nile fever but did not seek medical treatment.

Dr. Laurene Mascola, county public health director of the Acute Communicable Disease Control Program, said most people infected with the virus display no symptoms.

``About 20 percent get West Nile fever and one in 150 gets encephalitis or meningitis,'' Mascola said. ``But those are the people who get hospitalized and get reported to us. So it's not surprising.''

Mascola said she didn't know whether anyone has suffered paralysis or permanent neurological damage as a result of infections, and didn't know what parts of the county people with the more severe forms lived in.

``Except for the people who have died, the rest are in recovery,'' Mascola said. ``We are still at the beginning of this epidemic.''

From Aug. 11 through Thursday, the number of human cases in the county has more than doubled from 32 to 69, including nine in the San Fernando Valley. The San Gabriel Valley has had the majority of cases.

On Thursday, officials reported that a 60-year-old man with a variety of chronic ailments had died from the virus. He was later identified as Raoul Cuevas of Pico Rivera, who died Aug. 12 from encephalitis.

West Nile also killed Los Angeles County residents Hester Martin, 91, of Northridge and Vivian Lorraine Kennedy, 88, of Long Beach. Two San Bernardino County residents and a 57-year-old Fullerton resident also have died of the virus.

West Nile has been detected in 41 of California's 58 counties, and officials believe it has spread throughout the state and expect the number of human cases to continue to grow during the peak of the mosquito season - now through October.

The virus has killed 20 people nationwide, with the highest death toll of six in California, followed by five deaths in Louisiana. Three deaths have been reported in Arizona. The virus killed 262 people in the nation last year.

Jack Hazelrigg, general manager of the Greater Los Angeles Vector Control District, said his workers are continuing to treat underground storm drains with larvicide in a 5-square-mile area that includes Van Nuys and Northridge and extends through the Sepulveda Basin up to the 118 Freeway.

``Our focus is still the San Fernando Valley where we've had a number of cases in the Van Nuys area. We won't know how successful the treatments are until we monitor the population underground for adult mosquitoes early next week.''

Troy Anderson, [phone]

troy.anderson(at)dailynews.com

AT A GLANCE

West Nile virus has killed 20 people nationwide this year, including six in California. West Nile is carried by birds and can be transmitted to humans by mosquitoes. About 20 percent of those bitten by an infected insect show flulike symptoms, while about one in 150 suffers the most severe form of the illness.

The Los Angeles County Health Department is distributing insect repellent and educational brochures to senior citizens, who are more susceptible to the disease. For information on the DEET Education Program, call [phone] or log on to www.deetonline.org.

To report stagnant or standing water, call the Greater Los Angeles Vector Control District at [phone] or [phone]. To report a dead bird, call the state hotline at [phone].

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AT A GLANCE (see text)