Man, 67, dies of West Nile

A Modesto man who was stricken with West Nile illness last year and hospitalized for eight months died Thursday in a Visalia rehabilitation hospital, his wife said.

Jim Ruffolo, 67, was hospitalized at Modesto's Memorial Medical Center in August with severe symptoms of neuroinvasive West Nile disease. He later was transferred to the Visalia hospital, where his treatment continued for complications of the mosquito-borne disease.

"He was improving," said Ginny Ruf-folo, his wife of 43 years. "This was really a shock."

Her husband never was well enough to be discharged from hospital care, and he died from West Nile complications, she said.

As of Friday, county and state agencies that track the illness had not recorded the case as a West Nile virus death. Stanislaus County had its first West Nile fatality in 2005 when a 63-year-old Patterson man died.

Dr. John Walker, public health officer for Stanislaus County, said Friday he wasn't aware of Ruffolo's death and had not talked with the family. He said he didn't know whether the case met the state's criteria for reporting West Nile fatalities.

"If the assessment is that it's due to long-term complications of West Nile, this is a tragic reminder that this disease can have fatal consequences," he said.

Deaths from West Nile illness are rare -- one in 150 people infected develop severe illness. "But clearly it can happen, and it happened 21 times in the state of California last year," Walker said.

Ruffolo, who lived in north Modesto, came down with a fever Aug. 15 and lost control of his muscles over the next five days. He spent weeks in a semiconscious state at Memorial, as doctors gave him medication to control brain swelling and kept him on a ventilator.

Ruffolo regained consciousness and some movement in his limbs by the second week in September. His condition gradually improved to the point he was moved to rehabilitative care in Visalia.

Ginny Ruffolo said Friday she wasn't emotionally prepared to discuss details of her husband's extended bout with the effects of the illness. She was arranging a funeral for her husband in Chicago, where he spent his childhood.

Most fatalities from West Nile are caused by encephalitis that can strike within two weeks of the infection. Some patients who survive the crisis struggle with paralysis for months or longer. According to health experts, some have trouble regaining mobility because the virus destroys the cells in the spinal column that are responsible for movement.

Stanislaus County's 24 cases of West Nile infection last year was one-fourth the number in 2005, but county health officials are concerned about the increase over 2006, when the county had 11 cases. The number of people infected also was up statewide in 2007, with 380 cases and 21 fatalities, compared with 278 cases and seven fatalities in 2006.

Local mosquito abatement districts began their surveillance and spraying efforts to control mosquitoes in early April. Next week begins a six-month season in which the state expects counties to step up West Nile virus prevention.

The East Side Mosquito Abatement District is focusing attention on green swimming pools dotting the cities within its territory, including Modesto, Salida, Oakdale, Riverbank and Waterford.

The district arranged for aer-ial photographs that show roughly 600 pools that haven't been cleaned and are breeding mosquito larvae, said Lloyd Douglas, district general manager.

District employees have treated about 150 pools this year with a registered insecticide. Many of the homes are vacated foreclosure properties; others are occupied homes where the owners didn't maintain their pools during the colder months.

"We are getting larvae in those pools; they are producing mosquitoes," Douglas said.

There are other signs of mosquito activity this spring. For example, San Joaquin County has an increase of dog heartworm, a virus spread by some mosquitoes, Douglas said.

Stanislaus County is intensifying an informational effort to prevent a resurgence of West Nile infections. A new brochure that includes easy steps for protecting homes against mosquitoes was modeled after literature produced in Illinois, which had a bad outbreak after an annual decline in cases, Walker said.

Bee staff writer Ken Carlson can be reached at kcarlson@modbee.com or 578-2321.