Late in the summer of 1999, Dr. Deborah Asnis had three patients in Flushing Hospital in New York who had similar, dire symptoms and were not responding to treatment.

The patients had three things in common: all were from the same part of Queens, were 60 or older, and had dark tans. It was that last clue that eventually unlocked the mystery, leading to the diagnosis of the first known West Nile virus cases in the country.

It was the kind of situation that Asnis, chief of infectious diseases at the hospital, had trained for.

“I found infectious diseases to be fascinating,” she said in a 1999 New York Daily News interview. “It was challenging and intellectual, like a mystery that you have to solve.”

Asnis, 59, died Sept. 12 at Memorial Sloan Kettering Cancer Center in New York. The cause was breast cancer, said her son, Joshua Kazdin.

The medical mystery began when a man who lived in Queens was admitted to Flushing Hospital with a high fever and signs of delirium. Within a few days, he was so weak he couldn’t lift his arms. Before long, additional patients arrived with similar symptoms.

Asnis thought the cause might be a virus that hit the area, but antiviral drugs didn’t help. Other causes she considered included Guillain-Barre syndrome or botulism, but those didn’t quite fit the symptoms she was seeing.

She sounded the alarm, calling the city’s Bureau of Communicable Diseases, which in turn notified the Centers for Disease Control and Prevention. Asnis kept doing tests on patients, sending blood samples and spinal fluid packed in dry ice to a state lab.

More local people with similar symptoms were admitted. “It almost came to the point where if you showed up in the hospital with a 104-degree fever and a headache, you got a spinal tap,” Asnis told the Daily News.

Patients grew steadily worse, with some needing respirators to breathe, the Associated Press reported. Investigators, including Marci Layton of the city health department, came to the hospital to talk to the families, looking for clues.

The fact that they many were tanned indicated they spent a lot of time outdoors during the summer, and as it turned out, several loved to garden. Could the cause be a virus carried by mosquitoes?

“[Dr. Marcelle C. Layton (born 1958)] said that first,” Asnis said in an interview with Newsday.

An entomologist sent to the neighborhood found that stagnant ponds and even liquid in discarded beer cans had become vibrant breeding grounds for the insects in a summer with less rain than usual. The mosquito-borne disease was identified, wrongly as it turned out, as St. Louis encephalitis.

With some patients dying and word of the disease spreading, Mayor Rudolph Giuliani announced measures were being taken, including malathion insecticide spraying from helicopters. The onset of cooler weather also helped wipe out the disease-carrying mosquitoes.

In late September it was finally determined that the actual disease was West Nile virus, also carried by the insects.

Asnis’ quick actions in identifying and reporting the mysterious “cluster” of patients with serious symptoms was credited with keeping the outbreak from being worse.

She was born July 17, 1956, in New Hyde Park on Long Island and graduated from Roslyn High School. Asnis went to Northwestern University for her undergraduate and medical degrees.

The medical profession ran in the family — her father was a dentist and two older brothers became physicians. But Asnis’ inspiration was her mother, Ruth.

“She was an accountancy teacher, but we called her ‘Doctor Mom,’” Deborah Asnis told the Daily News in the 1999 interview. “She wanted me to pursue a career that I could use to be independent.”

Ruth Asnis died on Friday.

Deborah Asnis is survived by her husband, Dr. Hal Kazdin; sons Joshua and Matthew Kazdin; and brother Dr. Gregory Asnis.

Deborah Susan Asnis (July 17, 1956 – September 12, 2015, aged 59) was an American infectious disease specialist and H.I.V. clinical researcher, who is credited with reporting the first human cases of West Nile virus in the United States.^[1][2]

In August 1999, Asnis, the chief of infectious diseases at Flushing Hospital Medical Center in Queens, New York, noticed two male patients with similar, mysterious symptoms. Their symptoms included loss of arm and leg control, high fevers, and disorientation. She reported her patients' unusual symptoms to health authorities, who pursued further testing and analysis of the illness.^[1] Asnis' patients were diagnosed with West Nile virus in September 1999, the first known human cases of the disease in the United States.^[1][2]

Asnis had been praised for reporting her patients' symptoms to authorities.^[1] Not only did her actions lead to the discovery of the West Nile virus in the United States, but, by alerting authorities, Asnis likely prevented a more widespread initial outbreak of West Nile in the country.^[1][2]

Biography

Asnis was born on July 17, 1956, in New Hyde Park, New York, to Ruth (née Kornblum), an accounting teacher, and Myron Asnis, a dentist.^[2] She graduated from Roslyn High School in Roslyn, New York.^[2] Asnis then earned her bachelor's degree from Northwestern University and her medical degree from Northwestern's Feinberg School of Medicine in 1981.^[1]

She resided in Hewlett, New York, with her husband, Hal Kazdin; the couple had two sons, Joshua and Matthew Kazdin.^[1][2]

West Nile discovery in the United States

In August 1999, Deborah Asnis, an infectious disease specialist at Flushing Hospital Medical Center in Queens, noticed two male patients who were suffering from similar, unusual symptoms. The two patients, aged 60 and 75 respectively, were exhibiting sudden paralysis in their arms and legs, as well as disorientation and high fevers.^[1][2] Lab testing also showed elevated numbers of white blood cells within the spinal fluid of both males.^[1] None of the patients were responding to antiviral drugs.^[2] Possible early hypothesizes included botulism, viral encephalitis, Guillain–Barré syndrome, or meningitis, but none of these illnesses exactly matched the symptoms.^[1] Asnis decided to pursue a more concrete diagnosis by contacting authorities and other colleagues.^[1]

Asnis contacted Marcelle Layton, the New York City Department of Health's chief epidemiologist, on Monday, August 23, 1999, to report her patients' symptoms.^[1] Layton advised Asnis to send samples of the patients' blood and spinal fluid to the New York State Department of Health in Albany for further analysis.^[1] By Friday, August 27, 1999, just four days after Asnis had contacted Layton, two additional patients had been identified in Queens.^[1] The number rose to eight by Sunday, August 29, at Flushing Hospital Medical Center and other hospitals in Queens.^[1] All of the early patients resided within a few miles of one another. They were also frequent gardeners in the evenings.^[1]

The Centers for Disease Control and Prevention (C.D.C.) initially identified the mystery illness as St. Louis encephalitis on September 3, 1999.^[1] The city of New York began widespread spraying for mosquitos later that same day.^[1] However, laboratory testing continued to determine a definitive cause of the symptoms.

The U.S. federal government revised its diagnosis from St. Louis encephalitis to West Nile virus on September 27, 1999, citing research by [Dr. Duane J. Gubler (born 1939)], a C.D.C. expert on arborviruses, as well as several bird deaths in the Bronx, located to the north of Queens.^[1]

Deborah Asnis was credited by health experts with the early identification of West Nile virus in the United States.^[1] Her actions likely prevented a more widespread outbreak.^[1][2]In their 2003 book, "The New Killer Diseases: How the Alarming Evolution of Germs Threatens Us All," authors Elinor Levy and Mark Fischetti praised Dr. Asnis' response to the symptoms, writing that, "Asnis did something other doctors might not have bothered to do."^[1] They elaborated that, "One of the worst problems with our disease-detection system is that many doctors never report cases of strange symptoms, either because they are unsure of the disease they are facing, they're ignorant of the reporting requirement, or they simply never get around to it. Deborah Asnis was highly conscientious."^[1]

Later life

Asnis continued to practice as the chief of infectious diseases at Flushing Hospital Medical Center.

She died from breast cancer at Memorial Sloan Kettering Cancer Center in Manhattan, New York City, on September 12, 2015, at the age of 59.^[2] She was survived by her husband, Hal Kazdin; their sons, Joshua and Matthew Kazdin; and one of her two brothers, Gregory Asnis.^[1] Her mother, Ruth Asnis, died on September 18, 2015.^[2]

References

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• ^{a b c d e f g h i j k l m n o p q r s t u v w x} Roberts, Sam (2015-09-15). "Dr. Deborah Asnis, Who Sounded Alert on West Nile Virus Outbreak, Dies at 59". The New York Times. Retrieved 2015-10-10.

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• ^{a b c d e f g h i j k} Colker, David (2015-09-21). "Deborah Asnis dies at 59; helped detect West Nile virus in U.S." Los Angeles Times. Retrieved 2015-10-10.

Authority control

• ISNI: 0000 0000 4522 413X

• LCCN: n2002136560

• VIAF: 4300406

• WorldCat Identities: lccn-n2002136560