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Dr. Deborah Asnis reported puzzling symptoms in 1999.
Dr. Deborah Asnis, whose suspicions about two Queens hospital patients suffering from sudden paralysis led to the discovery of the first outbreak of West Nile virus in the Western Hemisphere, died on Saturday in Manhattan. She was 59.

The cause was breast cancer, her son, Joshua, said.

On Aug. 23, 1999, a Monday, Dr. Asnis, an infectious disease specialist, contacted Marcelle Layton, the chief epidemiologist at the New York City health department, reporting that two of her patients at Flushing Hospital Medical Center were displaying similar puzzling symptoms.

"Asnis did something other doctors might not have bothered to do," Elinor Levy and Mark Fischetti wrote in the 2003 book "The New Killer Diseases: How the Alarming Evolution of Germs Threatens Us All."

"One of the worst problems with our disease-detection system," they added, "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."

Her two male patients, one 60 and the other 75, had high fevers, had lost control of their arms and legs, seemed disoriented and registered excess white blood cells in their spinal fluid. Initial tests suggested viral encephalitis, Guillain-Barre syndrome, meningitis or even botulism.

Dr. Layton urged Dr. Asnis to send blood and spinal fluid samples to the State Health Department's laboratory in Albany for further testing.

By Friday, two more cases had developed. By Sunday, Flushing and other Queens hospitals had identified eight cases. All of the patients shared two traits: They lived within a few square miles of one another, and in the evening they were either avid gardeners or backyard loungers.

The federal Centers for Disease Control and Prevention was enlisted, and on Sept. 3 the culprit was identified as St. Louis encephalitis. Two hours later, the city began dousing insect breeding grounds with insecticide, generating a separate panic over the potential health danger of aerial spraying. (Emergency management officials also bought half a million containers of aerosol mosquito spray and other repellents.)

On Sept. 27, 1999, further tests by Dr. Duane J. Gubler, a C.D.C. expert on arborviruses, coupled with earlier suspicious deaths of birds in the Bronx, prompted the federal government to revise its diagnosis to West Nile virus.

New York City health officials credited Dr. Asnis's vigilance and speedy response with helping prevent the virus from spreading more widely.

The virus is carried by birds and is spread to mosquitoes. Initially, it killed seven people and sickened at least 62 in the New York area and may have infected as many as other 1,900 residents of northern Queens without their realizing it, health officials said.

Experts speculated that the virus may have been carried to America by a bird that arrived by ship or a mosquito that arrived on a plane.

The C.D.C. reports that there are no vaccines to prevent West Nile infection or medications to treat it, but that most people infected with it will have no symptoms. Less than 1 percent of those infected develop a serious neurologic illness, the agency says.

Deborah Susan Asnis was born in New Hyde Park, on Long Island, on July 17, 1956, the daughter of Myron Asnis and the former Ruth Kornblum. She graduated from Northwestern University and from its medical school in 1981.

She was director of infectious disease at Flushing Hospital Medical Center and a clinical researcher into H.I.V. infection.

Dr. Asnis lived with her husband, Dr. Hal Kazdin, in Hewlitt, also on Long Island. Besides him and her son Joshua, she is survived by another son, Matthew; her mother; and a brother, Dr. Gregory Asnis.