"I would say key information was kept from the public eye to avoid a debate on [spraying], and a muted public message was misleading and, in my view, it contributed to complacency. It may have led to more infections," said Dr. Rau, an infectious disease specialist who works at Credit Valley Hospital in Toronto and Halton Healthcare Services in Oakville. "It became a big epidemic; it wasn't just a case here and a case there."

According to Ontario estimates, there were 373 human cases of West Nile in the province last year. Quebec reported eight cases and Alberta just a single case, probably contracted in the U.S.

However, in Quebec City this morning, Dr. Rau is scheduled to present a study conducted in seven Toronto-area hospitals looking at 64 cases of patients who were seriously ill with the virus. The study will reveal that about 1,000 people sought medical treatment for West Nile infection last summer, not including cases that were not diagnosed correctly.

Dr. Rau said that, last August, he was treating seven cases at two hospitals and had evidence of a cluster of cases in Oakville, but was told to keep quiet about it. "I have some regrets now for following that doctrine because I think it was not in the public interest not to release this information," he said.

Dr. Rau said government officials are now furious with him for going public. "I've already been told to shut up by some public health officials," he said. "I've already been told not to talk about this, so I'm going to talk about it because I think it's dishonest to the Canadian public. We really have to ask questions about how much information does the public deserve with the onset of any emerging infection."

At a news conference on Aug. 30, Ontario's chief medical officer of health, Colin D'Cunha, said: "I would stress there is no reason for people to get alarmed and concerned because we, in fact, can manage our exposure ... and personal protective measures have been found to be the most effective ways to avoid being bitten by a mosquito."

Dr. Rau, who attended the news conference, said he was disturbed by this response, and believes the the government wanted to avoid a public debate on mosquito spraying.

"It was a politically difficult decision because if you do spray, the environmentalists go ballistic," he says. "If you don't spray, and people know how many cases there are, [they say] you're letting people die. I think the nice, intermediate solution was not to show any cases."

Dr. Rau says provincial officials also offered an unlikely story that a 51-year-old Burlington, Ont., man -- a confirmed West Nile infection -- was bitten by a mosquito during a trip to the U.S. He says geographical records show many crows had died of West Nile infection in the vicinity of the man's house; it's more likely he was bitten in his own backyard, says Dr. Rau.

Provincial officials say the laboratory test used in Ontario in 2002 could not confirm cases of West Nile, so samples had to be sent to a federal lab in Winnipeg, taking six to eight weeks to get results.

"We ... worked with the best information that was available to us at the time," says John Letherby, a spokesman for the Ontario Ministry of Health and Long-Term Care.

But Douglas Elliott, a Toronto lawyer who represented victims of tainted blood at the Krever Inquiry in the 1990s, says the province was warned by U.S. health authorities to have good testing capacity available. "They didn't have that," says Mr. Elliott, who has been contacted by people who suffered West Nile infection and their relatives.

"In fact, they laid off [scientists] in the face of the impending epidemic who would have been able to develop tests. They relied on the private sector, and the private sector didn't come through." Mr. Elliot also criticizes the government's efforts to minimize the risk of West Nile virus. The official line, he says, was that only old people or those with compromised immune systems were affected.

"The entire epidemic was downplayed from start to finish," says Mr. Elliott.

Evidence now shows young, healthy people can be infected, often with devastating results. Mr. Elliott says he's been approached by people with brain damage and paralysis who cannot return to work; one victim was only 18 years old when she was infected.

This week, researchers at McMaster University announced they will collect blood samples from residents of south Oakville, Ont. to determine the prevalence of antibodies for West Nile, proof they were infected with the potentially deadly virus.

bevenson@nationalpost.com