A story on the Star-Telegram's front page Oct. 10 implied that Tarrant County Public Health (TCPH) officials underreported West Nile virus cases and did not perform due diligence in notifying the medical community. Nothing could be more wrong.The article, written by The D allas Morning News, was based on a Dallas County report that used a formula to examine statistics of the recent West Nile outbreak in Collin, Dallas, Denton and Tarrant counties.Officials at Dallas County Health and Human Services are the source of the data. The numbers are estimates, projections based on a formula presented in a research article published in Emerging Infectious Disease in 2006. (wwwnc.cdc.gov/eid/article/12/3/05-1287_article.htm)These estimates are not based on actual reported cases of West Nile, Tarrant County's human case data.Symptomatic West Nile virus is a reportable condition in Texas. When a person becomes ill and has symptoms, seeks medical attention and then is diagnosed with West Nile virus infection, it is expected that the case will be reported to TCPH in accordance with the "Notifiable Conditions" reporting laws.A public health investigation follows. This reporting and investigation process is standardized and practiced statewide and nationwide.Tarrant County Medical Society and TCPH are confident that Tarrant County physicians and the medical community consciously follow disease reporting laws.The medical society and public health department have a long-standing, collaborative and collegial relationship. This past summer, our relationship was enhanced.Local physicians and the medical community were well notified of all aspects of the outbreak through various channels. TCPH used e-mail and fax updates, health-alert advisories, Web site and social media postings, group and community presentations and correspondence to individual physicians. These outlets were complemented by regional, state and federal public health efforts and by media coverage.Physicians don't live in bubbles. Tarrant County physicians were well aware of the outbreak, and they also were well aware of their responsibility to report and interact with TCPH.West Nile neuroinvasive disease is not subtle and not easily overlooked. State data demonstrate that almost 90 percent of the patients affected by the neuroinvasive disease required hospitalization, and more than 40 percent needed to be in intensive care.State health officials agree with TCPH that the estimates reported by Dallas County Health and Human Services in The D allas Morning News article are not consistent with the actual/real human case reports and other supporting evidence such as hospitalization and laboratory report data -- particularly relating to the severe type of West Nile virus infection, neuroinvasive disease.The estimates were based on a research formula that can only be applied after an event has occurred.But Tarrant County physicians and the medical community supplied TCPH with accurate, real-time data to guide the community's response.It was a record-breaking year, and, unfortunately, the disease burden was high in Tarrant County, in surrounding counties and across the nation. Significant effort was expended in the fight against West Nile virus by individuals, physicians and the medical community, TCPH and local city governments.The actual case numbers demonstrate West Nile's effects and don't lie.Are there lessons to be learned and work to do in the future? Yes, certainly.I am confident that Tarrant County Medical Society and Tarrant County Public Health will continue to learn and work together collaboratively and collegially to safeguard the community's health.G. Sealy Massingill, M.D., is president of the Tarrant County Medical Society.