Becky Dennis

Preparing for West Nile 2013

Why West Nile Isn’t Just Media Hype

The mosquito is the most deadly creature in the world, killing well over 1 million people a year across the globe. And we thought the great white shark and grizzly bear were scary! Well, they are, but not near as deadly as the pesky mosquito.

To put that in perspective, that would be like eliminating the entire population of Dallas, Texas, in one year. Pretty staggering stat when you look at it that way. And according to the U.S. Center for Disease Control (CDC), there were more than 5,300 cases of West Nile Virus (WNV) in humans last year in the U.S. Roughly half of these were West Nile fever, which means the patient had flu-like symptoms, such as fever, headaches, muscle aches or fatigue. And it’s quite possible that the number of cases is much higher, but some patients did not seek medical help, so their information was never reported. Stinks to be sick, but this gets more fearsome.

The other half of human cases were of the neuro-invasive type. What does that mean? It means the virus broke the blood-brain barrier, which is quite rare. The blood-brain barrier protects the brain from viruses and other foreign substances. Once this barrier is broken, the brain cannot kill the virus, but it has defenses to slow the virus from reproducing.

This “rare” patient will undergo one of three life-threatening results in these cases:

1. Encephalitis – quite simply, inflammation of the brain
2. Meningitis – inflammation of the membrane around the brain and spinal cord
3. Acute flaccid paralysis – inflammation of the spinal cord

The first two of these essentially mean that an infected tiny flying insect caused an acquired brain injury (ABI). One that, other than malaria and Japanese Encephalitis, has no prevention.

Unless you’re a horse.

For more than 10 years, horses have been protected by a vaccination for WNV. But why not humans? Maybe because it’s not financially attractive for pharmaceutical companies to produce one and get it passed through the U.S.’ stringent FDA guidelines. Perhaps the WNV epidemic of 2012 will make these entities rethink this.

So why should you care? 

Because more than 50% of neuro-invasive survivors never return to work after undergoing this type of brain injury. Let’s personalize that. Statistically speaking, about 2,700 people in the U.S. left the work force last year. Not due to layoffs or the economy. Not due to a car accident or cancer. But due to a simple bite from a winged nuisance. Of the remaining 2,700 who did go back to work, about half took a lesser role due to the brain damage. And nearly 250 didn’t have the option of returning to work because they didn’t survive.

Regardless if neuro-invasive WNV survivors went back to work or not, most will suffer life-long residuals. These residuals (or sequella in medical terms) are far reaching, including extreme fatigue, short-term memory loss, concentration issues, difficulty learning new things, balance issues, loss of vision, among a long list of others. Many experience behavioral disorders from frontal lobe damage, so their personality is altered … overnight. For many, debilitating headaches become a daily struggle. Imagine a lifelong migraine.

Depending on the parts of the brain most impacted and the severity of the onset, diagnosis can be difficult. For many, getting an accurate diagnosis is difficult because patients have such varying symptoms. It’s quite common for patients to bounce from doctor to doctor without answers to why they suddenly cannot function like they did prior to the mosquito’s release of the brain-altering toxin.

But if it affects the brain, why would it be so difficult to diagnosis? Lots of reasons, including these:

1. MRIs are not as advanced as we’d like to think.
2. Even in severe cases, MRIs are not always conclusive. Impacted areas of the brain are not easily detected.
3. Cases present differently based on what portions of the brain are most affected, so many other illnesses are considered before encephalitis or meningitis (except, perhaps, during an epidemic). Some of the common misdiagnoses include flu, MS, complex migraine, psychological disorders or stroke.
4. Some patients look and sound “normal,” so despite them saying “I don’t feel right … I can’t remember things and I’m sleeping all the time,” they are dismissed as candidates for psychological evaluation.

Another strike against survivors in the U.S. is there is no protocol for treatment. Makes advocating for yourself quite important to create a more favorable recovery.

In other geographies, such as the UK, once a patient is diagnosed with encephalitis or meningitis, doctors follow a regimented course of treatment that includes behavioral therapy, occupational therapy, physical therapy, medications to address lingering residuals and counseling.

Doesn’t sound like a battle you’d want to fight, right? So how do you prevent West Nile if it’s bad again this year?

1. Don’t wave off the tips just because the media has said them a zillion times. They are repeating them for our benefit.
2. Spray down. Yep, bug spray creates a nasty, sticky feeling, but read this again and maybe you’ll think twice.
3. Stay inside during peak mosquito hours.
4. If you like to be outside for neighborhood BBQs, invest in a bug zapper. Embrace the endorphin that you won’t contract a mosquito-borne illness each time you hear the zap.
5. Drain standing water. And encourage your neighbors to do so as well. If they live next door and have a green swimming pool in need of chlorine, take action.
6. Tiki torches can provide help in a limited area.
7. If you don’t like bug spray, try battery-powered personal devices with a high pitched sound that repels mosquitoes.
8. Wrist bands work for some people and don’t leave a residue on your skin.

Looking back at 2012‘s epidemic, one thing the media emphasizes about contracting West Nile is that those who are most at risk for this virus are primarily the elderly or immune compromised. This can happen to anyone, really. Don’t get a false sense of security and think all the recommendations for taking precautions are “for everyone else.” There is no treatment for West Nile. If you get it, there is no silver bullet to reverse its effect.

A mosquito changes many lives … sometimes temporary illness, sometimes brain damage and sometimes death. Don’t let it unnecessarily change yours.