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Researcher warns conditions are ripe for dramatic rise in hurricane-related West Nile virus cases

Susan Christensen
Health and Research News Service

JACKSON, Miss.—Communities hit hard by Hurricane Katrina are now in the flight path of another menace—mosquitoes bearing West Nile virus.

Methodist Rehabilitation Center researcher Dr. Art Leis says September and October are typically peak months for the virus and conditions are ripe for a “dramatic rise” in cases.

“A major issue is you have water collecting everywhere, and mosquitoes are breeding uncontrolled,” said Dr. Leis, a senior scientist for the Jackson hospital’s Center for Neuroscience and Neurological Recovery (CNNR). “Eggs laid two days after Katrina have produced two generations of mosquitoes that are all hungry.”

And those ravenous insects have basically been feasting on an all-you-can-eat buffet.

“Electrical power has been down and a lot of people are keeping their windows open or camping out,” Dr. Leis said. “That makes them vulnerable to multiple mosquito bites.”

As of Sept. 21, the Mississippi State Department of Health had reported 43 human cases of West Nile virus and four deaths—which is on par with last year’s infection rate. But Leis expects those numbers to climb markedly because of Katrina, and he urges people to take precautions.

“I know when people are concerned about where their next meal is coming from that using DEET is not high on their priority list,” Dr. Leis said. “But it’s still important to do all you can to lessen your risk of getting West Nile virus. At its worse, this virus can cause some very serious illnesses, including encephalitis, meningitis and a polio-like paralysis.”

Dr. Leis and CNNR director Dr. Dobrivoje Stokic were the first in the world to report the link between West Nile virus and polio-like paralysis in 2000. They’ve since wrapped up a federally funded study that looked at the long-term outcome of 33 patients who experienced muscle weakness and fatigue as a result of the West Nile virus.

Now they are collaborating with colleagues at the University College of London in the United Kingdom to learn more about the severity of neurological injury associated with West Nile virus infection.

Hazel McBride is one of four Methodist Rehab patients currently recovering from West Nile virus infection, and she can attest to its severity. “I almost died is what I’ve been told,” said the 65-year-old Winona retiree.

Now faced with severely weakened legs and a paralyzed right arm, McBride is working hard with Methodist therapists to get her strength back. “My doctor thinks I will be able to walk again,” she said. “But I don’t know if my right arm will rehabilitate for a long time.”

Although the elderly are more susceptible to West Nile virus, McBride never worried about her risk. “I’m not an outdoors person—that’s what shocked me,” she said. “One mosquito bite—that’s all it takes.”

McBride’s illness began with nausea and high fever, two symptoms people should be on the lookout for at this time of heightened risk, Dr. Leis said. Other signs include headache, vomiting, diarrhea, chills, a rash, muscle weakness or swollen lymph nodes.

While recent outbreaks of West Nile virus infection have made physicians more aware of such symptoms, Dr. Leis said cases are still being missed.

He said a contributing factor has been the timing of blood work. “It takes a week to 10 days after infection with the West Nile virus for the test to be positive. Therefore, some infected people initially test negative for the disease. That’s why it’s important for physicians to do follow-up blood tests on patients with suspicious symptoms.”

After consulting with Dr. Leis, Jimmy Mize of Brandon said he opted to get a second West Nile test. And he and his wife Joan are glad he did.

“We wouldn’t have known he had West Nile if it hadn’t been for Dr. Leis,” she said. “The other physicians we saw were dead set against it being West Nile. They wanted to blame it on Rocky Mountain Spotted Fever. They said at some point he had gotten bitten by a tick.”

Instead, the culprit was a mosquito that blew in with Hurricane Katrina. “Jimmy was out in the storm pulling a tree off our house and he came back in with a big welt on the back of his neck,” Joan said.

Mize, a service manager at Rogers-Dabbs Chevrolet Hummer in Brandon, got sick the Saturday after the hurricane. While Mize still suffers from headaches and fatigue, he hopes therapy at Methodist’s outpatient clinic will help him get back to his old self.

Joan said it’s “a very scary thought” how much damage a little mosquito can do. And she has made it her mission to warn others about West Nile. “I was telling my neighbors: Please spray your kids before they go out to play.”

“Local governments also should be more aware and step up spraying for the mosquitoes,” Mize said. “It’s peak season and this is the time it really needs to happen.”

Dr. Leis agrees that the best strategy is prevention. “I would get mosquito repellant, wear clothes that protect your skin from exposure and avoid being outdoors at dawn and dusk. In addition, prevention of infection rests on being able to control the mosquito population.”

As for those who suspect they might have West Nile virus infection, Dr. Leis recommends seeking medical attention. “There is some hope that early doses of steroids, certain antibiotics, intravenous immune globulin or a group of agents known as interferons may have some beneficial effects,” he said.