West Nile Virus

By now most of the community has been hearing about West Nile virus as this has become a bigger and bigger problem in this community and all of us in the clinic are seeing folks with West Nile-like symptoms.

West Nile virus is transmitted to humans from mosquitoes. Usually the mosquitoes get the virus from birds who bring it up from tropical areas as they migrate North in the Spring. It is possible to spread the virus from person to person but this will only happen with exposure to body fluids such as blood exposure, sharing needles and possibly through breast milk.

The majority of people who carry the disease never get any symptoms. Only about 1 in 5 will even feel symptoms. After contracting the virus there is an average incubation period of 2-14 days. There is a wide range of symptoms and most people will have:
1) F0ever
2) Headache
3) Malaise
4) Back pain
5) Myalgias (muscle aches)
6) Loss of appetite

These tend to last 3-10 days. Other known symptoms include eye pain, pharyngitis, nausea, vomiting, diarrhea, rash, and abdominal pain. Some of the symptoms especially fatigue and muscle aches can persist for a month or longer.

The diagnosis is made based on symptoms but we can do a blood test to confirm that diagnosis. Currently there have been so many cases of West Nile virus in this area that we do not test everybody that we think has the disease. Especially since treatment is symptomatic meaning that we just do what we can to help you feel better as your body fights the disease itself. So often we do not test because if a positive test will not help us treat you then there is no value in doing the test other than just to know for sure. The test shows us if you have had West Nile in the last six months so if you had the disease a few months prior the test will be positive even though you do not have it anymore.

Because we have no treatment to get rid of the disease faster the main treatment is Tylenol or ibuprofen. I recommend these to help with fevers and muscle aches but nothing has been proven to shorten the course of the disease. The most important thing is to avoid mosquitoes. The key ways to do that are to:
1) Use insect repellents containing DEET (for people greater than 6 months old)
2) Avoid the outdoors from dusk to dawn.
3) Wear long sleeve shirts and long pants when outdoors.
4) Drain standing water sources on your property.

On occasion the disease can spread into the brain and cause meningitis and more severe disease. In these cases we often will have to send patients to the hospital in Billings and will consider using experimental treatments. In such times the disease is much more serious and can possible lead to death. Fortunately it is not common for the disease to become this severe.

If you think you may have the virus please schedule a visit with your doctor. For more information on West Nile virus you can visit http://www.patients.uptodate.com/topic.asp?file=inf_immu/2199&title=West+Nile+virus+infection