John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Mild infections are common with the West Nile virus. Symptoms of a
mild infection include fever, headache, and body aches, which are
often accompanied by a skin rash and swollen lymph nodes.
More severe infections are less common and are marked by headache,
high fever, neck stiffness, stupor (sleepiness), disorientation,
coma, tremors, occasional convulsions, paralysis, and rarely death.
West Nile virus meningitis or encephalitis may result in a prolonged recuperation and rehabilitation period, especially in the elderly.
West Nile virus can have some long-term effects after severe illnesses. Memory loss, depression, irritability, and confusion are the most prevalent residual effects.
Symptoms in children are basically the same as symptoms in adults. Children may complain of headache, may have a fever, and may become lethargic.
Since most cases of West Nile virus infection are mild, the prognosis for recovery is generally good. In severe cases, death rate statistics range from 3%-15% and are highest in the elderly.
When is there an increased risk for infection?
The risk of infection is highest during mosquito season and does not lower until mosquito activity ceases for the season (when freezing temperatures occur). In temperate areas of the world, cases of West Nile virus infection occur primarily in the late summer or early fall. In southern climates where temperatures are milder, West Nile virus infections can occur year round.
Who is at risk for getting West Nile virus?
All residents of areas where active cases have been identified are at risk of developing West Nile virus infection. People
who are 50 years of age or older have the highest risk for more severe cases.
The American Academy of Pediatrics states children appear to be at low risk for the disease, although the youngest person in New York to become seriously ill was 5 years old.
What is the treatment for West Nile virus? Can West Nile virus be prevented with a vaccine?
The diagnosis of West Nile virus infection is confirmed with a blood or cerebrospinal fluid test. There is no specific treatment for West Nile virus infection. Intensive supportive therapy is directed toward the complications of brain infections. Anti-inflammatory medications, intravenous fluids, and intensive medical monitoring may be required in severe cases. There is no specific antibiotic or antidote for the viral infection. There is no vaccine to prevent the virus.
Is a woman's pregnancy at risk if she gets West Nile
virus?
There is no clear evidence that a pregnancy is at risk due to
infection with West Nile virus. However, the CDC states that in 2002, one case of transplacental (mother-to-child) transmission of West Nile virus was reported. In this case, the infant was born with West Nile virus infection and severe medical problems. In 2003 and 2004, a CDC registry identified 77 women who acquired West Nile virus illness while pregnant. Seventy-one of these women delivered live infants,
two had elective abortions, and four miscarried in the first trimester. The CDC is continuing to gather research and outcome data for pregnancies of West Nile virus-infected mothers.
Due to concerns that mother-to-child West Nile virus transmission can occur, the CDC recommends that pregnant women take precautions to reduce their risk for West Nile virus and other mosquito-borne infections. Pregnant women who become ill should see their health-care provider, and those who have an illness consistent with acute West Nile virus infection should undergo appropriate diagnostic testing.
What can a community do to reduce the risk of an outbreak of
the West Nile virus?
First, a community can monitor the bird population, including surveillance of birds that are sick or have died of disease, for the virus.
Second, the community can watch out for stagnant water, particularly if it is nutrient-laden; it is inviting for
Culex mosquitoes.
Third, widespread mosquito-control efforts, including the use of spraying and larvacide, may be warranted. However, even with rigorous surveillance, spraying, and larvaciding, the virus may still infect people.
The word "rash" means an outbreak of red bumps on the body. The way people use this term, "a rash" can refer to many different skin conditions. The most common of these are scaly patches of skin and red, itchy bumps or patches all over the place.
Headaches can be divided into two categories: primary headaches and secondary headaches. Migraine headaches, tension headaches, and cluster headaches are considered primary headaches. Secondary headaches are caused by disease. Headache symptoms vary with the headache type. Over-the-counter pain relievers provide short-term relief for most headaches.
Lymph nodes help the body's immune system fight infections. Causes of swollen lymph nodes (glands) may include infection (viral, bacterial, fungal, parasites). Symptoms of swollen lymph nodes vary greatly. They can sometimes be tender, painful or disfiguring. The treatment of swollen lymph nodes depends upon the cause.
Depression is an illness that involves the body, mood, and thoughts and affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. The principal types of depression are major depression, dysthymia, and bipolar disease (also called manic-depressive disease).
Although a fever technically is any body temperature above the normal of 98.6 degrees F. (37 degrees C.), in practice a person is usually not considered to have a significant fever until the temperature is above 100.4 degrees F (38 degrees C.). Fever is part of the body's own disease-fighting arsenal: rising body temperatures apparently are capable of killing off many disease- producing organisms.
Tremor is the involuntary movements of one or more parts of the body. Causes of tremor include neurological disorders, neurodegenerative diseases, drugs, mercury poisoning, overactive thyroid and liver failure. There are several types of tremor. Treatment depends upon the type of tremor and availability of medications for the condition.
Encephalitis is a brain inflammation that causes sudden fever, vomiting, headache, light sensitivity, stiff neck and back, drowsiness, and irritability. Meningitis is an infection that causes inflammation of the meninges that surround the brain and spinal cord. Symptoms of meningitis include high fever, headache, nausea, vomiting, and stiff neck.
Coma is the inability to waken or react to the surrounding environment. The Glasgow Coma Scale is frequently used to measure the depth of coma. Causes of coma include trauma, bleeding, edema, lack of oxygen, poisoning, or hypoglycemia. Prognosis for a patient in a coma depends on the cause of the coma.
Insomnia is the perception or complaint of inadequate or poor-quality sleep because of difficulty falling asleep; waking up frequently during the night with difficulty returning to sleep; waking up too early in the morning; or unrefreshing sleep. Secondary insomnia is the most common type of insomnia. Treatment for insomnia include lifestyle changes, cognitive behavioral therapy, and medication.
Ticks are known transmitters of disease to humans and animals. Tick-borne diseases include Lyme disease, Rocky Mountain spotted fever, Q fever, tularemia, babesiosis, and Southern tick-associated rash illness. Infected ticks spread disease once they've bitten a host, allowing the pathogens in their saliva and mouth get into the host's skin and blood. Tick bites are typically painless, but the site of the bite may later itch, burn, turn red, and feel painful. Individuals allergic to tick bites may develop a rash, swelling, shortness of breath, numbness, or paralysis. Tick bite treatment involves cleaning and applying antibiotic cream.
Bug bites and stings have been known to transmit insect-borne illnesses such as West Nile virus, Rocky Mountain spotted fever, and Lyme disease. Though most reactions to insect bites and stings are mild, some reactions may be life-threatening. Preventing bug bites and stings with insect repellant, wearing the proper protective attire, and not wearing heavily scented perfumes when in grassy, wooded, and brushy areas is key.
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