West Nile?

[dreamshark]

Who ever thought the day would come when Minnesotans had to worry about something called West Nile fever? But I'm pretty sure that's what Richard has. Headache? Check. Fever? Check. Nausea? Check. Muscle weakness and malaise? Check. In other words, sudden onset of "flu-like symptoms," but without the respiratory component. Came on rather abruptly Friday night. I suspected West Nile because of the flu-like but non-respiratory bit, but could be any little virus. Then the next morning the rash came out. Boy, hard to miss that symptom. Bright red, scaly, and ugly as sin. What else could it be but West Nile?

So he's taking it easy, sleeping a lot, and staying hydrated, but eating very little. Cortisone for the rash, which is a bit itchy but otherwise not as bad as it looks. We're keeping close to home and staying alert for sudden fever surge, but other than that, there isn't much to do about it.

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Comments

[barondave.livejournal.com]

I don't know what that is either, but a trip to a doctor seems warranted.

[fgherman.livejournal.com]

Please make sure he gets looked at by a doctor. The Nation Library of Medicine says:

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0004457/

"Calling your health care provider

Call your health care provider if you have symptoms of West Nile virus infection, especially if you may have had contact with mosquitos. If you are severely ill, go to an emergency room."

[dreamshark.livejournal.com]

Unfortunately, "a trip to the doctor" is not an option on a weekend. The only options are Urgent Care or Emergency Room. Both of these can be stressful and time consuming and produce no results unless the patient is in acute distress with something treatable. Richard is not very sick - not even as sick as a bad cold. There is only one danger from West Nile: the very small possibility of it evolving into encephalitis or meningitis (which is what they mean by "severely ill"). If you show any signs of that, yes, you go right to the hospital, no matter what time of night it is.

Unfortunately, there is no treatment for the mild form of the disease, and no treatment that will lessen the chance of brain infection except the usual things you do to take care of yourself when you are sick. But the danger of encephalitis is why I said we're keeping close to home and watching for any sign of escalating fever (or you know, splitting headache, stiff neck, etc.). So far his fever is mild and his major symptom is queasiness and fatigue. And the rash, of course. But that's mostly ugly, not painful.

I'm watchful, of course, but not too worried. The websites that list the chances of encephalitis give the odds as 1/150, which sounds scarier than it really is. For one thing, it is not clear whether that's 1/150 of diagnosed cases or actual cases. It's a huge difference, since other information indicates that most people do not get sick enough with this disease to even go to the doctor. I think it's of diagnosed cases, based on the numbers I've seen in newspaper articles. Secondly, people at the highest risk are those with poor immune response, and Richard is not one of those. He hardly ever gets sick these days.

Interestingly, getting the rash (which only occurs in 50% of cases)is associated with NOT progressing to the severe form of the disease. I would say that is the third reason not to be too worried, except that I think it's another form of reason #2. The rash is a sign of a strong immune response. So it's actually a good sign, just a little bit alarming looking.

[mplsfish.livejournal.com]

This comment of yours, Sharon, is why I like you so much. Exactly the kind of thinking I would have in this situation. I had similar conclusions when we were pretty sure Osce had H1N1.

Hoping Richard feels better soon. And glad he has you there to look after him while he is sick.

[wombat-socho.livejournal.com]

Ah, damn. Whatever it is, I hope it heals up/passes quickly.

[quility.livejournal.com]

Yikes! I'm glad he has someone taking good care of him. May he heal quickly + you stay well.

[dreamshark.livejournal.com]

Thanks. West Nile is a "dead-end disease" in humans, meaning it can't be passed on to anybody else. But of course, I could get bitten by the same mosquito.

Oddly enough, there don't seem to BE any mosquitoes in the back yard this year, at least during the day. According to a recent Strib article, this is the worst year for West Nile since the year it first appeared in Minnesota (about 10 years ago, I think). They say it's because hot, dry summers favor this particular type of mosquito. I suppose that makes sense, considering the sort of climate that is brought to mind by the term "West Nile."

So I guess that means there aren't very many mosquitoes around this year, but the ones that are around are more likely than usual to carry this particular disease. And according to another website, the highest chance of infection is... mid-August to early September. So wear skeeter repellent if you're worried.

[cakmpls.livejournal.com]

Oh, jeez, what next? I hope this is the mildest and Richard recovers quickly. And agreed that Urgent Care or the ER aren't much help except as you describe. (Very useful, of course, in cases such as when P had a fever of 103 and red streaks running up his leg.)

[dreamshark.livejournal.com]

Richard seems to be doing fine, just a little annoyed that he's too fatigued to do anything much. He just got up from a 3 hour nap and is out watering the garden. According to various web sites, a mild case of WN lasts about as long as a cold. The rash specifically lasts 3-5 days. This is Day 2 and it's still in full bloom.

As for Urgent Care, I've been there two or three times myself when I had something obviously bacterial (generally earache and/or bronchitis, both of which can progress dangerously fast in my personal internal ecosystem). Same principle as the high fever and red streaks up the leg (yikes). So I'm not agin it, just see no point in going in for something that can wait until Monday or can't be treated anyway.

[pameladean]

Wow, that's dramatic. I hope he feels better soon.

P.

[minnehaha.livejournal.com]

Wowzers. I am glad you are clueful and that he's seemingly not too ill. Take care, y'all.

K. [does it make sense to visit the doc to add to the statistical record? I'd call the nurse and ask that]

[dreamshark.livejournal.com]

I thought of that, but forgot to mention it Richard. I'd be curious to see what, if anything, a regular old doctor does when presented with something that looks like a disease that is currently being tracked like this one is. My guess is, nothing, assuming the patient is not dangerously ill. I think there's a blood test for West Nile, but I'll bet if Richard went to the doctor right now they wouldn't even bother to do the test. But I'm curious to see if I'm right, which I'd prefer not to be.