West Nile had man down, out No treatment for mosquito-borne virus

By CHARLIE SMITH News Editor The Greenwood Commonwealth

Barry Barth loves being outdoors and, in particular, hunting ducks and fishing.

But a month and half ago he didn’t feel like doing anything but lying in bed.

The Greenwood resident didn’t know it yet, but he was suffering from the debilitating effects of the West Nile virus.

It started with Barth feeling tired from his hips down. The weakness turned his normal gait into a shuffle.

The first thought for the 73-year-old retired painter and carpenter was, “Well, you’re getting old.”

But then came a fever accompanied by more fatigue. He was spending almost all of his time in bed and had little appetite.

“You don’t feel like doing anything else,” he said.

His wife, Alice, encouraged him to go see his doctor. A blood test revealed Barth had West Nile.

He knew what he had, at least, but that alone didn’t do him much good: There’s no treatment for the disease. Barth was told just to stay out of the heat, which was fine with him.

He got over the sickness in a couple of weeks and said he feels great now. He walked a mile Thursday morning — something he never could have done while suffering from West Nile.

West Nile is contracted when a mosquito carrying the virus bites you. Mosquitoes get the virus when they bite infected birds.

People often ask Barth how he got it, but there’s no way for him to pinpoint when he was bitten by a mosquito. He imagines he got it in his yard or his shop.

Although he has immunity from West Nile now, Barth sprays a DEET-based repellent now before going outside.

Dr. Ravi Pande, a neurologist at the Greenwood Neurology Clinic, said DEET is one of the three D’s of West Nile prevention. The other two are to remain inside at dusk and dawn, when mosquitoes are most active.

“I am scared of West Nile,” the physician said.

The most frightening aspect is that there is no treatment, he said. Pande said some have tried a process in which blood is removed from the body and cleaned, but he doesn’t think that helps.

Another unsettling aspect is that about 80 percent of people who get West Nile never experience any symptoms so they never know they have it. Speaking to three people in his office this morning, Pande said it’s likely two of them would test positive for antibodies the body produces to fight West Nile. In other words, two out of three of them would have contracted West Nile at some point without knowing it.

Blood tests for West Nile don’t test for the virus itself but rather for the antibodies the body produces to fight it. IgM antibodies indicate the person currently is suffering from West Nile, Pande said; IgG antibodies indicate the person has had West Nile in the past.

The virus first came to the United States in 1999 in New York City and quickly spread throughout the country. It got widespread attention after a 2002 outbreak.

This year could be one of the worst ever. There have already been more than 1,200 cases in the country and 43 deaths. Mississippi has the second most cases in the country with 85, and the state Department of Health on Thursday reported a second death from the West Nile virus, this time in Lincoln County. The first death occurred in Smith County.

Barth is one of two people who have been diagnosed with it this year in Leflore County.

Pande said two more months remain in the prime West Nile season, he expects to see more cases.

“It’s about reaching an epidemic form,” he said.

Of the 20 percent who experience symptoms after getting West Nile, most of them — like Barth — only develop what is called West Nile fever. It can involve fatigue, headaches and fever.

However, about one in 150 people who get West Nile develop much more serious symptoms called West Nile neuroinvasive disease, which affects the brain and central nervous system.

The virus can create sicknesses similar to meningitis, which is inflammation of the lining of the brain or spinal cord, or encephalitis, inflammation of the brain itself.

And Pande said some of the most serious cases involve polio-like symptoms, including paralysis.

“You don’t die, but you’re disabled,” he said.

Doctors aren’t sure what influences why some people have worse reactions that others, but  Pande said it most likely has to do with weakened immune systems.

“We don’t know why it happens, but that’s a logical explanation, that it’s the immune system,” he said.

Also, the viral load a person receives can vary from mosquito to mosquito, he said.

Older people tend to be more at risk of developing serious symptoms, according to the Centers for Disease Control. The median age of people who got West Nile fever during the 2002 outbreak was 49, but the average age of those who developed encephalitis or died was much older — 64 and 78, respectively.

And researchers are also looking into a possible genetic explanation.

A 2006 study in the Journal of Experimental Medicine focused on a mutation of the gene CCR5. The mutation is most often found in Caucasians, and the study involved white people from Arizona and Colorado who had been diagnosed with West Nile virus and suffered symptoms.

In the typical Caucasian population, only 1 percent of people have the mutation. But among the West Nile victims, 8.3 percent had the mutation in Colorado and 4.2 percent had it in Arizona. So scientists believe the gene plays a role in how bad the West Nile symptoms become.