For the small percentage of people who develop severe West Nile fever from a mosquito bite, the road to recovery is long and arduous
Janice Thurrell doesn’t recall anything from last October and November, the two months she spent nearly comatose after contracting the West Nile virus.
Probably bitten by an infected mosquito near her Hockessin home, Thurrell started showing severe symptoms within 10 days of feeling ill, and was hospitalized shortly after.
Doctors ran numerous tests, and she spent time in the cardiac ICU, believing that her condition was the result of heart surgery she’d had in September.
It took a full two weeks to determine that she had the virus, but by then her lungs had collapsed and she was in and out of consciousness.
She spent 78 days in the hospital, including five weeks of inpatient physical therapy. Nearly seven months after her diagnosis, she uses a wheelchair and requires a lift to get upstairs.
“It took over my whole life, we were turned upside down,” Thurrell said. “We had no idea the virus was so serious, or [was] in this area as much as it is. It’s scary.”
“Once you get the symptoms, it’s usually too late,” her husband Lars Thurrell said.
Rare life-threatening illness
Thurrell is one of the extremely small percentage of people who have life-threatening symptoms from West Nile virus.
The virus affects numerous mammalian and bird species, including cats, dogs and horses. Last year, five cases in horses were reported in Delaware, and three of the horses died. The Department of Agriculture reported that none of the horses were vaccinated.
The virus cannot be transmitted from horse to owner since mosquitoes are the carriers.
The Centers for Disease Control and Prevention reports almost 80 percent of infected people will show few or no symptoms. The subsequent illness is called “West Nile Fever.”
Another 20 percent will suffer from extreme flu-like symptoms with a rash and muscle aches, while less than 1 percent of cases – roughly 1 in 150 – can develop into encephalitis, meningitis and other neurological disorders.
The CDC estimates that 10 percent of those who develop neurological problems are at risk for death.
Jen Brestel, chief of community relations with the Department of Health and Social Services, said in subclinical cases, patients typically don’t seek medical care, and those cases are not reported.
“West Nile virus is considered a mandatory reportable disease in Delaware, which means that Delaware physicians, laboratories and other health care providers are required to report cases to the Division of Public Health Office of Infectious Disease Epidemiology,” Brestel said.
According to the DHSS, there were 10 reported cases in the state in 2018, with one fatality. That is the highest number on record since 2005. Last year saw a spike in reported cases throughout the country, with the CDC logging 2,544 reported cases and 5 percent mortality.
Brestel said that cases are primarily reported through laboratory reporting, from blood bank blood donor screening, other states via interstate reciprocal reporting or directly from health care providers.
Finding and preventing
West Nile was first discovered in the U.S. in 1999 in Queens, New York. Since then, the CDC said there have been an average 130 deaths per year due to the virus.
Often dismissed as the “summer flu,” West Nile symptoms often make it appear as a random bad cold.
Severe symptoms to look for include headache, high fever, neck stiffness, muscle weakness, stupor, disorientation, tremors, convulsions, paralysis and coma.
Treatment focuses on the symptoms, as there is no human West Nile vaccine. The full recovery time for severe cases is unknown. According to WebMD, while lifelong immunity after contracting West Nile is assumed to follow, as in most viral infections, it may wane in later years.
Still very limited in her movements and unable to be left alone, Thurrell struggles with daily tasks, although she feels she is improving.
“They have no idea how long it could take if I am back to normal, if I ever even get there,” she said. “It could be weeks or it could be months. I was a very active, healthy person. It’s going in the right direction but it’s a process. Hopefully I will get there.”