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Fight the Bite - West Nile Virus

A mosquito-transmitted virus causes most cases of West Nile infection. Most people infected with West Nile virus either don’t develop signs or symptoms or have only minor ones, such as fever and mild headache. However, some people develop a life-threatening illness that includes inflammation of the spinal cord or brain.

Mild signs and symptoms of a West Nile virus infection generally go away on their own. But severe signs and symptoms – such as a severe headache, fever, disorientation or sudden weakness – require immediate attention.

Exposure to mosquitos where West Nile virus exists increases your risk of getting infected. Protect yourself from mosquitoes by using mosquito repellant and wearing clothing that covers your skin to reduce your risk.

Symptoms and causes

Symptoms

Most people infected with the West Nile virus have no signs or symptoms.

Mild infection signs and symptoms

About 20 percent of people develop a mild infection called West Nile fever. Common signs and symptoms include:

  • Fever
  • Headache
  • Body aches
  • Vomiting
  • Diarrhea
  • Fatigue
  • Skin rash

Serious infection signs and symptoms

In less than 1 percent of infected people, the virus causes a serious neurological infection, including inflammation of the brain (encephalitis) and of the membranes surrounding the brain and spinal cord (meningitis).

Signs of symptoms of neurological infections include:

  • High fever
  • Severe headache
  • Stiff neck
  • Disorientation or confusion
  • Stupor or coma
  • Tremors or muscle jerking
  • Seizures
  • Partial paralysis or muscle weakness

Signs and symptoms of West Nile fever usually last a few days, but signs and symptoms of encephalitis or meningitis can linger for weeks or months. Certain neurological effects, such as muscle weakness, can be permanent.

When to see a doctor

Mild symptoms of West Nile fever usually resolve on their own. For signs and symptoms of serious infection, such as severe headaches, a stiff neck, disorientation or confusion, seek medical attention right away. A serious infection generally requires hospitalization.

Causes

Typically, West Nile virus spreads to humans and animals via infection mosquitoes. Mosquitoes become infected when they feed on infected birds. You can’t get infection from casual contact with an infected person or animal.

Most West Nile virus infections occur during warm weather, when mosquitoes are active. The incubation period – the period between when you’re bitten by an infected mosquito and the appearance of signs and symptoms of the illness – ranges from two to 14 days.

West Nile virus has occurred in Africa, Asia, Europe and the Middle East. It appeared in the United States in the summer of 1999, and since then has been reported in every state except Hawaii and Alaska, as well as in Canada.

Other possible routes of transmission

In a few cases, West Nile virus might have spread through other routes, including organ transplantation and blood transfusion. However, blood donors are screened for the virus, substantially reducing the risk of infection from blood transfusions.

There also have been reports of possible transmission of the virus from mother to child during pregnancy or breast-feeding or exposure to the virus in a lab, but these are rare and not conclusively confirmed.

Risk factors

Most cases of West Nile virus in the United States occur June through September. Cases have been reported in all 48 lower states.

Risk of serious infection

Even if you’re infected, your risk of developing a serious West Nile virus-related illness is extremely small – less than 1 percent of people who are infected become severely ill. And most people who do become sick recover fully. You’re more likely to develop a severe or fatal infection based on:

  • Age. Being older puts you at higher risk.
  • Certain medical conditions. Certain diseases, such as cancer, diabetes, hypertension and kidney disease, increase your risk. So does receiving an organ transplant.

Diagnosis

Besides conducting a physical exam, your doctor can confirm the presence of West Nile virus or a West Nile-related illness, such as meningitis or encephalitis, by performing one of the following tests:

  • Laboratory tests. If you’re infected, a blood test may show a rising level of antibodies to the West Nile virus. Antibodies are immune system proteins that attack foreign substances, such as viruses.
  • Lumbar puncture (spinal tap). The most common way to diagnose meningitis is to analyze the cerebrospinal fluid surrounding your brain and spinal cord. A needle inserted between the lower vertebrae of your spine is used to extract a sample of fluid for laboratory analysis. The fluid sample may show an elevated white cell count – a signal that your immune system is fighting an infection – and antibodies to the West Nile virus.
  • Brain tests. In some cases, an electroencephalography (EEG) – a procedure that measures your brain’s activity – or an MRI scan can help detect brain inflammation.

Treatment

Most people recover from West Nile virus without treatment. Most severe supportive therapy in a hospital with intravenous fluids and pain medication.

For mild cases, over-the-counter pain relievers can help ease mild headaches and muscle aches. Use caution when given aspirin to children or teenagers. Children and teenagers recovering from chickenpox or flu-like symptoms should never take aspirin. This is because aspiring has been linked to Reye’s syndrome, a rare but potentially life-threatening condition, in such children.

Interferon therapy

Scientists are investigating interferon therapy – a type of immune cell therapy – as a treatment for encephalitis caused by West Nile virus. Some research shows that people who receive interferon recover better than those who don’t receive the drug, but more study is needed.

Prevention

Your best bet for preventing West Nile virus and other mosquito-borne illnesses is to avoid exposure to mosquitoes and eliminate standing water, where mosquitoes breed.

  • Unclog roof gutters
  • Empty unused swimming poos or empty standing water on pool covers
  • Change water in birdbaths and pet bows regularly
  • Remove old tires or unused containers that might hold water and serve as a breeding place for mosquitoes
  • Install or repair screens on windows and doors

To reduce your exposure to mosquitoes:

  • Avoid unnecessary outdoor activity when mosquitoes are most prevalent, such as at dawn, dusk and early evening.
  • Wear long-sleeved shirts and long pants when outdoors.
  • Apply mosquito repellent containing an Environmental Protection Agency-registered insect repellent to your skin and clothing. Choose the concentration based on the hours of protection you need – the higher the percentage (concentration) of the active ingredient, the longer the repellent will work. Follow the directions on the package, paying special attention to recommendations for use on children.
  • When outside, cover your infant’s stroller or playpen with mosquito netting.