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Warm weather means mosquitoes and West Nile Virus

Staff writer

For someone who seldom gets sick, Marion resident Alan Kruse knew something was wrong.

"It started with dizziness, exhaustion, and a terribly severe headache," Kruse said. "Typically, I don't have headaches. And the symptoms progressively got worse."

Kruse was one of untold numbers of Kansans last year to contract a mild form of West Nile Virus (WNV). Kruse also was one of the many who was not officially diagnosed with the virus, or counted, by the Kansas Department of Health and Environment (KDHE).

"I was just so weak I could have slept 24 hours a day," he said.

Although he continued working through his bout with WNV, Kruse said he would have to go home and sleep for a couple of hours.

"We had heard there was West Nile in the area and joked about it. My wife went online to review symptoms and asked me if I had a rash.

"I hadn't really looked on my back and torso, but when we looked my back was as red as red can be," he said.

At that point the Kruses became concerned and Alan went to the emergency room on a Saturday and had his blood drawn. Several months ago, Kruse learned tests did not verify the virus.

"But the doctor said most likely I did have it," Kruse recalled. "I was weak for a long time after the rash went away, my energy level was low, and the severe headaches persisted for about a week," he said.

The ordeal lasted more than a month beginning in mid-to-late September and subsiding in October.

Caitlyn is a Marion area woman who requested her real name not be used. She spent five days in a hospital dealing with the meningitis form of the disease. Her case was positively confirmed by a private lab, but KDHE would not count it officially because it did not meet all their criteria.

"I felt kind of sick for a week but still went to work," Caitlyn said. "I had a terrible headache, stiff neck, temperature of 103. When I couldn't see to drive, I went to the hospital."

During her stay, five others also were hospitalized with WNV, she said. All told, Caitlyn was away from work three to four weeks.

Caitlyn said she was aware of the disease but didn't think it was a problem in Kansas due to the low numbers being reported by the state.

"Every state around us except Oklahoma had really huge numbers of cases," she said. "I didn't know Kansas had a big problem with it."

Consequently, Caitlyn felt it was better to put up with a few bites than use mosquito repellent.

"I was concerned about the effects of DEET," she said. "But now I'd tell everyone to put on mosquito repellent."

Most people who are infected never become sick. Of those who do get sick, only a few develop severe diseases of the central nervous system, like meningitis, encephalitis, and acute paralysis.

KDHE says symptoms are usually mild and include fever, headache, and body aches, occasionally with a rash on the trunk of the body, and swollen lymph glands.

Severe symptoms include headache, high fever, neck stiffness, stupor, disorientation, coma, tremors, convulsions, muscle weakness, and paralysis.

West Nile Virus is primarily a bird disease transmitted by mosquitoes to birds, horses, and humans.

As the summer season drew to a close last year, Kansans became concerned about KDHE's testing and reporting procedures. Private labs were reporting numerous cases, which did not reflect the relatively few numbers confirmed and reported by the state.

Also, neighboring states were reporting high numbers. Colorado had 2,947 human cases and 161 deaths, while Nebraska reported 1,942 human cases with 29 deaths, according to the CDC website.

Initially, KDHE's policy was to test cases where the individual had signs of encephalitis or meningitis, based on CDC (Centers for Disease Control) criteria.

In October, the agency changed its reporting to include private lab test results where there is a "a high probability" for WNV, but the results did not meet all the components required by KDHE and the CDC.

Among other changes KDHE decided to release cases where a physician listed West Nile Virus as the cause of death on the death certificate. KDHE also decided to publicly release results of WNV screening determined through blood donation centers.

In terms of final 2003 statistics, Kansas had 91 human cases confirmed by the KDHE and 731 presumptive cases based on positive results gathered by commercial labs, according to Sharon Watson, public information officer with the Kansas Department of Health and Environment.

There were five KDHE-confirmed WNV deaths and two presumptive deaths based on death certificates listing it as the cause of death.

As for non-humans, 142 birds, 82 horses, and 45 mosquito pools tested positive.

Although there is a vaccine for horses, no vaccine currently exists for humans. The CDC has been conducting trials, but so far has not come up with a human vaccine.

"They tried to use it on birds and animals but it was not successful," Watson said. "But with the vaccine, we've had a dramatic drop in cases with horses."

As for now KDHE advises Kansans to avoid mosquitoes when possible and to wear mosquito repellent containing DEET. Also people should wear protective clothing, eliminate pools of standing water, and repair doors and screens to keep mosquitoes from getting indoors.

"If you have a birdbath or pool refill it often," Watson said.

Traditionally, mosquitoes found early in the season have not posed much of a problem. It hasn't been until July and August when mosquito populations seem to pass the disease onto humans.

"Last year, the first positive WNV mosquito was in late May," Watson said

KDHE is hoping Kansas will not be as severely affected by the virus this summer as compared to last year, based on conditions observed on the East Coast.

"The virus has moved west of Kansas and it's expected to hit harder there," she said.

"We'll be entering our fifth season for the virus here in Kansas. After the third year those less difficult cases tend to drop off," Watson said. "We don't know for sure, but we hope it will."

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