From Our 2012 Archives
Beyond Statistics: 2 Faces of West Nile Virus
Thousands Now Live With West Nile Virus Infection. Here, 2 Share Their Stories
By Kathleen Doheny
Reviewed by Louise Chang, MD
Aug. 31, 2012 -- This year, more than 1,500 people in the U.S. have been diagnosed with West Nile virus infection and several have died.
Transmitted by the bite of a mosquito, the infection isn't equal opportunity.
Some infected people don't notice any symptoms. Others have a milder form of the disease, known as West Nile fever. About 1 in 150 people infected develop severe complications, including infections of the brain (encephalitis) or spinal cord and connecting nerves (meningitis) or paralysis.
Rob Wagner Jr., 52, is a construction worker in Riverside County, Calif., near Los Angeles. He learned he had West Nile virus earlier this month.
Don R. Read, MD, is a Dallas surgeon who became infected in 2005 at age 63. He says he is still coming back from the complications, including paralysis.
Rob Wagner Jr.
Rob Wagner Jr., is a big guy who has worked construction most of his life. Most recently, he has been working as a glass glazer in Southern California.
In early August, he was hanging out at a friend's house in the city of Riverside, spending a lot of time in the backyard.
A lifelong mosquito magnet, he remembers being bitten but not thinking much about it. "I was getting bitten every night," he says.
One morning soon after, he woke up with a burning fever. "I was sweating like crazy," he says. The day before, he remembers feeling like he was coming down with something.
He was lagging at work. "I have to deal with measurements, stuff like that," Wagner says. "I was really slow, feeling incompetent in my measurements."
"I had a friend take me to the emergency room." They told him the fever was 105 degrees.
"They started doing tests, taking blood. They did CT scans and MRI." He had two painful spinal taps, a typical test to check for meningitis, which doctors suspected.
Doctors admitted him to the hospital. They decided the diagnosis was bacterial meningitis and started him on antibiotics.
The pain was so bad the doctors put him on morphine.
The week he spent in the hospital was a nightmare, his sister, Pamela Vest, says. "A whole week, we couldn't even talk to him because he was so out of it."
"One morning he woke up crying," she says, "saying, 'What is wrong with me?' 'What is it?'"
When he improved some, he was released.
Then came the call from the Riverside County Department of Health. "It wasn't bacterial meningitis, it was West Nile virus," he says.
"I didn't know that much about it," he says. "I was still kind of out of it."
Weeks later, in late August, many of the symptoms remain. "I just get up achy. My joints and everything. I get real tired real fast."
His appetite lagged so much he lost 35 pounds.
As of late August, Wagner's still not back at work. He's still on pain medicine and the headaches still occur.
Even so, he takes hope in the positive: the bacterial meningitis diagnosis was incorrect.
He has an appointment next week to see a new doctor whom he hopes will describe what he can expect. He hopes to return to work soon.
He reminds his son, 11, who lives nearby with his mother, that the mosquitoes love him too and to wear repellent.
At this point, he would be happy to have some semblance of a normal life back. "I just want to get my strength back," he says.
Don R. Read, MD
Don R. Read, MD, a Dallas surgeon, was taking an evening walk with his wife, Roberta, in July 2005 when they got bitten by swarms of mosquitoes.
The evening walk had become a ritual, says Read, who was 63 at the time. "My wife's bone density was low, and her gynecologist told her to do some weight-bearing exercises, so we'd go out walking."
A few days later, he was performing an abdominal surgery and got more tired than usual.
"When I finished, I was unusually tired and went home and went to bed," he says.
It wasn't typical for the hard-driving surgeon, who was accustomed to performing surgery all day long and then joining family members for social activities.
The next day was no better. "I felt as bad when I got up [as when he had gone to sleep]," he says.
Read isn't a guy who gets sick, he says. "I'd missed four days of work in 27 years."
He went to work, thinking he would shake it off. He didn't.
Within a few days, he was sleeping 20 hours a day.
His wife begged him to go to the hospital, but one of their daughters had a music recital in Indiana, and he didn't want to miss it.
Off they flew, and they planned a reception for her afterward. Read slept all day, went to the recital, made it through 30 minutes of the reception, and collapsed into bed.
Then both of his legs became paralyzed. It was time to go to the hospital.
His arms were affected, too. "I could barely move my arms and I couldn't move my legs at all," he says.
At the hospital in Indiana, they placed him in the intensive care unit and gave him the only available treatments -- supportive care and treating of the symptoms, including strong pain medicines.
After eight days, Read was flown back to Medical City Dallas Hospital, where he's on staff.
In all, he says, "I spent almost five weeks in ICU."
"I had meningitis, encephalitis, and polio-like paralysis," he says. All are complications of the infection, suffered by a minority of people infected. The infection also affected his speech.
He had to relearn how to walk and talk.
After hours of physical, occupational, and speech therapy, he "graduated" to home health rehab.
"I could walk with a walker but not very far," he says. "I had no strength, no stamina."
Finally came the day he'd hoped for -- back to work. "From the day I got sick until the day I went back to work was seven months," he says.
"It was about a year before I could work 35 hours a week," down from his usual 88, he says.
Seven years later, recovery is ongoing, he says. "I still wear braces on both legs," he says. It helps him walk and avoid overusing the muscles.
"I had to give up doing abdominal surgery." Those procedures, he says, require a doctor to stand in "funny" positions for long periods.
Now, he focuses on colon and rectal surgeries and colonoscopies.
In 2006, he and his wife launched a support group for others infected. In recent years, it has gone on hiatus due to too few cases to gather a group.
In September, Read says, they will begin meeting again, as Dallas has been hard-hit this year.
SOURCES: Don R. Read, MD, colon and rectal surgeon, Dallas. Rob Wagner Jr., construction worker, Riverside County, Calif. CDC teleconference, Aug. 29, 2012.
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