NEPA Vital Signs - Summer Fall 2018 - 21

SUMMER/ FALL 2018

People of any age can acquire West Nile virus, however, those over the age of 50 are at
significantly higher risk of developing severe neuroinvasive disease. Of those who develop
severe neuroinvasive disease, full recovery is much more likely in people who are less than 65
years of age. The risk of death from West Nile is significantly higher with advancing age.

Why is this important for the
aging population?

What can you do to protect
yourself ?

Older age is a very significant risk factor in developing severe
illness with West Nile virus, making it important for the aging population to protect themselves. People of any age can acquire West
Nile virus, however, those over the age of 50 are at significantly
higher risk of developing severe neuroinvasive disease. Of those
who develop severe neuroinvasive disease, full recovery is much
more likely in people who are less than 65 years of age. The risk of
death from West Nile is significantly higher with advancing age.

In order to protect yourself, it is recommended to follow
basic mosquito precautions during the summer, but especially
the high-risk months of August and September. Mosquitos
are most active at dawn and dusk, so preventive measures
during these times of day are especially important. Insect
repellants containing DEET, picardin, oil of lemon eucalyptus,
2-undecanone, and IR3535 are recommended while spending
time outdoors. Wearing long pants and sleeves and applying
permethrin to clothing can add extra protection. Minimizing
standing water in areas where you gather outside can help to
decrease the mosquito burden. Making sure to have working
screens on open doors and windows will help to keep mosquitos
out of your home.

How is West Nile diagnosed and
treated?
Anyone who develops symptoms that are worrisome for West
Nile virus should see a healthcare provider and discuss their
concerns. When West Nile virus is suspected, a blood sample
can be collected and examined for antibodies to the virus. If the
antibodies are detected, this is an indicator that the person has
been infected with West Nile virus. If the symptoms are suspicious
for West Nile neuroinvasive disease, cerebrospinal fluid can be
collected and tested as well.

A Legacy for Prevention

Unfortunately, there are no known treatments for West Nile
virus. In less severe disease, the symptoms will usually improve
on their own. In severe neuroinvasive disease, the patient will
sometimes require hospitalization for close monitoring and
supportive care.

What are the long-term
consequences of West Nile?

The author with her
father, Chick Rader

Most people with the less severe form of West Nile will make a
full recovery, but some have reported fatigue persisting for weeks
after the onset of illness. In the survivors of severe neuroinvasive
disease, a majority will continue to experience symptoms such
as fatigue, memory impairment, weakness, and headache even
years after illness. A significant number of these patients have
also reported having depression. Older age is a risk factor for
having continued symptoms after the initial illness.

N E PA

After 40 days in a coma, my
father awoke with profound
consequences of West Nile
neuroinvasive disease. He had
significant memory impairment, profound weakness, and
a tremor. He battled for two
and a half more months, but
his weakness made it impossible to breathe on his own.
He died in December 2017
surrounded by his wife and
nine children. As a physician
and daughter, I hope to educate to prevent another local
family from the rare but real
devastation of West Nile.

MELISSA RADER BUCK, M.D., FAAP, is a Neonatology
Fellow at Nemours/AI DuPont Hospital for Children at Thomas
Jefferson University.

VITAL SIGNS

Table of Contents for the Digital Edition of NEPA Vital Signs - Summer Fall 2018