{"id":70463,"date":"2023-06-23T16:22:06","date_gmt":"2023-06-23T22:22:06","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=70463"},"modified":"2025-02-28T11:02:30","modified_gmt":"2025-02-28T18:02:30","slug":"west-nile-virus-still-a-threat-to-colorado-how-to-know-if-you-have-west-nile","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/west-nile-virus-still-a-threat-to-colorado-how-to-know-if-you-have-west-nile\/","title":{"rendered":"Two decades on, West Nile virus still a threat to Colorado"},"content":{"rendered":"
<\/div>
\"A
A mosquito bite a year ago has changed the lives of Lisa Montez, husband Abel, and daughter Aria. After experiencing challenging symptoms, Lisa eventually learned she has West Nile virus. Photo by Joel Blocker for UCHealth.<\/figcaption><\/figure>\n

It\u2019s been 20 years since West Nile virus cleared the skies of crows and magpies and, courtesy of Culex tarsalis<\/em> mosquitoes, infected thousands of people in Colorado, killing 66.<\/p>\n

As we enter the months in which birds flock and mosquitoes multiply, Lisa Montez has a message to share: West Nile never went away, and if you\u2019re among the unlucky few, it can do lasting damage.<\/p>\n

How do you know if you have West Nile virus? What are the symptoms?<\/h2>\n

Montez, who lives in Windsor, came down with West Nile in July 2022. That she was diagnosed put her in the minority: Roughly 80% of those infected show no symptoms at all, or symptoms are mild enough that the person doesn\u2019t know they\u2019re sick. Most of the 20% who get sick and deal with symptoms that can include fatigue, fever, headaches, joint pain, rashes, and stomach issues recover within a couple of weeks. But about 1% of all cases become neuroinvasive.<\/p>\n

\"Dr.
Dr. Dan Pastula is an expert on West Nile virus and other infectious diseases. Photo: UCHealth.<\/figcaption><\/figure>\n

Dr. Daniel Pastula<\/a>, chief of neuroinfectious disease and global neurology at the University of Colorado School of Medicine and Colorado School Public Health, places those neuroinvasive cases into three categories. West Nile meningitis involves the membranes around the brain and spinal cord. West Nile encephalitis involves the brain itself. And West Nile acute flaccid paralysis involves the gray matter of the spinal cord or peripheral nerves<\/p>\n

The precise mechanisms differ, and they\u2019re still not well understood. But, Pastula says, some combination of damage done by the replicating West Nile viruses and the immune system\u2019s efforts to clear those viruses out can kill neurons that can\u2019t regenerate as most other bodily cells can.<\/p>\n

In other words, the damage can be permanent.<\/p>\n

Severe cases can strike older people and those who are immunocompromised. Young mom was not a typical patient.<\/strong><\/h2>\n

Some people are at greater risk for West Nile virus than others: those older than 60, those who are immunocompromised, those who are fighting cancer, those with diabetes, and those with kidney disease among them. None apply to Lisa Montez.<\/p>\n

She is 31. She was, until last July, a software developer pulling 50-hour weeks while helping run a household with husband Abel and being an active mom to daughter Aria, 5. She was an avid hiker.<\/p>\n

Nearly a year later, Montez has dialed back to a simpler job and works only part-time. She lacks the energy to hike. Her trouble focusing has sapped the enjoyment from her knitting and pleasure reading. For months on end, she couldn\u2019t drive, and the reasons why shed light on what West Nile has done to her cognitive functioning.<\/p>\n

\u201cI just couldn\u2019t use my brain to multitask and do all of the things that you need to do to drive safely, like check your speed limit and check other cars around you,\u201d Montez says. \u201cIf another car in front of me stopped abruptly, I couldn\u2019t really do all of the fast processing I need to do to react in time.\u201d<\/p>\n

Her husband has taken over much of the cooking, cleaning and child care. He, or local in-laws, drive her to appointments.<\/p>\n

Aria is coming to terms with her mom\u2019s curious limitations.<\/p>\n

\u201cShe just could not understand why, all of a sudden, Mommy can\u2019t play with me. Mommy has to lay down,\u201d Montez says. \u201cSo she\u2019s really kind of understood, you know, \u2018If Mommy needs to rest, let Mommy rest.\u2019\u201d<\/p>\n

Montez\u2019s balance has also been affected. Aria sometimes holds her mom\u2019s hand in a parking lot and walks her into the store, \u201cbecause she thinks she\u2019s helping,\u201d Montez says.<\/p>\n

\"Aria
Aria has learned to adapt to her mom\u2019s physical limitations due to West Nile virus. Photo by Joel Blocker for UCHealth.<\/figcaption><\/figure>\n

With no vaccine or cure yet, how can you deal with West Nile virus?<\/strong><\/h2>\n

Twenty-four years after the first North American West Nile case was diagnosed<\/a> in New York, there\u2019s only so much modern medicine can do for neuroinvasive cases. There are neither vaccines to prevent nor antivirals to treat the infection yet. Pastula says that by the time someone presents with neuroinvasive West Nile disease, much of the damage may have already been done.<\/p>\n

But that\u2019s not to say nothing can<\/em> be done. Those who have had West Nile and feel they\u2019re experiencing cognitive symptoms should seek what\u2019s called supportive care and rehabilitation, Pastula says. To that end, Montez has seen physicians and therapists at UCHealth Greeley Medical Center<\/a>, UCHealth\u00a0Medical Center of the Rockies<\/a>, and UCHealth University of Colorado Hospital<\/a> on the Anschutz Medical Campus. Her medical team consists of a primary care physician, a neurologist, an infectious disease specialist, a clinical audiologist, a psychiatrist, and specialists in vestibular rehabilitation (to help with balance issues) as well as occupational therapy.<\/p>\n

Physical therapy, speech therapy, and sleep therapy can come into play also, Pastula adds. The brain may not be able to significantly regenerate lost neurons, but it can adapt in many cases, he says.<\/p>\n

\u201cIt\u2019s important to come up with a multidisciplinary rehabilitation plan to gradually push the nervous system to try to adapt to various physical or cognitive loads,\u201d he says. \u201cIt\u2019s important for people who have West Nile neuroinvasive disease to do rehabilitation to maximize the recovery they can get.\u201d<\/p>\n

The earlier one receives such care, the better, he says. But starting weeks or months can also sometimes bring benefits.<\/p>\n

\u201cThere is hope for recovery \u2013 whether complete or partial \u2013 through rehabilitation,\u201d Pastula says.<\/p>\n

Montez\u2019s progress is a case in point: She recently started driving again.<\/p>\n

\"Montez
Montez and Aria enjoying time in the kitchen together. Photo by Joel Blocker for UCHealth.<\/figcaption><\/figure>\n

Scientists working to better understand West Nile and to develop vaccines<\/strong><\/h2>\n

Meanwhile, scientists continue to work the West Nile problem. Vaccine development has been slow, but there has been progress, and the endemic nature of the virus and the personal and health-care-related costs merit more resources be dedicated to vaccine development, experts argue<\/a>. In the meantime, scientists are focusing on understanding the still-foggy mechanisms of neuroinvasive West Nile. Some of that work his happening on the Anschutz Medical Campus.<\/p>\n

\"Leslie
Leslie Berg, chair of the Department of Immunology and Microbiology at the University of Colorado School of Medicine. Photo: University of Colorado School of Medicine.<\/figcaption><\/figure>\n

CU School of Medicine postdoctoral research fellow Jennifer Berger, PhD, is working under the guidance of CU School of Medicine Immunology and Microbiology Department Chair Leslie Berg, PhD<\/a>, on understanding how the virus infects the central nervous system. The key question their work is addressing, Berg says, is whether and how much damage the immune system\u2019s T-cells are doing to neurons and other cells as they clear out the infection.<\/p>\n

\u201cFor certain viral infections, a lot of the bad symptoms come not from the virus, but from the immune response,\u201d Berg says.<\/p>\n

Using a weakened strain of a West Nile-type virus called Venezuelan equine encephalitis virus, Berger is observing in mice how a first wave of T-cells rushes into the infected brain before the immune system has had a chance to produce many West Nile-specific T-cells.<\/p>\n

\u201cWe\u2019re very interested in trying to understand things like, \u2018What told them to go there?\u2019 \u2018How did they know to go there?\u2019 \u2018What kind of cells are they?\u2019 \u2018Are they helpful or harmful?\u2019\u201d Berg says. \u201cBased on the data so far, it looks like they\u2019re helpful.\u201d<\/p>\n

There\u2019s much more scientific work to be done, she says.<\/p>\n

\u201cThat\u2019s the goal of most basic science \u2013 you try to figure out the basic mechanisms of how things work, and that will help you decide where to put your energy in developing therapeutics,\u201d she says.<\/p>\n

How can you prevent West Nile virus?<\/h2>\n

In the meantime, protecting yourself from mosquito bites can help prevent West Nile infection in the first place. That means taking seriously<\/a> combinations of bug spray, long sleeves and pants, and avoiding being outside at dusk and dawn. We\u2019ve heard this all before, but take it from Montez \u2013 and Pastula, who has spent time<\/a> studying infectious diseases in some of the world\u2019s mosquito-born-disease hotspots \u2013 avoiding getting bitten is worth the trouble.<\/p>\n

\"Montez
Montez continues to improve, having recently started driving again. But there\u2019s a long road ahead. She encourages people to prevent mosquito bites to protect themselves from West Nile virus. Photo by Joel Blocker for UCHealth.<\/figcaption><\/figure>\n

Whether this spring\u2019s heavy precipitation across much of Colorado will translate into a bad West Nile year remains to be seen. Pastula says seasonal severity depends on some still-nebulous combination of temperature, rainfall, mosquitoes, bird migration, bird immunity, and human activity. Last year was worse than<\/a> recent ones, with 132 neuroinvasive cases and 20 deaths.<\/p>\n

Montez, one of those 132, says being aware of \u2013 and avoiding \u2013 mosquitoes is the way to go.<\/p>\n

\u201cMosquitoes are just a part of summer. You never think about West Nile or dengue or anything like that \u2013 until it happens to you,\u201d she says. \u201cIt has cost people their careers and their lives, and children are growing up not being able to be kids because of this. I just I really hope that we can do something to either prevent it or help people that get it in the future.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"

It\u2019s been 20 years since West Nile virus cleared the skies of crows and magpies and, courtesy of Culex tarsalis mosquitoes, infected thousands of people in Colorado, killing 66. As we enter the months in which birds flock and mosquitoes multiply, Lisa Montez has a message to share: West Nile never went away, and if […]<\/p>\n","protected":false},"author":23,"featured_media":70516,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[6],"tags":[162,4781],"class_list":["post-70463","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-healthy-living","tag-infectious-diseases","tag-research-in-health-care"],"acf":[],"yoast_head":"\nTwo decades on, West Nile virus still a threat to Colorado - UCHealth Today<\/title>\n<meta name=\"description\" content=\"There's still no cure for West Nile virus. 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