West Nile hit Dr. Fauci like a “truck.” What you should know about the virus

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As mosquito season reaches its peak in the United States, a prominent public health figure said his illness with West Nile virus felt like he had been “run over by a truck.”

Dr. Anthony Fauci, former director of the National Institute of Allergy and Infectious Diseases and a key player in the country's initial response to the COVID-19 pandemic, made the comment after spending several days in the hospital with West Nile virus, a mosquito-borne virus.

On Saturday, Fauci's spokesman told news outlets like USA TODAY that the 83-year-old immunologist had contracted the West Nile virus and spent six days in the hospital. He has since been recovering.

In an interview with STAT, a health news website, Fauci said he felt like he had been “hit by a truck.”

“I've never been this sick in my life. Ever,” he told the publication. “This is by far the worst illness I've ever had.”

Fauci's case was a rare one. Most people who contract West Nile virus from mosquitoes do not develop symptoms, although in rare cases it can cause permanent neurological problems and even death.

When did the West Nile virus appear?

West Nile virus became endemic in the United States 25 years ago in Fauci's hometown of New York City. There are now thousands of cases each year, although experts say cases are vastly underreported.

So far in 2024, 216 cases have been reported in the United States – 142 of which involved people suffering from the severe neuroinvasive form of the disease, according to the Centers for Disease Control and Prevention.

“We've learned a lot, but we still have the same tools we had back then to prevent disease,” Dr. Erin Staples, a medical epidemiologist with the CDC's Division of Vector-Borne Diseases, told USA TODAY. “We need to do better.”

After all, she explained, mosquitoes are the deadliest animals in the world.

What is West Nile virus?

West Nile spreads primarily among birds, which serve as vectors for mosquitoes, according to the CDC. West Nile was first detected in Uganda's West Nile region before spreading across Africa, Europe, Asia, Oceania and the Americas, the European Center for Disease Prevention and Control said. In the U.S., West Nile follows the mosquito season, which begins in the summer months. Infections are usually detected in August and September.

Mosquitoes, usually of the genus Culex, bite the birds, transmit the disease, and then spread it to humans. There is not enough virus in the human bloodstream for mosquitoes to reinfect and transmit it to other people. In rare cases, West Nile virus has been transmitted through blood transfusions, organ transplants, or from mothers to babies.

There is no vaccine to prevent West Nile virus in humans, but there is a vaccine for horses.

How common is the West Nile virus?

According to the CDC, West Nile virus is the most common mosquito-borne disease in the United States. In August 1999, the year the virus was first introduced into the United States, there were 62 cases and a handful of deaths.

In the years that followed, the virus began to spread through migratory birds crossing the country. In the United States, there was a rise in human infections, starting with about 66 cases in 2001 and rising to over 4,100 recorded cases in 2002. That same year, there were 284 deaths from West Nile. In 2003, 9,862 people were infected in the United States and 264 died. Most cases are now in the central and western United States.

West Nile cases are massively underreported and many people are unaware they have the virus. The reported cases tend to be the most severe infections. A blood test is traditionally used to detect West Nile in patients, although cerebrospinal fluid samples are also used to look for the neurological form of the disease, said the CDC's Staples.

What are the symptoms?

About 4 out of 5 people who contract West Nile fever show no symptoms. About 1 out of 5 infected people develop the most common symptom, West Nile fever. Other common symptoms include headache, body or muscle aches, joint pain, vomiting, diarrhea and rash, according to the CDC. According to Penn Medicine, a hospital and medical school, symptoms usually appear 1 to 14 days after the bite and can last three to six days.

In rare cases, a more severe neuroinvasive form develops, which can cause encephalitis or meningitis. Symptoms include muscle weakness, stiff neck, weakness in an arm or leg, confusion, loss of ability to think clearly, and unconsciousness or coma.

About 10% of these severe cases result in death. In 2023, 182 people died from West Nile virus in the United States.

Anyone can develop severe disease, but older people and people with certain underlying medical conditions – including cancer, cardiovascular problems and kidney disease – and organ transplant recipients are at greater risk. Most people who become infected with West Nile virus are protected against future infection.

How to prevent West Nile infection

The best prevention for West Nile is to limit the areas where mosquitoes can thrive and bite people. Here are some recommended steps:

  • Use an insect repellent approved by the Environmental Protection Agency.
  • Wear loose-fitting long-sleeved shirts and pants when outdoors.
  • Remove areas around homes where mosquitoes can settle, such as standing water where mosquitoes can lay their eggs. Use screens on windows and doors and repair holes in screens.
  • If possible, use the air conditioning on hot days instead of leaving windows and doors open.

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