Liz Larmin never let a headache slow her down. A mother of four, the 42-year-old homemaker from Evergreen Park, Ill., couldn't afford to. But on Aug. 26, as she was busy getting daughter Stephanie, 12, off to seventh grade and prepping triplets Eric, Emily and Julia, 3, for their first day of preschool, Larmin was laid low by nausea and hammering pain in her skull. Her husband, Keith, 40, an electrician, figured she had the flu, but Larmin—who had spent time this summer outdoors without wearing insect repellent—suspected a more sinister culprit. "I felt I had West Nile," she says. "I just knew in my bones."
The next day Larmin had a 103° fever and could barely walk. She landed in the hospital—where doctors confirmed her self-diagnosis and later discovered that the virus had spread to the tissues surrounding her brain and spinal cord, resulting in meningitis. "I actually thought she might die," says Keith. After seven days Larmin largely recovered, but she still suffers from fatigue and vision problems. "I never liked bugs before," she says. "Now I totally hate them."
It's easy to see why. There have been more than 2,700 verified cases of West Nile virus, which is primarily carried by the Culex, or house mosquito, and at least 146 deaths this year—the worst outbreak since the disease first struck the U.S. in 1999. (Officials speculate that West Nile, which is common in the Middle East, Africa and parts of Eastern Europe, came over on a plane.) Spurred on by a hot, dry summer—baked ground absorbs rainwater slowly, leaving more puddles for mosquitoes to breed in—the virus spread farther than ever into the West and South. And though most Americans may associate the disease with barbecue season, the threat has hardly vanished with the advent of fall.
In late September health officials announced that West Nile most likely can be spread via blood transfusions and organ donations—and that six victims in Louisiana and Mississippi had developed a poliolike paralysis. Then came Hurricane Lili, whose heavy rains may lead to a resurgence of cases on the Gulf Coast. "We're going to find out in a few weeks," says Dr. Raoult Ratard, a Louisiana epidemiologist. In fact, mosquitoes can remain active until first frost sends them into dormancy. So in regions where the weather remains balmy, vigilance is a continuing necessity.
Still, experts stress the need to keep the danger in proportion. "More people are killed crossing the street than by West Nile," notes Ratard. In most cases West Nile is harmless, causing flu-like symptoms that disappear within days. But in about 1 out of 150 cases it can develop into potentially deadly meningitis or encephalitis. Most who become severely ill are elderly, but some, like William Robert Conley, 44, a shipbuilder from Gautier, Miss., were in robust health. Conley believes he caught the virus while fishing over the July 4 holiday. "My friends were spraying on mosquito spray, but I didn't get any," Conley says. "I don't like the smell." By the next weekend he was wildly disoriented. "He was talking out of his head, believing he was at work in the shipyard," recalls his wife, Sandy, 47, who called 911. The father of three is home after a month in a rehab hospital but still can't walk without a cane.
Like Conley, Tara Bergeron gambled against West Nile and lost. One evening last July, the 22-year-old nurse's aide and single mother of two from Pointe Coupee Parish, La.—the community that has had the highest concentration of the disease, with 11 verified cases among 22,800 residents—went outside at dusk in a T-shirt and shorts. "I laughed and asked my boyfriend what are the chances of me being bitten by a West Nile mosquito," she says. Bergeron was admitted to the hospital Aug. 17, and though she was discharged six days later, she still suffers from memory loss and has not returned to work.
Although the National Institutes of Health and a private biotechnology company are working on vaccines—one has been successfully tested on monkeys—the research process could take up to five years. Meanwhile, experts say, the current outbreak will recede in most of the U.S. by the end of October. Until then, a DEET-based repellent and long sleeves at dusk should be part of everyone's wardrobe.
There is an upside for those who do get sick: Doctors believe exposure to the virus brings permanent immunity. For Larmin the disease also led her to slow down and focus on her loved ones. "We're all huggers and kissers now," she says. "Everyone in the family feels more appreciative of each other."
J.D. Heyman
Barbara Sandler in Evergreen Park, Alice Jackson-Baughn in Gautier and Bob Stewart in Pointe Coupee Parish
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