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Life after W. Nile virus

For 65-year-old Marilyn Gammett of Chico, the voices in the meeting room at work boomed in her ears like jet engines.

Upland resident Jack Raney, 46, couldn't stop crying - when he wasn't laughing uncontrollably.

And Elton Gentner, 75, of Elk Grove, became so agitated that nurses had to restrain him in his hospital bed.

Although their many symptoms varied, all three had a disease health experts predict could reach epidemic proportions in Northern California this year: West Nile virus.

And while no humans have been hit with the mosquito-borne illness in California yet this year, these residents talked to The Bee about their experiences, which were among the most severe reported, in hope of alerting everyone to the potentially serious consequences of mosquito bites.

"What frustrated me most is the lack of awareness within the medical community and the total fluff-off by all of the people I talked to," said Gammett, who lives in Chico but works at the Sacramento National Wildlife Refuge in Willows and is a volunteer wildlife rescuer.

Nip Boyes, Glenn County public health nurse, said Gammett's age and her profession should have been clues to her diagnosis, but she suspects West Nile was then too new to warrant consideration.

"In public health, we are told that when you hear the sound of hoofbeats, look for horses, not zebras," he said.

The trim and energetic Gammett said she woke up with a raging fever on a Saturday last July and had to be helped to her car for the ride to an urgent care center.

There the doctor suggested she had a urinary tract infection and sent her home with an antibiotic drug.

"The next day it was worse, vomiting had started and extreme nausea," she said. A second trip to another urgent care center resulted in a probable pneumonia diagnosis.

"They gave me more antibiotics. I went home," she said.

Gammett couldn't stay awake, and felt a burning sensation from the base of her skull to the heels of her feet.

"I was having extreme difficulty doing anything," she said. "I could not feed myself."

It was her regular doctor the following Monday who suggested they test her for West Nile virus.

Gammett was severely ill with what is called West Nile fever for more than two months; she could not work for three months. Although she has regained strength, she still becomes irritated around loud voices.

Although Gammett's illness never progressed to meningitis or encephalitis, the more rare and serious consequences of West Nile, her case represents what experts have determined only recently: West Nile fever symptoms such as fatigue and loss of concentration can linger for a month or more.

Of all the people who will become infected with West Nile virus, only 20 percent will experience any symptoms at all, and of those, only 1 percent will have what is called neuroinvasive disease - meningitis, encephalitis or flaccid paralysis, a polio-like syndrome that destroys nerves.

Raney and Gentner were among them.

Like Gammett, both men were essentially healthy when they got West Nile virus.

The symptoms for Raney - a self-employed mason who is married with three children, ages 16, 12 and 11 - began Aug. 4 when he woke up feeling so tired he could hardly move. He went back to sleep for 12 hours. "I don't remember getting up and going to the bathroom or eating anything. I just remember the next morning I started throwing up and I couldn't stop."

His wife took him to a hospital emergency room where, a doctor informed him, he had the flu.

Dr. Larry Drew, director of clinical virology and infectious disease at UCSF Mount Zion Medical Center, said flu symptoms in summer should give doctors pause.

"True influenza is a winter disease, and so you get a patient with a 103-degree fever and muscle aches ... you should think about West Nile," he said.

It was a week before the hospital confirmed the diagnosis of West Nile. By that time, Raney was in a coma, being fed through a tube and using a ventilator to breathe.

"They kept telling my wife to be prepared for the worst," he said.

The virus had caused both meningitis - inflammation of the lining around the brain and spinal cord - and encephalitis, brain swelling.

Raney came out of the coma, but still suffers from serious problems as a result of the virus. A former baseball coach, he can no longer throw a ball, much less lift anything bigger than a six-pack of soda with his right arm.

Worst of all are Raney's mental problems - anxiety, depression and generally feeling overwhelmed.

"It has changed my whole life," he said. "It's hard to imagine being a productive part of society."

Drew said about 30 percent of those with neuroinvasive disease have prolonged symptoms that may never improve.

For Gentner, who lives in a rural area south of Elk Grove, the first sign of the disease was a weakness in his left arm last September. A week later, he crashed to the floor while changing clothes. His wife, Evelyn, ran for help next door and brought her husband to UC Davis Medical Center.

He remembers little of his 19-day hospital stay. His symptoms were fever and rapid heart rate and tremor. Initially, doctors discovered some age-related heart problems, but a blood test confirmed six days later he had West Nile encephalitis.

Evelyn Gentner said her husband was a different man while hospitalized. He became ornery and demanding.

Gentner, now fully recovered and enjoying his associated 25-pound weight loss, has been told he is extremely lucky to be alive.

He and his wife now take extraordinary precautions to avoid mosquito bites.

"If a mosquito comes in here, the wife annihilates it immediately," he said.

West Nile virus symptoms

Serious:

About one in 150 people infected with the virus will develop severe illness. Symptoms can include high fever, headache, neck stiffness, stupor, disorientation, coma, tremors, convulsions, muscle weakness, vision loss, numbness and paralysis. These symptoms may last several weeks, and neurological effects may be permanent.

Mild: Up to 20 percent of people who become infected will display symptoms that can include fever, headache, body aches, nausea, vomiting and sometimes swollen lymph glands or a skin rash on the chest, stomach and back. Symptoms can last as little as a few days, though even healthy people have been sick for several weeks.

None: Approximately 80 percent of people who are infected with the virus will not show any symptoms.

Source: U.S. Centers for DiseaseControl and Prevention

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