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Mississippi hospital receives CDC grant to study long-term effects of West Nile virus

Susan Christensen
Health and Research News Service

JACKSON, Miss.—Jack Fowler’s bout with West Nile virus put him in the hospital for nine days last September, but the retired Jackson dentist says he’s back to full throttle. “I work like a Trojan outside,” he says.

Betty Mitchell, on the other hand, still suffers from lack of muscle control, even though it has been over a year since the Madison art teacher contracted West Nile virus infection. “Sometimes when I walk, I look like I’ve had too much to drink,” she says.

Why Fowler recovered fully and Mitchell hasn’t remains a puzzle for now. But a study under way at Methodist Rehabilitation Center in Jackson may help unravel the mystery.

Researchers at the hospital’s Center for Neuroscience and Neurological Recovery (CNNR) recently received an $82,000 grant from the Centers for Disease Control and Prevention to do follow-up studies on patients with West Nile virus infection in collaboration with the Mississippi State Department of Health. Principal investigators are CNNR director Dr. Dobrivoje Stokic and CNNR senior scientist Dr. Art Leis.

“The CNNR at Methodist Rehab was a logical choice for this grant because of the center’s previous research on West Nile,” said Dr. Sally Slavinski, an epidemiologist for MSDH. Last fall, Methodist Rehabilitation Center researchers were the first to report a link between West Nile virus and a polio-like paralysis in some of its victims.

“Last year’s findings have been instrumental in the identification of the pathological process in certain patients,” Slavinski said. “This additional research will provide us with a better understanding of the long-term medical problems associated with WNV illness and allow the MSDH to better respond to the health care needs of people with WNV illness and their health care costs.”

Stokic said the study will examine the outcome of two groups: patients who experienced muscle weakness during the acute stage of the illness and those who didn’t.

“The long-term outcome of people with muscle weakness has not been carefully studied, so we don’t know to what extent they recover,” Stokic said. “We have seen some recover in days, some recover in longer periods and some are still paralyzed. We want to know what kind of recovery has taken place in the past year so that we can compare it to their evaluation soon after they were infected. We hope this will eventually tell us if the severity of initial impairment is related to long-term outcome.”

Such knowledge would help physicians better manage the care of patients. “If physicians know what to expect in a year’s time, they can appropriately plan treatment options,” Stokic said. For example, a patient destined to remain in a wheelchair would need more extensive rehabilitation services than one with short-lived muscle weakness.

Stokic said that 40 patients will be recruited for the study and participants are still needed. Researchers are looking for patients who had a confirmed case of West Nile virus infection in 2002 and who developed symptoms during the acute stage of the disease. Stokic said anyone interested in participating in the study should call him at 601-364-3314. Patients will receive a nominal fee for their participation.

The 20 study participants who exhibited muscle weakness will be expected to answer a questionnaire and undergo extensive clinical and laboratory examinations. Participants without muscle weakness will only answer the questionnaire.

As one who knows the seriousness of a West Nile virus infection, Fowler said he’s glad to see further study of the disease. “It’s a good thing because there’s so much they still don’t know or aren’t sure of,” he said.

Mitchell also advocates more research, particularly if it leads to better prevention efforts. “I think it’s very needed because we live where mosquitoes are and we can’t get away from them,” she said. “We need some type of vaccine or something because everyone isn’t going to walk around all wrapped up and with DEET on.”