Infectious Diseases: Beyond COVID-19

By Eva Briggs, M.D.

Four infectious diseases that get less attention than COVID-19 and flu have recently been in the news.

The first two, while rare, could be contracted in the Central New York area. The second two are causing outbreaks in other areas but rarely occur in people who have traveled to these spots.

West Nile virus made news when Anthony Fauci was hospitalized for this illness. It belongs to a group of viruses called flaviviruses and is related to dengue, zika and yellow fever.

All 48 of the contiguous United States and many other countries harbor West Nile virus. It’s not named after the Nile River, but for the Ugandan district called West Nile where the virus was first isolated.

Birds are the main hosts of the virus. Although it can kill some birds such as crows and jays, the main reservoir species include robins and house sparrows. Mosquitoes that feed on infected birds transmit West Nile to people. It can spread from person to person rarely, only via blood borne routes such as transfusion, blood or organ donation — or from mother and child.

Most (eight out of 10) people who contract West Nile virus have no symptoms. Those with symptoms develop fever, headache, muscle aches, vomiting, diarrhea, and rash. One out of 50 people suffers serious neurologic disease with high fever, severe headache, stiff neck, stupor, confusion, coma, tremors, seizures, vision loss, numbness, and paralysis. One out of 10 patients with severe neurologic disease die and others are left with permanent impairments. There is no vaccine to prevent West Nile disease and no specific treatment. Preventing mosquito bites is the best way to reduce risk.

Eastern Equine Encephalitis (EEE) is another viral disease. It is also spread via mosquitoes. There is no vaccine and no specific medicine to treat the disease. This dangerous disease kills about 30% of patients. It spreads to humans from birds in freshwater swamps. Despite the name equine, horses and people are dead-end hosts and can’t transmit the disease.

Oropouche virus is one that I learned about recently. It is found in South America, Central America and the Caribbean. Biting midges are the main route of transmission although some mosquitoes can spread it. Midges, also called no-see-ums, are tiny insects much smaller than mosquitoes. Because oropouche virus has occurred in travelers in the U.S. returning form areas where this disease is found, there is concern that it could become established and spread by midges in the eastern U.S. Infected pregnant woman can spread this virus to their fetus, leading to stillbirth.  Symptoms include fever, headache, muscle aches, and chills. There is also no vaccine or specific treatment for oropouche. Another name for oropouche is sloth fever because it was first isolated from three-toed sloths.

Valley fever was in the news on the day I wrote this article due to an outbreak at a California music festival. This one is due to the fungus coccidiomycosis. Fever, cough, and fatigue are the usual symptoms. It’s contracted by inhaling fungal spores in contaminated soil. It’s found in the south and west. So, while it wouldn’t be contracted here in New York state, it can return home with travelers. A friend who lives in Oklahoma had a dog who died from valley fever.