You have just come back
from vacation and have posted your Facebook and Instagram photos of idyllic
locations. But now you are also noticing headaches and muscle pains and
have started to develop a high fever. Maybe you detect unusual skin eruptions
or swelling and are feeling fatigued. Chances are that you may have contracted one
of a number of viruses that are most commonly caused by bites from infected
ticks or mosquitoes.
When you see your
doctor, you should inform him or her of your most recent travels and share a
log of your symptoms so that the correct tests and diagnosis can be made. Some
patients may even find the offending tick in their body and should bring it to
the office for laboratory testing. It is quite simple actually, place the tick
dead or alive in a small container and bring the container to the doctor’s
office.
More than likely the
symptoms above can mean any of the following more common viruses: Lyme disease,
West Nile virus, St Louis encephalitis among others. Of course you don’t need
to have travelled to a tropical country to have been infected with either Lyme
or West Nile diseases.
If your travels included
South America, Asia or Africa then your doctor should check for rarer but
equally worrying diseases such as Dengue or Chikungunya or even Ebola if it
applies.
The most important thing
to remember about all these viruses is that they are rarely fatal (well
except maybe Ebola) and are not highly contagious. If left untreated,
however, they can lead to serious complications especially in small children
and the elderly.
Nowadays, there is
a growing fear about the spread of the Ebola virus in Africa and reports
of patients suffering from this disease entering the United States is causing
widespread alarm. Again, to allay your fears, remember that, unlike respiratory
viruses that can spread in the air, Ebola can only be spread through exchange
of bodily fluids or through sharing of infected needles.
Lyme Disease/
West Nile Virus:
Symptoms: fatigue,
muscle pains, headaches, red swellings on the skin
Perhaps the most common
here in the north east, Lyme disease is a tick-borne virus that can cause more
complications if left untreated. Some people come to the office with the tick
that they found in their body which is helpful to test. If the laboratory tests
prove positive for Lyme disease a treatment of antibiotics will be prescribed
for a short duration but if untreated initially the treatment may be longer.
It is important to follow-up with your doctor as post-treatment Lyme
disease syndrome can occur in a few rare cases.
How to avoid
Lyme disease? - Use repellents that contain 20 to 30% DEET, and shower
after going outdoors in the countryside and do a fully body scan for ticks on
you and your children, including under the arms, behind the knees and even in
the hair.
Chikungunya:
Like most other
diseases, rarely is this fatal. It is more commonly found in Africa and Asia
and has spread through the Caribbean and in the New York area in recent
months. The symptoms usually develop three to seven days after being
bitten by an infected mosquito and can be more severe in small children and the
elderly.
Dengue Fever
Symptoms: Severe
headache, body pains, fatigue, rash
Also known as the bone
breaking disease, Dengue is commonly found in South America, Africa and
Asia. It is advisable not to take any
blood thinning medicines, such as aspirin and ibuprofen (Advil), etc… if you
think you may have dengue fever
St Louis Encephalitis
Symptoms: St Louis
Encephalitis should be considered in all cases of viral encephalitis occurring
in the summertime, but particularly in elderly patients or when two or more
similar cases cluster in a community. SLE and West Nile infections must be
distinguished by serologic tests the viruses contain cross-reactive antigens
Ebola:
Ebola and Marburg hemorrhagic fever typically begin with the
abrupt onset of fever, chills, and general malaise. Other signs and symptoms
include weakness, severe headache, pain in the muscles of the trunk and lower
back, nausea, vomiting, diarrhea, and abdominal pain. High fever may be
accompanied by relative bradycardia (slow cardiac rate), as seen in typhoid
fever. A nonproductive cough and pharyngitis, with the sensation of a lump or
"ball" in the throat, are also frequently present
As you see, the differential
diagnosis can be challenging even for your doctor.
It is important to
remember that rare diseases occur rarely. Try to use common sense and consult
your doctor if you are not sure about some new symptoms you have developed
recently.
Albert
Levy, MD
