West Nile virus victim says symptoms were overlooked

HEALTHY SUSPICIONS

By David A. Lieb ~ The Associated Press

JEFFERSON CITY, Mo. -- First he noticed the pain -- a cramping in his joints and a pressure that felt like his eyes were about to pop out of his head. Then there was the fever -- more than 102 degrees.

So Tim Morff went to his doctor's office, where he diagnosed with strep throat and given antibiotics.

But he didn't get better. His stomach felt like it was tied up in knots. His skin got super sensitive and a rash broke out over his body. His lymph nodes swelled up like walnuts. His neck and back felt like someone was punching him. What's more, he was becoming disoriented.

Morff visited his doctor's office three times in one week. The diagnosis twice was strep throat, then a generic viral infection.

"It was getting frustrating, because I knew that it was more than strep throat," says Morff, 38, who finally called the county health department and a hot line for the national Centers for Disease Control and Prevention, both of which urged him to get tested for the West Nile virus.

Preliminary tests confirmed he has the mosquito-borne virus -- the first human case of the disease in central Missouri.

Extra suspicion

Morff's case makes an important point: As the West Nile virus spreads west across the United States, doctors and nurses accustomed to seeing patients with common illnesses need to start using an extra dose of suspicion, officials said.

"The doctors need to be thinking West Nile if they have a combination of the flu-like symptoms," said Dr. Howard Pue, chief of communicable diseases for the Missouri health department.

"I don't think it's particularly difficult to diagnose if you have a high level of suspicion for it," Pue said. "But there's just many other diseases it can be confused with."

The Jefferson City Medical Group plans to review its treatment Morff, said Dr. Don Miller, the clinic's infectious disease specialist.

But Miller said there are no West Nile screening tests that are cheap, accurate and quick. So there likely are others who had West Nile virus and recovered without ever being diagnosed, he said.

"To diagnosis this early, when there's no good treatment ... is not highly encouraged," Miller said, "because we don't want to flood the health department with a lot of tests that are fairly spurious."

Doctors are more likely to test the elderly for West Nile virus, because they are at a greater risk of dying, he said.

Morff, who works for the Missouri Department of Transportation, said he believes he got West Nile virus from mosquito bites Aug. 8 while standing outside his home in rural Centertown. A horse had died of the West Nile virus at a neighbor's farm not too long before.

Morff starting feeling ill four days after the bites. By Wednesday evening, he said he was nearly recovered -- at least enough to look back on the illness with irony.

"The amusing part of it was, when we were standing out there, I didn't have any repellent on. I was talking to a friend of mine, and a mosquito fogger drove by and buzzed us, and the biting stopped," Morff said.

If only the mosquito sprayer had driven by a few minutes earlier.