February 15, 2007
DAVIS—Keira Simmons knew something was wrong the minute she woke up that fateful morning in mid-June 2005.
A strange red rash splotched her inner arms and torso. Within four days, the rash covered her entire body, even between her fingers and toes. A knife-splitting headache, coupled with crushing muscle pain, projectile vomiting, neck stiffness,fatigue, dizziness and nausea ensued.
Her normal 98.5 degree temperature spiked to 102 and then raged to 106.5. She dropped 20 pounds in 10 days.
The University of California, Davis scientist remembers four trips to the hospital emergency room, a three-day hospitalization to treat the raging fever, worsening pain, dizziness and dehydration, and a three-week recovery period at home. The illness incapacitated her for seven weeks.
It nearly killed her.
"The doctors thought I had the flu," recalled Simmons, then 27 and a post-graduate researcher in a UC Davis School of Medicine lab.
It was not the flu.
Only after she’d accepted a research position at the UC Davis Center for Vectorborne Diseases in November 2005, did a routine blood test confirm her worst suspicions: neuroinvasive West Nile virus (WNV), the most severe virus spread by Culex mosquitoes.
"Keira’s blood test proved strongly positive for the West Nile virus," said CVEC research entomologist William Reisen, who researches Culex mosquitoes and their ability to transmit arboviruses, including WNV.
Simmons, a 2001 microbiology graduate of UC Davis who grew up in Sacramento, tells her story to alert others to the disease and encourage precautionary measures. She addressed the Mosquito and Vector Control Association of California at its Feb. 5 conference in Fresno. Frontiers, a UC Davis TV news production, will broadcast a show on the West Nile virus, featuring Reisen and Simmons, sometime in March.
Simmons speaks from the unusual standpoint of scientist and a victim. As a scientist (lead molecular lab technician), she’s involved in both research and surveillance, testing mosquito pools and dead bird tissue submitted from throughout the state. As a victim, she knows the havoc that a tiny insect with a brain the size of a period at the end of this sentence, can wreak.
"Her story puts a face on this disease," said UC Davis medical entomologist and CVEC director Gregory Lanzaro, who also directs the UC Mosquito Research Program. "What happened to her can happen to any of us. This is a reality check."
Looking back, Simmons speculates that the infected mosquito bit her when she and her fiancé were hiking along Putah Creek on the UC Davis campus. "My fiancé and I like to hike along the creek," she said. "We’d do so every evening after work during the spring and summer. So it was probably dusk when I was bitten. And, no, I was not taking the precautions of wearing repellant or long sleeves and pants. I learned the hard way."
Initially, Simmons attributed the debilitating symptoms to the flu. "But the headache got worse and worse and wasn’t alleviated by any medication. Later, I had a pretty good idea that I had West Nile virus," said Simmons, whose parents, now retired, worked in the medical field; her father as a nurse practitioner and her mother as an oncology nurse. "I had all the classic symptoms and I knew that something was seriously wrong with my body and my central nervous system."
Despite her medical and scientific background, Simmons said she couldn’t convince the physicians who treated her that "I was sick, very sick and in need of more serious attention and treatment." Hospital technicians drew her blood, but Simmons learned later "it was never tested for West Nile virus." She repeatedly asked that it be tested for WNV. "They ran a few non-invasive tests and some cultures. When none of them was conclusive, they simply gave me IV fluids and sent me home. They said I had the flu."
The illness alarmed her family and friends. "No one around me had been sick and no one was getting sick from exposure to me. It was quite frightening for my mom, dad, sister and fiancé to stand by, powerless and watch me deteriorate. Four or five days after my first ER visit, my personal physician admitted me to the hospital," Simmons said. "I wasn’t real aware of my surroundings or what was going on at that time. I had literally started to mentally check out. I was quite fortunate that I had my fiancé, family and my physician advocating on my behalf.
"When I was admitted, I had a fever of 106.5, tremors, I’d lost 20 pounds and I was severely dehydrated. I couldn’t turn my head or move my eyes to trace objects. I couldn’t keep my balance. I was completely disoriented to time, place and location. Just before I was admitted, I lost consciousness." During her three-week recovery period at home, she battled chronic vertigo. "I was unable to leave the house or walk on my own," Simmons said.
Had she not changed jobs and taken the mandatory blood test, she believes the disease may have gone undiagnosed. Her reaction to the positive blood test? "Vindicated. Validated. I knew there was something wrong with me."
The medical profession and general populace, she said, need to know the symptoms of the relatively new disease, identified in California only since 2003. Traced to the West Nile region of Uganda in 1937, it was first identified in the United States (New York) in 1999.
"From a public health standpoint, the medical profession failed to serve as the frontline of observation for reportable diseases in their community. There was no good reason why I wasn’t tested. I had a proper history, accurate symptoms, and my condition was worsening visit after visit." Today side effects still persist. "I feel generally healthy," Simmons said, "but I still have about three or four headaches of migraine-intensity a week. I also still have some weakness in my arms and hands affecting my manual dexterity. I have transient spells of vertigo that leave me unable to work in my capacity as a researcher. I have no idea when these symptoms will resolve. West Nile virus is so new to our population that they really don’t have any idea how it may affect people or their quality of life."
The UC Davis scientist credits what happened to her in that summer of 2005—her illness, her recovery, and her survival—with a renewed sense of purpose in her research. "Daily I help conduct surveillance of the state for emergence of WNV within our communities. My efforts here help dictate policy in counties throughout the state. That’s a pretty powerful thing. I’m quite fortunate to find such purpose in my work."
Advice for the general populace? "Don’t take your good health for granted. Protect yourself and those close to you who may not know better or who resist. Wear protective clothing, use repellant. I think we may have underestimated the severityof this disease. I think that it’s led to nonchalance in prevention and improper assumption on the part of medical professionals as to who gets sick with West Nile virus. 'Know thyself' and be your own advocate. Always.
"I hope my story will help others be their own advocates when they know there’s something wrong with their bodies and when those that are charged with their medical care don’t listen well enough."
The scientist strongly supports preventive measures, including aerial spraying to disrupt the virus transmission cycle."People seem unwilling to support aerial spraying, and I think it's due, in part, to people not having a clear and personalized picture of the effects of this disease," Simmons said. "We are willing to vaccinate our children against diseases like polio, hepatitis, and measles because of the horrible effects and side effects of those diseases. We overlook the minimal risk to receive the enormous benefit of being protected from these debilitating diseases.
"If people knew that West Nile virus could cause long-term side effects, if they knew that vertigo and chronic headaches and paralysis could be their fate IF they survived an infection, perhaps they'd think differently about protecting their children and themselves through aerial spraying. People are willing to support such policies only if they can see and feel a personal threat."
Reisen, a noted WNV researcher who helped identify the presence of the virus in California in 2003, agrees. "West Nile virus is here to stay," he said, "and we must learn how to live safely."
More information on the symptoms of West Nile virus is at the Centers for Disease Control and Prevention Web site.
Editor’s Note: Molecular lab technician Keira Simmons and research entomologist William Reisen of the UC Davis Center for Vectorborne Diseases recently discussed the West Nile virus with host Paul Pfotenhauer of Frontiers, a new UC Davis television interview show. The segment on West Nile virus will be broadcast in March. Further information will be posted soon on http://frontiers.ucdavis.edu. Frontiers focuses on faculty research, teaching and public service.
Kathy Keatley Garvey
California Statewide Mosquito Research Program
Department of Entomology
Phone: (530) 754-6894 Fax: (530) 752-1537
More on the Web:
UC Mosquito Research Program
Lanzaro Vector Genetics Lab
UC Malaria Research and Control Group
UC Davis Center for Vectorborne Diseases (CVEC), School of Veterinary Medicine