Saint Louis Encephalitis

31st Oct 2014 Diseases, Medical News, Viruses

Over the summer there have been mentions of Saint Louis encephalitis virus (SLEV) in regards to Pinellas County. This virus is a flavivirus – a group that includes West Nile – and has the potential to cause severe illness or death in older adults. The name of this disease comes from a particularly extensive outbreak that occurred in St. Louis, Missouri and the surrounding St. Louis County in 1933. Due to the high number of cases NIH was able to investigate and isolate this previously unknown virus. It is thought to have originated in northern Mexico and have been carried north by birds. Pinellas County Mosquito Control uses sentinel chickens to monitor for Saint Louis encephalitis and other arboviruses, since birds are usually the source of infection for mosquitos. Blood is drawn from the chickens weekly and tested for antibodies to the viruses of concern. Fortunately for the chickens they do not develop any symptoms, although once they test positive they have to be removed from the program since they will always carry the antibodies. Sentinel chickens from Pinellas County have tested positive for Saint Louis encephalitis in late July as well as August and into September. Regions with confirmed SLEV include Cross Bayou, Walsingham Park, Sawgrass Lake Park, and Lake Maggiore. While it is more common during hot and humid months, Saint Louis encephalitis can occur year round. Most individuals that are infected have no symptoms, but in rare cases it can manifest with such signs as fever, headache, nausea, vomiting, and fatigue. Severe infections can result in high fever, neck stiffness, disorientation, confusion, tremors, coma, and sometimes convulsion, spastic paralysis, and death. Older adults are at a greater risk for fatal disease. Since there is no cure for Saint Louis encephalitis the only treatment available is supportive care. If you or anyone you know shows symptoms of this disease be sure to talk to your health care provider for proper diagnosis. Since this virus is spread by mosquitos you should take the appropriate precautions. Wear insect repellent and protective clothing and be sure to avoid areas with high mosquito populations. Drain standing water, change pets’ water dishes and birdbaths regularly, and maintain your pool’s water balance to prevent mosquitos from breeding. If you use rain barrels be sure to cover them with fine mesh. Ornamental ponds can be stocked with fish that eat the mosquito larvae and any ornamental bromeliads should be flushed with fresh water regularly and treated with a larvicide. Mosquito Control field technicians can respond to concerns by use of the Mosquito Control Request form found on the Pinellas County website. http://www.pinellascounty.org/forms/mosquito_form.htm

Starkey Hearing and Doctor Robert Dean Afghanistan Mission

There are many civilians living and working in war zones and, despite not being military personnel, they are exposed to many of the same hazards. There has been significant research done into the effects of war on soldiers, but very little has been done for those not enlisted. Recently it was reported that the number of children and other vulnerable Afghan civilians injured or killed has increased dramatically since the beginning of 2014. There has been a rise in the number of ground engagements in areas with higher civilian populations, which has accounted fro this steep increase in causalities. While civilians can be accidentally injured or killed during war, there has been a disturbing trend of attacks directed toward them – particularly tribal elders or government officials in this case. The number of children and women causalities has increased the most as the fighting moves into areas with higher population density.

Afghan civilians are exposed to everything from gunfire, IED attacks, mortars, and grenades, to loud noises from trucks, helicopters, and aircrafts.  All of these sounds can damage hearing and lead to tinnitus or permanent hearing loss on top of any other injuries.

Hearing damage can occur in one of two ways – long-term exposure to a loud environment (driving a loud truck,) short-term exposure to a high-intensity sound (gunfire or IEDs.) Exposure to loud noise causes destruction of the hair cells in the inner ear, but the degree of destruction is based on the intensity and duration of the noise. These hair cells are responsible for carrying sound vibration information to the auditory nerves, so without them available to convey this information the individuals experience hearing loss.

Hearing loss is irreversible, but there are methods to cope. Hearing aids are the most recommended method to restore some, if not nearly all, hearing to an individual. Starkey Hearing Foundation has been working with the Bayat Foundation  in order to distribute hearing aids to Afghan civilians, many of them children affected by war, who would otherwise be left unable to hear.  We were able to fit over 600 people with hearing aids while on our mission to Afghanistan.