BOUNTIFUL A Utah state health epidemiologist knows firsthand that the West Nile virus infection can create severe impairment. And that it only takes one time without mosquito repellent to turn what seems an unlikely risk into a hard-to-overcome reality.
Melissa Dimond, 34, nearly died after she was infected by a mosquito during a chance encounter with a neighbor in September 2006. She and her husband, Blake, who had been married less than a year, had just returned from playing tennis when the neighbor introduced himself and they stopped to chat. She remembers thinking "almost flippantly" that she hoped she didn't get West Nile. She always put on repellent when outside from dusk to dawn. But this night, instead, the newlyweds lingered in their driveway for 15 minutes or so.
Those minutes would change her life.
Almost two years have passed, but she still struggles with fatigue and blurred vision. The toes of her left foot curl, a condition called dystonia, so that it's sometimes excruciating to walk. She's battled vision problems and headaches and weakness. But she's made tremendous progress since she became ill.
She can swallow and eat again. She can smile and stick out her tongue. She's regaining control over her vocal range and is back in her church choir. And she remembers how to spit, so she's now able to brush her teeth properly.
The Dimonds told their story to media Wednesday, on the eve of a holiday that's bound to send people outside for evening barbecues and fun. Her hope is simple, she said: That people this Pioneer Day weekend and beyond will wear insect repellent and stay safe from mosquitoes that might carry the virus.
The virus has so far this year been found in several counties statewide, including Uintah, Salt Lake, Kane, Utah, Washington, Millard, Davis and Box Elder. Two human infections have been reported.
The risk of severe illness is small, since most people who are infected do not develop any, much less severe symptoms like she did. But that risk is also real. She nearly died.
"Prevention," she says, "is such a simple thing."
She knew she'd been bitten. Two weeks later, she started having strange symptoms. She was "spacey" at work, she says. She's had type 1 diabetes since she was little; that day, she twice put her glucometer in the trash. Then her peripheral vision changed, with a cut-out area. She developed a rash and then a severe headache. When she asked a doctor if it could be West Nile, she was told it's not the right season.
"I said, 'I think it is,"' she remembers.
She became so nauseated she could neither eat nor drink, vomiting continuously, which sent them to the emergency room. She was severely dehydrated and dizzy. On a second trip to the ER, she had a reaction to her nausea medication and couldn't close her eyes. The ER doctor told her to see a neurologist right away.
When she did, she was diagnosed was viral meningitis, with the expectation she'd feel better shortly. It just got worse.
Back in the emergency room yet again, her husband, Blake, refused to take her home. She was hospitalized and was in the hospital when results came back from a blood sample a doctor had earlier sent to the lab. She had West Nile in its most severe form meningal encephalitis. The people most likely to have that severe form are the elderly and those with compromised immune systems. She's not sure if her diabetes made her more vulnerable.
She would be hospitalized for a month, including about a week in intensive care and two weeks in rehabilitation, before going home, still eating through a feeding tube, still weak and impaired.
Along the way, she's lost and regained various seemingly simple abilities, like swallowing. Her longtime friend and colleague JoDee Summers describes relearning to stick out her tongue as "huge," while Dimond humorously recounts sitting beside her on their couch listening to her practice coughing "for hours and hours and hours" until he could hardly stand it.
She's still weak and fatigued and the thought of another mosquito bite terrifies her.
Blake Dimond doesn't smile as he remembers the horror of seeing his wife unable to move her face, lying expressionless, reliant on a machine for food. They were told she'd have some residual brain damage, but they're not going there, content that she has made so much progress, regained so much of who she is.
It would be a couple of months before she returned to her job as a program manager in communicable disease epidemiology for the Utah Department of Health. And six months since she was bitten before life would start to return to normal.
Even today, she's making little gains. But she may never get all the way back to where she was.
She forgets things more easily, she says, especially when she's tired.One thing she doesn't forget, though, is putting on mosquito repellent and taking other West Nile precautions.