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"We got hit pretty hard with the outbreak,"
said John Pape, epidemiologist with the Colorado Department
of Public Health and Environment. "It was a busy
summer."
Pape stressed that Colorado's relatively large population
as well as a break in the region's recent drought and
the prominence of a particular mosquito species adept
at transmitting the virus all helped to give the state
a thrashing.
Such an explanation offers cold comfort to Helen Lutz,
RN, who spent the better part of the summer tending
to West Nile patients on her floor at Longmont (Colo.)
United Hospital. "It was crazy," she said.
"There were a lot of sick people with horrible
headaches, nausea and weakness. Summer is normally a
bit of a slow time for us, but not this year."
Lutz said that one of the difficulties in dealing with
West Nile patients is that many of them require extra
time and attention from the nursing staff. "Their
limbs and extremities are extremely weak, and so they
need help walking and doing most other things. It was
a labor-intensive couple of months for us."
Another challenging aspect of the disease, Lutz added,
is the lack of a known cure-which leaves nurses with
little else to do but try to make patients as comfortable
as possible and wait for the virus to run its course.
"It's definitely frustrating," Lutz said,
"but you do the best you can to help the patients
get through it. Pain management becomes the main focus."
Faber agreed. She said that much of her work with West
Nile patients revolved around easing pain and suffering.
She added that the closest thing she found to a wonder
drug was Toradol (ketorolac tromethamine), a quick-acting
anti-inflammatory medication. reduced the swelling in
a lot of patients, which really helped their situation,"
Faber said. "You can't use it for too long because
it can cause stomach problems, but it works quickly."
In addition to addressing the obvious physical suffering
exhibited by West Nile patients, Faber said that nurses
also should be prepared to address the emotional and
psychological symptoms that accompany such a notorious
and panic-inducing disease.
"There was a lot of fear," Faber said, referring
to the patients she treated this past summer. "A
lot of people, particularly our elderly patients, thought
they were going to die." She added, "You have
to keep them calm and reassure them that they're most
likely going to be OK. This virus really requires you
to treat the whole patient."
Signs are cropping up that a possible cure may be on
the way. Last year, scientists developed an experimental
vaccine for the virus-made from the existing yellow
fever vaccine with West Nile genes spliced in. Scientists
say the vaccine has proved effective in protecting laboratory
animals from the disease.
Officials with the National Institutes of Health recently
reported to Congress that a biotechnology company, Acambis,
plans to begin tests on the vaccine with a small group
of people to determine whether it is safe and effective
for humans. If all goes well, officials said, the vaccine
could be available for public use in about three years.
That, of course, means that West Nile will enjoy at
least a few more seasons of unabated activity. Perhaps
nowhere is this more of a concern than in California,
where officials fear the virus will strike hardest next
year. West Nile, experts said, is expected to continue
its westward migration-and that leaves the Golden State
directly in its path.
The telltale signs of a looming invasion are already
there. State investigators detected infected mosquitoes
for the first time in August, and since then, more dead
birds have begun turning up. Health officials believe
that human cases erupt one season after the virus first
appears in the environment. (California officials reported
the state's first human case of West Nile several weeks
ago, erasing any doubts that the virus might bypass
the state.)
"We're definitely bracing for next spring,"
said Liz Jacobs, RN, spokeswoman for the California
Nurses Association.
In light of California's well-known budget crisis,
Jacobs said she doubts there will be much funding for
any kind of well-organized statewide campaign against
the virus. She sees more of a grass-roots effort, with
nurses and other frontline health care providers working
to get the word out early and often about what in the
end is still the only way to combat the virus: prevention.
"It all comes down to preventive measures,"
Jacobs said, "wearing long clothing and strong
repellent, and for some, such as the elderly and sick,
avoiding outdoor activity in the evening." She
added, "The key to battling this disease remains
educating the public on the ways to avoid it."
Contact H. Cheever Griffin at cgcommunications@ameritech.net
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