Study focused on mystery of West Nile virus

Mark Rupp, M.D.

Doctors and researchers at UNMC’s hospital partner, The Nebraska Medical Center, are working to uncover the mystery of why some people infected with West Nile virus become severely ill and others show no symptoms.

The Nebraska Medical Center began enrolling study participants last summer.
So far, about 600 Nebraskans have stepped forward to volunteer and have qualified for the study. The enrollment goal is about 850. The medical center is one of several sites for the study that’s being conducted in the United States and Canada.

“Most illnesses related to West Nile virus aren’t reported because people experience flu-like symptoms,” said Mark Rupp, M.D., infectious disease specialist at UNMC and The Nebraska Medical Center. “But some persons develop a serious neuro-invasive disease that can involve the brain or spinal cord resulting in paralysis or permanent neurologic impairment. We don’t understand why — this study is designed to find that crucial piece of information.”

Only one in 150 people with the West Nile virus will become severely ill. One in five will develop a fever, head and body aches or skin rashes.

“Unfortunately, there is no way to know ahead of time if you’ll get sick or not when infected,” Dr. Rupp said.

It is estimated that more than one million Americans have contracted the West Nile virus since it was introduced into the United States in 1999.

“The peak of the season is usually in August and September, so for this year, the worst is yet to come,” Dr. Rupp said.

The year 2003 had the greatest number of reported West Nile illnesses. More than 9,800 cases were reported in 45 states and there were 264 deaths. Almost 2,000 of those cases occurred in Nebraska.

Tips on reducing risk of West Nile Virus infection Apply insect repellent to exposed skin. A 10 percent concentration of DEET will work well for about two hours. Higher concentrations will work for a longer period of time. The American Academy of Pediatrics recommends that DEET not be used on infants less than two months of age. Wear loose long sleeve shirts and pants. Help reduce the number of mosquitoes in areas outdoors where you work or play, by draining sources of standing water.

“For unknown reasons, Nebraska has been at the center of the West Nile virus epidemic in the United States. On a per capita basis, we are near the top of the list of involved states,” Dr. Rupp said.

So far in 2007, The Nebraska Department of Health and Human Services reports that there have been 14 human cases in 12 different counties in the state. In 2006, there were 311 reported human cases of the virus and two deaths.

Adults diagnosed with West Nile virus from 2002 until present date may be eligible to join the research effort. Participation involves testing of blood and saliva, a brief medical interview and a release of the individual’s previous West Nile Virus testing results. The blood and saliva samples can be collected through a home medical visit for those participants who live outside the Omaha-metro area.

For enrollment information, call The Nebraska Medical Center Clinical Trials Office at 552-2254 or toll free 1-800-763-6858.

The study is scheduled to conclude in the Fall of 2008.