Could this illness be West Nile and what should I do next? Anirudh Rai, MD, Physician at Henry Mayo Newhall Primary Care, walks us through how West Nile virus is transmitted (mosquitoes, sometimes via bird reservoirs), why about 80% of infections are asymptomatic, and which symptoms — fever, malaise, chills, GI upset or blood in stool — suggest you should seek testing. He explains PCR blood testing, current supportive treatments (fluids, nutrition, occasional steroids for inflammation), and who is at higher risk for severe disease (people with weakened immunity, diabetes, high blood pressure, or smokers). Dr. Rai also gives practical prevention advice discussed on the show: eliminate standing water, use repellents and nets, watch for community abatement programs, and maintain overall health to help your immune response. He notes recent attention to rising cases and weather-driven mosquito increases so listeners can better recognize, prevent, and respond to possible West Nile virus exposure.
Selected Podcast
West Nile Virus: Symptoms, Testing, Prevention, and When to Seek Care
Anirudh Rai, MD
Anirudh Rai, MD is a Primary Care Physician at Henry Mayo Newhall Primary Care. He completed a residency in Family Medicine at Saint Joseph Providence Hospital in Eureka, California. He has also done extensive medical research in the treatment of kidney disease and other medical conditions.
West Nile Virus: Symptoms, Testing, Prevention, and When to Seek Care
It's Your Health Radio, a special podcast series presented by Henry Mayo Newhall Hospital. Here's Melanie Cole.
Melanie Cole, MS: Welcome to It's Your Health Radio with Henry Mayo Newhall Hospital. I'm Melanie Cole. And fan favorite, Dr. Anirudh Rai, primary care physician at Henry Mayo Newhall Primary Care is here to tell us about West Nile virus today.
Hi, Dr. Rai. Thank you so much for joining us. Now, West Nile virus, I remember hearing about this many years ago and then kind of not hearing about it so much. What is it?
Anirudh Rai, MD: So, West Nile virus is a well-known virus, particularly in those exotic regions where it's kind of very dampy and mosquitoes love to thrive there. It's usually passed on through mosquitoes. And if I recall, the first time it was actually mentioned in the US was in the East Coast around New York where it was cold and, you know, sometimes the mosquitoes tend to harbor around these kind of wet areas once it gets warmer.
So, West Nile virus is a very potent virus. Unfortunately, there's no vaccine against it. But it is a virus where of 80% of the people who likely have the virus have no symptoms. So, your body can do a good job of preventing it, but the 20% that does have symptoms is quite, quite harsh, and they may end up going to the hospital because of it.
Melanie Cole, MS: So, you mentioned mosquitoes. So, is that how it is transmitted and we're getting it through mosquitoes?
Anirudh Rai, MD: Yeah, the vector is particularly mosquitoes. Sometimes even birds carry because mosquitoes go to birds and back and forth, but particularly it's the mosquitoes. And the reason why it's in the news more often is they're thinking about the weather changes, this whole El Niño scenario where they're thinking it's going to be a lot more wetter. And that's usually the area where mosquitoes thrive, is wet, damp kind of environments, and that's usually where this virus kind of hangs out as well. So, it is something that is carried by mosquitoes majority of the time.
Melanie Cole, MS: So geographically, if people are in colder climates coming up on the winter, this is not going to be such a concern because, you know. But then, in the warmer climates, this can be something that is really of concern all year round.
Anirudh Rai, MD: In a sense, yes. So, that is something, whenever you're traveling in those areas, they would tell you, "Hey, be cautious about these sort of things. Always have some sort of barrier to prevent yourselves from getting mosquito bites." That would be the best way to even prevent yourself from getting it.
Melanie Cole, MS: Are there risk factors, Dr. Rai, for developing severe West Nile virus? I mean, are there like levels of severity, someone who's got a good, robust, healthy immune system maybe would get bit by an infected mosquito but not really suffer too much, whereas somebody who's immunocompromised it would be worse?
Anirudh Rai, MD: Essentially, anyone who is immunocompromised will have more of a robust reaction likely will get the active West Nile virus in their system. Majority of the time, about 80% of the time, people fight it off well. They don't even realize they have it. So, your body, if you have a good immune system, you keep it healthy without any sort of risk factors like diabetes, high blood pressure, things like that, will sometimes lower your immune system, and definitely smoking and anything that will reduce your immune system in any way or fashion will give you a higher risk of having that 20% reaction where your West Nile runs havoc in your system.
Melanie Cole, MS: How do we know? I mean, so what are the symptoms? How would someone know if they have West Nile? Is there a test? You mentioned there's no vaccine. So, is there treatment for this? And what are some of the symptoms that would even alert someone and say, "Okay, this is something different"?
Anirudh Rai, MD: Symptoms are usually pretty nonspecific. You might get what they call malaise, which is general tiredness, fever, chills. They might become more apparent too with GI symptoms, sometimes blood in the stool. But overall, it is a very intense reaction where you most of the time can end up going to the hospital.
Treatment for it is going to be treatment for your body, trying to keep it up. So fluids, trying to make sure it's well-hydrated. Any sometimes steroids can help reduce inflammation because more often than not, our body reacting to the virus will cause your whole body to be inflamed. And it's not the virus doing this, your body's just reacting to it. So, steroids can help, plenty of hydration, making sure have good nutrition. I believe they are testing some new treatments for it. But overall West Nile, given that only 20% of people who've gotten a bit bite get some symptoms, it's not something you see too often here, but we are getting some cases. I think right now they've measured around like, what, 100 cases so far in the US and they're worried about it coming to California and things like that. So, it is something that the symptoms are nonspecific. The test for that is pretty straightforward. We do have PCR, meaning that we could get the blood, run the test and see, okay, do you have this particular virus there? So, we do have a good, robust way of testing for it. But at the same time, you have to have symptoms for it to become apparent that you have it. You can still test positive for the PCR but have no symptoms because you're the 80% that says, "Okay, my body fought it off. We're good to go."
Melanie Cole, MS: Wow. So, that's really interesting. Now, you mentioned barriers. So obviously, we're looking at repellent and layers of clothing. Tell us what are your most recommended barriers, because there's DEET and some people don't like DEET. Tell us, what do we do?
Anirudh Rai, MD: Well, generally, like you mentioned, sprays are a good way to prevent it, but the best way to prevent it is to avoid having standing water. So, avoid even mosquitoes getting in those areas. So anytime in your backyard or front yard, if you see any kind of pools of water, particularly in those times of the season where it's damp and mosquitoes like to go there, it's good to clean them up because it's easy to prevent that even from even occurring.
But if you do have mosquitoes and you can't really figure out where they're coming from, definitely having nets are a good way, making sure you have good sprays to prevent these bites from occurring, at the same time, keeping track of it. And if you can find the source of where these mosquitoes are breeding, taking care of the source is the most ideal way for even preventing this from happening.
Melanie Cole, MS: Yeah, that certainly is true. And some communities have mosquito abatement. So, you know, that can happen in certain communities. But watching out for that standing water is really a great piece of advice. If there was one action that you hope everybody who is watching and listening to this episode would take back with them, what would you like them to know about West Nile virus?
Anirudh Rai, MD: Well, we'll let them know that West Nile is around the corner. It is in areas where mosquitoes are prevalent, and the best way to prevent that is keep your area clean, avoid standing water, as you mentioned, and have good protection during the season where you know mosquitoes will be more prevalent. So, it's important to understand that this virus exists, and it's becoming more apparent in the US even though it has not been for quite some time.
So, getting ready for it is going to be the best way you can prevent it from spreading or even causing some havoc. But rest assured, the best thing you can do is to make sure you're eating healthy, staying healthy, make sure your immune system's healthy, and that could also prevent this West Nile virus from causing havoc in your body. So, it's a lot of overall health as well as taking care of your surroundings.
Melanie Cole, MS: And that seems to be a running theme with you, Dr. Rai, is that when we do keep ourselves healthy, then our immune system will be more robust and help us to fight some of these things off. You give us so much great information, and you're so smart, and you're easy to listen to and talk to. So, thank you so much for always coming on and sharing your expertise and all of this great information with us. And to book an appointment with Dr. Anarudh Rai, you can visit our website at henrymayoprimarycare.com. You can also visit the free Henry Mayo Newhall Hospital online health information library at library.henrymayo.com. I'm Melanie Cole. And that concludes this episode of It's Your Health Radio with Henry Mayo Newhall Hospital. Thank you so much for joining us today.