Saturday, August 13, 2016

Zika-fied

Slap! My less agile left hand slammed down on the back of my dominant right hand. Lifting my left hand revealed a smudge of flattened black mosquito carcass, as well as a trace of bright red blood that had just been sipped from me. Another one bites the dust—a small victory in the ever-present war against mosquitoes in the tropics! Yet once again, I told myself “I hope that one didn't have Zika.” I resumed my lonely watch for the transport van I would catch as it rolled by my village in the dawn's early hour this past Saturday (the beautiful view from the bus stop is shown below).
By Saturday evening, I wasn't feeling quite right. Dang it! That mosquito may have been the one that finally infects me, I (mistakenly) thought. Just to be safe, I took a couple of the generic acetaminophen tablets issued in our Peace Corps medical kit (shown below). After a rough night's sleep, I woke up on Sunday morning with a low grade fever (99.9 degrees). At that point, I didn't have any rash or other symptoms. I skipped my usual trip to the Catholic church service and took it easy all day. I decided not to mention it to my sister and parents during our weekly video chat, since at that point I really didn't know anything for sure.
Later that day, I noticed a small group of red bumps on my chest area. I prepared an email to the Peace Corps medical officer explaining my situation, and attached a picture of the rash on my chest. The two doctors assigned to the Eastern Caribbean take good care of us! There had been a number of Zika cases in my village over the past several months, including some of my students who live nearby. I was hoping I wasn't the latest casualty in this mosquito war.

The villagers seem relegated to mosquito-borne illnesses. They had already figured out that the symptoms of Zika were a lot milder than the others—with the important exception for the impact it can have on pregnant women. Most of them have had dengue, chikungunya, etc., when those mosquito-borne viruses invaded the island. It is just a fact of life in this part of the world, and they accept it. As Doris Day used to say, “Que Sera Sera, whatever will be, will be!”

I don't mean to imply that the folks here don't care. I wrote a blog story back in February about the concern for Zika. There were various clean-up efforts to minimize breeding areas, and we tried to educate the school children about it. However, once it finally arrived in our village, no one was surprised. About all we can do is hope there are no babies are born with microcephaly.

On Monday morning after reading my message, the Peace Corps medical officer reminded me that the mosquito which bit me on the back of my hand on Saturday could not have given me Zika. The virus doesn't spread that quickly, so if I had Zika, it must have been from an earlier bite. Or perhaps I had something different. I had complained of headaches (which I almost never get), back ache, and pain in my neck when turning my head. The back of my eyeballs seemed to be the focus for the headache pain. I assured the doctor, however, that this pain was mild compared to the time two decades ago when I had meningitis. I certainly didn't want to go through that experience again! Spinal taps are not fun!

Since I was not going to teach summer school with a 100.2 fever on Monday morning, I walked to a neighbor's house to give some materials to take to my counterpart teacher at the school. Several members of that family had already been through Zika themselves. As soon as they saw me, they noticed all the red rash that I had not noticed yet. [The red rash definitely is more visible on my white skin than on their dark skin!] It had spread up my neck and was starting to work its way out my arms.

I knew my back had been itching a bit, but I thought it was just from a spot of sunburn I received after I didn't get my back completely covered in sunscreen when I was snorkeling. So I lifted my shirt for them to check it—indeed, it was covered in rash. I took some pictures so I could update the doctor. She told me to keep taking the generic Tylenol and arranged for me to get some testing in the capital city for Friday. However, Zika is so prevalent now that they only test to make sure you don't have dengue fever.

Over the next few days, the rash spread over my body, eventually reaching my hands and later all the way to my feet. Fortunately, I didn't really itch all that much. However, the joint pain increased all over. It wasn't major pain, but any unusual twist of the wrist, or just simple movements such as clenching your fist, let you know that something wasn't right. Heck, even normal walking was different, because your knees, ankles, and toes didn't have their normal flexibility. I hate looking like an old man when I walk!
Fortunately, by Tuesday night, my fever broke. On Wednesday I awoke to find the red rash was beginning to dissipate, clearing up in the order that it had first appeared (my thigh is shown above). The worse part of the symptoms was behind me, although it was going to take awhile before all traces of this illness are gone. The final area with the red spots is my feet (shown below).
Perhaps the worst part is that I hate becoming one of the victims. I tried to take precautions, but now the virus resides in my blood. I can only hope that some future mosquito which bites me (which is virtually inevitable down here, despite prevention efforts) doesn't pass it on to a pregnant woman. I am just one of many in my village who got Zika, so it hardly matters whether it comes from me or someone else. However, I will do all I can to reduce the chance of that happening. For now, I am spending much more time inside my cottage. Plus, I will continue to use mosquito repellent when I am out, burn mosquito coils on my porch, and sleep under my mosquito net, as described in my earlier Zika story linked above.

I am not the first Peace Corps Volunteer to get Zika. I'm not sure who was the first, or the exact total, but a number of us on the four islands supported by the Peace Corps have been infected. Here is a blog story written by one of my colleagues on St. Lucia who got it. I'm glad my mother (a former nurse) read his account prior to learning that I had acquired the virus, because it made her less worried about me. By the way, my counterpart teacher came down with it the day after I did. We are convinced we got it from a mosquito at the school.

Of course, this means that I am now a carrier of the Zika virus. I need to return to the USA in October for my daughter's wedding (I'm hoping for an early frost to kill all the mosquitoes before I return). I guess every Peace Corps Volunteers brings home some sort of souvenir from their country of service—my “souvenir” is just a bit more unique than a coffee mug or a t-shirt. Indeed, for the first time in my life, I have a disease that is (at least temporarily) capable of being sexually transmitted (also known as an STD). Fortunately, I've not had a lot of young women throwing themselves at me down here.

The mosquito at the bus stop may not have been the one that gave me Zika, but it did bite me in a spot where I've suffered bites before—the back of my hands. After applying repellent, I always wash my hands, so that I don't end up inadvertently getting the chemicals in my eyes or mouth via my fingers. However, that washes the repellent off my hands, making them vulnerable. It is a difficult balance—how much repellent to use to prevent mosquitoes, without suffering consequences from the harsh chemicals? How much effort should one put into what may eventually be inevitable? Some experts have said the best vaccination against Zika is to get Zika, since it is rather mild compared to other diseases. Now that I've had it, I can say it really doesn't amount to all that much.

I guess that is why the locals, for the most part, just go about their normal routine, and chalk up whatever happens as “Que Sera, Sera.”

2 comments:

  1. Wow, Dave, as usual you are a model citizen.
    The care that it takes to track and prevent the spread of Zika is huge. I'm so glad that you are aware of, and modeling, best practices.
    Hope you feel better soon.

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  2. Stay away from women still of child bearing age!!!! Sorry this happened, but at least it's not gonorrea!! Will kept you in my prayers brother!!Thanks again for your service!!

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