Vampire Diaries

Mosquitoes not only can spoil a fine summer day—they can pose a deadly serious health hazard. Chatham County is in fighting mode.   

Beth Concepción finds out how far Chatham County will go to fend off the bloodsuckers. Photography by Beau Kester

Cora Bett Thomas thought she had the flu—or maybe just a nasty 24-hour virus. Then 24 hours stretched into a couple of days.  Her vision was off and she had “dancing eyes”—pupils that jumped a little from side to side.

“I was weak, clammy, sick to my stomach,” the local real estate icon recalls.  “I didn’t have a clue what it was, but I knew it was something.”

That something turned out to be West Nile virus and it nearly killed her.  Thomas credits Dr. Arun Venkatesan, director of the Johns Hopkins Encephalitis Center, with saving her life.

“Most patients infected with West Nile virus are asymptomatic—that is, they have no symptoms,” says Venkatesan—“Dr. V” to Cora Bett.  “About 20 percent of infected patients develop West Nile fever, characterized by headache, fatigue, muscle aches, swollen lymph nodes and rash.  Less than one percent of patients develop the most feared complication, West Nile encephalitis, and that is what Cora Bett had.”

Encephalitis causes inflammation of the brain, which can lead to convulsions, muscle weakness, vision loss, numbness and paralysis.  What was worse in Cora Bett’s case, her brainstem was involved—the vital area charged with basic human functions like breathing.

“We call it ‘high-rent real estate’ because of all of the important aspects of function that are found in a very small space,” Venkatesan says.

How ironic that a real estate agent’s most important properties would be at risk—and all because of one nasty bite from a tiny winged creature.

Know Your Enemy

Of the approximately 40 different species of mosquitoes that call coastal Georgia home, only one mosquito feeds on both birds and humans, and thus can carry and transmit the West Nile virus.  This is the Southern House Mosquito, known as Culex quinquefasciatus—or “Quinks” to the folks at Chatham County Mosquito Control.  The CCMC is an entire local government department, established in 1957 and devoted to the study and control of the mosquito population that breeds in our salt marshes.

Mosquito Activity Release_71613

 

Summer is the prime season for the Quinks to carry West Nile.  Various kinds of birds, such as crows, blue jays and raptors, can be infected by carrier mosquitoes and become virus reservoirs.  The Quinks prey on those birds as they nest during spring.  Then these mosquitoes become carriers of the virus, sharing it with humans in the summer when people are outside exposing their tasty, sun-kissed skin to the elements.  Bite victims can start showing symptoms anywhere from two days to two weeks after exposure.

Point of No Return

Cora Bett says she must have been bitten while enjoying her Jones Street courtyard sometime in late July or August 2011.  She doesn’t remember the bite.  She does remember feeling “flu-ish” for a little while and then getting weaker, having chills, a fever and being “out of it.”  She remembers friends and work associates calling EMS.  She remembers a stint in St. Joseph’s/Candler and then months in treatment at Johns Hopkins in Baltimore, Md.  And she remembers wondering if she was going to make it. She remembers little else until her doctors managed to pull her back from the brink.

“I’m so lucky to be alive,” she says.

Venkatesan agrees.  “West Nile Virus encephalitis can be such a devastating condition, and can even result in death,” he says.  “When she came to see me, she had just contracted the disease and was severely affected.   I knew that she was a very highly functional, dynamic woman and that the person I was seeing in front of me was far from her usual self.”

Cora Bett couldn’t see.   She couldn’t walk.  She couldn’t talk.  Her body was in danger of shutting down.  This lively woman was bedridden for months.

Fight Against the Bite

According to the Centers for Disease Control and Prevention, more than 30,000 people in the United States have reported getting sick with West Nile virus since 1999.  The virus didn’t make an appearance in Chatham County until four years later when eight people tested positive for the disease, according to the CDC.

The CCMC has changed its mosquito-fighting tactics since that banner year.  Whereas they once used trucks to spray for mosquitoes, they now launch an aerial approach in their trademark low-flying yellow helicopters.  They’ve changed the pesticide they use to better control the Quink.  They’ve focused their efforts on spraying at dusk on targeted days to reach a larger Quink population.

“We used to treat 1,000 acres per hour by truck,” says Scott Yackel, chief pilot. “Now we can treat 9,600 acres in 45 minutes.”

The CCMC now uses a three-pronged approach to track and kill the Quinks.  The first part is surveillance.  The team traps mosquitoes in 24 Gravid traps mostly concentrated in the downtown/Ardsley Park area. They put the traps on dry ice and bring the catch—anywhere from 200-600 of the critters in the summer—to the lab in the nondescript industrial-looking CCMC office off Dean Forest Road. Here, entomologist Laura Peaty spends hours separating out the males one by one.  The males stay close to the breeding area, so that’s a good indication of where they need to treat.  Interestingly enough, only female mosquitoes bite.  They send off the lady Quinks for West Nile testing at the University of Georgia.

The second part of the CCMC approach is aerial control.  Based on what Peaty and the team discover during testing, the CCMC sprays adulticide timed with peak mosquito activity.  Usually this happens twice a week from June through December.

“We’re very target-specific,” says Yackel.  “We’re wasting taxpayer money and product if we’re not.”

The final part of the approach is urban area catch basin (i.e., stormwater drain) treatment.  The CCMC team treats 12,000 catch basins monthly to prevent juvenile Quinks from living to adulthood, thus breaking the cycle.

“Most communities don’t spray until there is a human case,” says entomologist Henry Lewandowski Jr., Ph.D., the director at CCMC.  His team, however, sprays regularly, monitors constantly and increases aerial efforts if the test results come back positive for West Nile.

“It’s very quick, very responsive,” Yackel says.  “We are real-time and in action within 24 hours of reaching a threshold.”

Lewandowski credits the CCMC’s efforts with keeping West Nile instances low.  It was fairly quiet on the virus front in Chatham County from 2003 to 2010.  Then all hell broke loose; 2011 was the perfect storm of dry conditions plus a large number of susceptible birds.  Ten people in the county tested positive for the disease.  Cora Bett Thomas was one of them.

A Medical Miracle

What finally worked for Cora Bett was a special “serum” administered by Venkatesan, along with a “multidisciplinary” approach to treatment that involved a team of neurologists, neurocritical care physicians, infectious disease specialists, laboratory pathologists and rehabilitation specialists.

“We decided that, in addition to supportive treatments, we would treat her with intravenous immunoglobulin,” Venkatesan explains.  “The idea was to use antibodies against West Nile virus proteins to help her recover better and faster.”

These antibodies came from people previously exposed to West Nile.

“If you pool enough antibodies from enough people, you will have a preparation that contains antibodies that may help to fight off the virus,” Venkatesan says.

Cora Bett got better, but her vision and coordination still weren’t back to normal.  She went through more than two months of rehab at the Shepherd Center in Atlanta to help her overcome the effects of the encephalitis.  She still has trouble with her right eye, so her Shepherd therapy continues with visits every couple of months.  Cora Bett said another lingering effect is that she is weaker than she was and sleeps more.

“I feel good and I’m thankful,” she says.  “But it is a long row to hoe.”

She almost lost her life, and almost lost her business.  Agents defected because of the uncertainty surrounding her health.  The bank took over her office property on Oglethorpe Avenue.

Cora Bett is back at work and rebuilding her business, but she has a different perspective on life.

“My youngest daughter said, ‘God looks after you because you wouldn’t have stopped working.  It took West Nile to get you to slow down.’”

Once Bitten, Twice Shy

The new Cora Bett Thomas is, naturally, “petrified” of mosquitos.  She now keeps a can of bug spray next to her bed.  She tells her friends to wear long-sleeved shirts and long pants.  It’s one of her ways of caring for the people who were so crucial to her recovery.

Tears start to well in her eyes as she describes the outpouring of support she received from the community in the form of phone calls, cards and hugs on the street.

“It’s enough to live off of for the rest of your life,” she says, looking away to keep her composure.

“You look at life differently,” she continues. “I want to do those things that are meaningful.  I hope I can be the person I’m supposed to be.”

Meanwhile, the CCMC team is trying to ensure that no one goes through what Cora Bett did.

“Our goal is to prevent the virus from getting to humans,” Yackel says.

Spoken like a true vampire slayer.

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