Warning on 'West Nile virus' after Mpox: Transmitted by that species of mosquito...

Prof. Dr. Yavuz noted that cases linked to West Nile virus infection have begun to be reported in the Marmara region, specifically from Bursa and Istanbul, and pointed out that this virus can be fatal in the elderly due to the risk of it settling in the brain. Noting that this infection is currently more important for society than Mpox, Prof. Dr. Yavuz emphasized that efforts to combat mosquitoes will be prioritized through the cooperation of relevant ministries and local governments.

Stating that cases linked to the West Nile virus, which first appeared in our country in 2010 and last caused an outbreak in 2019, have re-emerged in the Marmara region, particularly in areas with many dam lakes and stagnant water, KLİMİK President Prof. Dr. Serap Şimşek Yavuz made statements to DHA.

CASE REPORTS IN ISTANBUL AND BURSA

Prof. Dr. Yavuz pointed out that cases have been reported from provinces such as Bursa and Istanbul, stating that the disease is transmitted to Culex mosquitoes that come into contact with birds carrying the virus, and then from those mosquitoes to humans. Noting that the virus can lead to meningitis by affecting the central nervous system, especially in the elderly population, Prof. Dr. Yavuz stated that the reported cases are severe cases requiring hospitalization.

Prof. Dr. Yavuz said, “80 percent of people experience the disease mildly. However, it can be severe and fatal in the elderly and immunocompromised individuals. With the cooperation of local governments and relevant ministries, we must take more active measures in the fight against mosquitoes, especially in our provinces and districts on the migration routes of birds coming from Africa. This virus, which can breed rapidly in stagnant water, is also found in areas where Culex mosquitoes can multiply quickly. For this reason, it is necessary to spray or drain all kinds of sources that create water accumulation, including closed farms and summer houses, as well as pools, barrels, and inside tires. Personally, measures such as insect repellents or mosquito nets can also be taken.”

'NOT A PREDICTABLE VIRUS'

Prof. Dr. Yavuz said: “Actually, what we need to take more seriously and put more effort into preventing among current infectious problems in our country right now is West Nile fever. We are experiencing more trouble with this in society than with Mpox. An important feature of this virus is that, although it is generally asymptomatic, it can cause a febrile illness in one group of cases, and in another group, it can affect the brain or spinal cord, which we call the central nervous system. That is where it can be a bit fatal. Honestly, it is not a very predictable virus in terms of the peaks it creates. There are more cases in certain periods.

For example, you don't see it at all for years. Then suddenly the number of cases increases. It had its biggest outbreak in Turkey in 2010. It was mostly in the Aegean region. We hadn't seen such an increase since 2019. There is a significant increase in the number of cases right now. The cases are mainly concentrated in the Marmara region. Including Istanbul, Bursa, those regions… We generally see it more in districts that have lakes, dams, and stagnant water sources. The European side is dominant in Istanbul. The patients we see in hospitals are the most severe and rarest forms. Therefore, if you see 10 cases of the most severe form, there could be at least a thousand to 1,500 mild cases.”

WARNING ON ENCEPHALITIS, PARALYSIS, AND PARKINSON'S

Explaining that the disease does not pose a very high risk for children and adults, and that 80 percent of people to whom mosquitoes transmit the virus can go through the disease without even showing symptoms, Prof. Dr. Yavuz emphasized the risk in the elderly and provided the following information: “There is a death risk exceeding 10 percent in the elderly. 80 percent of people who contract the virus have no symptoms at all. Symptoms can appear in 20 percent of those who contract the virus. 90 percent of those who are symptomatic have a febrile illness. There is fever, malaise, and fatigue. When there is a febrile illness in the summer months, it already comes to our mind. Muscle and joint pain, and in some, there may be a rash. That is, there may be a rash, especially in the upper parts of the body. It is actually a disease that passes on its own within a week or 10 days. However, in a 1-2 percent group of those who contract the virus, and in about 10-20 percent of those who show symptoms, an infection affecting the brain or the spinal cord, which we call the medulla spinalis, can develop. That is what we fear.”

Stating that when there is central nervous system involvement, meningitis, encephalitis affecting the brain tissue, and even paralysis can be seen, Prof. Dr. Yavuz said, “Headache, change in consciousness, personality changes, imbalance, slowing of movements, a Parkinson-like condition (because this is a virus that affects the areas that Parkinson's affects), and tremors in the hands can occur. These mosquitoes are mosquitoes that have existed in our country for a long time. It is transmitted through the species we call Culex. Mosquitoes also get this virus from birds. Both Turkey and Istanbul are on bird migration routes. There is a constant entry of birds. Bird entry means that the virus is also entering. Mosquitoes can also transmit this to horses. If you remember, in previous years, it was transmitted to horses in Karacabey and caused deaths. There is no risk of transmission between humans. That is, it does not pass from person to person.”

'THERE IS NO SITUATION TO PANIC'

Noting that the reason why West Nile fever, which is generally like a summer disease, does not appear every summer is related to suitable climate conditions, Prof. Dr. Yavuz continued her words as follows: “There must be mosquitoes for transmission. But specific climate conditions are also required. So, we don't actually have a problem with West Nile fever every summer. Periods when rainfall increases significantly, followed by very hot weather, create ideal conditions. It usually appears in July-August in our country, peaks in August-September, and reaches its highest numbers. Depending on the weather, it is generally expected to end around September-October. But as the weather gets warmer, this period can extend. Apart from us, there is an outbreak in Israel right now. They reported very high numbers; they reported only 164 cases until June, and these are also serious cases, that is, neuroinvasive cases that affect the brain.”

Explaining that there is no vaccine or specific treatment for West Nile fever, Prof. Dr. Yavuz noted that they only try to heal patients in the high-risk group who experience it severely with supportive treatments, and said that PCR tests can be used in the detection of the virus or the body's antibodies against the virus can be checked. Prof. Dr. Yavuz said, “We have these tests in public health center laboratories. Culex species mosquitoes generally do not bite during the day. It is classic, as those in Turkey know very well, they come out at night and bite us at night. They are smaller, and their bites do not have a distinguishing feature from a normal mosquito bite. It is not the case that every mosquito bite will transmit the disease. Because not every mosquito carries it. That is, those mosquitoes that come into contact with birds can take it from the bird and transmit it to humans. There is no situation to panic here, of course. We just need to prioritize the fight against mosquitoes in a rational way.”

'IT CAN MULTIPLY EVEN IN THE SMALLEST CONTAINERS'

Stating that citizens can protect themselves from mosquitoes individually with measures such as mosquito repellent sprays, long-sleeved clothing, mosquito nets, or screens on windows, Prof. Dr. Yavuz pointed out that especially empty summer houses and farmhouses, and even small water containers left on the street whose water is not changed, create ideal areas for mosquitoes to breed rapidly, and concluded her words as follows:

“What is important here is the joint work of all stakeholders. After all, you have no chance of preventing bird migration. If I speak for Istanbul, we actually held a meeting as the KLİMİK association yesterday. There were representatives from all stakeholders there as well. I was very happy to see that a very coordinated and beautiful work is being done right now. Both by the ministry and by provincial and district municipalities. The awareness of the situation is very high. I also want to warn about this issue, it was also voiced in yesterday's meeting, especially in areas around Istanbul such as farms, etc., and in unused houses, there are some private areas that the municipality cannot enter. Pools, water-filled barrels, tires, everything that has water in it, all kinds of water accumulation, mosquitoes can multiply even in the smallest containers you put water in.”