Saturday 28 February 2015

Ross River Virus [RRV]

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See also my experience post

Well this is a divergence from my typical posts about technology related matters, mainly because of current personal experience.
I, along with a growing epidemic number of people within Queensland Australia, have contracted Ross River Virus. 






For an otherwise reasonably healthy and active 57 year old, its been absolutely amazing and eye-opening for me to experience the effect one filthy little dirty-mouthed mosquito can cause!
I've heard all the stories about all the diseases that mosquitoes can cause and paid scant attention to the effects of those diseases.
Working in the back yard of a Brisbane suburb I frequently encounter the little blighters nipping me, even through clothing.
Frequently worse in the evenings between dusk and dark but constantly present even in broad daylight, especially round our trees along the back boundary.
While I'm somewhat cautious of redback and other nasty spiders and dress accordingly, gloves; sleeves; etc; I've been bitten by several nameless spiders while pruning trees with one even causing a patch of my skin to ulcerate ... maybe a white-tail?
I contracted an infection in a leg wound which took many months to heal using Saline and Silver Oxide treatments, at one point threatening my leg as the decay could not be arrested.



That was painful and tedious enough, but  this ... one little mosquito bite with almost no outwardly visible symptoms ... staggering ... literally !
  
I took the week off work to prepare for my daughter's 21st at our place. Cleaning the house and yard; Doing some painting; Turning the back yard into a fairy-light 'special place' with 100's of meters of fairy lights networked high above the yard; Trees all lit up; Volley ball and basketball; Air Hockey; Table Tennis; The hired fridges; Food; Drink; It all came together, looked great and we had a fun night.
The first day of leave ... the Monday was the worst day for the mosquitoes. I got bitten quite a few times throughout he day. I also worked later into the dark several nights that week sustaining bites as I tried to get everything ready for the Saturday night party.
The party comes and goes ... its a great success.

3AM Sunday morning we are seeing the last of the guests off and I notice my voice is a little croaky, someone even commented on it. I also quite suddenly felt rather tired and a bit achy in my feet and legs, but hey! I'd been up and down ladders, mowing lawns, pruning trees, clearing rubbish, moving fridges ... more physical work than I do in a normal week ... guess my age was (grudgingly) starting to show.

Later Sunday morning we had to return a trailer-load of borrowed chairs and tables. With my daughter helping, it was none-the-less quite painful for me ... very odd ... and by the time we unloaded them I felt quite exhausted and my legs from knees down were really aching! I began to think I had picked up something from one of the guests as a couple had withdrawn due to illness ... maybe some 'flu-thing' was going round ... but no-one else in the family was unwell - just me.

Monday I need to go back to work. Getting up, showering, getting into and out of the car was actually painful! I knew something wasn't right.
By the time I walked the 1.2km to work from the train station, my knees, lower legs, ankles and even my toes were screaming at me.
As the day wore on the symptoms got worse, not better.
I was also starting to notice my wrists were quite sore and the 1.2km walk back up the hill to the train became an exercise in sheer mental doggedness of just telling myself I had to climb that hill and had to get to the train, so I could get home. I was in a LOT of pain now.
Every time I bent my knees, rolled off my toes, pivoted my knees or ankles or pushed off as I walked, it was like searing pains in all those joints!

I definitely had the 'flu' ... only ... it was different somehow.
Some years back we all came down with a serious case of 'flu' which first trashed the kids then laid my wife and I up in bed for several days, even requiring assistance looking after the (then young) kids.
This was different.

I called in sick on Tuesday and spent the day feeling sorry for myself.
Unusual for me, I slept for much of the day. Normally even when I'm not well I am up and about to some degree, but not this time.

Tuesday evening I did the "Google self diagnosis" ... always a bit risky because its easy to ms-diagnose, but one of the things which struck me was the similarity to symptoms described for Ross River Fever, also known as Ross River Virus or RRV.
I began thinking about all those bites I had throughout the week leading to the party.

Monday and Tuesday were my worst days initially, I really should NOT have gone to work Monday ... in hindsight.

Wednesday I called our local medical center to see if I could get a Dr's appointment to assess what was going on.
My own GP, a very 'wise' woman, similar to my own age perhaps, was available.
I like her because she does not just 'jump to conclusions. She is thorough, checking facts before prescribing medication. She prefers natural remedies wherever possible but does not hesitate to prescribe when she feels there is sufficient evidence.

She comments how well I was looking and what was I there for.
I run through the symptoms with her, not mentioning my now growing suspicion that Ross River might be involved.
She questions me and does her observational examination and toward the end asks if I noticed if I'd been bitten by anything recently .... da! da!
"Yes" was my answer of course.

She then talked through the details of Ross River Virus noting the slight rash on my arms and the slight possibility of Barmah Forest Virus (BFV)
She pointed out that it has been identified that RRV can be carried by daytime mosquitoes as well as the evening variety previously thought to be the main carriers.
She noted that symptoms can take up to 11~21 days to appear after an infected bite and it can take several weeks for the antibodies to appear in blood tests so it is wise to wait before doing those tests otherwise they can return a negative result.

People recover from RRV - depending on a number of factors as to the speed and totality of recovery.
Typically in healthy people, many of the symptoms will have disappeared after several months, though some severe cases last for a year or more. Symptoms may re-occur from time-to-time.

There is no real treatment for RRV apart from initial rest because of the pain and tiredness, however, as Ross River induces a form of arthritis known as polyarthritis where multiple joints are affected concurrently, lack of activity can worsen the effects, so return to normal activity as soon as possible but "take it easy" because of the pain and tiredness which will be prevalent for some time. "Don't overdo it".

Dr advised that I could take anti-inflammatory medication but that does have digestive side-effects (so I have opted not to use any) and the best bet was the use of something like Paracetamol to lessen the pain. 

Dr also prescribed the rest of the week off and gave me a certificate through to the Friday.
As late as Thursday night I still genuinely thought I would be well enough to go back to work Friday ... but I slept till 11:30 Friday morning ... having slept large portions of Wednesday and Thursday also!
Each day was a little less painful, but with broken nights sleep even come the following Monday I was still in a lot of pain.

The interesting thing for me has been the movement of that pain.
Sometimes worse in wrists, sometimes wrists and knuckles, sometimes just knees and toes, other times knees, toes, ankles and elbows, wrists and knuckles ... you whole body just aches and the joints burn when you use them.
Apparently I've been fortunate because it has not particularly affected my back!
I have a new appreciation for those people who suffer from arthritis!
The weakness of your wrists and fingers to grip and lift things ... most frustrating.

Anyhow ... three weeks on and the end of what has been a "long" week despite the fact I was holed up in a training course for four days of it.
Yesterday was perhaps one of my most pain-filled days apart from that first Monday and Tuesday.
Why? Who knows! It just was.
I slept till midday again today, (Sat) I was just so incredibly tired ... perhaps from the constant pain.

So the purpose for writing this post was to share my experience for anyone else who may be suffering similarly, but also to share findings of my research on managing this disease.

Moderate exercise is better then total rest (as my Dr had suggested)
Avoid alcohol
Selenium is involved in the production of prostaglandins in the body, which regulate inflammation and may reduce inflammation related to arthritis.
Selenium works in close conjunction with vitamin E and can be found in things such as:
  • Brazil nuts, 1 ounce: 543 micrograms
  • Sunflower seeds, ¼ cup: 25 micrograms
  • Egg, 1 large: 16 micrograms
  • Bread, whole wheat, 1 slice: 10 micrograms
Some Articles I found useful include:
Ross_River_disease
Infections_bacterial_and_viral
Ross River Virus Infection - symptoms treatment and prevention
Mosquito Borne Diseases
RRV Fact File
Ross River Joint Pain - explained
huggies.com.au/forum - I just found out I have Ross River Virus