NSW Health has confirmed a Corowa local is one of two NSW residents in an intensive care unit battling Japanese encephalitis (JEV) virus- a disease being spread from pigs to humans by the bites of infected mosquitoes.
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The disease, which can cause severe neurological illness in people, is typically only found in far north Queensland, however a wet humid summer brought on by La Nina has created the perfect breeding ground for mosquitos, leading to an increase in diseases not typically seen in the southern part of the country.
JEV was declared an issue of national significance last week with NSW Health warning the public to be vigilant and safeguard themselves against mosquito bites.
Long-time Corowa resident David Kiefel, aged 61, was confirmed as infected with JEV last Friday after falling seriously ill mid-February.
His wife Jacqueline Monk told the Free Press he had been suffering from achy joints and a mild headache from February 16.
“We had those big storms at the end of January. Corowa and particularly the west of Corowa had been badly flooded. David was fine then,” she said.
“I had my horses at a family friend’s place on the northern end of Cemetery Road. All that area was a lake following the storm. Our horses were knee deep in water and so we had to evacuate them.
“I’m not sure when David was bitten but it’s easy to assume that this is when it happened.
“That area of Corowa always floods, even after a normal amount of rain. The channels that service that area have never been adequate. They run from Whitehead Street, down Bullecourt Road, out past the airport and then onto Skehans Lane where they run down to the river. Council hasn’t maintained them for years, so they were full of grass and tree debris.
“The day after the flooding occurred, that part of Corowa had a huge mosquito plague. We’ve always had mosquitos in Corowa, and they do get bad with all the water lying around, but it was just a black cloud out there during that week. There were billions of them.”
Ms Monk, a registered nurse, suspected there was something seriously wrong with her husband.
“I took him to the Corowa Hospital and on Friday night, February 18, he was discharged from the ED,” she said.
“By 3am Saturday he was much, much worse cognitively and physically very weak. I rang the ambulance, and they took him straight to Albury.
“Saturday evening, he was sitting up watching the Winter Olympics and he just dozed off. His breathing wasn’t conducive to life and so he was intubated and taken straight to the ICU.”
Mr Kiefel had multiple tests including lumbar punctures, MRI’s CT scans and blood tests to find out what was going on.
“Because of the outbreak of mosquito viruses, he was put under the care of the infectious team,” Ms Monk said.
“Initial tests suggested it was probable he had a mosquito virus but it takes a long time for antibodies to show up in the blood.”
Ms Monk said her husband was airlifted to the Alfred Hospital in Melbourne on March 1 as they had a greater capacity to care for him.
“Albury were fantastic with their care, and they consulted with the Alfred with the specialists with imaging and testing,” she said.
Ms Monk said she wasn’t sure how Mr Kiefel would be moving forward.
“Being intubated for so long is a problem. If he survives, he’ll need a tracheotomy and he’ll having ongoing neurological and physical problems,” she said.
Ms Monk is now advocating for the JEV vaccine to be made free to at risk communities.
“It’s not on the PBS and it’s quite expensive. We know now that this virus is in our community, and we are going to be at risk until the mozzies disappear,” she said.
Meanwhile Rivalea in Corowa has been confirmed as one of six Riverina farms with piglets infected with JEV. In Victoria, Campaspe and Wangaratta Shires have also had cases.
Several people in NSW and Victoria are also undergoing further testing as more cases of the virus are expected to be confirmed in the coming weeks.
Locally, public health response is underway with Federation Council liasing with NSW Health.
Federation Council Mayor Pat Bourke extended thoughts to the local family affected.
“Council will continue to liaise with health authorities and provide any assistance possible, to support the ongoing management of this new and serious threat to the Federation community,” he said.
“Now is the time for our residents to take health advice, including limiting your exposure to mosquitoes and being even more aware of their increased presence in our community following the recent unprecedented rain events. Council will provide updates on the evolving situation as it becomes available.”
Dr Marianne Gale, NSW Health Acting Chief Health Officer, said the best way to avoid infection is to avoid being bitten by mosquitoes which are most active between dusk and dawn.
“NSW Health is cautioning people undertaking outdoor activities such as camping and fishing to carefully consider their plans. This is especially important for people planning activities near waterways or where mosquitoes are present, particularly the Murray River and its branches,” Dr Gale said.
“People should be particularly vigilant given the recent wet weather conditions, which have led to very high mosquito numbers that may increase further in the coming days and weeks.”
Some simple tips to limit your exposure to mosquitoes include:
Avoid going outdoors during peak mosquito times, especially at dawn and dusk.
Wear long sleeves and pants outdoors (reduce skin exposure). Also wear shoes and socks where possible. There are insecticides (e.g. permethrin) available for treating clothing for those spending extended periods outdoors.
Apply repellent to all areas of exposed skin, especially those that contain DEET, picaridin, or oil of lemon eucalyptus which are the most effective against mosquitoes. The strength of a repellent determines the duration of protection with the higher concentrations providing longer periods of protection. Always check the label for reapplication times.
Reapply repellent after swimming. The duration of protection from repellent is also reduced with perspiration, such as during strenuous activity or hot weather so it may need to be reapplied more frequently.
Apply the sunscreen first and then apply the repellent. Be aware that DEET-containing repellents may decrease the sun protection factor (SPF) of sunscreens so you may need to re-apply the sunscreen more frequently.
For children in particular - most skin repellents are safe for use on children aged 3 months and older when used according to directions, although some formulations are only recommended for children aged 12 months and older - always check the product. Infants aged less than 3 months can be protected from mosquitoes by using an infant carrier draped with mosquito netting that is secured along the edges.
Be aware of the peak risk times for mosquito bites. Avoid the outdoors or take preventive actions (such as appropriate clothing and skin repellent) between dawn and dusk when most mosquitoes become active, especially close to wetland and bushland areas.
If camping, ensure the tent has fly screens to prevent mosquitoes entering.
Mosquito coils and other devices that release insecticides can assist reducing mosquito bites but should be used in combination with topical insect repellents.
Reduce all water holding containers around the home where mosquitoes could breed. Mosquitoes only need a small amount of liquid to breed.
For further information on Japanese Encephalitis and other mosquito-borne viruses visit health.nsw.gov.au/environment/pests/vector/Pages/factsheets.aspx (NSW) or health.vic.gov.au/health-advisories/japanese-encephalitis-virus-detected-in-victoria (VIC).