The Frightening Rise Of West Nile Virus

A few weeks ago top US medicine man Anthony Fauci spent a few days in hospital with West Nile virus, saying “by far, this is the worst I’ve ever been with an illness.”

So I looked into West Nile virus and woah, did I find out some things. Not good things.

The first astonishing thing I found out is how quickly this virus has become a serious health threat in many parts of the world, especially Europe and North America, where a little over twenty years ago it didn’t even exist.

The first outbreak in North America happened in New York City in 1999, where the virus, which is spread by the common house mosquito, infected around 8,000 people and killed seven.

This outbreak was in fact the first time the virus had been documented in the entire Western Hemisphere.

A few years before that, the first documented outbreak in Europe had occurred in Romania, where it killed 17 people.

Prior to that, sporadic outbreaks had been documented in the Middle East, Russia, Africa and eastern Europe. Nine different evolutionary lineages of West Nile Virus have been identified, but only two, lineages 1 and 2, cause disease in humans. While in a majority of cases the virus causes a fever and a nasty but self-limiting illness, in a not insignificant number of people the virus invades the brain, triggering swelling, inflammation, and even death. This presentation is known as West Nile Neurological Disease, and is estimated to happen to one in every 140 people infected.

When it emerged in New York in 1999, the high proportion of neurological infections was the clue that doctors were dealing with something serious. Misdiagnosed at first as St. Louis encephalitis virus, a mosquito-borne disease seen occasionally in the southern US, it took over a month before the true cause of illness and death was established.

In the year after the first North America outbreak, the virus spread out into New Jersey and Connecticut. By 2003 it was in the US south, where an outbreak that year in Louisiana had a case fatality rate of 20%, and the following year it was detected on the US west coast. By 2012, just 13 years after its emergence, all 48 continental states and the District of Columbia had reported a locally acquired human case. The virus has seen a similar pace of growth in Canada, where it was first detected in 2001, with human cases subsequently documented in Ontario, Quebec, Manitoba, Saskatchewan, Nova Scotia and British Columbia. In Europe, cases have recently been documented as far north as Germany and the Netherlands.

By 2015, researchers described West Nile virus, due to its rapid spread, as “the most important causative agent of viral encephalitis” in North America and worldwide.

Meaning it took barely 15 years for this virus to go from non-existent in parts of the world to the leading cause of virus-induced brain damage.

It is spreading so rapidly because of interlocked modern phenomena produced by capitalist economic incentives: global heating, climate breakdown and expansion of intensive agriculture. Hotter temperatures in northern regions (and outside the summer months) are expanding the range of the mosquitoes that carry the virus; heat driven drought, which causes birds to congregate more closely together around limited water sources, boosts feeding opportunities for mosquitoes; migratory birds carrying the disease are arriving in the northern hemisphere earlier in the year (and in new places); and industrial agriculture is providing more suitable conditions for its spread. In particular, researchers say the increased number of intensively farmed birds like chickens and geese is creating more hosts for mosquitoes to feed on.

The growth of infections may even be causing a hidden brain damage epidemic. Knowledge of the disease is low among healthcare workers, with a study in Arizona finding that only a minority of people who presented with neurological symptoms consistent with the virus were tested for it. Yet a conservative estimate puts the number of infections in the US, from 1999 to 2016, at 7 million. How many cases of West Nile virus-induced brain damage are being missed?

Perhaps the most concerning thing (in a grim yet informative parallel with SarsCov-2) is that if the virus invades the brain, it leads to a cascade effect that harms your body well beyond the acute phase. Researchers have found that when the virus crosses into the central nervous system (a 1 in 140 occurrence), severe and chronic sequelae results, with up to 40% of survivors failing to return to baseline health years after infection.

You would expect such a serious and growing epidemic to be the focus of pharmaceutical research, but there is no vaccine and there are no therapeutics, because the virus, until the 2000s, had not been a threat in the west. Developing treatments was therefore, in the words of researchers, ‘unlikely to result in cost savings’ compared with the small economic cost it was exacting.

This calculation will almost certainly change, and soon, as the viral burden grows. In the US cases could triple in the next 30 years, with researchers forecasting epidemic outbreaks that will see thousands struck down every year with the serious neurological form of the disease and prolonged sequalae. In Europe, under all climate heating scenarios, the virus becomes a high risk disease across most of the continent (see below graphic). An outbreak in Italy in 2018 recorded a 22% case fatality rate for those who presented with West Nile encephalitis, demonstrating how dangerous this future might be. So far in Europe this season there have been 13 newly-affected areas of the continent.

And all these projections were done pre-covid. We now have a significantly larger global population of people with damaged immune systems from repeat covid infections, and West Nile, like all viruses, hits the immune-compromised harder. It may have been a factor in the seriousness of Fauci’s illness - he was hospitalised with what he said was the non-neurological disease just weeks after his third covid infection.

The story of West Nile virus, from non-existent concern to a major health threat and brain damager, is a story of globalised capitalist growth economics. The WHO said recently that greater awareness would be vital “as globalisation, growing volumes of travel and trade, and weather patterns all mean that vector-borne diseases could spread to countries in Europe which have not seen them before.”

The WHO, like all media coverage of West Nile virus, especially after Fauci’s illness, presented the virus in this way: its growth an inevitability, something to be monitored, to be ‘aware’ of, to be prevented with individual action, repellents and covering exposed skin. There is never any suggestion that we should do anything to address the root causes, ‘the globalisation’ or ‘the growing volumes of travel’ or the global heating, or the intensive agriculture, or the climate breakdown. The rapid growth of the virus is never contextualised, there is never any suggestion that economic structures and capitalist incentives that demand forever growth are the problem. This Washington Post article failed to mention that just a short time ago the virus didn’t even exist in the US, instead emphasizing the ‘good news’ of asymptomatic infections.

As mosquitoes hosting brain invading viruses come to dominate our increasingly unbearable summers, don‘t think of revolution, just wear long sleeves.