Persistent signs and symptoms of vague viral illness with elevated WNV IgM and IgG.

By Anonymous June 2, 2009 - 10:46am

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I am an Internist in Thornton, Colorado following a 45 years-old HispanicAmerican male who developed fever, headaches, muscle aches, excessive fatigue and a skin rash on his face in August 2006. His West Nile Virus IgM has been positive persistently (6.21 in August 2006; 2.09 in September 2007; 1.58 in September 2008; and 1.76 on 05/18/2009. The corresponding IgG for WNV has also remained elevated.

My 2 questions are as follows:

1. Does persistent elevation of WNV IgM along with WNV IgG mean a "chronic active" infection with the virus - especially since the patient continue to show symptoms and signs?

2. Is there a "quantative cut-off" level of WNV IgM for suggesting that diagnosis?

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Anonymous

Hi -- I contracted WNV in 2002 and as it was my experience that there were (and are) long-term sequelae, I've been following the research. There was a study done in North Dakota which interested me and I was able to contact one of the authors. He responded after a couple of weeks. There is a good chance he will have the answers you need. Information / links below.

The question I was trying to get answered - in order to get insurance coverage for it - was whether or not Provigil was actively being used to manage the fatigue of WNV (as it is used for the fatigue of MS). I didn't win the insurance battle, but it remains my experience that Provigil did more for the symptoms than anything else. (Persistent fatigue, word-finding difficulty, depression. My migraines also go MUCH worse for about 18 months then began to resolve back to normal). Anyway ... Contact info / links for Dr. Carson:

JournalWatch Abstract: http://infectious-diseases.jwatch.org/cgi/content/full/2006/913/1

Medline Abstract with Dr. Carson's email address at time of publication: http://www.ncbi.nlm.nih.gov/pubmed/16912946?dopt=Abstract

[email protected]

If you have any useful information to pass back, pls post here - am asking to be notified via em when this post is commented on.

GOOD LUCK to you and your patient. Nice to see an internist asking questions about this !!! Wish more would!

June 8, 2009 - 9:18pm

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Alison Beaver

Hi,
I will see if one of our medical experts can answer your question. This site is primarily to provide health information for patients, and is also a place where women can share their medical stories with one another for support, encouragement and information-gathering. We are unable to confirm diagnosis with doctors or other health professionals, and I'm wondering if you have a peer within your field whom you can consult with?

June 2, 2009 - 12:44pm