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Ross River Fever - Epidemic Polyarthritis

Immune | November 13, 2017 | Author: Naturopath

Immune

Ross River Fever - Epidemic Polyarthritis

Mosquito bites are itchy, annoying and sometimes they can be completely debilitating...

Infection with Ross River virus isn't fatal, but the symptoms of severe joint pain and fatigue can be serious. The virus is carried and transmitted by mosquitos but is not contagious between humans.

The theory goes that mosquitos pick up the virus from kangaroos, wild rodents and other wildlife that act as natural incubators, before passing it on to humans via mosquito bite. Once the virus has entered the blood stream it immediately travels to skeletal muscles where it multiplies for days before re-invading the blood stream in large numbers. Symptoms then occur as the body tries to fight off the infection. These symptoms are diagnosed as Ross River fever (RRF) [1].

The incubation period takes about 5 – 15 days after the initial mosquito bite, but symptoms can appear earlier or later in some people [1].

While kangaroos don't suffer from symptoms of RRF, most humans do!

Quick Reference:

Symptoms of joint pain, fatigue, fever, headache and nausea can occur after an incubation period of 5 – 15 days. Most people feel better in 7 – 10 days but severe cases can develop into chronic Ross River fever.

Symptoms of Ross River Fever

Symptoms vary in severity depending on health before infection and presence of any other diseases. About 1/3 of people who are infected with Ross River fever will have no symptoms – children are especially likely to have no problem after being bitten by an carrier mosquito. The other two-thirds of people infected with the Ross River virus may experience:

Chronic Ross River FeverFatigue: Fatigue from Ross River fever can feel like extreme tiredness, muscle weakness, and inability to focus. Some people are unable to perform basic daily tasks due to the severity of RRF fatigue.

Joint pain: Up to 95% of people with Ross River fever report severe joint pain and stiffness.

The pain usually affects the fingers, toes, jaw, ankles, wrists, knees, elbows and back and is usually symmetrical – joints on both the left and right sides of the body will be stiff and sore. In some people, the joints can swell up and the pain can be so severe that it is debilitating.

Fever: You would think that all cases of Ross River fever would present with fever, but temperatures over 38.3 °C in adults are seen in only ~50% of patients!

Rash: A distinctive rash often appears on the torso and limbs about 10 days after the onset of joint symptoms. It can last up to 10 days and looks like tiny, red dots in no discernible pattern.

Rare symptoms: Some people with Ross River Fever may experience raised lymph nodes, sore throat, and sinus congestion.  [1][2][3]

Aside from the rash, these symptoms are commonly mistaken for a cold or flu and they tend to run the same course – most people feel better after 7 – 10 days. Some severe cases can last much longer though:

Chronic Ross River Fever

Some people can suffer from chronic Ross River fever and experience symptoms of joint pain, stiffness and general fatigue for months or even years after the initial infection. This can be mistaken for chronic fatigue or fibromyalgia, but RRF is usually verifiable with a series of blood tests.

While joint pain and stiffness can be so severe that it is debilitating, the virus does not cause permanent physical damage to bone or ligaments. 
Complete recovery is possible when infection is eliminated and inflammation is reduced [1]. It can be tricky to find the right treatment to speed up recovery, so speak to your doctor and naturopath if you think you may have chronic Ross River fever.

Ross River Fever Prevention

Some people consider Ross River Fever to be a concern for rural Australians but populated coastal regions are also high-risk areas.

Ross River Fever PreventionRisk of being bitten by a virus-carrying mosquito is particularly high near marshes and lakes but urban stagnant water is hotbed breeding ground for mosquitos too. A 1km radius from bodies of water are the highest risk areas, but this extends out to 2km in some cases [2].

Epidemics occur when there are environmental factors that favour mosquito breeding such as heavy rainfall, especially high tides, floods and warmer temperatures [1].

Mosquitos are most active at dawn and dusk so use extra precautions at this time to avoid being bitten.

Basic mosquito evasion tactics include:

  • Wear long sleeved shirts and pants that are light coloured.
  • Use effective mosquito repellant and apply regularly.
  • Affix fly-screens to your external doors and windows.
  • Regularly wash out and change any containers of stagnant water found around the home to prevent mosquitos breeding; e.g. pet bowls, water holding plants, garden buckets and wheelbarrows. If you have a pond, consider adding some fish to eat any mosquito larvae that may be present.
  • Burn citronella candles and mosquito coils whenever outdoors at dawn or dusk.
  • Boost your health before stepping into mosquito territory so that your immune system has the resources it needs to fight off any potential infection. Vitamin C, vitamin E, zinc and selenium are key virus-fighting nutrients. [1] [2] [4]

Natural Therapies for Ross River Fever

Medications to shorten the duration of Ross River fever are currently being researched [5]. Until then, these natural therapies may provide some relief from the symptoms of Ross River virus infection:

Echinacea  

Echinacea angustifolia is a popular and potent anti-viral herb that is commonly used for symptoms of influenza. With potent anti-viral activity, it could help to combat the Ross River virus and traditional herbalists use it to treat both acute and chronic cases of RRF [8].  The active constituents in Echinacea angustifolia extracts have direct anti-viral activity and have been shown to deactivate viruses – they can also boost the immune system's natural defences against viruses by encouraging the proliferation and action of white blood cells [9]. Supplements are available as capsules, tablets, liquids and teas – take your pick!

St John's Wort

The Ross River virus is an Alpha-virus. There are no known herbal medicines specifically indicated for the treatment of Ross River fever, but Hypericum comes close.

st johnsSt John's Wort is one of the few herbs that have been shown to have potent anti-viral activity specifically against Alpha-viruses [6]. This popular European herb may be able to inactivate Alpha-viruses like the Ross River virus throughout various stages of their life-cycles by attacking its membrane [7]. It is also a potent anti-inflammatory herb and may help to alleviate symptoms of joint pain and headache, as well as providing mitochondrial antioxidant protection that may help to boost energy levels and fight off fatigue [6].

CAUTION: It can be dangerous to use St John's Wort alongside other medications. Speak to your doctor and naturopath before taking St John's Wort.

Zinc

Zinc is an essential mineral and a superstar nutrient when it comes to fighting viruses and strengthening the immune system [10]. Zinc is quickly depleted from our bodies when under stress – like the kind of stress of being infected by a mosquito-borne virus! Boost zinc levels with a therapeutic dose of 60mg - 90mg for 3 weeks and then cut back to a 25mg maintenance dose for another month.

CAUTION: Zinc is great to support the immune system during infection, but long-term use can cause deficiencies in other immune nutrients like copper and iron. Use short-term only or speak to a nutritionist if you suspect you have an on-going zinc deficiency.

Therapeutic Braces & Gloves

Compression, heat and bracing can help to improve the mobility of inflamed arthritic joins and can significantly relieve pain and stiffness. Therapy gloves and braces are used widely in people with rheumatoid arthritis and could help to relieve the inflammation and joint symptoms of Ross River fever [11].

Anti-Inflammatory Diet

For people suffering from chronic Ross River virus infection, symptoms of joint pain, stiffness and fatigue may be significantly relieved by reducing inflammation throughout the body.

Foods to reduce inflammation include fresh fruits and vegetables, healthy fats (e.g. avocados, walnuts and olive oil), and legumes and spices particularly turmeric.

Common inflammatory foods to reduce in the diet include meat, fried foods, artificial sweeteners and processed sweet foods, as well as any foods you may have an allergy or intolerance to (dairy, eggs, and gluten are the most common).

NOTE: Speak to a nutritionist or naturopath before making major changes to your diet to make sure you'll be getting the right nutrients for your particular situation.

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References

[1] Harley, D., et al. (2001) Ross River Virus Transmission, Infection, and Disease: a Cross-Disciplinary Review. Clin Microbiol Rev., 14:4, 909 – 932. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC89008/

[2] Jardine, A., et al. (2015) Proximity to Mosquito Breeding Habitat and Ross River Virus Risk in the Peel Region of Western Australia. Vector Borne Zoonotic Dis., 15:2, 141 – 146. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4340642/

[3] Claffin, S. B. & Webb, C. E. (2015) Ross River Virus: Many Vectors and Unusual Hosts Make for an Unpredictable Pathogen. PLoS Pathog., 11:9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4559463/

[4] Beck, M. A. & Levander, O. A. (2000) Host Nutritional Status and Its Effect on a Viral Pathogen. The Journal of Infectious Diseases, 182, S93 – S96. https://academic.oup.com/jid/article/182/Supplement_1/S93/2191642/Host-Nutritional-Status-and-Its-Effect-on-a-Viral

[5] Small Caps (2017) Paradigm Biopharma to commence Phase 2 Ross River virus trial. https://smallcaps.com.au/paradigm-biopharma-phase-2-ross-river-virus-trial/         

[6] Klemow, K. M., et al. (2011) Medical Attributes of St. John’s Wort (Hypericum perforatum). Herbal Medicine: Biomolecular and Clinical Aspects, 2nd edition. https://www.ncbi.nlm.nih.gov/books/NBK92750/

[7] Birt, D. F., et al. (2009) Hypericum in infection: Identification of anti-viral and anti-inflammatory constituents. Pharm Biol., 47:8, 774 – 782. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2774925/

[8] Bone, K. & Mills, S. (2013) Principles and Practices of Phytotherapy – E-Book: Modern Herbal Medicine. Elsevier Health Sciences. Page 136. https://books.google.com.au/books?id=Ca3QAQAAQBAJ&printsec=frontcover#v=onepage&q&f=false

[9] Hudson, J. & Vimalanathan, S. (2011) Echinacea—A Source of Potent Antivirals for Respiratory Virus Infections. Pharmaceuticals (Basel)., 4:7, 1091 – 2031. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4058675/

[10] Science, M., et al. (2012) Zinc for the treatment of the common cold: a systematic review and meta-analysis of randomized controlled trials. CMAJ, 184:10, E551 – E561. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3394849/

[11] Nasir, S. H., et al. (2014) Therapy gloves for patients with rheumatoid arthritis: a review. Ther Adv Musculoskelet Dis., 6:6, 226 – 237. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4239152/

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