“It’s a terrible way to die. I’m sharing this with you because it’s underreported and everyone’s focused on COVID, which I understand. But this is largely preventable,” said Myra Janus, the widow of Lincoln Janus, a 73-year-old retired attorney who was left paralyzed and on a ventilator within a few weeks of being bitten by a mosquito carrying West Nile virus sometime in late August or early September 2021.
Lincoln Janus grew up in Winnetka and graduated from New Trier High School, Harvard College and Chicago-Kent School of Law. Before he retired, he was a labor and regulatory lawyer at AT&T. He and his wife raised their family here and were active in the community.
His rapid decline and eventual death took place within a few short weeks. Lincoln Janus went from being an active Rotarian, devoted husband, father and grandfather, and accomplished athlete who ran nearly every day, to being incapacitated. He died in the first week of October 2021.
In her grief, Myra Janus feels strongly about making the public aware of the dangers of West Nile virus (WNV) and how lethal it can be, especially for older people with certain medical conditions. Her late husband had been treated for Non-Hodgkin lymphoma in his 50s.
Mosquito Abatement District
On July 19, in conjunction with Evanston Lighthouse Rotary Club, where Lincoln Janus served as secretary for three years, Myra remotely introduced Mark Clifton, Executive Director of the North Shore Mosquito Abatement District (NSMAD), to speak about the importance of mosquito abatement and what the public can do to help. The district covers 70 square miles and was established in 1927.
Clifton said the district’s role is to “reduce the risk of disease from mosquito-borne viruses and minimize the negative impact mosquitoes have on the quality of life for communities within the district.“ The staff of NSMAD tests and treats mosquito infestations weekly and shares the information with the public.
West Nile virus by the numbers
The presence of West Nile virus in Illinois was first confirmed in September 2001. The following year, 2002, Illinois registered 884 cases of West Nile virus disease with the Centers for Disease Control and Prevention, the most of any state in the country. Illinois also registered 553 neuroinvasive incidences of disease in 2002, the second highest number. (Michigan had the most, with 557.)
A neuroinvasive disease is one capable of moving from the respiratory system to the central nervous system, a direct pathway to the brain and spinal cord.
It’s not just mosquitoes that carry disease. The CDC also reports that between 2004 and 2016, the number of confirmed cases of diseases stemming from mosquito, tick or flea bites has tripled in the US, in part because there have been nine new germs discovered since 2004 deemed capable of spreading diseases via these insects.
Currently the Illinois Department of Public Health has not documented any cases of West Nile virus this year in humans, but the season is just starting. Reports of the disease typically start showing up in late June or early July, peak in August and September, and decrease steadily as the temperatures decline.
While the overall risk for West Nile virus is low, this year through July 27 there have been 47 confirmed positive batches of mosquitoes out of 900 batches tested within the NSMAD. Fifteen of those positive batches, 32%, were from Evanston.
Evanston area a virus hotspot
In an email with ERT, Clifton referenced data from an article “Surveillance for West Nile virus disease — United States, 2009–2018” published in 2021 in The American Journal of Transplantation. The five authors evaluated data collected between 2009-2018 from the health departments of all 50 states, the District of Columbia and Puerto Rico.
The authors also note that WNV is typically underreported nationally since many cases are asymptomatic or can be treated without going to the hospital. These cases do not affect the brain or spinal cord. Numbers are gathered from blood test results requested by physicians based on patient symptoms and testing of blood donations.
Cases that involve the brain and spinal cord are very serious and typically require hospitalization. In a hospital setting, confirmation of WNV would be reported to state public health departments and the CDC, so these numbers are considered highly credible.
For data collected between 2009-2018, Illinois had the third largest number of cases in the country with 728. Of all the counties in the entire country, Cook County in Illinois had the third highest number of neuroinvasive cases with 432.
Clifton provided additional context about why the Evanston-Skokie area is both a hotspot and a prime breeding ground for hybridized mosquitoes, especially those who have acclimated to feeding on human blood. He wrote, “Chicago (Evanston and Skokie especially) has an extensive subterranean habitat where both sewers and storm drains can be connected together creating nutrient rich, warm places for mosquito reproduction year-round.”
Local sewers and storm drains are a primary focus of NSMAD’s work.
Like a little tiny vampire, a female mosquito needs protein found in blood and water to live and to nourish her eggs. She will typically live for about two to three weeks and reproduce three to five times before dying. Each “raft” of eggs contains 100-300 eggs.
One photo Clifton put on screen (at 16:30 on the video) was of a discarded kiddie pool that had some stagnant water in it. The NSMAD specialists counted 65 egg rafts, which would have resulted in 6,500 to 19,500 mosquitoes within just one week. They estimated anywhere from 260-780 of those mosquitoes could have become infected with West Nile virus.
But this example has a happy ending. The specialists from NSMAD emptied the pool and the egg rafts died without water.
The risk to humans also increases with age; older men are especially vulnerable, for reasons not completely understood. Those with medical conditions such as cancer, hypertension or diabetes or who have received an organ donation are more susceptible and at risk for becoming infected.
The CDC estimates about 80% of people who become infected with West Nile virus do not develop any symptoms. Of those who do become infected, 20% will develop a fever and symptoms such as achiness, headache, vomiting, diarrhea, or rash, which in most cases can be helped by over the counter medications. The vast majority will fully recover, but the recovery period could be lengthy and include prolonged fatigue and weakness.
Less than 1% of those severely infected will be diagnosed with severe illnesses such as encephalitis or meningitis, which affect the central nervous system. In most cases those people will be hospitalized and a very small percentage of those people will die.
West Nile virus is difficult to confirm and requires testing blood serum or cerebrospinal fluid via a spinal tap. Currently there is no cure or vaccine available to treat West Nile virus, which is why increasing public awareness of prevention and reporting of hotspots to NSMAD is so important.
Birds and Bugs
The virus is primarily a bird virus. Infected mosquitoes bite birds. During the summer of 2001, Illinois public health officials confirmed the presence of West Nile virus based on laboratory tests of two dead crows found in Cook County.
Humans are accidental hosts infected by a ‘vector’ like a mosquito or tick. Eliminating areas of stagnant water where mosquitoes gather is an essential part of controlling disease outbreaks.
The public health mnemonic for West Nile virus is “reduce, repel and report.”
- Reduce containers and hotspots where there is stagnant water.
- Repel biting mosquitoes by using an insect repellant recommended by the Environmental Protection Agency, and by wearing long pants and long-sleeved shirts.
- Report stagnant water sitting for longer than a week to the NSMAD.
Dawn and dusk are “prime time” for when mosquitoes are active, so avoid being outside during those times, if possible.
The ATJ article also suggests that public health officials and businesses and organizations that focus on older people develop educational programs for their communities to increase awareness about precautions to take and the risks associated with outdoor activities during dusk and dawn. Make older people in your life aware of proper safeguards.
Look around your property and neighborhood. Kiddie pools, old tires, rain barrels and trees with large holes could all collect stagnant water and be breeding grounds for disease-carrying mosquitoes. The best way to reduce mosquito-borne illnesses is to reduce the number of mosquitoes and mosquito larvae.
Watch the video presentation here. Contact NSMAD at 847-446-9434 to report biting mosquitoes (ext. 1007) or standing water (ext. 1008), or click here to fill out the online service request form. There is no charge for mosquito treatment. It is a public service funded by tax dollars.