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Mystery Man
When flu-like symptoms appear out of nowhere, it may take detective work to identify possible suspects. In one man's case, no one knew the culprit until his wife recalled that he had recently spent a day on one of his favorite outdoor activities: fly-fishing. John Gray, a retired computer specialist at the Air Force Academy in Colorado Springs , wasn't feeling great in July 2003, but he wasn't going to let a cold or flu keep him from his sprawling family's annual reunion in < Tennessee. Tall and fit, he'd hardly been sick a day in his life. "My husband's full of charm," says his wife, Dorothy, "but he's also bullheaded."Despite John's fever and chills, on July 24 they started the 1,500-mile car trip east. But John felt worse with every passing mile. When they finally found an emergency room, doctors diagnosed an ear infection and prescribed an antibiotic. It all seemed pretty routine, and after a day's rest, the Grays pressed on to John's sister's home in Blountville, Tennessee.
But as more than 100 relatives gathered nearby, John stayed in bed with a high fever, nausea, vomiting and diarrhea. A red rash began spreading over his legs, upper chest and shoulders. He became increasingly disoriented and confused. Alarmed, his older sister, Jean Williams, drove the Grays to Wellmont Holston Valley Medical Center. "He was acting kind of goofy," says Robin Peavler, the emergency room physician who examined John. "His mental train kept going off the tracks." He looked for the usual suspects behind mental confusion, until a spinal tap signaled an infection in the brain or central nervous system. John was admitted to the hospital immediately. "I remember him looking at me and saying, 'I love you,' as if it was going to be the last time," Dorothy says.
Eventually he was diagnosed with encephalitis, an inflammation of the brain. Its cause was a mystery. Because the Grays came from < Colorado, the Tennessee team speculated John might have contracted Rocky Mountain spotted fever, a deadly infectious disease carried by ticks. "His wife tugged at my sleeve, saying, 'It wasn't a tick; it was a mosquito,' "says Rhonda Morgan, a clinical nurse specialist. While fly-fishing a few days before their trip, John had been bitten behind the ear by a mosquito, which he'd killed with a quick slap. "A light bulb went off in my head," recalls Morgan, who suggested a special blood test for West Nile virus, which mosquitoes transfer from infected birds to humans. The disease, once limited to Africa, first appeared in the United States in 1999.
As they waited for results, John's condition deteriorated. As his lungs filled with fluid, he struggled to breathe. A chest x-ray confirmed that he had an often fatal complication called adult respiratory distress syndrome. Unable to breathe on his own, he was put on a ventilator for 11 days. "I couldn't leave him," his wife recalls. Several days later the test results confirmed the first-ever case of West Nile virus in Tennessee. "At that point John was still in dire straits, but at least he wasn't getting worse," says Morgan.
After two weeks in the ICU, he was transferred, first to a less restrictive intensive-care room, next a general medical floor and then a rehabilitation facility. When he finally left the hospital, John had one goal: to return to Colorado. "A lot of people in Colorado got West Nile that summer, and most of the deaths were people over age 65," John observes. "I say I'm an answer to prayers. The congregations of all my brothers' and sisters' churches were praying for me. They're one of the reasons I'm here today."
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