Mosquito-Borne Chikungunya Virus Invades America

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Soon Judy was running a high fever and feeling nauseous. For the next four days, she barely left the bed. Her ankles were so swollen that it hurt to make contact with the ground, and when she did stand, she often felt as if she were going to lose her balance and fall. But within a week, by the 26th, Judy was feeling slightly better. Her pain was still severe, and she had developed a rash, but she could at least get out of bed and limp around the house.

Then Richard fell ill. Like Judy, he developed a fever in the late afternoon, climbed into bed, and within hours was writhing in pain. His case was much worse. It felt as if someone were squeezing his back, hands, feet, and knees with pliers, or maybe beating on him with a hammer. Richard and his wife were no strangers to tropical diseases, having both previously contracted typhoid fever and amoebic dysentery as they transported boats through the Caribbean. "But this made typhoid fever feel like a light cold," Richard says.

He took Benadryl every four hours -- "You don't notice the pain as much when you're asleep" -- but for the next two weeks, he barely stood up. It hurt too much, and he was too weak. "I had to have somebody help me get out of bed."

Even to walk to the bathroom, Richard was forced to yell for his wife, who herself would then limp over and support him as he leaned against the walls for support. She also had to open the door -- Richard's hands and wrists hurt too much to turn the knob himself.

"Before, the [doctors] would always ask you what kind of pain you're in, from zero to ten," says Richard. "Ten is kill me; I don't want to live... I guess I was up pretty high, about like a six."

Still in agony, the Wittigs, who had contracted both chikungunya and dengue fever, managed to fly back to Florida on June 7. But they still couldn't drive a car, go for a walk with the dog, or enjoy their morning coffee. Richard still couldn't turn a doorknob. "I thought it was going to do us in," says Judy. "You feel so debilitated... like you're never going to get better."

Ten days after the Wittigs arrived home, Florida health officials made an announcement: The country's first two locally acquired cases of chikungunya had been confirmed. The victims were a 41-year-old woman in Miami-Dade County and a 50-year-old man in Palm Beach County. "At this time, there is no broad risk to the health of the public," Dr. Celeste Philip, a Florida deputy secretary for health, said in a telephone news conference from Tallahassee.

Monica Abrams, a 56-year-old small-business owner in St. Lucie County, saw the announcement on the news. That same afternoon, she walked into a local clinic, her lobster-red legs showing below her shorts, and asked for a blood test. "I think I have chikungunya," she says.

She didn't know that a highly efficient virus had been injected into her and was multiplying, traveling through her bloodstream to her liver, muscles, and brain.

Abrams, who asked that her real name and exact location not be used because of privacy concerns, is gregarious and animated, with short ginger hair and a Long Island accent. Less than two weeks before, her summer had been going well. On July 4, she had watched a fireworks show while sitting outside. The next day, a Saturday, she had helped a friend paint the exterior of her house. On Sunday, she had gone for a leisurely ride with her husband on the back of his Harley Road King. She doesn't remember being bitten. She didn't feel a mosquito land on her skin or suck her blood. She didn't know that a highly efficient virus had been injected into her and was multiplying rapidly, traveling through her bloodstream to her liver, muscles, and brain. But a week or so later, Abrams realized something was very wrong.

On July 11, she woke up around 7 a.m., as she always does. When she rolled out of bed and stood, she felt a sharp pain in her left hip. For years, she's had a bad back, and she assumed she must have thrown it out during the night. A bit later in the kitchen, she flipped on the local TV news, made a cup of coffee, and took a seat on a barstool.

A few minutes later, she tried to stand, but when her right foot touched the ground, she felt a shot of searing pain. "It was like I had dislodged a bone," she says. Within a few hours, her right wrist and thumb also ached. She stubbornly tried to walk it off, still thinking she just needed to loosen up her back, but it only got worse. By evening, her right foot and ankle had swollen, and her wrist was sensitive enough that even a faint touch made her wince. Still, Abrams convinced herself she'd be better by morning. "Tomorrow's another day," she thought to herself as she collapsed into bed. "I'll be OK."

The next day was worse. It hurt to stand, walk, or move her arms. The following day was the same. But then the pain disappeared. "Halfway through Monday, it was like a light switch. It was gone."

That afternoon Abrams' 1-year-old granddaughter came over, and the proud grandma bobbed up and down in the pool with the baby, the cool water relaxing her body and lifting her spirits. Then she got out, and Paul, her husband, noticed that her entire body and face were bright red. "When did you get time to get a sunburn?" he joked.

The next few days, the pain was bearable, but the rash remained. For a few days, Monica Abrams wavered about getting her blood tested. She had seen reports in the news about travelers returning with chikungunya, and she knew her joint pain and rash seemed to fit the disease's symptoms. But it still seemed absurd to think she could have contracted it around her suburban home. Then came the announcement of the first locally acquired cases, and Abrams knew she had to go.

"You feel silly, because you know there's only two other people that locally contracted this, none in St. Lucie County. Now you're going to be this crazy 56-year-old lady that thinks [she has] every symptom they put on the news."

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Trevor Bach and Dianna Wray