Cases of the mosquito-borne West Nile virus in the United States have become increasingly severe, and the Centers for Disease Control and Prevention says the COVID-19 pandemic is partly to blame.
"Since COVID, we have seen even fewer non-neuroinvasive disease cases reported in proportion to total cases, with usually about 70% of reported cases being classified as neuroinvasive disease," Tom Skinner of the CDC told the Washington Examiner.
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West Nile virus, which is transmitted by mosquitoes, has been documented in the U.S. since 1999, with the highest year on record being 2003 at nearly 10,000 total cases across the country.
Since then, however, the percentage of neuroinvasive cases, the most severe form of the disease, has increased from nearly 201% in 2003 to over 68% so far in 2023.
Many people infected with West Nile do not experience any symptoms, with fever, joint pain, headaches, and long-lasting fatigue being the most common early complications.
Severe symptoms of West Nile, however, affect the central nervous system, which can cause tremors, vision loss, and paralysis. West Nile can also cause encephalitis, or inflammation of the brain, and meningitis, or inflammation of the membranes that protect the spinal cord and the brain.
Although the number of reported cases per year seems to be going on the downhill trend, with only 190 cases so far in 2023 compared to 1,226 in 2022 and 2,911 in 2021, this and the higher percentage of severe case reports may be due to patients only seeking healthcare in dire circumstances.
Skinner attributes the rise in severe case reports to "changes in healthcare seeking behaviors."
"People with mild to moderate symptoms may be delaying or foregoing care [due to the pandemic]," Skinner said. "It is unclear if we will see a shift in these behaviors moving forward now that the pandemic has ended."
Another reason, however, could be in part because of cost.
Although exact amounts vary by state, the national average price without insurance of a visit with an infectious disease expert can cost upwards of $365 per appointment, or $146 with private insurance.
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Gallup's annual healthcare poll found that 38% of the public skipped or delayed seeking medical treatment in 2022, amid the highest inflation rates in 40 years.
Cases of West Nile have been reported in a total of 28 states, with Wisconsin being the most recent state to report a human infection.