When Robert Sachs went to Oak Hill Hospital on March 6 with a stiff neck, a fever, aches and shortness of breath, he and his wife, Gina, had no clue just how sick he was.
After a battery of tests, doctors told the couple that Sachs, 49, had been exposed to West Nile virus within the past couple of weeks and his symptoms were classic for the disease, which is spread by mosquitoes and can be fatal in extreme cases.
"We thought flu, really, really bad flu,'' Mrs. Sachs said this week. "When we went in, we were not thinking of West Nile at all.''
If Sachs tested positive for active West Nile virus, he would be the first case of a human contracting West Nile in Hernando County, according to Al Gray, environmental health manager for the Hernando County Health Department.
In the hospital, Sachs tested positive for exposure to the virus at some point in his past. But a second test to confirm that he had an active case came back negative.
Gray likened the results to an array of defenses a body creates when exposed to West Nile. After a time, the defenses that remain are like an occupying army, giving the person some residual ability to fight off future exposures.
Without that response present in the blood test, the agency does not consider the case to be active.
Despite that, doctors were so sure that Sachs had an active case, they took him off antibiotics they had prescribed, which don't help with West Nile, and sent him home, allowing the disease to run its course, Mrs. Sachs said.
"Our paperwork says West Nile,'' Sachs said. "I still have the symptoms of it. I still shake real bad.''
The paperwork from the hospital notes that the infectious disease doctor was consulted. "He advised me that there is not specific treatment for West Nile virus infection other than supportive care,'' a hospital official wrote.
The Health Department has since asked Sachs if it can repeat the blood test to determine if he has an active case and he has agreed. That test is scheduled for today.
"To me, even if there was a possibility that's what he had, they'd better be telling people about it,'' Mrs. Sachs said.
In October, a routine blood screening of sentinel chickens found West Nile virus in mosquitoes north of Cortez Boulevard in the Weeki Wachee area, the Health Department reported.
"That's just where we are,'' Mrs. Sachs noted.
Since the diagnosis, Mrs. Sachs said she and her husband voiced concern about water standing in old tires on a nearby lot. They took their concerns to the county's mosquito control office and, since then, county employees have been to the neighborhood to hang traps and treat standing water.
Birds and other animals in Hernando County have been found with West Nile virus, but never a human, Gray said.
The virus can show a variety of strengths in people ranging from no symptoms at all to severe symptoms including encephalitis. Those with suppressed immune systems are especially at risk. The most severe cases can end in death.
Since there is no treatment, health officials stress that the key to fighting West Nile is to avoid mosquito bites. Last summer, as the county was preparing to slash its budget for mosquito control, the health department brought an expert to warn commissioners about the threat of mosquito-borne diseases.
A person can get West Nile only from the bite of an infected mosquito.
Commissioners considered budget cuts that would have obliterated the sentinel chicken program, some education and outreach and half the mosquito spraying. They ultimately settled on a compromise that kept the chickens and education programs but reduced spraying by one-third.
Those cuts trimmed $94,430 from the budget with $564,295 remaining.
Commissioner Jeff Stabins said that after he learned of Sachs' case, he was concerned about both the past cuts and any that may be anticipated in mosquito control in the coming budget year.
"I think our administrator should do a little investigating into this,'' he said. "Maybe we want to consider restoring the cuts we made. … I sure as hell don't want any of my constituents dying from this horrible disease.''
Mrs. Sachs said she also didn't want to see cuts from a program which is obviously needed. "I think mosquito control is not something they need to be cutting back on right now,'' she said.
She said she and her husband have learned some lessons from their situation. "We never in our lives used bug spray, but we do now,'' she said. She hopes others take heed of the potential danger, too.
"It kind of changes the way you feel about sitting outside,'' she said.
Barbara Behrendt can be reached at firstname.lastname@example.org or (352) 848-1434.