Sunday morning reflections

The Midwest loves extremes. Our spring is a quick, cold bucket of water to the face, and the fall a brief but intense set of umber and auburn brush strokes on the landscape. Today is neither of those, but still, hot, and humid enough to make breathing uncomfortable. So I'm looking out the window, rather than sitting outside, and I see something heartening: a crow.

I've noticed---really noticed---the crows and blue jays this year. Several years ago, when I was a young attending physician, the hospital seemed filled with a new ailment. The victims were often elderly, had high fevers, paralysis, confusion; they often died, or were left permanently disabled. There were younger people too, but they usually had a bad headache and a fever which resolved without incident. That's when the crows and jays died.

They died in huge numbers. On a hike with my parents, I found a dead crow lying in the middle of the path, an experience that would be repeated over and over. The bird had succumbed to West Nile Virus, as had a number of my patients.

I haven't seen a serious case of West Nile in years. I've seen suspected mild cases, but I wasn't about to do a spinal tap to find out for sure. And this year, the crows and jays are everywhere. West Nile is probably a regular part of our hot, humid summers, although we don't see the same number of severe cases that we saw in that first year. Still, when the sun sets, and the temperature becomes bearable outside, I am much more aware of each mosquito buzzing around my ankles.

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Are there any studies of how many Americans unknowingly carry antibodies for West Nile and dengue fever? Down here in south Texas, I suspect there have to be a few.

I've really noticed the crows this year, too. The jays didn't seem as affected in my neck of the woods, but I hadn't seen a crow for years. Now I hear them all the time. They are pleasantly annoying.

I live in Oakland county, which, IIRC, was the epicenter of the WN epidemic. My patients weren't at particular risk (obstetrics), unlike the recent H1N1 outbreak, but I did fear for my elderly parents and their friends.

The corvids are starting to come back in New York City as well--jays faster than crows. And little or no serious West Nile here the last couple of years. (I'm guessing there won't be much this year just because it's been so dry, meaning fewer puddles and hence fewer mosquitoes.)