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May 24, 2010

One mosquito bite can change a life - Dallas man's story of survival

Source: SHERRY JACOBSON / The Dallas Morning News

J.Sean Lemoine grew up in the swamps of Louisiana, so he never worried much about mosquito bites.

Until that day last August, when his ankles were being devoured by mosquitoes as he was trying to repair the front porch of his East Dallas home. After a couple seconds of useless swatting, the 37-year-old lawyer dashed inside for a quick spray of bug repellent.

But it was too late. The mosquitoes had done their damage.

Within a few days, Lemoine began feeling the first symptoms of West Nile virus – fever, chills and upset stomach.

No one can say why he went on to develop an extremely rare, life-threatening case.

But the fact that it happened to him, and could happen to someone else this summer, prompted Lemoine to work with county officials and preach the benefits of using insect repellant.

"People need to spray their kids and themselves whenever they're in mosquito-infested areas," he said. "I'm from Louisiana. I've been eaten up by mosquitoes all my life. But when you get this virus, it's a long road back."

Last year, Lemoine gradually lost his ability to walk, talk and even breathe on his own. For six months, he fought for his life in two Dallas hospitals, all because of a little mosquito bite.

"His chance of survival was 14 to 15 percent at one point," recalled his sister, Dr. Tara Lemoine, a pediatric fellow who moved to Dallas from Salt Lake City to oversee his medical care.

"It went from really bad to awful to the worst by the end of October," she recalled of her brother's condition in the first two months. "He couldn't hold a pen or squeeze my finger. I could get more strength out of an infant."

Lemoine was among the rarest of West Nile victims because of his relative youth and the seriousness of his symptoms.

He suffered not only encephalitis, or swelling of the brain, but also respiratory failure that required mechanical ventilation for five months. He also developed poliomyelitis, which attacked his nervous system and caused paralysis.

Such severe West Nile infections usually occur in people over age 50, said Dr. Wendy Chung, chief epidemiologist for Dallas County Health and Human Services.

Her staff has tracked nearly 300 serious West Nile cases in the county since 2002, the year the virus first showed up in Texas.

West Nile, a virus harbored in birds and spread to humans by mosquito bites, made its initial U.S. appearance in the summer of 1999.

It was detected first in dead birds in New York City, but eventually spread to people and moved methodically across the country.

The virus can be carried by more than 65 mosquito species, but the primary spreader is the southern house mosquito, whichfeeds on humans and birds. This breed is active in the summer and fall and tends to stay close to the house.

"It likes a hot, dry climate," said county entomologist Morgan Kohut, who leads a crew of workers that traps and tests mosquitoes for West Nile all summer long.

Since 2002, there have been 13 West Nile-related deaths in Dallas County, 131 in Texas and 1,163 in the U.S., according to government reports.

The virus appeared to peak here in 2006 with 67 severe infections and four deaths countywide. Officials fear that a decline in recent cases might be causing people to ignore the county's warnings about preventing mosquito bites.

"We have to remind people that this is a real threat," said Blanca Cantu, the county's public information officer. "People don't realize how devastating this can be."

But not everybody gets sick. The virus causes no symptoms in about 80 percent of the people who are infected. Another 20 percent suffer only mild symptoms such as a headache or slight fever.

About one in 150 infected people will develop more severe symptoms, including fever, malaise, headache, neck stiffening and altered mental status that send them to the doctor or hospital, Chung said.

"There's still no treatment for West Nile," she said, "which is another reason why prevention is so important."

Last year, Lemoine was among 13 Dallas County residents diagnosed with serious West Nile infections. One person died.

Even though Lemoine was still in a wheelchair and had a breathing tube, he joined a recent news conference to unveil the county's West Nile prevention plan.

He made a convincing spokesman.

Lemoine is still on the road to recovery, guided by six hours of physical, occupational and speech therapy daily at the Baylor Institute for Rehabilitation.

He has relearned the simple tasks of daily living from getting out of bed to taking a shower to dressing himself.

"Sean was so weak when we started working with him that it took two or three people to help him stand up," said Lee McAfee, his occupational therapist.

"Now, he goes from sitting to standing with the help of one person."

Lemoine has been home with his wife, Elizabeth, and their two young children for about three months now.

He's slowly building up strength and stamina to return to his job at Wick, Phillips, Gould and Martin, a Dallas law firm where he is a partner specializing in business litigation.

"My goal is to try a jury trial in 2011," he said.

Until then, he's moving forward slowly and with a new respect for how a mosquito bite can change your life.

"It's a tough little bugger," he said with a laugh. "But I'm an old junkyard dog."