Ross River Virus and Barmah Forest Virus are something that the pretty Kimberley travel brochures usually don't tell you about...
It's not something that should worry you, but I do think you should know about it.
Since I just contracted Ross River disease I figured it's a good time to make this page.
Ross River Virus and Barmah Forest Virus are much the same thing. They are two different nasty viruses, carried and transmitted by mosquitoes in Australia's tropical north, including the Kimberley.
Ross River Virus has spread and is now present in nearly all of Australia. You can also find it in Papua New Guinea, parts of Indonesia, the Solomon Islands and a few other places. Barmah Forest Virus is mostly restricted to Australia's tropical north (although this virus is spreading, too) and it is not as common.
It makes no difference which one gets you. The symptoms and the treatment are exactly the same. So for the rest of the page I'll just talk about Ross River Virus. But what I say applies to both.
The Ross River Virus is named after the Ross River in Townsville, where it was first identified.
Ross River Virus is an arbovirus. That's short for arthropod-borne virus. And let's just say arthropods are bugs, like insects, we don't want to get too scientific here.
The bugs transmitting Ross River Virus (and a few other, less common arboviruses) are female mosquitoes of any mosquito species (we have quite a few...)
The Ross River Virus lives in what is called a reservoir host. The reservoir host for Ross River are marsupials, mostly kangaroos and wallabies. If a mosquito bites an infected wallaby it becomes infected, too, and it can then transmit the disease through a bite to other animals or humans.
Ross River Fever is the most common mosquito borne human disease in Australia, and there are nearly 5000 Ross River Virus infections reported each year.
The only way to get Ross River Fever is from mosquitoes, it is not transmitted from human to human. The biggest chance to contract Ross River disease is during times when mosquitoes are very active, in areas that have a large mosquito population.
Lets' first look at how likely you are to get Ross River Virus.
I live in the Kimberley, in tropical northern Australia, in an area with lots of water and lots of mosquitoes. I very rarely use insect repellent. (I figured, Ross River you get and get over, cancer you have for the rest of your life and that might not be much...)
Every wet season I get bitten by thousands of mosquitoes (over the course of 6 months). And it took me thirteen years to become infected.
So: no need to panic because you hear or see some mosquitoes. On the other hand it theoretically only takes one bite... The less bites you get the better.
If you visit the Kimberley in or shortly after the wet season there will be more mosquitoes and more risk. (My infection occurred in February.)
Now what happens once you have the virus? How dangerous is that?
First of all, not everybody who does get infected develops symptoms. Many people will never know they had it. The older you are, the more likely you are to develop symptoms, children almost never get symptoms.
Even if you do develop symptoms, Ross River is a disease that everybody recovers from eventually. And once you had it you can't get it again. It doesn't cause any complications, and it doesn't do any permanent damage to you. Ross River Virus isn't dangerous, but having it definitely sucks big time. See below.
The first symptoms of Ross River Disease usually appear between three and 21 days after infection. The average is seven to nine days.
Ross River Fever is also known as Epidemic Polyarthritis, because it affects your joints just like arthritis does: swollen, inflamed and very painful jointsare probably the most characteristic symptom of Ross River Disease. This was the symptom that hit me first, only three days after I was bitten. (Of course I can't prove which bite it was, but there haven't been many mozzies around, I remember only one evening when I was badly bitten all over...)
The joints most likely affected are the wrists, hands, ankles and knees. (I can confirm that.)
Apart from that it gives you flu like symptoms (not the coughs and sniffles though): fever, headaches, dizziness, tiredness, generally feeling like crap... I'm sure you know what it's like to have a bad flu.
The flu symptoms appear only at the beginning of the disease, usually only for a few days. Thank god is all I can say... It wasn't nice, I give you the hint.
Another symptom that sometimes occurs, though not always, is a rash. In most cases this is not a very noticeable, angry rash. Just a few dark red dots, slightly raised, so you can feel them too. (I'm kicking myself now that I didn't take a photo.) It looks more like a rubella infection than an allergy. The rash usually appears on the limbs, but it can also spread to the torso.
The rash can appear up to two weeks before or after any other symptoms. I had it all at the same time, and the rash was only on my feet.
So why is Ross River Fever such a big deal, if it's just a flu that you get over?
Well, the problem with Ross River Fever is that although the initial flu symptoms disappear very quickly, many other symptoms can hang around for a long, long time. About half of the people who are affected by the virus will get over it in less than a month. (Which, I think you will agree, is still a long time to get over any infection...)
However, the other half of the people will have symptoms for much longer, on average six months, and it may take up to a year to fully recover! In some cases people struggle for many years.
Especially the joint pains are persistent, and in some people are so severe that they can't work (depending on what job they have). People often struggle with a general feeling of tiredness and fatigue that can be totally debilitating. The pains and fatigue can last for months, and in some cases years.
The other annoying thing about Ross River Virus is that even once you are over it and are perfectly well again, the symptoms can come back. Those recurring symptoms can be triggered by heat, humidity and exhaustion. For many who live here it means that every wet season Ross River revisits. This can go on for quite a few years. As I said, it sucks...
The only way to prevent Ross River Fever is to avoid getting bitten by mosquitoes.
I said I don't use insect repellent. I actually do use natural repellents, but they are not as effective. The reason I don't use other repellents is that for me to avoid all mosquito bites would mean to douse myself in toxic stuff several months of the year every year.
If I was here on a holiday, for only a few weeks, I'd make darn sure I use repellent and don't get bitten. And I always make sure my wet season visitors do the same.
You should also wear light coloured, loose fitting clothes with long sleeves and legs. Use mosquito coils if you sit outside at night and sleep inside a mosquito dome or under a mosquito net when camping.
The only way to be sure that what you have is indeed Ross River Virus is to do a blood test.
Having said that, I think the symptoms are very characteristic. If you've been in an area where Ross River Virus exists and have been bitten by mosquitoes, and all of a sudden you get severe joint pains and feel like s**t, there's a good chance it is Ross River Fever.
On the other hand you may not get all the symptoms, or they may not be very clear. But if you're not feeling too bad anyway it doesn't really matter. You'll likely get over it very quickly.
Go see a doctor to get a blood test and let him/her know what you suspect. And be aware that the doctor can't help you (see below). The test is more for public health reasons, to keep track of the number of infections, and also to rule out that it is something else, more exotic and possibly dangerous.
There is no treatment. No medical treatment, that is. There is no vaccine, and nothing like antibiotics. There are no drugs that kill the virus. However, depending on your symptoms your doctor may be able to suggest medication to help with the pain and inflammation (eg. anti-inflammatories, panadol).
Having said that, it's not like there is nothing you can do. Your immune system has to fight the virus off, and there are ways to support your immune system.
The most important thing to do is rest. Exhaustion compromises the immune system. To ignore this is the biggest mistake Ross River sufferers make. (I'm talking about the people around me that I know.)
Everybody wants to be tough, nobody wants to be sick, so people try to continue working, grit their teeth and try to overcome it that way. Sorry, but that is the worst thing you can do and only prolongs the symptoms.
If you go back to work every time you feel a bit better, you'll just keep getting relapses. You have to rest, totally rest, for as long as it takes, and then a bit more.
Another important thing to mention (though not scientifically proven) is Vitamin C. I know, it sounds like such a boring, standard advice. If you can't think of anything take Vitamin C, it can't hurt. But there is more to it.
I had heard this so many times, so I took it as soon as I felt the first twinges in my joints. (It is a lot easier to beat the virus in the earlier stages than it is once it has become firmly established.)
A few days later I spoke to our pharmacist, probably the person in Kununurra who knows the most about Ross River Virus. Our doctors come and go, but Gareth has been here for many, many years and probably knows every single Ross River case. According to him Vitamin C is the one and only thing that has worked consistently in all these years for most people.
He even told me about a little crisis. There was a shortage of supply and the Kununurra pharmacy ran out of the Vitamin C powder that most people used back then. And all the Ross River sufferers in town got worse...
All I know is that I am doing very well. I was fine after less than a week, which I think is something of a record. I did get symptoms very early, I knew immediately what I was dealing with and started to take Vitamin C straight away. (To be honest, knowing what Ross River Virus can do in a worst case scenario I panicked a bit. I threw everything at it that I could think of. Seems to have worked.) Gareth says a gram a day is probably the minimum for it to be effective. I took (still take at the time of writing) a gram, two or three times a day.
I also upped my fish oil and evening primrose oil intake (from sporadically to actually taking the recommended dose). Those oils contain omega-3 fatty acids, which are known to help the joints and reduce inflammation. They are not only recommended for Ross River Fever but also for arthritis sufferers.
Another tip Gareth gave me is magnesium. Apparently, if Vitamin C doesn't work, some people had success when adding magnesium. It's a good supplement to take anyway in my opinion.
And last but certainly not least: eat healthy. (Big amounts of garlic never hurt. You won't feel like going anywhere so you may as well indulge...) Lots of fresh fruit and vegetables, easily digestible meals, nutrient dense natural foods, low sugar, no alcohol... That's how you support a good immune system in the first place.
And don't think this is just a general wishy washy recommendation! It is amazing how big a difference your nutrition makes when it comes to this particular virus!
Update: Thanks to a reader I have discovered a new weapon in the fight against RR: olive leaf extract! I have yet to come across a Ross River sufferer who did not experience considerable improvement in symptoms with regular olive leaf extract supplementation. Make sure that you get the real stuff, fresh leaf extract, not some reconstituted powder.
I don't want anyone to think Ross River Fever is a big problem or something to worry about, but I wanted you to know that Ross River Virus exists in the Kimberley, so that if the unthinkable occurs you recognise it straight away, can do all the right things, and get well real quick.
PS.: This page is not intended as medical advice. It's a heads up and a sharing of my experiences. Always consult your doctor for medical advice.