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It's one of the worst outbreaks of West Nile virus since the mosquito-borne disease arrived in the U.S. back in 1999. According to the Centers for Disease Control and Prevention, more than 1,500 cases have been reported this summer, at least 66 people have died.
As South Dakota Public Broadcasting's Cara Hetland reports, the disease is now spreading well beyond the outbreak's epicenter in Texas.
CARA HETLAND, BYLINE: Amanda Larson runs a home daycare in the small South Dakota town of Volga. The 30-year-old mother of two woke up on a Monday morning with a migraine-like headache. By Tuesday, she developed a fever.
AMANDA LARSON: Just getting a little bug. I'll be fine by tomorrow. And then, August 1st, I woke up and I just - I couldn't get myself out of bed. I had to have a family member help me get me to the emergency room.
HETLAND: Larson spent eight days in the hospital and was diagnosed with West Nile Fever and meningitis. All she remembers from her sickness is the pain.
LARSON: It felt like a migraine times a thousand. I had a hard time, like, if I tried to stand up, having my balance. Lights were too bright. People talking hurt my head. I just was out of it by all the pain of the headache. Just wanted to sleep.
HETLAND: Even sleeping wasn't easy. Dr. Jenifer Hsu is an infectious disease physician at Sanford Health in Sioux Falls. She says for her it's full time West Nile.
DR. JENIFER HSU: We've been seeing a lot of West Nile in our hospitalized patients. We've seen every variety, from patients coming in with just fever and headache to meningitis that resolves relatively quickly, to patients with more severe neurologic disease.
HETLAND: Hsu says after diagnosis, there is only comfort care, fluid and pain meds until the virus runs its course.
So far this year, there are 98 confirmed cases of West Nile in South Dakota. One person has died in the state so far this year. West Nile first arrived in South Dakota 10 years ago. In 2003, there were more than a thousand confirmed cases.
State epidemiologist Lon Kightlinger says the number of cases ebb and flow from year to year. Last year, for example, there were only two confirmed cases.
LONG KIGHTLINGER: Each year recreates itself. It depends on the rain, it depends on the heat, it depends on the birds, it depends on the community mosquito control, it depends on if you have a hot spring or a dry spring. You know, we haven't figured this out yet.
HETLAND: Kightlinger says universities are doing research but there's still a lot of mystery associated with the disease. He says education is key to keeping people healthy. They can wear bug repellent with Deet, avoid the mosquitoes' active time or wear protective clothing if outside at dusk. Communities are also spraying. But because of the economy many mosquito control programs have been cut.
For Amanda Larson, who is still recovering from West Nile, she's being cautious.
LARSON: We're keeping our whole family kind of inside after five, six o'clock just to be safe; until I'm back to being totally healthy.
HETLAND: Larson says she's been home from the hospital for about three weeks. She's still tired and fatigued and often needs a nap after doing simple chores. She's not able to work. Several small children held a lemonade stand, raising more than a thousand dollars for her bills and living expenses. She says the community support is making her recovery easier.
For NPR News, I'm Cara Hetland in Sioux Falls. Transcript provided by NPR, Copyright NPR.
