Ross River virus

What is Ross River virus and Barmah Forest virus?

Ross River virus and Barmah Forest virus are infections that are spread to humans through mosquito bites.

They cause similar illnesses, including joint inflammation and pain. People of all ages are at risk of developing these infections. Ross River virus is the most common and widespread of mosquito borne diseases that infect humans in Australia. It is also known as epidemic polyarthritis.

Most people recover completely from these viruses, although recovery can take a few weeks to a few months.

What are the symptoms?

The majority of people infected with these viruses have slight or no symptoms. About three out of ten people will develop symptoms which usually appear within three to 21 days after infection and can include:

• a rash on the trunk and limbs. The rash usually consists of small red spots and lasts around seven to ten days. It can occur up to two weeks before or after other symptoms. It may appear similar to rashes associated with other infectious diseases.
• general illness with fever, chills, headaches and tiredness.
• joint pain, stiffness and swelling. It commonly affects the fingers, wrists, ankles and knees, but any joint can be affected. Pain can also be felt in tissues surrounding joints, such as muscles, ligaments and tendons.

What causes it?

You can be infected if you are bitten by a mosquito carrying the virus. It is suspected that mosquitoes pick up the viruses from native animals, most likely kangaroos and wallabies. The viruses occur throughout most regions of Australia. Human infections tend to occur more often in regions with a warm, humid climate that are close to bodies of water where mosquitoes breed. Outbreaks also occur when local conditions of rainfall, tides and temperature result in increased mosquito populations.

How is it diagnosed?

Anyone who develops symptoms of these viruses should see a doctor so that the exact condition can be diagnosed. Your doctor can diagnose Ross River virus or Barmah Forest virus infection from your symptoms and physical examination. A blood test can confirm that there has been recent infection by the virus although it may need to be repeated to be certain. Your doctor may also order blood tests to help rule out other types of arthritis as the symptoms may be similar.

What will happen to me?

Most people recover completely from these viruses, although recovery can take a few weeks to a few months. During this time you may find that your symptoms are worse some days and better other days. You may also need some form of treatment, usually medicines, while symptoms are present to help control joint pain and swelling. For some people, symptoms persist or come and go for a year or more, although this is rare. The viruses do not cause any permanent damage to the joints and your joints will recover fully over time. Once you have had the virus, you are protected from the disease for the rest of your life.

Is there a cure?

There is no known cure for these viral infections. However there are many treatments available to relieve the symptoms and most people will recover with time. Protection against mosquito bites is the best way to avoid infection.

What treatments are there?

Your doctor will tailor your treatment to your symptoms and how severe your condition is. There is no way of predicting exactly which treatment will work best for you. Your doctor may need to trial several different treatments before finding the one that is right for you. Medicines used to treat Ross River virus and Barmah Forest virus include:

• pain relief, using medicines such as paracetamol
• non-steroidal anti-inflammatory drugs (NSAIDs).

What can I do?

1. See your doctor for treatment and advice. Your doctor can help you find the best treatment to manage your symptoms. Your doctor may refer you to a rheumatologist (an arthritis specialist) if your condition is difficult to control. If you have joint pain that continues for several months or starts worsening, ask your doctor to consider referring you to a rheumatologist.
2. Learn about the condition and play an active role in your treatment. Not all information you read or hear about is trustworthy so always talk to your doctor or healthcare team about treatments you are thinking about trying. Reliable sources of further information are also listed in the section below. Self management courses aim to help you develop skills to be actively involved in your healthcare. Contact your local Arthritis Office for details of these courses.
3. Learn ways to manage pain.
4. Live a healthy life. Stay physically active, eat a healthy diet, stop smoking and reduce stress to help your overall health and wellbeing.
5. Acknowledge your feelings and seek support. Your everyday life can be turned upside down by arthritis and it is natural to feel scared, sad, frustrated and angry. Be aware of these feelings and get help if they start affecting your daily life.

Websites:
Australian Rheumatology Association, American College of Rheumatology, Arthritis Foundation (US)