JAMESTOWN, N.D.-Dawn Entzminger had been having migraines and nausea almost constantly. Thinking it was "just a headache," she powered through.
"One day was so bad I had to go in," she said.
Entzminger, a Jamestown veterinarian, tested positive for West Nile virus, one of 86 cases in North Dakota through Sept. 4, 2018.
Jenny Galbraith, surveillance epidemiologist at the North Dakota Department of Health, said in all of 2017, the state had 62 cases.
"We're a little bit high, but not ridiculously high yet this year," she said.
As of Aug. 28, she said 24 cases had resulted in hospitalization.
South Dakota State University's Mosquito Information Systems estimated that there had been 123 cases in South Dakota through Sept. 3, far more than 2016. Montana had 19 confirmed human cases of West Nile Virus through Aug. 29, compared to 13 human cases in 2017, One death from West Nile Virus was reported in Yellowstone County in August.
West Nile virus positive cases tend to peak in August in North Dakota, though 2018 cases got an early start in North Dakota, Galbraith said. She said the first case was reported in June.
Humans are not the only species susceptible to West Nile virus; horses and birds also get it. Entzminger said there have been 12 positive tests in dead wild birds and four in horses. A vaccine for horses helps keep the numbers at bay, she said.
Entzminger doesn't know whether horse owners are vaccinating at the same rate they were when West Nile virus first was identified in the area. But she said that is the best way to prevent equine problems.
"It's there, just waiting for you to not vaccinate," she said.
West Nile is preventable, Galbraith said. The Health Department has a list of insect repellents that are recommended, but Galbraith said products containing DEET are the most well-known. Wearing long-sleeved shirts and long pants also can help prevent mosquito bites, as can avoiding being outside at the peak mosquito times of dawn and dusk. Removing standing water to reduce places where mosquitoes can breed also is important, as is keeping grass trimmed around homes.
"You just need to make sure you're taking those precautions to protect yourself. That's what's going to save you from West Nile," she said.
The risk of West Nile Virus lasts until the first hard freeze, which will stop mosquito activity.
Galbraith said most people who get West Nile never will know they have it. About 20 percent of people may have flu-like symptoms, including headaches and chills. A very small number of people-less than 1 percent of those infected-will have severe problems, including very high fevers, disorientation, paralysis, coma or death.
When to seek treatment is up to each person. There is no cure for West Nile virus, but symptoms can be treated.
"If you feel like you can't manage (the symptoms) at home by yourself, really that's when you should be going to the doctor," Galbraith said.
Entzminger has recovered and returned to normal.
"I happen to be healthy and of an age group that doesn't usually have serious symptoms," she said.
She received medication to help her deal with migraines and nausea, as well as muscle relaxants to help with aches. Going in sooner may have helped her find relief for the uncharacteristically regular migraines she experienced.
"It can be a pretty serious thing, so you want to go in. Don't be stubborn like I was," Entzminger said.