A couple of days after returning to Seattle, his mother took him to his primary-care doctor. He tested him for a variety of common infections, including mumps, Lyme disease and, of course, sexually transmitted diseases. Everything came back normal.
What the Right Tests Tell
Three weeks after returning from vacation, mother and son — pale and 15 pounds thinner than he was in June — made their way to see Dr. Chia Wang, an infectious-disease doctor at Virginia Mason Hospital in downtown Seattle.
Wang listened to the strange litany of symptoms that plagued the boy’s summer. Most were gone by now. He had the occasional twinge in his chest, but not the pressure. His appetite was better, and his testicles were back to normal. But he still felt so tired — not as though he hadn’t slept, but as if each part of his body was worn out, the way you feel after going to the gym. Of course, he added, he was still too tired to actually go to the gym.
Wang sent off a few blood tests to see if she could figure out what he had, focusing on infections that he hadn’t been tested for, including the Zika virus, which was first seen in the United States the summer before, and ehrlichia, a tick-borne infection that can cause persistent fevers and is common on the East Coast. Neither was known to cause orchitis.
The Mother Adds a Thought
“Could this be dengue fever?” the mother asked Wang. Dengue is the most rapidly spreading mosquito-borne illness in most parts of the world. It is rare in the United States, because the species of mosquitoes that transmit the virus, Aedes aegypti and Aedes albopictus, don’t thrive here. But the mother had heard there was an outbreak in Hawaii the year before.
The mosquito that carries Zika also carries dengue, so Wang thought it made sense to order both tests. Both viruses cause a febrile illness, with body aches and usually a rash — though in Zika, the symptoms are often less severe. There are no medications for these viral infections, just supportive care. Wang told the boy and his mother that it probably wouldn’t matter which infection he had, because he looked as though he was recovering. And even if it wasn’t a virus but had been a bacterial infection, he had already taken weeks’ worth of the most beneficial antibiotics.