West Nile Virus
West Nile virus (WNV) is a neurotropic human pathogen that is the causative agent of West Nile fever and encephalitis. The virus, first isolated from the blood of a woman in the West Nile district of Uganda in1937, historically has been endemic to Africa, Western Asia, and the Middle East. WNV was introduced into the Western Hemisphere during the late summer of 1999, when infected individuals were diagnosed in New York State. West Nile virus, a single-stranded RNA flavi virus and member of the Japanese encephalitis virus antigenic complex was first isolated in 1937 in the West Nile province of Uganda from the blood of a febrile woman.
West Nile Virus (WNV) has three different effects on humans.
The first is an asymptomatic infection;
The second is a mild febrile syndrome termed West Nile Fever;
The third is a neuroinvasive disease termed West Nile meningitis orencephalitis.
All infected persons, less than 1% develops West Nile virus neuroinvasive disease (WNND). Although WNND has been reported among all ages, the proportion of persons who progress to WNND is greater among older compared to younger persons.
Based upon a limited number of cases, patients who acquire WNV infection from infected donor organs are likely at a higher risk for severe neurologic disease and death compared with patients infected through the natural route of mosquito bite inoculation. In addition to increased age and organ transplantation, hypertension, cerebrovascular disease, renal disease and diabetes have also been identified as possible risk factors for WNND.
Tests to diagnose West Nile virus include:
Complete blood count (CBC)
Head CT scan
Head MRI scan
Lumbar puncture and cerebrospinal fluid (CSF) testing.
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WNV infection can be prevented by avoiding exposure to infected mosquitoes.
Coordinated mosquito control programs that eliminate mosquito breeding sites, apply larvicides to breeding areas, and spray pesticides targeted at adult mosquitoes can reduce their abundance.
To reduce their exposure to mosquito bites, people should wear insect repellent on skin and clothes and avoid being outdoors during hours of peak feeding by WNV mosquito vectors, usually from dusk to dawn.
Repellents containing N,N-diethyl-m-toluamide have excellent safety records and are effective.
Oil of lemon eucalyptus, soybean oil, and picaridin also appear to provide effective protection.
Permethrin is effective when applied to clothing.
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