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HWN Suggests

West Nile Virus: An Update with Pearls and Pitfalls

WNV presenting with fever and meningitis, encephalitis, paralysis, or mixed pattern characterizes this subset of patients. Fortunately, less than one percent of patients infected with WNV suffer from neuroinvasive disease. The mortality rate is 10% of those with this disease. The incubation period is up to two weeks. Encephalitis is more common than meningitis in neuroinvasive disease, with symptoms ranging from confusion and headache to coma. Extrapyramidal symptoms such as tremor, clonus, rigidity, and bradykinesia are also common. Acute flaccid paralysis may occur, called West Nile poliomyelitis, with anterior horn cells affected in the spinal cord.

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 Case Report: West Nile Encephalitis

West Nile Virus (WNV) is a member of the Japanese Encephalitis antigenic complex and can lead to a wide range of clinical symptoms, from asymptomatic disease to severe meningitis and encephalitis.

Previously Featured

Management of West Nile Encephalitis: An Uncommon Complication of West Nile Virus

West Nile virus disease (WNVD) is a mosquito-borne disease that affects the meninges and central nervous system, causing West Nile virus (WNV) encephalitis, a debilitating, life-threatening condition, especially in the elderly. While there is a lot of research discussing different aspects of the disease, the treatment is mainly unknown. Diagnosis of WNV encephalitis is based on clinical findings and by detecting immunoglobulin M (IgM) antibodies in serum or cerebrospinal fluid (CSF).

Neurologic Presentation of West Nile Virus: Difficult Diagnosis

West Nile virus infection symptoms can range from mild febrile illness (20%) to severe illness with central nervous system involvement (<1%). Diagnosis is often an after-thought, especially when other viruses (SARS-CoV-2 and Influenza) dominate clinical care.

West Nile encephalitis

This article reviews the recent outbreaks and examines the current methods of diagnosis, treatment, and prevention.

West Nile Encephalitis or Neuro-Invasive Disease (WNV-NID)

West Nile virus (WNV) is a flavivirus belonging taxonomically to the Japanese encephalitis subgroup that includes the serologically closely related Saint Louis Encephalitis (SLE) virus, Japanese Encephalitis virus, Murray Valley encephalitis virus and others. These viruses commonly infect birds in nature. Yellow Fever and Dengue viruses are also in the flavivirus group. Some individuals have severe muscle weakness or complete flaccid paralysis, which is mostly due to axonal degeneration (poliomyelitis) rather than demyelinating syndromes like GuillainBarre syndrome.

West Nile Encephalitis: An Emerging Disease in the United States

The high rates of severe neurologic illness and death among humans, horses, and birds in these outbreaks are unprecedented and unexplained. We review the current status of WNV in the United States.

West Nile Virus and Eastern Equine Encephalitis

Eastern equine encephalitis, also known as “sleeping sickness,” is a potentially fatal disease caused by a virus that attacks the nervous system. Horses, people, birds, and a variety of small mammals can contract this disease from a mosquito bite. EEE is not spread from horse to horse or from horse to humans.

West Nile Virus Demands Vigilance from EPs

West Nile encephalitis (WNE) can be seen alone or in combination with meningeal inflammation. Encephalitis is characterized by alterations of consciousness ranging from mild lethargy to confusion, stupor, or coma. Seizures, personality changes, weakness, tremor, myoclonus, and Parkinsonism have been reported. Clinical evidence includes all of those described for WNM as well as electroencephalography, which may show findings consistent with encephalitis.

West Nile Virus Encephalitis: Recognising and Diagnosing Infection

The major categories of neuroinvasive disease include meningitis, encephalitis, and acute flaccid paralysis, with frequent overlap between these syndromes. Patients who develop encephalitis are typically older than those with meningitis or acute flaccid paralysis, and have a worse prognosis

West Nile virus vaccines – current situation and future directions

Since the (re-)emergence of WNV in the late 1990, substantial research has been invested in the development of vaccines for human and veterinary use. For horses, this was successful, and several equine vaccines have been licensed.14,15 For humans, no vaccine is yet available.

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Wild birds infected with WNE contain high titers of the virus and remain viremic for 1-2 weeks, making them ideal hosts to perpetuate the disease. Mosquitoes transmit WNE from birds to humans. Horses, dogs, and other small animals may harbor WNE after being bitten; however, they are inefficient transmitters because viral titers are relatively low, and WNE viremia is short-lived in these animals.