How Is West Nile Virus Infection Managed?
How Is West Nile Virus Infection Managed?
What should a patient do after contracting West Nile virus; what treatment is there, if any; and what is the prognosis?
West Nile virus (WNV) infection is caused by a mosquito-borne flavivirus, which is transmitted to humans through the bite of an infected mosquito, with birds acting as the primary amplification host. WNV is endemic to Israel and parts of Europe and Asia; since 1999, WNV has emerged as an important human and avian disease in the United States.
Following a bite from an infected mosquito, the virus enters the person's bloodstream and may cross the blood-brain barrier in the central nervous system. About 80% of infected people will remain asymptomatic. Following a 3- to 14-day incubation period, the remaining individuals will develop an influenza-like illness, characterized by the sudden onset of fever and/or chills, headache, malaise, and lymphadenopathy. Fewer than 1% of patients will exhibit severe neurologic symptoms, including meningitis, encephalitis, or acute flaccid paralysis, which may lead to permanent impairment. Typically, symptoms of milder WNV infection resolve over several days; however, long-term sequelae, including numerous somatic complaints, tremor, neuropsychological abnormalities, and motor skill deficits, have recently been shown to exist for at least 12 months post-infection.
There is no specific treatment for WNV. Supportive and symptomatic care remains the mainstay of therapy, based on the clinical presentation; this includes ventilatory support and intravenous rehydration fluids. There are case reports noting some success with the use of ribavirin and interferon alfa-2b, corticosteroids, antiepileptics, intravenous immunoglobulin as adjuvant therapy, and/or osmotic agents. Given the lack of definitive therapy for WNV, preventive measures against mosquito bites are encouraged.
What should a patient do after contracting West Nile virus; what treatment is there, if any; and what is the prognosis?
West Nile virus (WNV) infection is caused by a mosquito-borne flavivirus, which is transmitted to humans through the bite of an infected mosquito, with birds acting as the primary amplification host. WNV is endemic to Israel and parts of Europe and Asia; since 1999, WNV has emerged as an important human and avian disease in the United States.
Following a bite from an infected mosquito, the virus enters the person's bloodstream and may cross the blood-brain barrier in the central nervous system. About 80% of infected people will remain asymptomatic. Following a 3- to 14-day incubation period, the remaining individuals will develop an influenza-like illness, characterized by the sudden onset of fever and/or chills, headache, malaise, and lymphadenopathy. Fewer than 1% of patients will exhibit severe neurologic symptoms, including meningitis, encephalitis, or acute flaccid paralysis, which may lead to permanent impairment. Typically, symptoms of milder WNV infection resolve over several days; however, long-term sequelae, including numerous somatic complaints, tremor, neuropsychological abnormalities, and motor skill deficits, have recently been shown to exist for at least 12 months post-infection.
There is no specific treatment for WNV. Supportive and symptomatic care remains the mainstay of therapy, based on the clinical presentation; this includes ventilatory support and intravenous rehydration fluids. There are case reports noting some success with the use of ribavirin and interferon alfa-2b, corticosteroids, antiepileptics, intravenous immunoglobulin as adjuvant therapy, and/or osmotic agents. Given the lack of definitive therapy for WNV, preventive measures against mosquito bites are encouraged.
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