West Nile virus neuroinvasive disease: neurological manifestations and prospective longitudinal outcomes

West Nile virus (WNV) is a widely distributed enveloped flavivirus transmitted by mosquitoes, which main hosts are birds. The virus sporadically infects equids and humans with serious economic and health consequences, as infected individuals can develop a severe neuroinvasive disease that can even lead to death. Nowadays, no WNV-specific therapy is available and vaccines are only licensed for use in horses but not for humans. While several methodologies for WNV vaccine development have been successfully applied and have contributed to significantly reducing its incidence in horses in the US, none have progressed to phase III clinical trials in humans. This review addresses the status of WNV vaccines for horses, birds, and humans, summarizing and discussing the challenges they face for their clinical advance and their introduction to the market.

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Pediatric West Nile Virus-Associated Neuroinvasive Disease: A Review of the Literature

Pediatric Neurology ◽

10.1016/j.pediatrneurol.2018.07.019 ◽

2019 ◽

Vol 92 ◽

pp. 16-25

Author(s):

Rachelle Herring ◽

Nilesh Desai ◽

Mered Parnes ◽

Imad Jarjour

Keyword(s):

West Nile Virus ◽

Review Of The Literature ◽

West Nile ◽

Neuroinvasive Disease

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Increase in human West Nile and Usutu virus infections, Austria, 2018

Eurosurveillance ◽

10.2807/1560-7917.es.2018.23.43.1800545 ◽

2018 ◽

Vol 23 (43) ◽

Cited By ~ 40

Author(s):

Stephan W. Aberle ◽

Jolanta Kolodziejek ◽

Christof Jungbauer ◽

Karin Stiasny ◽

Judith H. Aberle ◽

...

Keyword(s):

West Nile Virus ◽

Blood Donors ◽

Blood Donation ◽

Virus Infections ◽

West Nile Fever ◽

West Nile ◽

Usutu Virus ◽

Neuroinvasive Disease ◽

Human West Nile Virus ◽

Imported Cases

Between 28 June and 17 September 2018, 27 cases of human West Nile virus infections were recorded in Austria; four cases of West Nile neuroinvasive disease, 11 cases of West Nile fever, six infections detected by blood donation screening and six imported cases. In addition, 18 cases of human Usutu virus infections (all blood donors) were recorded. This is the highest number of annual infections recorded in Austria since the introduction of both viruses.

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149 In an Epidemic of West Nile Virus Infection, Higher Risk of Death and Disability in Patients With West Nile Virus Neuroinvasive Disease Can Be Determined at Emergency Department Presentation

Annals of Emergency Medicine ◽

10.1016/j.annemergmed.2018.08.154 ◽

2018 ◽

Vol 72 (4) ◽

pp. S63

Author(s):

M. Burns ◽

L. Sylwanowicz ◽

S. Costantini ◽

M. Zahn ◽

S. Saadat ◽

...

Keyword(s):

Emergency Department ◽

West Nile Virus ◽

Virus Infection ◽

West Nile Virus Infection ◽

Emergency Department Presentation ◽

West Nile ◽

Risk Of Death ◽

Neuroinvasive Disease

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Human cases of West Nile Virus Infection in north-eastern Italy, 15 June to 15 November 2010

Eurosurveillance ◽

10.2807/ese.16.33.19949-en ◽

2011 ◽

Vol 16 (33) ◽

Author(s):

L Barzon ◽

M Pacenti ◽

R Cusinato ◽

M Cattai ◽

E Franchin ◽

...

Keyword(s):

West Nile Virus ◽

West Nile Virus Infection ◽

West Nile Fever ◽

Antibody Prevalence ◽

Igg Antibody ◽

West Nile ◽

The Third ◽

Neuroinvasive Disease ◽

Northern Areas ◽

North Eastern

In 2010, for the third consecutive year, human cases of West Nile virus (WNV) infection, including three confirmed cases of neuroinvasive disease and three confirmed cases of West Nile fever, were identified in north-eastern Italy. While in 2008 and 2009 all human cases of WNV disease were recorded in the south of the Veneto region, cases of WNV disease in 2010 additionally occurred in two relatively small northern areas of Veneto, located outside those with WNV circulation in the previous years. WNV IgG antibody prevalence in blood donors resident in Veneto was estimated as ranging from 3.2 per 1,000 in areas not affected by cases of WNV disease to 33.3 per 1,000 in a highly affected area of the Rovigo province. No further autochthonous human cases of WNV disease were notified in Italy in 2010. The recurrence of human cases of WNV infection for the third consecutive year strongly suggests WNV has become endemic in north-eastern Italy.

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Genome sequence analysis of the first human West Nile virus isolated in Italy in 2009

Eurosurveillance ◽

10.2807/ese.14.44.19384-en ◽

2009 ◽

Vol 14 (44) ◽

Author(s):

L Barzon ◽

E Franchin ◽

L Squarzon ◽

E Lavezzo ◽

S Toppo ◽

...

Keyword(s):

West Nile Virus ◽

Genome Sequence ◽

Virus Transmission ◽

Whole Genome Sequence ◽

Veneto Region ◽

West Nile ◽

Phylogenetic Relatedness ◽

Neuroinvasive Disease ◽

Human West Nile Virus ◽

First Time

In 2009, six new human cases of West Nile neuroinvasive disease (WNND) were identified in Veneto region, following the six cases already reported in 2008. A human West Nile virus (WNV) isolate was obtained for the first time from an asymptomatic blood donor. Whole genome sequence of the human WNV isolate showed close phylogenetic relatedness to the Italy-1998-WNV strain and to other WNV strains recently isolated in Europe, with the new acquisition of the NS3-Thr249Pro mutation, a trait associated with avian virulence, increased virus transmission, and the occurrence of outbreaks in humans.

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Procalcitonin measurement in West Nile virus neuroinvasive disease: a first case series

Official Journal of the Association of Medical Microbiology and Infectious Disease Canada ◽

10.3138/jammi-2020-0046 ◽

2021 ◽

pp. e20200046

Author(s):

Cheyanne Boehm ◽

Christopher Doig ◽

Justin Z Chen ◽

Wendy I Sligl ◽

Sean M Bagshaw ◽

...

Keyword(s):

West Nile Virus ◽

Antimicrobial Therapy ◽

Critically Ill Patients ◽

Bacterial Infections ◽

Viral Infections ◽

Case Series ◽

West Nile ◽

Neuroinvasive Disease ◽

First Case ◽

Low Serum

West Nile virus neuroinvasive disease (WNV-NID) is challenging to diagnose. Procalcitonin (PCT) is a useful diagnostic test to identify bacterial infections. We present four cases of WNV-NID with serum PCT measurements. Methods: Daily (days 1–7) serum PCT (bioMérieux) was examined for critically ill patients with sepsis enrolled in a provincial sepsis study. Patients with identified WNV-NID are descriptively analyzed in this case series. PCT values of ≥0.5 ng/mL were suggestive of bacterial infection. Results: Four patients with WNV-NID were identified. Those with viral infections alone had consistently low PCT values ranging from 0.09 ng/mL to 0.34 ng/mL. Those with documented bacterial co-infections had initially elevated PCT levels that decreased by more than 50% with antimicrobial therapy. Conclusion: These cases are the first to report serial PCT measurements in confirmed cases of WNV-NID and support a low serum PCT in WNV-NID.

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