scholarly journals Three case reports of West Nile virus neuroinvasive disease: lessons from real-life clinical practice

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Camilla Falcinella ◽  
Marina Allegrini ◽  
Lidia Gazzola ◽  
Giovanni Mulè ◽  
Daniele Tomasoni ◽  
...  
Keyword(s):  
West Nile Virus ◽  
Biological Fluids ◽  
Case Reports ◽  
Real Life ◽  
Signs And Symptoms ◽  
West Nile ◽  
Laboratory Findings ◽  
Neuroinvasive Disease ◽  
Transmission Period ◽  
Diagnostic Work

Abstract Background Despite being an uncommon cause of meningoencephalitis, West Nile virus (WNV) recently provoked significant outbreaks throughout Europe. West Nile neuroinvasive disease (WNND) is associated with significant morbidity and mortality in older and compromised individuals, while its diagnosis may be demanding for the clinician. Here discussed are three cases of WNND with a focus on the diagnostic challenges they presented due to atypical clinical presentation and laboratory findings. Case presentation Between July and September 2020 three patients presented to our attention with signs and symptoms compatible with meningoencephalitis. Among routine procedures, they underwent lumbar puncture and imaging. In the absence of microbiological isolates, biological samples were sent for serology and NAATs for WNV. Following diagnosis, the patients gradually recovered and were discharged either home or to rehabilitation facilities. Conclusions The laboratory findings here discussed, in particular CSF parameters, are only partially consistent with those described in the literature, which highlights the need for further research. While serology and NAATs on blood and urine appear the most reliable techniques in the diagnostic work-up of WNND, utility of NAATs on CSF specimens is limited by the kinetics of WNV viremia in biological fluids. This report underlines that WNND should always be included in the differential diagnosis of meningoencephalitis during WNV transmission period.

scholarly journals The Importance of Haematological and Biochemical Findings in Patients with West Nile Virus Neuroinvasive Disease

2016 ◽  
Vol 35 (4) ◽  
pp. 451-457 ◽  
Author(s):  
Aleksandar Urošević ◽  
Olga Dulović ◽  
Branko Milošević ◽  
Nebojša Maksić ◽  
Nataša Popović ◽  
...  
Keyword(s):  
West Nile Virus ◽  
Fatal Outcome ◽  
High Serum ◽  
West Nile ◽  
Muscle Enzymes ◽  
Laboratory Findings ◽  
Infected People ◽  
Neuroinvasive Disease ◽  
Mild Anaemia ◽  
Serum Crp

SummaryBackground:West Nile virus neuroinvasive disease (WNND) occurs in less than 1% of infected people. Leukocytosis with lymphocytopenia, mild anaemia, thrombocytopenia, elevated liver and muscle enzymes and hyponatremia are occasionally present in patients with WNND. Cerebrospinal fluid (CSF) findings resemble other viral neuroinfections. The purpose of this study is to present some of the most important laboratory findings of our patients with WNND and to evaluate their correlation with fatal outcome.Methods:The study included 161 patients with WNND. Their blood and CSF samples were cytobiochemically analysed and the obtained variables were then tested for predictive significance of the disease outcome, or used for differentiation between two clinical syndromes (encephalitis vs meningitis).Results:West Nile encephalitis was present in 127 (78.9%) patients and West Nile meningitis was diagnosed in 34 (21.1%) cases. Leukocytosis was found in 45.9% patients. CRP level higher than 100 mg/L was registered only in those with encephalitis (p=0.020). CSF leukocyte count was 146±171 per microlitre, with slight lymphocytic predominance (mean 52%). Hypoglycorrhachia was registered in 9.3% of our patients with WNND. Twenty-eight (17.4%) patients died and all of them had encephalitis. Independent predictors of fatal outcome in WNND were serum CRP > 100 mg/L (p=0.011) and CSF proteins > 1 g/L (p=0.002).Conclusions:WNND usually affects older males. Prolonged neutrophilic predominance in CSF can occasionally be present, as well as hypoglycorrhachia. Patients with encephalitis, high serum CRP and high CSF protein level have a higher risk of fatal outcome.

Malignant glial neuronal tumors after west nile virus neuroinvasive disease

2018 ◽  
Vol 8 (2) ◽  
Author(s):  
Alyx B Porter ◽  
Akanksha Sharma ◽  
Marie F Grill ◽  
Scott Spritzer ◽  
A Arturo Leis ◽  
...  
Keyword(s):  
West Nile Virus ◽  
West Nile ◽  
Neuroinvasive Disease ◽  
Neuronal Tumors

scholarly journals Animal and Human Vaccines against West Nile Virus

Pathogens ◽  
2020 ◽  
Vol 9 (12) ◽  
pp. 1073
Author(s):  
Juan-Carlos Saiz
Keyword(s):  
Clinical Trials ◽  
West Nile Virus ◽  
Vaccine Development ◽  
Phase Iii ◽  
West Nile ◽  
Specific Therapy ◽  
Phase Iii Clinical Trials ◽  
Neuroinvasive Disease ◽  
The Us ◽  
The Status

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.

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

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

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

2018 ◽  
Vol 23 (43) ◽  
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.

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

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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