scholarly journals Case Report: Neurologic Presentation of West Nile Virus: Difficult Diagnosis

2021 ◽  
Vol 9 ◽  
Author(s):  
Eron G. Manusov ◽  
Amalia Mora Campuzano ◽  
Omar Ahmed ◽  
Samantha Macias ◽  
Carolina Gomez de Ziegler ◽  
...  
Keyword(s):  
West Nile Virus ◽  
Mosquito Control ◽  
Central Nervous System Involvement ◽  
Febrile Illness ◽  
West Nile Virus Infection ◽  
Medical Decision ◽  
Virus Infections ◽  
West Nile ◽  
Decision Bias ◽  
Presenting Symptoms

West Nile virus infections have surged across the globe. South Texas, located on the path of bird migration, with Culex quinquefasciatus and other Culex species, and biotic primers that predispose the area to epidemics (floods, amplifying hosts, and lack of mosquito control and prevention) remains a highly endemic area for arbovirus spread. West Nile virus infection ranges from mild febrile illness to severe central nervous system involvement. The purpose of this report is to highlight complex presentations of WNV and how confounding presenting symptoms delay diagnosis. The secondary goal is to describe how pandemics, such as SARS-CoV-2, can overwhelm the system and result in medical decision bias errors.

scholarly journals Emergence of West Nile virus infections in humans in Turkey, 2010 to 2011

2012 ◽  
Vol 17 (21) ◽  
Author(s):  
H Kalaycioglu ◽  
G Korukluoglu ◽  
A Ozkul ◽  
O Oncul ◽  
S Tosun ◽  
...  
Keyword(s):  
West Nile Virus ◽  
Mosquito Control ◽  
Epidemiological Studies ◽  
Control Measures ◽  
Lower Activity ◽  
Virus Infections ◽  
West Nile ◽  
Notifiable Diseases ◽  
Routine Surveillance

In 2010, 47 human cases of West Nile virus (WNV) infection, including 12 laboratory-confirmed and 35 probable cases, were identified in Turkey. These were the first cases detected during routine surveillance. The patients were from 15 provinces, mainly located in the western part of the country. Incidence was 0.19/100,000 with a maximum of 1.39 in Sakarya province. Forty of the total 47 cases showed neuroinvasive manifestation. Median age was 58 years with a range of four to 86. Ten of the patients died. Enhanced surveillance in humans and animals and mosquito control measures were implemented. The WNV infections were included in the national notifiable diseases list as of April 2011. In 2011, three probable and two confirmed cases of WNV infection were diagnosed in provinces where infections had been detected in the previous year, supporting a lower activity than 2010. However, detection of WNV infections in humans in 2010 and 2011 consecutively, may indicate that WNV has become endemic in the western part of Turkey. Field epidemiological studies were undertaken to understand more about the nature of infection in Turkey.

scholarly journals Public Perceptions on Non-Pharmaceutical Interventions for West Nile Virus Infections: A Survey from an Endemic Area in Northern Italy

2021 ◽  
Vol 6 (3) ◽  
pp. 116
Author(s):  
Matteo Riccò ◽  
Simona Peruzzi ◽  
Federica Balzarini
Keyword(s):  
West Nile Virus ◽  
Mosquito Control ◽  
Severe Disease ◽  
Health Belief ◽  
Binary Logistic Regression ◽  
Virus Infections ◽  
West Nile ◽  
Po River ◽  
Control Programs ◽  
Preventive Practices

During the last decade, cases of West Nile Virus (WNV) have occurred in the Emilia Romagna Region (ERR). Even though the notification rates remain relatively low, ranging from 0.06 to 1.83 cases/100,000 inhabitants, the persistent pathogen’s circulation in settings characterized by favorable environmental characteristics suggests that WNV is becoming endemic to the Po River Valley. This study assesses knowledge, attitudes, and preventive practices toward WNV prevention among residents from 10 high-risk municipalities from the provinces of Parma and Reggio Emilia (total population: 82,317 inhabitants, census 2020). A web-based survey, based on the health belief model, was performed during the month of January 2021, with a convenience sampling of 469 participants from a series of closed discussion groups on social media (i.e., 2.1% of the potential responders). A total of 243 participants knew the meaning of WNV: Of them, 61.3% were aware of previous WNV infections in ERR, 76.5% acknowledged WNV infection as a severe one, but only 31.3% expressed any worry about WNV. Our results irregularly report preventive practices, either collective (e.g., draining standing water from items and the environment, 50.7%; spraying pesticides around the home, 33.0%) or individual (e.g., use of skin repellants when going outdoors, 42.6%). In a multivariate analysis, performed through binary logistic regression, participants reporting any worry towards WNV were more likely to characterize WNV as a severe disease (adjusted odds ratio [aOR] = 20.288, 95% confidence interval [CI] = 5.083–80.972). On the contrary, respondents supporting community mosquito control programs were more likely among people working with animals/livestock (aOR = 13.948, 95%CI = 2.793–69.653), and supporting tax exemptions for mosquito control programs (aOR = 4.069, 95%CI 2.098–7.893). In conclusion, our results suggest that future interventions promoting WNV prevention among residents in ERR should focus on perceptions of vulnerability to WNV, emphasizing the benefits of personal protective behaviors.

scholarly journals Case report: probable West Nile virus infection in Germany could be third imported case since 2003

2004 ◽  
Vol 8 (50) ◽  
Author(s):  
E Jensen ◽  
G Pauli
Keyword(s):  
Case Report ◽  
West Nile Virus ◽  
West Nile Virus Infection ◽  
Virus Infections ◽  
West Nile ◽  
Virus Prevalence ◽  
Imported Case ◽  
Imported Cases ◽  
High Virus ◽  
Migrating Birds

Transmission of West Nile virus infections within Germany via bites from mosquitoes that have had contact with migrating birds is thought to be a possibility, although no such transmission has yet been reported. Imported cases are also possible in people returning from areas of high virus prevalence. In

scholarly journals Calgary Experience with West Nile Virus Neurological Syndrome During the Late Summer of 2003

2004 ◽  
Vol 31 (2) ◽  
pp. 194-203 ◽  
Author(s):  
Ana-Luiza Sayao ◽  
Oksana Suchowersky ◽  
Ali Al-Khathaami ◽  
Brian Klassen ◽  
Nili R. Katz ◽  
...  
Keyword(s):  
West Nile Virus ◽  
Marked Improvement ◽  
Late Summer ◽  
West Nile Virus Infection ◽  
Case Review ◽  
West Nile ◽  
Presenting Symptoms ◽  
Interferon Alpha 2B ◽  
Ifn Alpha ◽  
Consultation Services

AbstractBackground:Between August 25 and September 25, 2003 seven patients with West Nile virus neurological manifestations were identified through the hospital neurology consultation services in Calgary, Alberta, Canada. Three of the seven patients were treated with interferon alpha-2b (IFN alpha-2b). In this report we document the clinical characteristics of these seven cases.Methods:Clinical and laboratory information was obtained from a retrospective review of patient hospital and clinic charts. Patients were included if they had serological evidence of West Nile virus infection and had clinical evidence of aseptic meningitis, encephalomyelitis, cerebellar syndrome or motor neuronopathy. Three patients received a treatment course of three million units IFN alpha-2b, administered by subcutaneous injection once per day for 14 days.Results:Four patients had cerebellar signs without change in consciousness, two had both encephalitis and neuromuscular weakness, and one patient had focal lower motor neuron arm weakness. The mean age was 52 (range 24 - 73). All patients had flu-like illness and fever as presenting symptoms and six had severe headaches. Two patients were immunocompromised prior to infection. Two patients with cerebellar signs (one with opsoclonus-myoclonus) improved spontaneously and exhibited only mild residual deficits on discharge. The other two patients with cerebellar findings developed brainstem involvement, one coinciding with and one subsequent to the cerebellar symptoms. Within one week of treatment with IFN alpha-2b these latter two patients showed marked improvement. One patient with encephalitis and neuromuscular weakness, was treated with IFN alpha-2b and subsequently recovered.Interpretation:In this case review of seven patients, multiple neurological symptoms occurred in each patient and the neurological presentation was varied. Four patients had predominant cerebellar findings and one patient had opsoclonus-myoclonus, not previously reported. The marked improvement in three patients who received IFN alpha-2b raises preliminary optimism towards this potential treatment.

scholarly journals Up-to-date knowledge of West Nile virus infection

2009 ◽  
Vol 62 (5-6) ◽  
pp. 231-235
Author(s):  
Ivana Hrnjakovic-Cvjetkovic ◽  
Dejan Cvjetkovic ◽  
Dusan Petric ◽  
Vesna Milosevic ◽  
Vera Jerant-Patic ◽  
...  
Keyword(s):  
West Nile Virus ◽  
Virus Infection ◽  
Mosquito Control ◽  
Virus Disease ◽  
West Nile Virus Infection ◽  
The United States ◽  
Flaccid Paralysis ◽  
Adult Mosquito ◽  
West Nile Fever ◽  
West Nile

Virus West Nile virus is a single-stranded RNA virus of the family Flaviviridae, genus Flavivirus. Epidemiology West Nile virus is maintained in the cycle involving culicine mosquitoes and birds .Humans typically acquire West Nile infection through a bite from infected adult mosquito. Person to person transmission can occur through organ transplantation, blood and blood product transfusions, transplacentally and via brest milk. Human cases of West Nile infections were recorded in Africa, Israel, Russia, India, Pakistan. In Romania in 1996 West Nile fever occurred with hundreds of neurologic cases and 17 fatalities. First human cases in the United States were in New York City where 59 persons were infected and had fever, meningitis, encephalitis and flaccid paralysis. Clinical manifestation Most human cases are asymptomatic. The majority of symptomatic patients have a self limited febrile illness. Fatigue, nausea, vomiting, eye pain, headache, myalgias, artralgias, lymphadenopathy and rash are common complaints. Less than 1% of all infected persons develop more severe neurologic illness including meningitis, encefalitis and flaccid paralysis. Laboratory diagnosis Diagnosis of West Nile virus infection is based on serologic testing, isolation of virus from patient samples and detection of viral antigen or viral genom. ELISA test and indirect immunofluorescenceassay are used for detecting IgM and IgG antibodies in serum and cerebrospinal fluid. Treatment In vitro studies have suggested that ribavirin and interferon alfa -2b may be useful in the treatment of West Nile virus disease. Prevention The most important measures are mosquito control program and personal protective measures. .

scholarly journals Clinical Spectrum of West Nile Virus Neuroinvasive Disease

2019 ◽  
Vol 10 (1) ◽  
pp. 43-47 ◽  
Author(s):  
Andrew Yu ◽  
Emily Ferenczi ◽  
Kareem Moussa ◽  
Dean Eliott ◽  
Marcelo Matiello
Keyword(s):  
Risk Factors ◽  
West Nile Virus ◽  
Febrile Illness ◽  
The United States ◽  
Ocular Involvement ◽  
West Nile ◽  
Presenting Symptoms ◽  
Neuroinvasive Disease ◽  
Neurologic Sequelae

West Nile virus (WNV) is the most common arbovirus infection in the United States. The diagnosis requires consideration of not only a broad spectrum of presenting symptoms, ranging from a mild febrile illness to severe encephalitis and acute flaccid paralysis, but also public health risk factors and seasonality. There is no approved targeted therapy for WNV, so treatment relies on supportive care, management of neurologic sequelae and airway, treatment of other systems including the eye, and aggressive rehabilitation. Here, we describe a series of 3 cases of WNV encountered in September 2018 at one institution. First, we describe a case of WNV encephalitis with worsened dyskinesias and a relatively good recovery. Second, we describe a severe WNV encephalitis with overlying motor neuron involvement with a poor outcome. Finally, we describe a case of a WNV meningitis with significant bilateral chorioretinitis, an underappreciated complication of WNV infections. Through these cases, we review the epidemiology of WNV, risk factors for infection, the neurologic sequalae and long-term outcomes, and the importance of recognizing ocular involvement to prevent ophthalmologic complications.

scholarly journals Ongoing outbreak of West Nile virus infections in humans in Greece, July – August 2010

2010 ◽  
Vol 15 (34) ◽  
Author(s):  
A Papa ◽  
K Danis ◽  
A Baka ◽  
A Bakas ◽  
G Dougas ◽  
...  
Keyword(s):  
West Nile Virus ◽  
Aseptic Meningitis ◽  
Mosquito Control ◽  
Control Measures ◽  
Virus Infections ◽  
Northern Greece ◽  
West Nile ◽  
Neuroinvasive Disease ◽  
First Time

Between early July and 22 August 2010, 81 cases of West Nile neuroinvasive disease were reported in the region of Central Macedonia, northern Greece. The median age of cases was 70 years. Encephalitis, meningoencephalitis or aseptic meningitis occurred mainly in patients aged 50 years or older. This is the first time that West Nile virus (WNV) infection has been documented in humans in Greece. Enhanced surveillance and mosquito control measures have been implemented.

scholarly journals VAMP8 contributes to TRIM6-mediated type-I interferon antiviral response during West Nile virus infection

2018 ◽  
Author(s):  
Colm Atkins ◽  
Sarah van Tol ◽  
Preeti Bharaj ◽  
Ricardo Rajsbaum ◽  
Alexander N. Freiberg
Keyword(s):  
West Nile Virus ◽  
Type I Interferon ◽  
Treatment Options ◽  
A549 Cells ◽  
Febrile Illness ◽  
West Nile Virus Infection ◽  
Antiviral Response ◽  
Type I ◽  
West Nile ◽  
Pre Treatment

ABSTRACTMembers of the tripartite motif (TRIM) family of E3 ubiquitin ligases regulate immune pathways including the antiviral type I interferon (IFN-I) system. Previously, we demonstrated that TRIM6 is involved in IFN-I induction and signaling. In absence of TRIM6 function, optimal IFN-I signaling is reduced, allowing increased replication of interferon-sensitive viruses. Despite numerous mechanisms to restrict vertebrate host’s IFN-I response, West Nile Virus (WNV) replication is sensitive to pre-treatment with IFN-I. However, the regulators and products of the IFN-I pathway important in regulating WNV replications are incompletely defined. Consistent with WNV’s sensitivity to IFN-I, we found that in TRIM6 knockout (TRIM6 KO) A549 cells WNV replication is significantly increased. Additionally, induction of Ifnb mRNA was delayed and the expression of several IFN-stimulated genes (ISGs) was reduced in TRIM6 KO cells. IFNβ pre-treatment was more effective in protecting against subsequent WNV infection in wt cells, indicating that TRIM6 contributes to the establishment of an IFN-induced antiviral response against WNV. Using next generation sequencing, we identified potential factors involved in this TRIM6-mediated antiviral response. One identified gene, VAMP8, is a soluble N-ethylmaleimide-sensitive factor attachment protein receptors (SNARE) in the vesicle-associated membrane protein subfamily. Knockdown of VAMP8 resulted in reduced STAT1 phosphorylation and impaired induction of several ISGs following WNV infection or IFNβ treatment. Therefore, VAMP8 is a novel gene involved in the regulation of IFN-I signaling, and its expression is dependent on TRIM6 function. Overall, these results indicate that TRIM6 contributes to the antiviral response against WNV by regulating the IFN-I system.IMPORTANCEWNV is a mosquito-borne flavivirus that poses threat to human health across large discontinuous areas throughout the world. Infection with WNV results in febrile illness, which can progress to severe neurological disease. Currently, there are no approved treatment options to control WNV infection. Understanding the cellular immune responses that regulate viral replication is important in diversifying the resources available to control WNV. Here we show that the elimination of TRIM6 in human cells results in an increase in WNV replication and alters the expression and function of other components of the IFN-I pathway through VAMP8. Dissecting the interactions between WNV and host defenses both informs basic molecular virology and promotes the development of host- and viral-targeted antiviral strategies.

scholarly journals Autochthonous West Nile virus infection outbreak in humans, Leipzig, Germany, August to September 2020

2020 ◽  
Vol 25 (46) ◽  
Author(s):  
Corinna Pietsch ◽  
Dominik Michalski ◽  
Johannes Münch ◽  
Sirak Petros ◽  
Sandra Bergs ◽  
...  
Keyword(s):  
West Nile Virus ◽  
Close Relationships ◽  
West Nile Virus Infection ◽  
Virus Infections ◽  
West Nile Fever ◽  
West Nile ◽  
Neuroinvasive Disease ◽  
Summer Heat ◽  
Lineage 2 ◽  
Seasonal Circulation

Following a distinct summer heat wave, nine autochthonous cases of West Nile fever and West Nile neuroinvasive disease, including one fatality, were observed in Leipzig, Germany, in August and September 2020. Phylogenetic analysis demonstrated close relationships in viruses from humans, animals and mosquitos in eastern Germany, obtained during the preceding 2 years. The described large cluster of autochthonous West Nile virus infections in Germany indicates endemic seasonal circulation of lineage 2 viruses in the area.

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