West nile feverA92.3

Author:Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Synonym(s)

west nile fever; WN

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HistoryThis section has been translated automatically.

Smithburn et al., 1940

DefinitionThis section has been translated automatically.

Infectious disease transmitted by mosquitoes with the West Nile fever virus (endemic arbovirosis).

PathogenThis section has been translated automatically.

  • West Nile virus, family Flaviviridae, belonging to the arbovirus family.
  • Vectors are Culex, Aedes and Mansonia species. Of particular importance are Culex. pipiens, Culex quinquefasciatus, Culex restuans, Culex salinarius and Culex talsalis.
  • The virus mainly infects birds (ravens, crows, etc.), but they do not become ill; humans, horses and other mammals are also infected.
  • Rarely transmitted during organ transplants.

Occurrence/EpidemiologyThis section has been translated automatically.

  • Spread in Africa, Middle East, Southern Europe, Russia, South India, South East Asia, North America.
  • Severe epidemic in New York in 1999. Since 1999, about 27,000 cases have been reported in the USA (as of 2007), in Canada 4600. The epidemic in the USA in 2002 caused 4008 clinically manifest infections with 263 deaths. During the 2005 epidemic in the USA, 2000 cases of the disease occurred (55 lethal courses).

Clinical featuresThis section has been translated automatically.

  • Incubation period: 3-12 days.
  • General symptoms: fever, headache, muscle and joint pain, nausea, vomiting, diarrhoea, generalized lymphadenitis. Often eye involvement. Rarely, especially in children or immunosuppressed, severe courses of viral meningitis.
  • Integument: In 50% of the cases maculopapular exanthema(mainly extremities and trunk). Occasionally strong local itching in the area of the injection site, scratch excoriations, possibly superinfections.

DiagnosisThis section has been translated automatically.

Serum antibodies (ELISA, immunofluorescence); cultivation.

Differential diagnosisThis section has been translated automatically.

Dengue fever and other alpha and flavivirus.

Complication(s)This section has been translated automatically.

Encephalitis, hepatitis, pancreatitis, myocarditis, high mortality.

TherapyThis section has been translated automatically.

Symptomatic. In very severe cases, IVIG may be necessary.

Progression/forecastThis section has been translated automatically.

Patients with encephalitis often suffer from neurological late sequelae (about 50% of cases). The lethality rate in manifest encephalitis is 15-40% and mainly affects older patients, immunocompromised persons, children.

ProphylaxisThis section has been translated automatically.

Mosquito protection and control.

Note(s)This section has been translated automatically.

It is assumed that Alexander the Great had already died of the West Nile virus. 1937 First description (and naming) by illness of a woman in Uganda who lived in the West Nile area.

LiteratureThis section has been translated automatically.

  1. Smithburn KC, Hughes TP, Burke AW, Paul JH (1940) A neurotropic virus isolated from the blood of a native of Uganda Am J Trop Med Hyg s1-20: 471-492

Authors

Last updated on: 29.10.2020

Author: Prof. Dr. med. Peter Altmeyer