scholarly journals Current Understanding of West Nile Virus Clinical Manifestations, Immune Responses, Neuroinvasion, and Immunotherapeutic Implications

Pathogens ◽  
2019 ◽  
Vol 8 (4) ◽  
pp. 193 ◽  
Author(s):  
Fengwei Bai ◽  
E. Ashley Thompson ◽  
Parminder J. S. Vig ◽  
A. Arturo Leis
Keyword(s):  
New York ◽  
West Nile Virus ◽  
Immune Responses ◽  
Clinical Manifestations ◽  
The United States ◽  
Current Understanding ◽  
Therapeutic Interventions ◽  
Clinical Practices ◽  
West Nile ◽  
Neuroinvasive Disease

West Nile virus (WNV) is the most common mosquito-borne virus in North America. WNV-associated neuroinvasive disease affects all ages, although elderly and immunocompromised individuals are particularly at risk. WNV neuroinvasive disease has killed over 2300 Americans since WNV entered into the United States in the New York City outbreak of 1999. Despite 20 years of intensive laboratory and clinical research, there are still no approved vaccines or antivirals available for human use. However, rapid progress has been made in both understanding the pathogenesis of WNV and treatment in clinical practices. This review summarizes our current understanding of WNV infection in terms of human clinical manifestations, host immune responses, neuroinvasion, and therapeutic interventions.

scholarly journals West Nile virus in Europe: understanding the present to gauge the future

2010 ◽  
Vol 15 (10) ◽  
Author(s):  
P Reiter
Keyword(s):  
New York ◽  
West Nile Virus ◽  
Natural History ◽  
Research Effort ◽  
Western Hemisphere ◽  
Current Understanding ◽  
Major Research ◽  
West Nile ◽  
Old World ◽  
History Of

The appearance of West Nile virus in New York in 1999 and the unprecedented panzootic that followed, have stimulated a major research effort in the western hemisphere and a new interest in the presence of this virus in the Old World. This review considers current understanding of the natural history of this pathogen, with particular regard to transmission in Europe.

Transmission dynamics and changing epidemiology of West Nile virus

2008 ◽  
Vol 9 (1) ◽  
pp. 71-86 ◽  
Author(s):  
Bradley J. Blitvich
Keyword(s):  
New York ◽  
West Nile Virus ◽  
Disease Outbreaks ◽  
Western Hemisphere ◽  
Transmission Dynamics ◽  
West Nile ◽  
Transmission Cycle ◽  
Neuroinvasive Disease ◽  
The Usa ◽  
The Caribbean

AbstractWest Nile virus (WNV) is a flavivirus that is maintained in a bird–mosquito transmission cycle. Humans, horses and other non-avian vertebrates are usually incidental hosts, but evidence is accumulating that this might not always be the case. Historically, WNV has been associated with asymptomatic infections and sporadic disease outbreaks in humans and horses in Africa, Europe, Asia and Australia. However, since 1994, the virus has caused frequent outbreaks of severe neuroinvasive disease in humans and horses in Europe and the Mediterranean Basin. In 1999, WNV underwent a dramatic expansion of its geographic range, and was reported for the first time in the Western Hemisphere during an outbreak of human and equine encephalitis in New York City. The outbreak was accompanied by extensive and unprecedented avian mortality. Since then, WNV has dispersed across the Western Hemisphere and is now found throughout the USA, Canada, Mexico and the Caribbean, and parts of Central and South America. WNV has been responsible for >27,000 human cases, >25,000 equine cases and hundreds of thousands of avian deaths in the USA but, surprisingly, there have been only sparse reports of WNV disease in vertebrates in the Caribbean and Latin America. This review summarizes our current understanding of WNV with particular emphasis on its transmission dynamics and changing epidemiology.

449: Age and Gender as Risk Factors for West Nile Virus Neuroinvasive Disease in Children in the United States, 1999–2004

2005 ◽  
Vol 161 (Supplement_1) ◽  
pp. S113-S113
Author(s):  
L B Davis ◽  
E Hayes ◽  
D O’Leary ◽  
T Smith ◽  
A Marfin ◽  
...  
Keyword(s):  
United States ◽  
Risk Factors ◽  
West Nile Virus ◽  
The United States ◽  
West Nile ◽  
Age And Gender ◽  
Neuroinvasive Disease ◽  
And Gender

scholarly journals The First Case Report of West Nile Virus-Induced Acute Flaccid Quadriplegia in Canada

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Yahya Salim Yahya Al-Fifi ◽  
Kamran Kadkhoda ◽  
Mike Drebot ◽  
Beverly Wudel ◽  
E. J. Bow
Keyword(s):  
New York ◽  
New York City ◽  
Case Report ◽  
West Nile Virus ◽  
York City ◽  
Favorable Outcome ◽  
West Nile ◽  
Neuroinvasive Disease ◽  
First Case ◽  
High Incidence

The 1999 New York City outbreak of West Nile virus (WNV) was associated with a high incidence of West Nile virus neuroinvasive disease (WNVND) where the outcomes for these patients were very poor. We describe a case of West Nile virus neuroinvasive disease (WNVND) characterized by acute flaccid quadriplegia with a favorable outcome in Winnipeg, Manitoba, Canada.

scholarly journals Induction of Potent Th1‐Type Immune Responses from a Novel DNA Vaccine for West Nile Virus New York Isolate (WNV‐NY1999)

2001 ◽  
Vol 184 (7) ◽  
pp. 809-816 ◽  
Author(s):  
Joo‐Sung Yang ◽  
J. Joseph Kim ◽  
Daniel Hwang ◽  
Andrew Y. Choo ◽  
Kesen Dang ◽  
...  
Keyword(s):  
New York ◽  
West Nile Virus ◽  
Immune Responses ◽  
Dna Vaccine ◽  
West Nile

scholarly journals Immunoglobulin G Avidity in Differentiation between Early and Late Antibody Responses to West Nile Virus

2006 ◽  
Vol 13 (1) ◽  
pp. 33-36 ◽  
Author(s):  
Janet L. Fox ◽  
Stuart L. Hazell ◽  
Leslie H. Tobler ◽  
Michael P. Busch
Keyword(s):  
United States ◽  
New York ◽  
West Nile Virus ◽  
The United States ◽  
Immunoglobulin M ◽  
West Nile ◽  
Marked Rise ◽  
Igm Antibodies ◽  
Igg Avidity ◽  
Igg Level

ABSTRACT In 1999 West Nile virus (WNV) surfaced in the United States in the city of New York and spread over successive summers to most of the continental United States, Canada, and Mexico. Because WNV immunoglobulin M (IgM) antibodies have been shown to persist for up to 1 year, residents in areas of endemicity can have persistent WNV IgM antibodies that are unrelated to a current illness with which they present. We present data on the use of IgG avidity testing for the resolution of conflicting data arising from the testing of serum or plasma for antibodies to WNV. Thirteen seroconversion panels, each consisting of a minimum of four samples, were used. All samples were tested for the presence of WNV IgM and IgG antibodies, and the avidity index for the WNV IgG-positive samples was calculated. Panels that exhibited a rise in the WNV IgM level followed by a sequential rise in the WNV IgG level were designated “primary.” Panels that exhibited a marked rise in the WNV IgG level followed by a sequential weak WNV IgM response and that had serological evidence of a prior flavivirus infection were designated “secondary.” All samples from the “primary” panels exhibited low avidity indices (less than 40%) for the first 20 to 30 days after the recovery of the index sample (the sample found to be virus positive). All of the “secondary” samples had elevated WNV IgG levels with avidity indices of ≥55%, regardless of the number of days since the recovery of the index sample. These data demonstrate that it is possible to differentiate between recent and past exposure to WNV or another flavivirus through the measurement of WNV IgG avidity indices.

Spinal Cord Neuropathology in Human West NileVirus Infection

2004 ◽  
Vol 128 (5) ◽  
pp. 533-537 ◽  
Author(s):  
Jonathan D. Fratkin ◽  
A. Arturo Leis ◽  
Dobrivoje S. Stokic ◽  
Sally A. Slavinski ◽  
Roger W. Geiss
Keyword(s):  
Spinal Cord ◽  
New York ◽  
West Nile Virus ◽  
Gray Matter ◽  
Sympathetic Neurons ◽  
Vital Signs ◽  
The United States ◽  
Sympathetic Ganglia ◽  
Interval Length ◽  
West Nile

Abstract Context.—During the 1999 New York City West Nile virus (WNV) outbreak, 4 patients with profound muscle weakness, attributed to Guillain-Barré syndrome, were autopsied. These cases were the first deaths caused by WNV, a flavivirus, to be reported in the United States. The patients' brains had signs of mild viral encephalitis; spinal cords were not examined. During the 2002 national epidemic, several patients in Mississippi had acute flaccid paralysis. Electrophysiologic studies localized the lesions to the anterior horn cells in the spinal gray matter. Four of 193 infected patients in Mississippi died and were autopsied. All 4 experienced muscular weakness and respiratory failure that required intubation. Postmortem examinations focused on the spinal cord. Objective.—To emphasize apparent tropism of WNV for the ventral gray matter of the spinal cord. Design.—Cerebral hemispheres, basal ganglia, diencephalon, brainstem, cerebellum, and spinal cord sections were stained with hematoxylin-eosin and incubated with antibodies to T cells, B cells, and macrophages/microglial cells. Results.—We identified neuronophagia, neuronal disappearance, perivascular chronic inflammation, and microglial proliferation in the ventral horns of the spinal cord, especially in the cervical and lumbar segments. Loss of ganglionic neurons, nodules of Nageotte, and perivascular lymphocyte aggregates were found in dorsal root and sympathetic ganglia. Severity of cellular reaction was proportional to the interval length between patient presentation and death. Conclusion.—West Nile virus caused poliomyelitis. Injury to spinal and sympathetic ganglia mirrored the damage to the spinal gray matter. The disappearance of sympathetic neurons could lead to the autonomic instability observed in some WNV patients, including labile vital signs, hypotension, and potentially lethal cardiac arrhythmias.

West Nile Virus Neuroinvasive Disease Incidence in the United States, 2002–2006

2008 ◽  
Vol 8 (1) ◽  
pp. 35-40 ◽  
Author(s):  
Nicole P. Lindsey ◽  
Stephanie Kuhn ◽  
Grant L. Campbell ◽  
Edward B. Hayes
Keyword(s):  
United States ◽  
West Nile Virus ◽  
Disease Incidence ◽  
The United States ◽  
West Nile ◽  
Neuroinvasive Disease

scholarly journals Retrospective Descriptive Analysis of West Nile Neuroinvasive Disease (WNND) in Northwest Louisiana

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Pradeep Kumar Mada ◽  
Philip Sneed ◽  
Gabriel Castano ◽  
Maureen Moore ◽  
Andrew Stevenson Joel Chandranesan
Keyword(s):  
West Nile Virus ◽  
Tertiary Care ◽  
Gastrointestinal Symptoms ◽  
Retrospective Chart Review ◽  
Late Summer ◽  
Antibiotic Use ◽  
The United States ◽  
Care Hospital ◽  
West Nile ◽  
Neuroinvasive Disease

Context. West Nile virus (WNV) has become endemic in many states in the United States in recent years. One in 150 individuals with West Nile virus infection develops the West Nile neuroinvasive disease (WNND) and can cause permanent and sometimes fatal neurological damage. Aims. The aim of the study was to describe the presentation characteristics and epidemiology of WNND in Louisiana to improve future recognition of cases and decrease inappropriate antibiotic use. Settings and Design. It was a retrospective descriptive-analytic cohort study. A total of 23 patients with WNND were identified at one tertiary care hospital center in Northwest Louisiana from a retrospective chart review from January 1, 2012 to October 31, 2017. Results. The median age was 49 years (range: 15–75) for patients with WNND. Of 23 patients diagnosed with WNND, twelve (52%) were diagnosed with encephalitis (WNE), six (26%) were diagnosed with meningitis (WNM), and five (22%) with myelitis (WNME). The common symptoms with WNND were fever in 65%, altered mental status in 61%, headache in 52%, fatigue in 43%, gastrointestinal symptoms in 43%, rigors in 30%, imbalance in 26%, rash in 9%, and seizures in 26% of patients. Most patients presented in the late summer season. The average duration of antibiotics given was six days. The average number of days from the admission to the diagnosis of WNND was nine days (3 to 16 days). Twenty-one (91%) patients survived the infection. Conclusions. Identifying WNV infection early in its clinical course would help in decreasing inappropriate antibiotic use when patients presented with fever and meningeal symptoms. Performing WNV serology in CSF studies is critical in making the diagnosis.

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.

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