West Nile Virus

Definition

West Nile virus (WNV) is an infection that is most commonly spread by a mosquito bite. In rare cases, WNV can lead to serious complications, or death.

This infection is found worldwide. In the United States, it tends to occur during late summer and early fall.

Causes

West Nile is caused by a virus. The virus is passed through the bite of an infected mosquito. The virus can also be passed through a blood transfusion with infected blood, but this is rare.

Risk Factors

The greatest risk factors for WNV are spending time in areas where mosquitoes are present and not using insect repellent. The risk of complications with WNV is highest in people:

• Over 50 years old
• With a weakened immune system

Mosquito Bite

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Symptoms

Most people with WNV have no symptoms. About 20% of the people who become infected with WNV develop flu-like symptoms such as:

• Fever and chills
• Headache
• Muscle pain
• Nausea and vomiting
• Diarrhea
• Rash
• Swollen lymph nodes
• Eye inflammation—conjunctivitis

Symptoms may appear within 2-6 days and can last from a few days to several weeks.

A small number of people with WNV will develop serious, neurological symptoms. These symptoms may include:

• High fever
• Headache
• Stiff neck
• Disorientation
• Stupor
• Tremors
• Vision loss
• Severe muscle weakness
• Paralysis
• Coma

These serious symptoms need immediate medical care.

Diagnosis

In addition to taking your medical history and doing a physical exam, your doctor will ask you:

• What kind of symptoms you are experiencing
• Where you have been living or traveling to
• Whether you have been exposed to mosquitoes

A blood test is commonly used to confirm the diagnosis of WNV. Depending on the symptoms that you have, your doctor may order other tests, such as:

• MRI scan
• Cerebrospinal fluid tests to evaluate the fluid that surrounds the brain and spinal cord

Treatment

Treatment for WNV focuses on supportive care. Depending on your symptoms your doctor may recommend:

• Pain relievers
• Antiemetics to reduce nausea and vomiting

If you are dehydrated, you may need to drink an oral rehydration solution or have fluid delivered through an IV.

Treatment for severe symptoms may include:

• Breathing support—mechanical ventilation
• Medication to control seizures
• Medication to decrease brain swelling

Prevention

The best preventive measure is to avoid mosquito bites. Prevention steps include:

• Avoid outdoor activities at dawn or dusk.
• Wear long pants and long-sleeve shirts when outdoors.
• Use an insect repellent with DEET.
• Repair screens to prevent mosquitoes from entering the house.
• Use proper mosquito netting at night. Look for netting treated with insecticide.
• Remove standing water to prevent mosquito breeding. Empty items like bird baths and gutters around your house.

Mosquitoes pick up the WNV by biting infected birds. If you see a dead bird, call the public health department. Do not touch the dead bird unless you are wearing disposable gloves.