West Nile Virus Disease Author: Amy V. Bode, MD, MSPH; James J. Sejvar, MD; Anthony A. Marfin, MD, MPH
Module updated - 2011-02-15
Author information and module status
Prevention
Screening
Diagnosis
Consultation for Diagnosis
Hospitalization
Non-drug Therapy
Drug Therapy
Patient Education
Consultation for Management
Follow-up

Tables
References
Glossary
What's New
Patient Information
Additional Resources
Tools
References
1. Petersen LR, Marfin AA. West Nile virus: a primer for the clinician. Ann Intern Med. 2002;137:173-9. (PMID: 12160365) [Full Text]
2. Gujral IB, Zielinski-Gutierrez EC, LeBailly A, Nasci R. Behavioral risks for West Nile virus disease, northern Colorado, 2003. Emerg Infect Dis. 2007;13:419-25. (PMID: 17552095)
3. Han LL, Popovici F, Alexander JP Jr, Laurentia V, Tengelsen LA, Cernescu C, et al. Risk factors for West Nile virus infection and meningoencephalitis, Romania, 1996. J Infect Dis. 1999;179:230-3. (PMID: 9841844)
4. Reisen WK, Takahashi RM, Carroll BD, Quiring R. Delinquent mortgages, neglected swimming pools, and West Nile virus, California. Emerg Infect Dis. 2008;14:1747-9. (PMID: 18976560)
5. Monath TP. Epidemiology. In: Monath TP, ed. St. Louis Encephalitis. Washington, DC: American Public Health Association; 1980:239-312.
6. Mostashari F, Bunning ML, Kitsutani PT, Singer DA, Nash D, Cooper MJ, et al. Epidemic West Nile encephalitis, New York, 1999: results of a household-based seroepidemiological survey. Lancet. 2001;358:261-4. (PMID: 11498211)
7. Fradin MS, Day JF. Comparative efficacy of insect repellents against mosquito bites. N Engl J Med. 2002;347:13-8. (PMID: 12097535)
8. Campbell GL, Marfin AA, Lanciotti RS, Gubler DJ. West Nile virus. Lancet Infect Dis. 2002;2:519-29. (PMID: 12206968)
9. Martin JE, Pierson TC, Hubka S, Rucker S, Gordon IJ, Enama ME, et al. A West Nile virus DNA vaccine induces neutralizing antibody in healthy adults during a phase 1 clinical trial. J Infect Dis. 2007;196:1732-40. (PMID: 18190252)
10. Investigations of West Nile virus infections in recipients of blood transfusions. MMWR Morb Mortal Wkly Rep. 2002;51:973-4. (PMID: 12433022)
11. Iwamoto M, Jernigan DB, Guasch A, Trepka MJ, Blackmore CG, Hellinger WC, et al. Transmission of West Nile virus from an organ donor to four transplant recipients. N Engl J Med. 2003;348:2196-203. (PMID: 12773646)
12. West Nile virus infections in organ transplant recipients—New York and Pennsylvania, August-September, 2005. MMWR Morb Mortal Wkly Rep. 2005;54:1021-3. (PMID: 16224451)
13. Kleinschmidt-DeMasters BK, Marder BA, Levi ME, Laird SP, McNutt JT, Escott EJ, et al. Naturally acquired West Nile virus encephalomyelitis in transplant recipients: clinical, laboratory, diagnostic, and neuropathological features. Arch Neurol. 2004;61:1210-20. (PMID: 15313837)
14. Food and Drug Administration. Guidance for Industry: Assessing Donor Suitability and Blood and Blood Product Safety in Cases of Known or Suspected West Nile Virus Infection. Available at: http://www.fda.gov/BiologicsBloodVaccines/GuidanceComplianceRegulatoryInformation/Guidances/Blood/ucm074111.htm.
15. McGready R, Hamilton KA, Simpson JA, Cho T, Luxemburger C, Edwards R, et al. Safety of the insect repellent N,N-diethyl-M-toluamide (DEET) in pregnancy. Am J Trop Med Hyg. 2001;65:285-9. (PMID: 11693870)
16. Koren G, Matsui D, Bailey B. DEET-based insect repellents: safety implications for children and pregnant and lactating women. CMAJ. 2003;169:209-12. (PMID: 12900480)
17. Fradin MS. Mosquitoes and mosquito repellents: a clinician's guide. Ann Intern Med. 1998;128:931-40. (PMID: 9634433) [Full Text]
18. Possible West Nile virus transmission to an infant through breast-feeding—Michigan, 2002. MMWR Morb Mortal Wkly Rep. 2002;51:877-8. (PMID: 12375687)
19. Intrauterine West Nile virus infection—New York, 2002. MMWR Morb Mortal Wkly Rep. 2002;51:1135-6. (PMID: 12537289)
20. O’Leary DR, Kuhn S, Kniss KL, Hinckley AF, Rasmussen SA, Pape WJ, et al. Birth outcomes following West Nile Virus infection of pregnant women in the United States: 2003-2004. Pediatrics. 2006;117:e537-45. (PMID: 16510632)
21. Laboratory-acquired West Nile virus infections—United States, 2002. MMWR Morb Mortal Wkly Rep. 2002;51:1133-5. (PMID: 12537288)
22. Fonseca K, Prince GD, Bratvold J, Fox JD, Pybus M, Preksaitis JK, et al. West Nile virus infection and conjunctival exposure. Emerg Infect Dis. 2005;11:1648-9. (PMID: 16355512)
23. Pealer LN, Marfin AA, Petersen LR, Lanciotti RS, Page PL, Stramer SL, et al. Transmission of West Nile virus through blood transfusion in the United States in 2002. N Engl J Med. 2003;349:1236-45. (PMID: 14500806)
24. Petersen LR, Epstein JS. Problem solved? West Nile virus and transfusion safety [Editorial]. N Engl J Med. 2005;353:516-7. (PMID: 16079376)
25. Transfusion-associated transmission of West Nile virus—Arizona, 2004. MMWR Morb Mortal Wkly Rep. 2004;53:842-4. (PMID: 15371966)
26. Kiberd BA, Forward K. Screening for West Nile virus in organ transplantation: a medical decision analysis. Am J Transplant. 2004;4:1296-301. (PMID: 15268731)
27. Watson JT, Jones RC, Gibbs K, Paul W. Dead crow reports and location of human West Nile virus cases, Chicago, 2002. Emerg Infect Dis. 2004;10:938-40. (PMID: 15200837)
28. Guptill SC, Julian KG, Campbell GL, Price SD, Marfin AA. Early-season avian deaths from West Nile virus as warnings of human infection. Emerg Infect Dis. 2003;9:483-4. (PMID: 12702231)
29. Mostashari F, Kulldorff M, Hartman JJ, Miller JR, Kulasekera V. Dead bird clusters as an early warning system for West Nile virus activity. Emerg Infect Dis. 2003;9:641-6. (PMID: 12781002)
30. Patnaik JL, Juliusson L, Vogt RL. Environmental predictors of human West Nile virus infections, Colorado. Emerg Infect Dis. 2007;13:1788-90. (PMID: 18217573)
31. O’Leary DR, Marfin AA, Montgomery SP, Kipp AM, Lehman JA, Biggerstaff BJ, et al. The epidemic of West Nile virus in the United States, 2002. Vector Borne Zoonotic Dis. 2004;4:61-70. (PMID: 15018774)
32. Lindsey NP, Kuhn S, Campbell GL, Hayes EB. West Nile virus neuroinvasive disease incidence in the United States, 2002-2006. Vector Borne Zoonotic Dis. 2008;8:35-9. (PMID: 18237264)
33. Tsai TF, Popovici F, Cernescu C, Campbell GL, Nedelcu NI. West Nile encephalitis epidemic in southeastern Romania. Lancet. 1998;352:767-71. (PMID: 9737281)
34. Chowers MY, Lang R, Nassar F, Ben-David D, Giladi M, Rubinshtein E, et al. Clinical characteristics of the West Nile fever outbreak, Israel, 2000. Emerg Infect Dis. 2001;7:675-8. (PMID: 11585531)
35. Nash D, Mostashari F, Fine A, Miller J, O’Leary D, Murray K, et al. The outbreak of West Nile virus infection in the New York City area in 1999. N Engl J Med. 2001;344:1807-14. (PMID: 11407341)
36. Bode AV, Sejvar JJ, Pape WJ, Campbell GL, Marfin AA. West Nile virus disease: a descriptive study of 228 patients hospitalized in a 4-county region of Colorado in 2003. Clin Infect Dis. 2006;42:1234-40. (PMID: 16586381)
37. Kumar D, Drebot MA, Wong SJ, Lim G, Artsob H, Buck P, et al. A seroprevalence study of west nile virus infection in solid organ transplant recipients. Am J Transplant. 2004;4:1883-8. (PMID: 15476490)
38. Kumar D, Prasad GV, Zaltzman J, Levy GA, Humar A. Community-acquired West Nile virus infection in solid-organ transplant recipients. Transplantation. 2004;77:399-402. (PMID: 14966414)
39. Pepperell C, Rau N, Krajden S, Kern R, Humar A, Mederski B, et al. West Nile virus infection in 2002: morbidity and mortality among patients admitted to hospital in southcentral Ontario. CMAJ. 2003;168:1399-405. (PMID: 12771068)
40. Sejvar JJ, Haddad MB, Tierney BC, Campbell GL, Marfin AA, Van Gerpen JA, et al. Neurologic manifestations and outcome of West Nile virus infection. JAMA. 2003;290:511-5. (PMID: 12876094)
41. Roehrig JT, Layton M, Smith P, Campbell GL, Nasci R, Lanciotti RS. The emergence of West Nile virus in North America: ecology, epidemiology, and surveillance. Curr Top Microbiol Immunol. 2002;267:223-40. (PMID: 12082991)
42. Murray KO, Baraniuk S, Resnick M, Arafat R, Kilborn C, Shallenberger R, et al. Clinical investigation of hospitalized human cases of West Nile virus infection in Houston, Texas, 2002-2004. Vector Borne Zoonotic Dis. 2008;8:167-74. (PMID: 18399781)
43. Jean CM, Honarmand S, Louie JK, Glaser CA. Risk factors for West Nile virus neuroinvasive disease, California, 2005. Emerg Infect Dis. 2007;13:1918-20. (PMID: 18258047)
44. Weiss D, Carr D, Kellachan J, Tan C, Phillips M, Bresnitz E, et al. Clinical findings of West Nile virus infection in hospitalized patients, New York and New Jersey, 2000. Emerg Infect Dis. 2001;7:654-8. (PMID: 11589170)
45. Ceausu E, Erscoiu S, Calistru P, Ispas D, Dorobat O, Homos M, et al. Clinical manifestations in the West Nile virus outbreak. Rom J Virol. 1997;48:3-11. (PMID: 9836323)
46. Murray K, Baraniuk S, Resnick M, Arafat R, Kilborn C, Cain K, et al. Risk factors for encephalitis and death from West Nile virus infection. Epidemiol Infect. 2006;134:1325-32. (PMID: 16672108)
47. Murray K, Walker C, Herrington E, Lewis JA, McCormick J, Beasley DW, et al. Persistent infection with West Nile virus years after initial infection. J Infect Dis. 2010;201:2-4. (PMID: 19961306)
48. Tilley PA, Fox JD, Jayaraman GC, Preiksaitis JK. Maculopapular rash and tremor are associated with West Nile fever and neurological syndromes. J Neurol Neurosurg Psychiatry. 2007;78:529-31. (PMID: 17435190)
49. Martin DA, Muth DA, Brown T, Johnson AJ, Karabatsos N, Roehrig JT. Standardization of immunoglobulin M capture enzyme-linked immunosorbent assays for routine diagnosis of arboviral infections. J Clin Microbiol. 2000;38:1823-6. (PMID: 10790107)
50. Tilley PA, Fox JD, Jayaraman GC, Preiksaitis JK. Nucleic acid testing for west nile virus RNA in plasma enhances rapid diagnosis of acute infection in symptomatic patients. J Infect Dis. 2006;193:1361-4. (PMID: 16619182)
51. Sejvar JJ, Leis AA, Stokic DS, Van Gerpen JA, Marfin AA, Webb R, et al. Acute flaccid paralysis and West Nile virus infection. Emerg Infect Dis. 2003;9:788-93. (PMID: 12890318)
52. Martin DA, Biggerstaff BJ, Allen B, Johnson AJ, Lanciotti RS, Roehrig JT. Use of immunoglobulin m cross-reactions in differential diagnosis of human flaviviral encephalitis infections in the United States. Clin Diagn Lab Immunol. 2002;9:544-9. (PMID: 11986257)
53. New York City Department of Health. West Nile surveillance and control: an update for healthcare providers in New York City. City Health Information. 2001;20(2).
54. Lanciotti RS, Kerst AJ, Nasci RS, Godsey MS, Mitchell CJ, Savage HM, et al. Rapid detection of west nile virus from human clinical specimens, field-collected mosquitoes, and avian samples by a TaqMan reverse transcriptase-PCR assay. J Clin Microbiol. 2000;38:4066-71. (PMID: 11060069)
55. Hirsch MS, Werner B. Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 17-2003. A 38-year-old woman with fever, headache, and confusion. N Engl J Med. 2003;348:2239-47. (PMID: 12773652)
56. Sejvar JJ, Bode AV, Marfin AA, Campbell GL, Ewing D, Mazowiecki M, et al. West Nile virus-associated flaccid paralysis. Emerg Infect Dis. 2005;11:1021-7. (PMID: 16022775)
57. Skoldenberg B, Forsgren M, Alestig K, Bergstrom T, Burman L, Dahlqvist E, et al. Acyclovir versus vidarabine in herpes simplex encephalitis. Randomised multicentre study in consecutive Swedish patients. Lancet. 1984;2:707-11. (PMID: 6148470)
58. Whitley RJ, Alford CA, Hirsch MS, Schooley RT, Luby JP, Aoki FY, et al. Vidarabine versus acyclovir therapy in herpes simplex encephalitis. N Engl J Med. 1986;314:144-9. (PMID: 3001520)
59. Rathi AK, Kushwaha KP, Singh YD, Singh J, Sirohi R, Singh RK, et al. JE virus encephalitis: 1988 epidemic at Gorakhpur. Indian Pediatr. 1993;30:325-33. (PMID: 8396069)
60. Agrawal AG, Petersen LR. Human immunoglobulin as a treatment for West Nile virus infection [Editorial]. J Infect Dis. 2003;188:1-4. (PMID: 12825164)
61. Petersen LR, Marfin AA, Gubler DJ. West Nile virus. JAMA. 2003;290:524-8. (PMID: 12876096)
62. Huhn GD, Austin C, Langkop C, Kelly K, Lucht R, Lampman R, et al. The emergence of west nile virus during a large outbreak in Illinois in 2002. Am J Trop Med Hyg. 2005;72:768-76. (PMID: 15964962)
63. Patnaik JL, Harmon H, Vogt RL. Follow-up of 2003 human West Nile virus infections, Denver, Colorado. Emerg Infect Dis. 2006;12:1129-31. (PMID: 16836833)
64. Carson PJ, Konewko P, Wold KS, Mariani P, Goli S, Bergloff P, et al. Long-term clinical and neuropsychological outcomes of West Nile virus infection. Clin Infect Dis. 2006;43:723-30. (PMID: 16912946)
65. Steele NP, Myssiorek D. West Nile virus induced vocal fold paralysis. Laryngoscope. 2006;116:494-6. (PMID: 16540915)
66. Sejvar JJ, Curns AT, Welburg L, Jones JF, Lundgren LM, Capuron L, et al. Neurocognitive and functional outcomes in persons recovering from West Nile virus illness. J Neuropsychol. 2008;2:477-99. (PMID: 19824176)
FAQs
Amy V. Bode, MD, MSPH has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. Anthony A. Marfin, MD, MPH has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. James J. Sejvar, MD has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. Nicole Nemeth, DVM, PhD, editorial consultant, has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
Deborah Korenstein, MD, FACP, Co-Editor, PIER, has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. Richard B. Lynn, MD, FACP, Co-Editor, PIER, has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.


The information included herein should never be used as a substitute for clinical judgment and does not represent an official position of ACP. Because all PIER modules are updated regularly, printed web pages or PDFs may rapidly become obsolete. Therefore, PIER users should compare the date of the last update on the website with any printout to ensure that the information being referred to is the most current available.
PIER is copyrighted © 2012 by the American College of Physicians,
190 N. Independence Mall West, Philadelphia, PA 19106-1572, USA.