West Nile fever is an infection by the West Nile virus, which is typically spread by mosquitoes.[1] In about 80% of infections people have few or no symptoms.[2] About 20% of people develop a fever, headache, vomiting, or a rash.[1] In less than 1% of people, encephalitis or meningitis occurs, with associated neck stiffness, confusion, or seizures.[1] Recovery may take weeks to months.[1] The risk of death among those in whom the nervous system is affected is about 10 percent.[1]
West Nile virus (WNV) is usually spread by mosquitoes that become infected when they feed on infected birds, which often carry the disease.[1] Rarely the virus is spread through blood transfusions, organ transplants, or from mother to baby during pregnancy, delivery, or breastfeeding,[1] but it otherwise does not spread directly between people.[3] Risks for severe disease include being over 60 years old and having other health problems.[1] Diagnosis is typically based on symptoms and blood tests.[1]
There is no human vaccine.[1] The best way to reduce the risk of infection is to avoid mosquito bites.[1] Mosquito populations may be reduced by eliminating standing pools of water, such as in old tires, buckets, gutters, and swimming pools.[1] When mosquitoes cannot be avoided, mosquito repellent, window screens, and mosquito nets reduce the likelihood of being bitten.[1][3] There is no specific treatment for the disease; pain medications may reduce symptoms.[1]
The virus was discovered in Uganda in 1937, and was first detected in North America in 1999.[1][3] WNV has occurred in Europe, Africa, Asia, Australia, and North America.[1] In the United States thousands of cases are reported a year, with most occurring in August and September.[4] It can occur in outbreaks of disease.[3] Severe disease may also occur in horses, for which a vaccine is available.[3] A surveillance system in birds is useful for early detection of a potential human outbreak.[3]
About 80% of those infected with West Nile virus (WNV) show no symptoms and go unreported.[5] About 20% of infected people develop symptoms. These vary in severity, and begin 3 to 14 days after being bitten. Most people with mild symptoms of WNV recover completely, though fatigue and weakness may last for weeks or months. Symptoms may range from mild, such as fever, to severe, such as paralysis and meningitis. A severe infection can last weeks and can, rarely, cause permanent brain damage. Death may ensue if the central nervous system is affected. Medical conditions such as cancer and diabetes, and age over 60 years, increase the risk of developing severe symptoms.[6][7]
Headache can be a prominent symptom of WNV fever, meningitis, encephalitis, meningoencephalitis, and it may or may not be present in poliomyelitis-like syndrome. Thus, headache is not a useful indicator of neuroinvasive disease.
