West Nile Virus
Since West Nile virus (WNV) was first isolated in 1937, it has been known to cause asymptomatic infection and fevers in humans in Africa, West Asia, and the Middle East. Human and animal infections were not documented in the Western Hemisphere until the 1999 outbreak in the New York City metropolitan area. Since then, the disease has spread across the United States. In 2003, WNV activity occurred in 46 states and caused illness in over 9,800 people.
WNV is transmitted to humans through mosquito bites. Mosquitoes become infected when they feed on infected birds that have high levels of WNV in their blood. Infected mosquitoes can then transmit WNV when they feed on humans or other animals.
WNV is not contageous from person to person and there is no evidence that a person can get infected by handling live or dead infected birds. But, to add a further level of safety, if birds or other potentially infected animals must be handled, a protective barrier (e.g., gloves, inverted plastic bags) should be used.
Most WNV infected humans have no symptoms. A small proportion develops mild symptoms that include fever, headache, body aches, skin rash and swollen lymph glands. Less than 1% of infected people develop more severe illness that includes meningitis (inflammation of one of the membranes covering the brain and spinal cord) or encephalitis. The symptoms of these illnesses can include headache, high fever, neck stiffness, stupor, disorientation, coma, tremors, convulsions, muscle weakness, and paralysis. Of the few people that develop encephalitis, a small proportion die but, overall, this is estimated to occur in less than 1 out of 1000 infections.
There is no specific treatment for WNV infection or vaccine to prevent it. Treatment of severe illnesses includes hospitalization, use of intravenous fluids and nutrition, respiratory support, prevention of secondary infections, and good nursing care. Medical care should be sought as soon as possible for persons who have symptoms suggesting severe illness.
Individuals can reduce their contacts with mosquitoes by taking these actions:
When outdoors, wear clothing that covers the skin such as long sleeve shirts and pants, apply effective insect repellent to clothing and exposed skin, and curb outside activity during the hours that mosquitoes are feeding which often includes dawn and dusk. In addition, screens should be applied to doors and windows and regularly maintained to keep mosquitoes from entering the home.