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Original Article

Clinical Description and Follow-up Investigation of Human West Nile Virus Cases

Kristy Gottfried, MS, Robbie Quinn, BS, Tim Jones, MD
Volume: 98 Issue: 6 June, 2005

Abstract:

Objectives: The objective of this study was to investigate long-term outcomes after West Nile virus infection.


Methods: We reviewed the medical records of persons reported with West Nile virus in Tennessee in 2002 and interviewed cases 1 year after acute illness.


Results: In 2002, 56 cases of West Nile virus were reported in Tennessee; 48 (84%) had meningitis or encephalitis. Of those, 9 (19%) died during acute infection and 12 (25%) died within 6 months of illness onset. Patients with West Nile virus neurologic illness spent a median of 10 days in the hospital and were unable to resume normal activities for a median of 25 days. One year later, 12 of 22 (55%) persons reported that they were not fully recovered, with symptoms including fatigue, weakness, difficulty ambulating, and memory problems.


Conclusions: West Nile virus infection leads to high rates of mortality and substantial persistent morbidity. Prevention efforts should be targeted to populations at highest risk of severe sequelae.

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References:

1. Mostashari F, Bunning MS, Kitsutani PT, et al. Epidemic West Nile encephalitis, New York, 1999: Results of a household-based seroepidemiological survey. Lancet 2001;28:261–264.
 
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4. Centers for Disease Control and Prevention. 2003. Epidemic/epizootic West Nile virus in the United States: Guidelines for surveillance, prevention, and control. 3rd revision.http://www.cdc.gov/ncidod/dvbid/westnile/resources/wnvguidelines2003.pdf Accessed January 22, 2004.
 
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6. Nash D, Mostashari F, Fine A, et al. The outbreak of West Nile virus infection in the New York City area in 1999. N Engl J Med 2001;344:1807–1814.
 
7. Chowers MY, Lang R, Nassar F, et al. Clinical characteristics of the West Nile fever outbreak, Israel, 2000. Emerg Infect Dis 2001;7:675–678.
 
8. New York Department of Health. West Nile virus surveillance and control: an update for healthcare providers in New York City. City Health Information 2001:20.
 
9. Weiss D, Carr D, Kellachan J, et al. Clinical findings of West Nile virus infection in hospitalized patients, New York and New Jersey, 2000. Emerg Infect Dis 2001;7:654–658.
 
10. Pepperell C, Rau N, Krajden S, et al. West Nile virus infection in 2002: Morbidity and mortality among patients admitted to hospital in south-central Ontario. CMAJ 2003;168:1399–1405.
 

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