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Related Experiment Videos

West Nile encephalitis and myelitis.

Karen L Roos1

  • 1Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA. kroos@iupui.edu

Current Opinion in Neurology
|May 29, 2004
PubMed
Summary

West Nile virus infections surged in western US states in 2003. Diagnosis of West Nile virus encephalitis and myelitis relies on cerebrospinal fluid testing, with early testing potentially yielding false negatives.

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Area of Science:

  • Neurology
  • Infectious Diseases
  • Public Health

Background:

  • West Nile virus (WNV) is a mosquito-borne flavivirus with significant public health implications.
  • Neurological manifestations, including encephalitis and myelitis, represent severe forms of WNV infection.
  • The geographic distribution and transmission routes of WNV are dynamic and require ongoing surveillance.

Purpose of the Study:

  • To review recent experiences and findings related to West Nile virus encephalitis and myelitis.
  • To highlight key diagnostic challenges and emerging transmission pathways.
  • To discuss current and future therapeutic strategies for severe WNV infections.

Main Methods:

  • Review of recent clinical cases and epidemiological data concerning West Nile virus.

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  • Analysis of diagnostic methodologies for WNV central nervous system infections.
  • Evaluation of emerging transmission routes, including transfusion and transplantation.
  • Assessment of ongoing clinical trials for WNV therapies.

    • Main Results:

    • The majority of US West Nile virus cases in 2003 occurred in western states.
    • Transmission via blood transfusion and organ transplantation was confirmed, leading to implementation of nucleic acid-amplification tests.
    • Intrauterine transmission of WNV infection was reported.
    • West Nile virus immunoglobulin M (IgM) in cerebrospinal fluid (CSF) is the recommended diagnostic marker for CNS infection, though early samples may be negative.
    • Serial CSF sampling may be necessary for antibody detection.

    Conclusions:

    • West Nile virus infections showed a geographic shift, with a concentration in western US states in 2003.
    • Identification of West Nile virus IgM in CSF is the gold standard for diagnosing CNS infection.
    • A single serum antibody titer is insufficient for diagnosing recent West Nile virus infection.