Outbreak of Human Neuroinvasive West Nile Virus Infection in Campania, Italy, August-September 2024

Background: West Nile Virus (WNV) infection is endemic in Italy, but it has rarely reported in humans in Southern Italy. We report the first human outbreak of WNV infection in the Campania region, Italy. Results: Five confirmed and seven probable cases of WNV were identified from August to September 2024. Predominantly affecting elderly males with comorbidities, all but one patient developed West Nile neuroinvasive disease, presenting with fever and impaired consciousness. Remdesivir was administered off-label in four cases, potentially reducing hospitalization and improving outcomes. Mortality was limited to two cases, attributed to bacterial infections. Conclusions: The outbreak underscores the importance of heightened surveillance in Italy and raises the potential for remdesivir in WNV treatment.