Variations in West Nile viral infections across North and Central Texas

West Nile virus is a single-stranded RNA arbovirus with variable clinical presentation.

To better understand the clinical characteristics, diagnostic evaluation, and outcomes, we performed a retrospective analysis of the Baylor Scott & White Health medical records for hospitalized adult patients with West Nile virus from January 1, 2015, to September 1, 2024.

A total of 79 patients were included. Most were male (55.7%) with a mean age of 64.15 years. The highest concentration of cases was reported in Dallas County (34.2%) and Tarrant County (22.8%). Seventy-three patients (92.4%) had neuroinvasive disease, while 6 patients (7.8%) had nonneuroinvasive disease. Presenting symptoms included fever (73.43%), confusion (49.59%), and weakness (40.51%). Six patients (7.6%) were found to have acute ischemic stroke during their admission. Fifteen patients (18.99%) died. Cerebrospinal fluid analysis generally showed elevated protein (mean value 104.7 mg/dL) with either neutrophilic (mean 32%) or lymphocytic pleocytosis (mean 51.6%). None of the treatments analyzed (intravenous immunoglobulin, plasma exchange, and steroids) was found to have any significant effect on morbidity and mortality.

West Nile virus is a common recurring disease across Texas. While some cases progress to neuroinvasive disease, there appears to be no meaningful way to predict these cases based on clinical and demographic data.