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Centers for Disease Control and Prevention. (2024a, May 15). About West Nile. Centers for Disease Control and Prevention. https://www.cdc.gov/west-nile-virus/about/index.html

Centers for Disease Control and Prevention. (2024c, May 15). Preventing west nile. Centers for Disease Control and Prevention. https://www.cdc.gov/west-nile-virus/prevention/index.html

Centers for Disease Control and Prevention. (2024d, May 15). Treatment and prevention of West Nile virus disease. Centers for Disease Control and Prevention. https://www.cdc.gov/west-nile-virus/hcp/treatment-prevention/index.html

Centers for Disease Control and Prevention. (2024d, May 15). Treatment and prevention of West Nile virus disease. Centers for Disease Control and Prevention. https://www.cdc.gov/west-nile-virus/hcp/treatment-prevention/index.html

Colpitts, T. M., Conway, M. J., Montgomery, R. R., & Fikrig, E. (2012). West Nile Virus: Biology, Transmission, and Human Infection. Clinical Microbiology Reviews, 25(4), 635.

Donadieu, E., Bahuon, C., Lowenski, S., Zientara, S., Coulpier, M., & Lecollinet, S. (2013). Differential Virulence and Pathogenesis of West Nile Viruses. Viruses, 5(11), 2856.

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Causative Agent, Mode of Transmission, Symptoms

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Causative Agent, Mode of Transmission, Symptoms

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The West Nile Virus is the causative agent of the West Nile Virus. The genus of the virus is Flavivirus, and the species name is Orthoflavivirus nilense.

Most commonly, the virus is spread through the bites of an infected mosquito. The virus moves from the mosquito into the blood of the mammals that they feed on, so it can also be contracted by exchange of blood or internal bodily fluids like breast milk, though it is rare. Mosquitos can become infected by biting an infected bird; this usually cycles between birds and mosquitos.

Symptoms include headaches, weakness, muscle aches, fatigue, gastrointestinal problems, and a maculopapular rash. Although, around 70-80% of people are asymptomatic and less than 1% of the infected develop a neuroinvasive disease.

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WNV is an enveloped virus that has a single-stranded, positive-sense RNA genome. The virus has a capsid, envelope, prM, and premembrane which is present in flaviviruses.

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The main virulence factor is the envelope of the virus which allows easier more efficient access to the host, specifically to mammals being infected. It also can inhibit the activation of innate immune pathways so it can evade the host immune system. As mentioned many times before WNV is neuroinvasive which means it can infect and replicate within the CNS.

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Testing for WNV should start with testing for WNV-specific (Ig)M antibodies in serum and or cerebrospinal fluid. The CDC recommends that if the IgM results are positive they should be confirmed by neutralizing the antibodies. Viral cultures and tests may be used, as well as immunohistochemistry detection. For testing patients with immunocompromising conditions, Reverse transcription-polymerase chain reaction should be used. These tests diagnose patients with the WNV antibodies but may not be current illness, the IgM results may show recent previous infection.

Unfortunately, there are no treatments for WNV other than mitigating symptoms of acute systemic febrile illness or neuroinvasive diseases.

The sequelae, long-term side effects, are weakness, persistent movement disorders, and cognitive deficits. However, these mostly occur in patients who acquired a neuroinvasive disease.

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The CDC advises that people avoid mosquito bites to most effectively prevent contracting the virus. Such preventative steps could include proper clothing and protective gear to keep skin away from mosquitos or infected birds. Chemicals and treatments may also be used to keep mosquitoes away from you and your property. There are no vaccines for the WNV.

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The article highlights the global climate effect on how this virus may become more apparent since mosquitos live in warm temperatures. The warmer the climate gets, the birds migrating times may change, and breeding seasons may shift which will affect the virus's movement.

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Figure 1. Reported West Nile Neuroinvasive Disease Cases in the United States, 2002-2023

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Additional Facts, Features, and History of the WNV

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Additional Facts, Features, and History of the WNV

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The WNV is the causative agent of encephalitis as well. It was introduced to the West in the summer of 1999, and found in New York after infected people were diagnosed.

Interesting Fact: Humans are "dead-end hosts" for this virus, meaning that when we are infected we don't have enough of the virus in our bloodstream that we cannot spread it to mosquitos when they drink our blood. Additionally, birds can contract WNV but can spread it through mosquitos unlike humans.