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Emerging Infectious Disease3

Emerging Infectious Disease3 - 16 The majority of...

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Emerging Infectious Diseases 10. Epizootic infections 10.1. West Nile Encephalitis Key Concepts: o Spread to humans from vertebrate host via bridge vector (mosquito able to bite both humans and birds, in case of WNV) that has transmitted virus as a result of globalization across continents o Rapidly expanding geographic distribution o Advanced age is greatest risk factor for severe neurologic disease 10.1.1. Virology: RNA flavivirus 10.1.2. Transmission cycle: Adapted from: Petersen et al. West Niile Virus: A Primer for the Clinician. Annals of Internal Medicine 2002;137:E173-E179 10.1.3. Clinical features: Symptom % Symptom % Fever 90 Myalgia 32 Fatigue 63 Photophobia 32 Δ Mental Status 58 Abnormal reflexes 32 Headache 58 Meningismus (stiff neck) 32 Weakness 42 Abdominal pain 21 Nausea 42 Motor weakness 16 Vomiting 42 Seizures
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Unformatted text preview: 16 The majority of infections are asymptomatic. Fever, neurologic and gastrointestinal symptoms are most common. The neurologic effects are most severe in the elderly; cases of acute flaccid paralysis/polio-like syndrome have been reported. A high index of suspicion for WNV in setting of older adults with onset of unexplained encephalitis or meningitis in late summer or early fall should be maintained. 10.1.4. Diagnosis: CSF examination: pleocytosis with lymphocytic predominance; elevated protein Serologic examination: the most efficient diagnosis is detection of IgM antibody to WNV in serum or CSF by ELISA – this test is available through local or state health departments. All cases should be reported to the CDC....
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