Patient's Query
Hello doctor,
I recently saw news about mosquitoes causing West Nile Virus and Saint Louis encephalitis. I am not entirely sure what these diseases entail, but they sound serious. My kids are young and often play in the woods. Should I be worried? Both diseases seem to spread through mosquito bites, and I am anxious about my kids getting bitten while they are outside. How significant is the risk for us?
Please help.
Thank you.
Hello,
Welcome to icliniq.com.
West Nile Virus (WNV) is in the genus Flavivirus, which includes Japanese encephalitis and Saint Louis encephalitis viruses. WNV can affect humans, horses, birds, and other vertebrates. The clinical presentation cannot be distinguished from other viral encephalitis infections. Human cases of Western Equine encephalitis (WEE) and Saint Louis encephalitis (SLE) have occurred in Oregon in the past, with most cases occurring in eastern Oregon. Most WNV cases occur in the late summer and fall.
The incubation period is usually two to 14 days, although longer incubation periods have been documented in immunosuppressed persons. Most infections are mild, with symptoms including fever, headaches, and body aches, often accompanied by skin rash and swollen lymph glands. More severe infections may involve meningoencephalitis, with a range of neurological and systemic manifestations, including headache, high fever, neck stiffness, stupor, disorientation, cranial nerve abnormalities, nausea, vomiting, coma, tremors, convulsions, muscle weakness (present in 40 percent of New York cases), paralysis (present in 20 percent of New York cases with electromyographic findings consistent with axonal neuropathy), and, rarely, death. Case fatality rates range from 3 to 15 percent and are highest in the elderly.
West Nile virus cases and outbreaks have been described in Africa, Europe, the Middle East, West and Central Asia, Oceania (subtype Kunjin), and, as of August 1999, North America. In 1999, 62 cases of severe disease, including seven deaths, occurred in New York City. WNV is transmitted by the bite of infected mosquitoes. Mosquitoes become infected from infected birds. Since 1999, 60 species of mosquitoes have been found to carry West Nile virus in the United States. WNV is not transmitted person-to-person or to humans directly from dead or living animals.
Currently, the disease has been identified throughout the continental United States and Canada. There is no human vaccine or specific therapy available. Approximately one out of 140 cases may develop neuroinvasive disease. In more severe cases, intensive supportive therapy is indicated, including hospitalization, intravenous (IV) fluids, airway management, respiratory support (ventilator) if needed, prevention of secondary infections (such as pneumonia, urinary tract infections, etc.), and diligent nursing care. The risk of neuroinvasive disease increases with age and among organ transplant recipients, and individuals with hypertension, diabetes, and other chronic diseases. Many survivors of neuroinvasive disease may experience long-term disabilities.
Please, let me know if you want some help.
Thank you.
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