West Nile virus

West Nile virus infections are now of great concern to parents. Here are some points to remember, extracted from US Centers For Disease Control information for physicians:

The virus has been reported in animal hosts or in humans in the majority of States. Most infections with the virus are mild, and often unknown to the parents.

about one fifth of the infected patients develop a mild illness known as West Nile fever.
Incubation is 3-14 days.
Symptoms last 3-5 days. They include:
- malaise
- headache
- eye pain
- muscle aches
- loss of appetite
- nausea
- vomiting
- rash
- swelling of the lymph nodes

About one in 150 affected individuals develop severe nervous system disease. Old age seems to be the greatest risk factor for severe disease. Encephalitis is more commonly reported than meningitis. Hospitalized patients have exhibited fever, weakness, gastrointestinal symptoms, and change in mental status. A few patients develop a measles-like rash of the trunk, arms or legs. Severely affected patients may experience sever muscle weakness or paralysis, seizures or other severe neurologic manifestations.

The diagnosis of West Nile virus infection is made by clinical impression and confirmed by laboratory testing. It is chiefly suspected in adults over 50 who develop an encephalitis or meningitis in the summer or early fall. The presence of other cases in the community or history of travel also raises suspicion. However, the disease has been reported in all ages, and should be considered in all patients with unexplained encephalitis or meningitis.

Local and state health departments provide diagnostic testing. Samples of blood and spinal fluid are required.

There is as yet no approved specific treatment for this infection. Anti-viral agents are being tested, with some promise. Prevention of mosquito exposure and the use of repellants makes the best sense. Since the disease is so rare (even if hyped by the news media), and even more rare in children, a bit of common sense precautions ought to be about all parents concern themselves with West Nile virus.

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