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John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
West Nile encephalitis is an infection of the brain that is caused by a virus known as the West Nile virus. First identified in Uganda in 1937, the virus is commonly found in Africa, West Asia, and the Middle East. "Encephalitis" means inflammation of the brain. One of the causes of encephalitis is viral and bacterial infections, including viral infections transmitted by mosquitoes.
West Nile virus had not been previously reported in the U.S. prior to an outbreak in New York in September 1999. According to the U.S. Centers for Disease Control and Prevention (CDC), since 1999 more than 30,000 people have been reported with West Nile virus. More than 1,200 have died.
In 2011, 41 cases of West Nile virus were confirmed by the CDC. Of those, 59% of patients developed neuroinvasive disease (involvement of the brain and nervous system), the most severe form of West Nile virus infection. The CDC reports neuroinvasive disease was reported by 46 states and the District of Columbia (none from Alaska, Hawaii, Maine, or Vermont or any U.S. territories).
Among all people who become infected with West Nile virus, most have mild symptoms that do not get reported. Less than 1% will actually develop severe neuroinvasive disease, according to the CDC.
West Nile Virus activity has been reported in the following states in 2011: Arizona, California, Colorado, Florida, Georgia, Indiana, Louisiana, Mississippi, New Jersey, North Dakota, South Dakota, Texas, Virginia, and Wyoming.
West Nile virus infection is also called West Nile fever or West Nile encephalitis.
To date, strains of the West Nile virus have been commonly found in humans, birds, and other vertebrate animals in Africa, Eastern Europe, West Asia, and the Middle East. Prior to 1999, the West Nile virus had not been recognized in the Western Hemisphere.
The first recorded epidemics were reported in Israel in the 1950s and in Europe in 1962. A subsequent outbreak occurred in New York in 1999. The American strain of the virus is almost indistinguishable from a virulent strain found in a goose on an Israeli farm in 1998. Thousands of people travel between New York and the Middle East each year. The virus may well have hitchhiked a ride to New York with an infected traveler.
People get West Nile virus from bites of a mosquito (primarily the Culex pipiens mosquito) that is infected with the West Nile virus.
Mosquitoes become infected by feeding on birds that are infected with the virus. The infected birds may or may not become ill. The birds are vectors, or intermediate carriers, of the virus that is important for the virus' life cycle and transmission cycle.
Among birds, crows are most vulnerable to infection by the West Nile virus. They are often killed by the virus. More than 200 species of birds have been found to be infected by the virus, and the common dust-colored house sparrow is probably a principal bird reservoir for the virus in New York. Sparrows can harbor the virus for five days or more at levels high enough to infect mosquitoes that bite them.
The infected mosquitoes then transmit the virus when they bite and suck blood from people and animals and, in the process, inject the virus into their victim.
The incubation period (the time from infection to the development of symptoms) is five to 15 days.
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