1/11. The west nile virus outbreak of 1999 in New York: the flushing Hospital experience.west nile virus (WNV) is a mosquito-borne flavivirus, which has been known to cause human infection in africa, the middle east, and southwestern asia. It has also been isolated in australia and sporadically in europe but never in the americas. Clinical features include acute fever, severe myalgias, headache, conjunctivitis, lymphadenopathy, and a roseolar rash. Rarely is encephalitis or meningitis seen. During the month of August 1999, a cluster of 5 patients with fever, confusion, and weakness were admitted to the intensive care unit of the same hospital in new york city. Ultimately 4 of the 5 developed flaccid paralysis and required ventilatory support. Three patients with less-severe cases presented shortly thereafter. With the assistance of the new york city and New York State health departments and the Centers for disease Control and Prevention, these were documented as the first cases of WNV infection on this continent.- - - - - - - - - - ranking = 1keywords = west (Clic here for more details about this article) |
2/11. Arbovirus studies in two towns in western state of nigeria.Three hundred and fifty-one persons were tested for HI antibody to arbovirus Groups A, B and Ingwavuma viruses in Ilesha and Oshogbo, two towns in western nigeria. Chikungunya accouted for most Group A infections (39%). antibodies to Group B virus were distributed as follows: dengue 22%, yellow fever 25%, West Nile 28% and Wesselsbron 30%. Few sera 5% were positive to Ingwavuma. No virus was isolated from 188 blood specimens processed for virus isolation.- - - - - - - - - - ranking = 5keywords = west (Clic here for more details about this article) |
3/11. optic neuritis complicating west nile virus meningitis in a young adult.A case of west nile virus (WNV) infection with meningitis and optic neuritis in a 28-year-old man is presented. The patient had a number of unusual clinical and laboratory findings that broadened the differential diagnosis. The emergence of WNV infection in southern europe and north america calls for increased awareness of physicians to this clinical entity.- - - - - - - - - - ranking = 4keywords = west (Clic here for more details about this article) |
4/11. Chorioretinal lesions in nonfatal cases of west nile virus infection.OBJECTIVE: west nile virus (WNV) disease is a zoonotic infection with recent outbreaks in the united states. Recent reports have highlighted the intraocular findings associated with WNV disease. We describe the intraocular findings observed in two patients infected by the west nile virus. DESIGN: Observational case reports. methods: During an outbreak of WNV disease in Southwest ohio, two patients with an acute onset of a systemic febrile illness accompanied by myalgia, arthralgia, headache, and a maculopapular rash were referred for blurred vision. Complete ophthalmologic examination, fundus photographs, and fluorescein angiograms were obtained on both patients. Both patients underwent serologic testing for viruses and cultures for bacteria, viruses, and fungi. RESULTS: Ophthalmologic examination in each patient revealed anterior segment and vitreous inflammatory cells and multiple partially atrophic and partially pigmented chorioretinal lesions clustered in the peripheral fundus. Fundus examination in case 2 also revealed mild disc edema in both eyes. intracranial pressure as measured by lumbar puncture was borderline elevated. The chorioretinal lesions in both patients showed a striking similarity and appeared hypofluorescent centrally and hyperfluorescent around the edges on a fluorescein angiogram. Serologic testing for the WNV was positive in both patients, and tests for all other bacteria, fungi, and viruses were negative. CONCLUSIONS: WNV usually causes mild symptoms, but it occasionally causes neurologic illness with fatal outcome or severe morbidity. We present the cases of two patients with serology-proven WNV disease who developed chorioretinal lesions with a targetlike appearance and iridocyclitis.- - - - - - - - - - ranking = 1keywords = west (Clic here for more details about this article) |
5/11. west nile virus encephalitis in organ transplant recipients: another high-risk group for meningoencephalitis and death.west nile virus infection has been spreading westward across the continental united states since 1999. Although it often presents as a mild, self-limiting viral illness, it can result in a devastating meningoencephalitis in some patient populations, particularly the elderly. We report in this article on two immunosuppressed transplant patients who developed a severe meningoencephalitis caused by mosquito-borne west nile virus infection. Suggestions for the prevention, diagnosis, and treatment of west nile virus infection in this patient population are described.- - - - - - - - - - ranking = 1keywords = west (Clic here for more details about this article) |
6/11. Possible dialysis-related west nile virus transmission--georgia, 2003.In October 2003, the georgia Division of public health (DPH) was notified of two patients from the same county with confirmed west nile virus (WNV) disease who had received hemodialysis on the same day and on the same dialysis machine. The two dialysis patients (patients A and C) had the only confirmed cases of human WNV disease reported in their county in 2003. review of the dialysis center's records indicated that another patient (patient B) had received dialysis on the same machine between these two patients on the same day. This report summarizes results of the epidemiologic investigation, which suggested that WNV might have been transmitted at the dialysis center. Hemodialysis centers should adhere strictly to established infection-control procedures to avoid WNV transmission through dialysis.- - - - - - - - - - ranking = 4keywords = west (Clic here for more details about this article) |
7/11. Systemic and intraocular manifestations of west nile virus infection.Since the introduction of west nile virus in the Western Hemisphere in 1999, the incidence of human infection has increased dramatically. As this virus spreads westward across the united states, ophthalmologists should be aware of this presently uncommon but important condition. Systemic features of west nile virus infection are well characterized; however, the ophthalmic presentations are not widely known. Intraocular involvement with west nile virus infection was first described in February 2003, and a variety of ophthalmic manifestations have since been recognized. A complete survey of the systemic and intraocular manifestations of west nile virus infection relevant to the ophthalmologist is presented.- - - - - - - - - - ranking = 1keywords = west (Clic here for more details about this article) |
8/11. west nile virus--the eye of the storm: a case study.west nile virus (WNV) is an arbovirus that emerged in the united states in 1999 and is migrating westward across the country. It occurs in the late summer or fall when there is an abundance of mosquitoes. Symptoms develop 3-14 days after an infected mosquito bites a person. Most WNV infections are asymptomatic or produce mild symptoms; however, 1 in 150 cases is severe with significant neurological deficits. The virus can attack the anterior horn cells, causing acute flaccid paralysis resulting in a poliomyelitis-like syndrome. diagnosis is based on history, clinical presentation, and laboratory tests. In the late summer or fall, WNV infections should be suspected in persons with unexplained encephalitis, meningitis, or flaccid paralysis. There is no definitive medical treatment for WNV. Preventive measures are the most effective means to combat the disease.- - - - - - - - - - ranking = 1keywords = west (Clic here for more details about this article) |
9/11. west nile virus infection and its neurological manifestations.The west nile virus caused an epidemic of meningoencephalitis in Midwest north america during 2002. The peak incidence coincided with the highest activity period of mosquito vectors in affected states. This epidemic followed recent established trends, not only of increased central nervous system involvement by the virus, but also increased incidence of dramatic neuromuscular impairment. Two cases are presented which illustrate the most concerning types of neuromuscular sequelae, diffuse weakness leading to respiratory insufficiency, and the development of focal weakness similar to poliomyelitis. The epidemiology and clinical characteristics of west nile virus infection are also reviewed. Concern is expressed regarding the possibility of epidemics in other Midwestern states during future seasons of increased mosquito activity.- - - - - - - - - - ranking = 2keywords = west (Clic here for more details about this article) |
10/11. rhabdomyolysis in patients with west nile encephalitis and meningitis.Since 1999, more than 6,500 cases of west nile virus neuroinvasive disease (WNND) have been reported in the united states. patients with WNND can present with muscle weakness that is often assumed to be of neurological origin. During 2002, nearly 3,000 persons with WNV meningitis or encephalitis (or both) were reported in the united states; in suburban Cook County, illinois, with 244 persons were hospitalized for WNV illnesses. The objective of this investigation was to describe the clinical and epidemiological features of identified cases of WNV neuroinvasive disease and rhabdomyolysis. public health officials investigated patients hospitalized in Cook County, and identified a subset of WNV neuroinvasive disease patients with elevated creatine kinase levels. Cases were defined as hospitalized persons with a WNV infection, encephalitis or meningitis, and rhabdomyolysis. Retrospective medical record reviews were conducted and data was abstracted with a standardized data collection instrument. Eight patients with West Nile encephalitis and one with West Nile meningitis were identified with rhabdomyolysis. Median age of the nine patients was 70 years (range, 45-85 years), and eight were men. For all nine patients, the peak CK level was documented a median of 2 days after hospitalization (range, 1-24 days). Median CK level during hospitalization for all case-patients was 3,037 IU (range, 1,153-42,113 IU). Six patients had history of recent falls prior to admission. Although the temporal relationship of rhabdomyolysis and neurological WNV illness suggested a common etiology, these patients presented with complex clinical conditions which may have led to development of rhabdomyolysis from other causes. The spectrum of WNV disease requires further investigation to describe this and other clinical conditions associated with WNV infection.- - - - - - - - - - ranking = 4keywords = west (Clic here for more details about this article) |
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