West Nile Encephalitis Virus Infection: Viral Pathogenesis and the Host Immune Response
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On the basis of these experiments, progress has been made on the identification of genetic factors that predispose to severe human disease. Thus, in a remarkably short period of time, insight has been gained on a wide variety of disciplines related to West Nile virus biology. The aim of this book was to assemble an up-to-date and cutti- edge anthology from the leading experts in the field.
Mini Review ARTICLE
The chapters are balanced by submissions from newcomers who have made significant recent contributions with those from established investigators who have dedicated their careers to the study of West Nile virus. Product details Format Paperback pages Dimensions x x Illustrations note XIX, p. Other books in this series. Bioterrorism and Infectious Agents I. Add to basket. Reemergence of Established Pathogens in the 21st Century I. Malaria Krishna R.
Infections and the Cardiovascular System I. Molecular Paradigms of Infectious Disease C.
Potentiation of West Nile Encephalitis by Mosquito Feeding | Viral Immunology
Challenges in Infectious Diseases I. New and Evolving Infections of the 21st Century I. Antimicrobial Resistance and Implications for the 21st Century I. Emerging Zoonoses I.
Back cover copy In West Nile Encephalitis Virus Infection, leading scientists and researchers discuss the West Nile virus, a neurotropic flavivirus that has emerged globally as a primary cause of viral encephalitis. Its appearance in the Western Hemisphere in , and the corresponding increase in global disease burden over the last decade has been accompanied by intensive study, including the entry of many scientists into the field.
While the topics in this book are focused on the West Nile virus, they are broad in scope ranging from understanding vector transmission patterns to the dynamics of structural transitions of proteins on the surface of the virion. Interferon alpha has also protected mouse neuroblastoma cells against West Nile virus infection Interferon alpha and its inducers Poly I:C and Ampligen are effective against flaviviruses in-vivo, but their effectiveness decreases if given late after infection.
Again, the efficacy of interferon alpha 2-b and Ampligen was decreased if treatment was delayed Interferon alpha has shown a therapeutic effect in mice infected with St. Louis encephalitis virus. There was no benefit if interferon was given 5 days after challenge 7. Few case re ports suggest that interferon alpha may be beneficial against human flavivirus infections. Improvement in the outcome of dengue fever in children and adults was noted in Cuba in , after treatment with interferon alpha Among four patients with severe Japanese encephalitis, two recovered after they received interferon alpha, and two who did not receive such therapy died A random ized, double-blinded, placebo-controlled study of interferon alpha therapy for Japanese encephalitis in children was conducted in Vietnam.
No difference in mortality and functional outcome was demonstrated. Louis viral meningoencephalitis, the neurologic status of 15 treated patients was compared to that of 17 previously untreated patients during the same outbreak. The results suggest that early initiation of therapy enhanced neurologic recovery at three weeks after enrollment A randomized, non-blinded study evaluated the potential therapeutic benefit and safety of interferon alpha-2b in patients with West Nile virus meningoencephalitis during the summers of and in the U.
The outcome of fifteen treated patients was compared to eight untreated patients. A statistically significant improvement occurred in the treated group B-cell m ediated humoral immunity is another essential component of the host immune response against West Nile virus infection. Neutralizing antibodies limit the dissemination of West Nile virus infection in animal models. These results suggest that neutralizing antibody is important in the control of disseminated West Nile virus infection, but that such efficacy depends upon timely administration.
Immunotherapy may not be sufficient to eliminate the virus from the host since immunocompromised mice succumbed to West Nile virus infection, even though they received antibody therapy When challenged with West Nile virus, mice deficient in secreted-IgM, but capable of expressing surface IgM and secreting other immunoglobulins, had higher levels of viremia and greater mortality than wild-type mice. The role of antibody to West Nile virus envelope E protein was also studied.
Recent advances in understanding West Nile virus host immunity and viral pathogenesis
Passive immunization with anti-E protein sera partially protected mice from infection with West Nile virus This suggests that anti-E antibody may be protective if given before West Nile virus infection, while antibody produced during infection cannot eliminate the infection, but might limit its dissemination Case reports describe the outcome of three patients with West Nile virus encephalitis treated with intravenous immunoglobulin containing a high titer of West Nile virus antibody. Two patients, one a lung-transplant recipient and the other with chronic lymphocytic leukemia, survived.
Three double-blinded, placebo-controlled, randomized clinical trials are in progress during These are testing different therapeutics among patients with, or at high risk of, neuroinvasive disease. One trial assesses the safety and efficacy of intravenous immunoglobulin G Omr-IgG-am containing a high concentration of anti- West Nile virus antibody. The second assesses the safety and efficacy of interferon alpha n3 Alferon , and the third is an exploratory study of the safety, tolerability, pharmacokinetics and potential effectiveness of an antisense compound, AVI www.
The potential value of systemic corticosteroids has not been tested. One report described the clinical course of a patient with West Nile virus meningoencephalitis and AFP who was treated with methylprednisone. To date, no human West Nile virus vaccine is available, but a number are in development.
It is given intramuscularly in two doses three weeks apart. West Nile virus ha s found its niche in North America and it is unlikely that diseases associated with it will disappear. Therefore, public education and mosquito control are most important in prevention.
Mosquito control is the most effective strategy for prevention of human infection. This should include surveillance for larval and adult mosquitoes, and determination of the prevalence of virus in the mosquito population. Control also involves source reduction; i. Insecticides larvicides or adulticides can be used against immature or adult mosquitoes to enhance source reduction if necessary.
Control programs should monitor the development of resistance to infecticides among the mosquito population The public s hould be educated about the modes of West Nile virus transmission and prevention of mosquito bites. Persons older than 50 or those who are immunocompromised are at highest risk for severe disease.
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Preventive measures should include use of mosquito repellent when outdoors. Spraying clothing with N,N-diethyl-meta-toluamide DEET or permethrin adds extra protection, since mosquitoes can bite through thin clothing. Wearing protective clothing long sleeves, socks, and long pants when outdoors should be encouraged.
It is advisable to remain indoors or use protective clothing and repellent from dusk to dawn, the primary mosquito-biting hours. Intact window and door screens prevent mosquitoes from entering homes. Mosquito netting should be used over beds when camping Nosocom ial transmission of West Nile virus can be prevented by screening blood products and donors or organs for transplantation. A high level of suspicion should be maintained between June and November, when human infection with West Nile virus predominates, coinciding with the seasonal activity of mosquitoes. Guillaine-Barre syndrome: An unusual presentation of West Nile virus infection.
Neurology ; Emerg Inf Dis. Barrett A. National Conference on West Nile Virus J Infect Dis. Detection of West Nile virus sequences in cerebrospinal fluid.
Clinical and neuroradiologic features of 39 consecutive cases of West Nile Virus meningoencephalitis. J Neurol Sci. Interferon-alpha protects mice against lethal infection with St. Louis encephalitis virus delivered by the aerosol and subcutaneous routes. Antiviral Res.
Phylogenetic relationships of southern African West Nile virus isolates. Emerg Infect Dis. West Nile virus.