Doctor's Notes on West Nile Virus
West Nile virus is a mosquito-borne viral illness. West Nile virus usually occurs in birds, and the virus is transferred from birds or animals to humans by the bite of an infected mosquito.
The majority of people infected with the West Nile virus show no symptoms. When symptoms do occur, they can range from mild to a rapidly fatal brain infection. Early symptoms of West Nile virus infection include
- abrupt onset of fever,
- chills, muscle aches,
- headache (may be severe),
- flu-like symptoms,
- sensitivity to light with pain behind the eyes,
- vomiting,
- diarrhea,
- rash,
- fatigue, and
- weakness.
Most patients will recover completely. In a small percentage of patients, the disease can progress to cause encephalitis or meningitis, which may appear as neurological changes such as disorientation, tremors, seizures, headache, high fever, and neck stiffness, and in about 10% of cases, death.
What is the Treatment for West Nile Virus?
There is no specific treatment for West Nile virus infection. Mild illness does not require therapy other than medications to reduce fever and pain such as acetaminophen (Tylenol) and ibuprofen (Motrin, Advil).
In cases of severe illness, supportive therapy in a hospitalized setting is necessary to limit complications of brain infections. Anti-inflammatory medications, intravenous fluids, and intensive medical monitoring are essential.
There is no specific antibiotic or antidote for the viral infection. There is no current vaccine to prevent the virus.
Avoiding areas that have high populations of mosquitoes is key to the prevention of the West Nile Virus.
The following recommendations can help reduce the risk of becoming infected with the virus:
- Stay indoors at dawn, dusk, and in the early evening.
- Wear long-sleeved shirts and long pants when outdoors.
- Apply insect repellent sparingly to exposed skin. An effective repellent contains 20%-30% DEET (N,N-diethyl-meta-toluamide). Avoid products containing more than 30% DEET.
- Insect repellents should not be applied to very young children (under 3 years of age) or babies.
- Repellents may irritate the eyes and mouth.
- Spray clothing with repellents containing permethrin or DEET since mosquitoes may bite through thin clothing.
- When using insecticide or insect repellent, read and follow the manufacturer's directions for use, as printed on the product.
- Take preventive measures in and around your home. Repair or install door and window screens, use air conditioning, and reduce breeding sites (eliminate standing water).
- If you find a dead bird, the Centers for Disease Control (CDC) recommends you not handle the carcass with bare hands. Contact your local health department for instructions.
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Encephalitis
Encephalitis is an acute infection and inflammation of the brain itself. This is in contrast to meningitis, which is an inflammation of the layers covering the brain. Encephalitis symptoms and signs include headache, fever, fatigue, seizures, and photophobia. Treatment depends upon the cause of the encephalitis. -
Insect Bites and Stings
Insect stings and bites are common. Common symptoms include: pain, swelling, redness, and itching. Treatment of insect stings and bites depends on the type of insect. Some may require home remedies such as anti-inflammatory agents, antibiotics, and in some cases, surgery. -
Meningitis in Adults
Meningitis is an infection of the layers around the spinal cord called meninges. This potentially life-threatening condition can be caused by bacteria, viruses, fungus, or reactions to medications or environmental toxins. -
Meningitis in Children
Meningitis is an inflammation of the membranes that surround the spinal cord or brain. Bacterial meningitis is caused by bacterial and viral meningitis is caused by a virus. Meningitis symptoms in children include vomiting, rash, stiff neck, fever, seizure, nausea, increased sensitivity to light, and altered mental status. Treatment may incorporate a breathing tube, a heart and breathing monitor, IV fluids, catheterization, and administering acetaminophen or ibuprofen. -
West Nile Virus Infection Symptoms
Symptoms and signs of West Nile virus infection range from no symptoms at all, to an abrupt onset of fever, chills, muscle aches, headache, and an overall feeling of illness.
REFERENCE:
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.