West Nile Virus - Neglected Tropical Diseases - North America

Authors: Bonnie E. Gulas-Wroblewski, Miguel A. Saldana, Kristy O. Murray, and Shannon E. Ronca

This volume of the Neglected Tropical Diseases (NTD) series covers the most prevalent NTDs in North America. This book discusses in detail pathology, diagnostics and control approaches of selected NTDs in the sub-tropical regions of the United States of America. There are disproportionate numbers of children and adults living in poverty within the United States that are at risk of infections caused by helminths, protozoa, viruses and bacteria which commonly lead to chronic, debilitating and stigmatizing diseases. Each chapter focuses on one specific disease or series of related diseases, and provides in-depth insights into the topic. 

Chapter West Nile Virus Abstract: Pages 197-224

Since its introduction to North America in 1999, West Nile virus (WNV) has established itself as an endemic pathogen with regular seasonal outbreaks. The single-stranded RNA flavivirus is primarily transmitted by mosquitoes in the genus Culex and maintained in an enzootic transmission cycle by a diverse assemblage of avian hosts. Humans, equines, and other mammals serve as incidental or dead-end hosts. WNV is a significant threat to public health, with estimates indicating that more than seven million individuals have been infected. Although the majority of these individuals are asymptomatic, approximately 20% develop a febrile illness or neuroinvasive disease, the latter associated with high rates of mortality in the elderly and immunocompromised. Disease-associated pathology of the central nervous system is prevalent not only during the acute phase of WNV infection but also as significant long-term sequelae. Although vaccine and therapeutic research progressed over the last 20 years, no agents are licensed for use in humans, and treatment depends on supportive care. Mitigation efforts are instead directed towards the elimination and control of mosquito vectors. Future research will need to leverage technological and epidemiological advances to overcome a host of challenges in order to alleviate the immense economic and human costs of this endemic zoonotic disease.

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