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Centro de Investigaciones Regionales Dr. Hideyo Noguchi, Universidad Autónoma de Yucatán

2001, Number 3

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Rev Biomed 2001; 12 (3)

West Nile Virus: A reemerging global pathogen.

Petersen LR, Roehrig JT

Language: English
References: 52
Page: 208-216
PDF size: 64.16 Kb.


ABSTRACT

The recognition of West Nile (WN) virus in the Western Hemisphere in the summer of 1999 marked the first introduction in recent history of an Old World flavivirus into the New World. WN virus, a member of the family Flaviviridae (genus Flavivirus) was first isolated in 1937 in the West Nile district of Uganda. Since the original isolation of WN virus, outbreaks have occurred infrequently in humans, those in Israel (1951-1954 and 1957) and South Africa (1974) being most notable. Since the mid-1990s, however, three disturbing epidemiologic trends for WN virus have emerged: 1) increase in frequency of outbreaks in humans and horses (Romania 1996; Morocco 1996; Tunisia 1997; Italy 1998; Russia, the United States, and Israel 1999; and Israel, France, and the United States 2000); 2) apparent increase in severe human disease (confirmed human infections in recent outbreaks: Romania, 393 cases; Russia [Volgograd], 942 cases; United States, 62 cases in 1999 and 21 in 2000; Israel, 2 cases in 1999 and 417 in 2000); and 3) high avian death rates accompanying the human outbreaks, in outbreaks in Israel and the United States. Recent outbreaks of WN virus have been accompanied by an apparent evolution of a new WN virus variant. WN virus can be divided genetically into two lineages. Only members of lineage 1 WN viruses have been associated with clinical human encephalitis. Lineage 1 WN viruses have been isolated from Africa, India, Europe, Asia, and North America. Lineage 2 WN viruses are maintained in enzootic foci in Africa and have not been associated with clinical human encephalitis. The close genetic relationship between WN virus isolates from Israel and New York suggests that the virus was imported into North America from the Middle East. The means of its introduction (infected bird, mosquito, human, or another vertebrate host) will likely remain unknown. A striking feature of the initial human epidemic in New York City in 1999 was the high number of avian deaths in the accompanying epizootic, particularly in American Crow s (Corvus brachrhynchos) and other corvids. In 2000, 14 mosquito species in five states had evidence of WN virus infection (by culture or nucleic acid amplification). Mosquitoes of the genus Culex are the principal maintenance vector in the Old World. However, which species are most important for transmission to humans or horses remains unknown. Given our incomplete and evolving knowledge of the ecology and public health impact of WN virus in the Americas, as well as the efficacy of control efforts, the virus will remain an important public health challenge in the next decade.


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