Since West Nile virus (WNV) was first isolated in 1937, it has been known to cause asymptomatic infection and fevers in humans in Africa, West Asia, and the Middle East. Human and animal infections were not documented in the Western Hemisphere until 1999. In 1999 and 2000, outbreaks of WNV encephalitis (inflammation of the brain) were reported in persons living in the New York City metropolitan area, New Jersey, and Connecticut. In these two years, 83 human cases of West Nile illness were reported; 9 died. In 2001, human infection with WNV occurred in 10 states with 66 cases and 9 deaths. In 2002, WNV activity has spread to most eastern and mid-western states, with 113 cases and 5 deaths as of August 8.

WNV is transmitted to humans through mosquito bites. Mosquitoes become infected when they feed on infected birds that have high levels of WNV in their blood. Infected mosquitoes can then transmit WNV when they feed on humans or other animals.

WNV is not transmitted from person to person and there is no evidence that a person can get infected by handling live or dead infected birds. But, to add a further level of safety, if birds or other potentially infected animals must be handled, a protective barrier (e.g., gloves, inverted plastic bags) should be used.

Most WNV infected humans have no symptoms. A small proportion develops mild symptoms that include fever, headache, body aches, skin rash and swollen lymph glands. Less than 1% of infected people develop more severe illness that includes meningitis (inflammation of the spinal cord) or encephalitis. The symptoms of these illnesses can include headache, high fever, neck stiffness, stupor, disorientation, coma, tremors, convulsions, muscle weakness, and paralysis. Of the few people that develop encephalitis, a small proportion die but, overall, this is estimated to occur in less than 1 out of 1000 infections.

 

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