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West Nile Virus

What is West Nile virus?

West Nile virus (WNV) is a virus carried by mosquitoes. Most people infected with the virus don’t have symptoms or have only a mild illness. Fewer than 1 in 100 people who are infected with the virus develop serious illness. Serious forms of illness caused by WNV include encephalitis (inflammation of the brain) and meningitis (inflammation of the membranes that cover the brain and spinal cord).

How does it occur?

Wild and domestic birds, mainly crows, carry the West Nile virus. Mosquitoes become carriers of the virus when they bite infected birds. Humans can get the virus when they are bitten by infected mosquitoes. There are no known cases of a human getting WNV directly from an infected bird.

The risk of West Nile virus is seasonal in the northern states of the US and usually starts in the spring. The peak time for infection is mid to late August. In milder southern climates, the infection may occur year-round. The risk of severe infection is greatest for people who are over 70 years old or who have a weakened immune system.

West Nile virus may be spread from person to person through blood transfusions and organ transplants. However, blood centers and hospitals screen for West Nile Virus in donated blood and organs. The virus might also be transmitted through breast milk. However, the risk of transmission of the virus to the baby is believed to be very low. If you are breast-feeding and you have a WNV infection, the American Academy of Pediatrics and the CDC say that it’s OK to keep breast-feeding.

The infection is not spread by normal person-to-person contact like touching, kissing, or caring for someone who is infected.

What are the symptoms?

About 4 out of 5 infected people don’t have symptoms. Children are more likely to have symptoms than adults. When symptoms do occur, they are usually mild and last a few days. Symptoms of WNV infection may include:

  • fever
  • headache
  • body aches
  • nausea or vomiting
  • rash
  • swollen lymph glands.

A WNV infection usually does not involve the brain. However, a few infected adults and children develop encephalitis or meningitis. Symptoms of these severe illnesses include:

  • tremors
  • stiff neck
  • high fever
  • severe headache
  • paralysis
  • muscle weakness
  • confusion
  • convulsions
  • coma.

Some people develop a polio-like syndrome with sudden weakness and paralysis.

Symptoms usually appear 3 to 14 days after you are bitten by an infected mosquito.

How is it diagnosed?

Your child's healthcare provider will ask about the symptoms and examine your child. Your child may have the following tests:

  • blood tests
  • spinal tap (lumbar puncture), a procedure in which a needle is inserted between 2 bones of the spine into the spinal canal to take a sample of spinal fluid to test for meningitis
  • electroencephalogram (EEG), a test that measures the electrical activity of the brain (brain waves)
  • computerized tomography (CT) or magnetic resonance imaging (MRI) scans of the brain.

How is it treated?

There is no medicine that cures West Nile virus. If the infection is serious, your child may need to stay at the hospital. At the hospital, your child may be given intravenous (IV) fluids, pain relievers, or other treatments.

How long will the effects last?

Most people infected with WNV, including nearly all children, don’t get seriously ill, and they recover fully. Symptoms usually last 3 to 6 days, but they can last as long as several weeks or months.

If you have a serious infection, you may be ill for weeks or months. Your nervous system or brain may be injured. The injury is sometimes permanent.

If you get West Nile virus, you will probably be immune to future infection by the virus, but your immunity might decrease over time.

How can I take care of my child?

  • Let your child rest if he or she is tired.
  • Give acetaminophen (Tylenol) for fever or an anti-inflammatory medicine such as ibuprofen if your child has a fever plus headache or muscle aches.
    • Check with your healthcare provider before you give any medicine that contains aspirin or salicylates to a child or teen. This includes medicines like baby aspirin, some cold medicines, and Pepto-Bismol. Children and teens who take aspirin are at risk for a serious illness called Reye's syndrome.
    • Nonsteroidal anti-inflammatory medicines (NSAIDs) may cause stomach bleeding and other problems. These risks increase with age. Read the label and take as directed. Unless recommended by your healthcare provider, don’t give them for more than 10 days for any reason.
  • Contact your healthcare provider if your child develops:
    • a stiff neck
    • severe headache
    • a fever of 101.5°F (38.6°C) or higher that does not go down with medicine
    • tremors
    • seizures (convulsions)
    • slurred speech
    • confusion
    • muscle weakness or paralysis (inability to use an arm or leg).

How can I prevent West Nile virus infection?

WNV can be prevented by taking precautions to avoid exposure to mosquitoes:

  • Stay indoors at dawn, dusk, and in the early evening, when mosquitoes are most likely to be around.
  • Wear long-sleeved shirts and long pants when outdoors.
  • Use an insect repellent whenever you are outdoors. Don't use more repellent than recommended in the package directions. Don't put repellent on open wounds or rashes. Don’t put it on your eyes or mouth. When using sprays for the skin, don’t spray the repellent directly on your face. Spray the repellent on your hands first and then put it on your face. Then wash the spray off your hands.
    • Adults should use repellent products with no more than 35% DEET. Children older than 2 months can use repellents with no more than 30% DEET. DEET should be applied just once a day. Wash it off your body when you go back indoors.
    • Picaridin may irritate the skin less than DEET and appears to be just as effective.
    • Spray clothes with repellents because mosquitoes may bite through thin clothing. Products containing permethrin are recommended for use on clothing, shoes, bed nets, and camping gear. Permethrin-treated clothing repels and kills ticks, mosquitoes, and other insects and can keep working after laundering. Permethrin should be reapplied to clothing according to the instructions on the product label. Some commercial products are available pretreated with permethrin. Permethrin does not work as a repellent when it is put on the skin.
    • In some studies, oil of lemon eucalyptus, a plant-based repellent, provided as much protection as repellents with low concentrations of DEET, but it hasn't been as well tested as DEET. Oil of lemon eucalyptus should not be used on children under age 3.
    • Some repellents can make children ill if they put it in their mouth or swallow it. Never let young children play with or put repellent on themselves. Adults should put repellent on their own hands, and then put the repellent on the child’s body.
  • Install or repair window and door screens so it is harder for mosquitoes to get indoors.
  • Mosquitoes lay eggs in water. To reduce mosquito breeding, drain standing water. Routinely empty water from flowerpots, pet bowls, clogged rain gutters, swimming pool covers, buckets, barrels, cans, and other items that collect water.

Note: Vitamin B and ultrasonic devices don’t help prevent mosquito bites.

A vaccine is available to protect horses from West Nile virus. No vaccine is available for humans yet, but several companies are working to develop a human vaccine.

Developed by RelayHealth.
Pediatric Advisor 2012.2 published by RelayHealth.
Last modified: 2011-08-15
Last reviewed: 2011-06-09
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
© 2012 RelayHealth and/or its affiliates. All rights reserved.
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