Epidemiology and Infection

West Nile Virus

Detection of West Nile virus genome and specific antibodies in Iranian encephalitis patients

S. CHINIKARa1, A. JAVADIa2, B. ATAEIa2 c1, H. SHAKERIa2, M. MORADIa1, E. MOSTAFAVIa1 and S. M. GHIASIa1

a1 Laboratory of Arboviruses and Viral Haemorrhagic Fevers (National Reference Laboratory), Pasteur Institute of Iran, Tehran, Iran

a2 Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

SUMMARY

West Nile virus (WNV) is a mosquito-borne flavivirus which circulates in birds, horses and humans. An estimated 80% of WNV infections are asymptomatic. Fewer than 1% of infected persons develop neuroinvasive disease, which typically presents as encephalitis, meningitis, or acute flaccid paralysis. This study was conducted from January 2008 to June 2009 in Isfahan, Iran. Patients attending the emergency department with fever and loss of consciousness were consecutively included. Cerebrospinal fluids (CSF) were initially analysed through bacteriology and biochemistry examinations, resulting in those with evidence of meningitis being excluded. Patients' CSF and serum were diagnosed by serological and molecular assays. A total of 632 patients with fever and loss of consciousness were tested by CSF analyses. Samples of the remaining patients (39·4%) were referred for WNV investigation. Three (1·2%) of the patients were positive for both serum and CSF by RT–PCR, and six (2·4%) were positive only for IgG antibodies. History of insect bite, and blood transfusion and transplantation were risk factors for being positive by RT–PCR (P=0·048) and being IgG positive (P=0·024), respectively. The results of this study showed that the prevalence of West Nile fever is low in patients with encephalitis.

(Accepted September 17 2011)

(Online publication October 19 2011)

Correspondence:

c1 Author for correspondence: Dr B. Ataei, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. (Email: ataei@med.mui.ac.ir)

Footnotes

† These authors contributed equally to this work as joint first authors.

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