The following symptoms and complaints may indicate West Nile fever: Main symptoms Fever, abrupt onset (biphasic course/twophasic). Chills Fatigue Emesis (vomiting) Exanthema (rash), pale and maculopapular (blotchy and with papules, ie with vesicles), from the trunk to the head and limbs. Headache and pain in the limbs Lymphadenopathy (lymph node enlargement) (sometimes). Myalgia (muscle pain) … West Nile Fever: Symptoms, Complaints, Signs
Pathogenesis (disease development) West Nile fever belongs to the group of flaviviruses (Flaviviridae). The virus is transmitted primarily by predominantly diurnal mosquitoes of the genus Culex, but also by Aedes and Mansonia species. In rare cases, transmission occurs through organ transplants, blood transfusions, and pregnancy and breast milk. Etiology (Causes) Behavioral causes Lack of protection … West Nile Fever: Causes
General measures Sufficient fluid intake! Observance of general hygiene measures! In the occurrence of fever: Bed rest and physical rest (even with only a slight fever). Fever below 38.5 °C does not necessarily need to be treated! (Exceptions: Children prone to febrile convulsions; old, weakened people; patients with a weakened immune system). In case of … West Nile Fever: Therapy
Medical history (history of illness) represents an important component in the diagnosis of West Nile fever. Family history Social history Have you been abroad recently? If so, where (endemic areas of India, Israel, the Middle East, western Turkey, parts of Southeast Asia and North and Central America, tropics)? Current medical history/systemic history (somatic and psychological … West Nile Fever: Medical History
Infectious and parasitic diseases (A00-B99). Bacterial and viral meningoencephalitis agents – infections leading to combined inflammation of the brain (encephalitis) and its meninges (meningitis). Chikungunya fever – infectious disease caused by the chikungunya virus (CHIKV). Dengue fever – (sub-)tropical infectious disease caused by dengue virus and transmitted by mosquitoes. Early summer meningoencephalitis (TBE). Yellow fever … West Nile Fever: Or something else? Differential Diagnosis
The following are the most important diseases or complications that may be contributed to by West Nile fever: Eyes and eye appendages (H00-H59). Optic neuritis (optic neuritis). Cardiovascular system (I00-I99) Myocarditis (inflammatory disease of the heart muscle) (rare). Liver, gallbladder, and bile ducts-pancreas (pancreas) (K70-K77; K80-K87). Hepatitis (inflammation of the liver) (rare). Musculoskeletal system and … West Nile Fever: Complications
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body temperature, body weight, body height; further: Inspection (viewing). Skin and mucous membranes [insect bite? exanthema (rash)?] Neck [lymphadenopathy (lymph node enlargement)?] Auscultation (listening) of the heart. Auscultation of the lungs Palpation (palpation) of the … West Nile Fever: Examination
1st order laboratory parameters – obligatory laboratory tests. Antibody detection by serologic methods such as ELISA (enzyme-linked immunosorbent assay) – antigen detection (IgM and IgG) [serum/liquor samples] – approximately 8 days after onset of first symptoms. Note: Other flavivirus infections or vaccinations may cause cross-reactions in ELISA! Direct virus detection using PCR (polymerase chain reaction) … West Nile Fever: Test and Diagnosis
Therapeutic targets Relief of discomfort (aching limbs, headache). If necessary, rehydration (fluid balance). Therapy recommendations There is no causal therapy! Symptomatic therapy (analgesics (painkillers), antiemetics (drugs against nausea and vomiting), anticonvulsants (anticonvulsants)) including fluid replacement – oral rehydration in signs of dehydration (fluid deficiency; > 3% weight loss): administration of oral rehydration solutions (ORL), which … West Nile Fever: Drug Therapy
To prevent West Nile fever, attention must be paid to reducing individual risk factors. Behavioral risk factors Poor protection from mosquitoes in endemic areas. Preventive measures The following measures should be carried out for individual prophylaxis: Detailed medical consultation before travel. Implementation of exposure prophylaxis, ie mosquito repellent, including at dusk and at night: Stay … West Nile Fever: Prevention
