Latest Report On West Nile Fever In India: Key Symptoms And Treatment Methods

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Published on: 15-May-2024

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Anvesha Chowdhury

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Latest Report On West Nile Fever In India: Key Symptoms And Treatment Methods

Latest Report On West Nile Fever In India: Key Symptoms And Treatment Methods

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West Nile Fever (WNF) is a mosquito-borne disease that has attracted international attention due to its profound impact on public health. However, last week, between 8th and 10th May 2024, Kerala, India, was diagnosed with 12 confirmed cases of West Nile fever in Thrissur, Kozhikode, and Malappuram. A single-stranded RNA virus was detected, which has been the talk of the town. The disease's symptoms include fever, headache, and neurological signs, which the National Institute of Virology, Pune, published in a report after sample testing.    

West Nile fever is an arbovirus (insect-borne virus) of the Flaviviridae family. It is one of the Japanese encephalitis antigenic serocomplex (WNV is part of a group of viruses that share similar antigenic properties with the Japanese encephalitis virus) and has become a major topic of discussion in the country since the outbreak. Since its emergence in the West Nile region of Uganda in 1937, this disease has spread to all countries, causing severe epidemics in many areas.  

This blog aims to provide a comprehensive understanding of West Nile fever. It will delve into the disease's pathogenesis, diagnosis, treatment, and prevention strategies. Additionally, it will highlight ongoing research and evaluation, offering readers the most up-to-date information on this pressing health issue. Keep reading to stay updated about West Nile fever.  

Table Of Contents 

1. What Is West Nile Fever Virus Infection? 

2. Highlights Of The West Nile Fever India Scenario 

3. Key West Nile Fever Symptoms To Be Aware Of 

4. What Are The Current West Nile Fever Treatment Options? 

5. Dietitian’s Recommendation 

6. The Final Say 

7. FAQs 

8. References 

What Is West Nile Fever Virus Infection? 

West Nile virus (WNV) is transmitted primarily by mosquitoes and birds, with humans and other animals as hosts. This disease is usually transmitted to humans by the bite of mosquitoes, mainly Culex mosquitoes. Although West Nile virus activity is seasonal and peaks in the warmer months, it can last indefinitely during warm weather. Over the years, the geographic distribution of the West Nile virus continued to expand, with outbreaks occurring in Africa, Europe, Asia, Australia, and the Americas, underscoring our vulnerability as hosts. Factors contributing to the spread of West Nile virus include international trade, urbanisation, climate change, and the spread of mosquito-borne diseases, highlighting the crucial role of environmental stewardship in disease prevention  

West Nile Fever Virus Transmission Cycle 

  • The West Nile virus is primarily transmitted by mosquitoes, including Culex tritaenorhynchus and Culex versicolor, which become infected after feeding on infected birds. 

  • Infected mosquitoes then transmit the virus to other birds, creating an amplification cycle. 

  • Infected mosquitoes can also transmit WNV to humans and other animals (such as horses) through bites. 

Humans and horses are considered dead-end hosts, meaning they do not develop high enough levels of virus in their blood to infect and transmit it to other mosquitoes. 



Pathogenesis Of West Nile Fever 

The primary route of West Nile virus (WNV) infection is through the bite of an infected mosquito. During a blood meal, the mosquito injects WNV-laden saliva into the host. The virus can then enter various cell types, including fibroblasts, vascular endothelial cells, and cells of the reticuloendothelial system. 

Following entry, WNV replicates within infected cells, leading to viremia, a condition where the virus circulates freely in the bloodstream. WNV can cross the blood-brain barrier, potentially leading to neuroinvasive disease affecting the central nervous system (CNS). 

The host immune system mounts a response against WNV infection. This includes the production of antibodies and the activation of immune cells. However, the immune response can sometimes contribute to tissue damage in the CNS. WNV infection can manifest in a variety of ways. Most individuals experience no symptoms (asymptomatic) or mild flu-like symptoms. In a small percentage of cases, severe neurological complications like encephalitis (inflammation of the brain) or meningitis (inflammation of the meninges) can develop. 

Highlights Of The West Nile Fever India Scenario 

In India, West Nile virus was determined to cause febrile and neurological diseases in humans. The first outbreak of West Nile fever in India occurred in the southern state of Kerala in 1955. Since then, sporadic cases and outbreaks of WNF have been reported in various parts of the country, and here are the various aspects related to West Nile fever in India: 

Follows A Seasonal Pattern 

  • West Nile virus outbreaks in India follow a seasonal pattern.  

  • Most cases occur during the summer and post-summer months when mosquitoes are abundant.  

  • Mosquitoes of the genus Culex, specifically Culex tritaenorhynchus and Culex versicolor, are known carriers of West Nile disease in India. 

Starts With Basic Symptoms 

  • Clinical manifestations of WNF in India are similar to those seen in other regions, with neurological complications ranging from mild to severe.  

  • Symptoms include fever, headache, fatigue, myalgia, and sometimes a maculopapular rash.  

  • In severe cases, individuals may develop neurological problems such as encephalitis, meningitis, or stroke. 

Diagnosis Is Based On Clinical Examination 

  • Diagnosis of West Nile fever in India is based on clinical examination, serological tests, and molecular methods to detect the presence of specific West Nile virus species or bacterial RNA in clinical samples such as blood or cerebrospinal fluid. 

Current Focus Is On Vector Control 

  • West Nile fever control measures in India focus on mosquito control strategies that include disease reduction, insecticides, and personal protection, such as the use of mosquito repellents and mosquito nets.  

  • Public health surveillance systems are essential in early detection and response to WNF outbreaks, enabling interventions to reduce spread and morbidity. 

Role Of NCVBDC And NIV Pune 

 

 

  • The National Centre for Vector Borne Diseases Control (NCVBDC), as the national program for vector-borne disease control, coordinates with state health departments to investigate the outbreak, provide technical guidance on surveillance and vector control measures, and disseminate information on preventive strategies.  

  • The NIV, a premier viral research institute, could aid in laboratory diagnosis by testing clinical samples and researching the specific viral strain involved in the outbreak.    

Key West Nile Fever Symptoms To Be Aware Of 

Key West Nile Fever Symptoms To Be Aware Of

Mild to moderate symptoms of West Nile fever usually appear 2 to 14 days after exposure and can last from one day to a week, depending on the person's immune status and overall health. Although most cases of West Nile fever resolve independently without needing specific medication, symptom management that includes taking ample rest, keeping yourself hydrated, and over-the-counter medications to reduce fever and discomfort can help relieve symptoms and promote healing. Here are a few symptoms you must be aware of: 

1. Fever 

Fever is one of the symptoms of West Nile fever. It occurs with increased body temperature, usually accompanied by a cold. Although the fever associated with WNF is typically low-grade, around 38°C (100.4°F) to 39°C (102.2°F), it can occasionally reach higher temperatures, especially once the infection has begun. The presence of fever indicates that the immune system is fighting the disease while trying to fight off the invading West Nile virus.  

2. Headache 

Headache is a common symptom of West Nile fever and affects most infected people. It ranges from mild to severe and may last several days or longer. Headaches associated with West Nile fever are often described as dull, throbbing pain that can be localised or widespread. Other symptoms, such as fever and fatigue, may worsen headaches  

3. Fatigue 

People with West Nile virus often report feeling tired and weak. Fatigue can occur early in the disease and persist long after other symptoms have resolved. The exact mechanism of fatigue during West Nile fever is not fully understood but may be attributable to the immune system, metabolic changes, and effects of infectious agents on cellular function.  

 4. Body Aches (Myalgia) 

Muscle pain (called myalgia) and joint pain (called arthralgia) are symptoms of West Nile fever. This condition can affect many body parts, including the back, arms, and neck muscles and joints, such as wrists, knees, and ankles. Myalgia and joint pain can cause general discomfort, anxiety, and fatigue during WNF  

5. Nausea And Vomiting 

Although less common than other symptoms, some people with West Nile virus may experience gastrointestinal symptoms such as nausea and vomiting. These symptoms are usually mild and include vomiting but can cause discomfort and dehydration, especially if drinking is not enough due to fever and decreased appetite.  

6. Lymphadenopathy 

Some people with West Nile virus may develop swelling or lymphadenopathy. Swollen glands indicate that the body's immune system is against the virus because the immune system recruits lymphoid tissue to fight the West Nile virus.  

In severe cases of West Nile fever, especially those with neuro-invasive disease, rapid clinical evaluation and support are essential to reduce complications and improve prognosis. People with severe symptoms such as confusion, seizures, paralysis, or severe headaches should seek immediate medical attention for evaluation and treatment. 

What Are The Current West Nile Fever Treatment Options? 

Here are the following West Nile fever treatment options available globally: 

1. Neurological Support 

It comprises monitoring and seizure management of West Nile Fever. 

  • Monitoring: Patients with suspected or confirmed neuro-invasive diseases such as encephalitis or meningitis should be closely monitored for neurological examination, symptoms of increased intracranial pressure, and the development of neurological deficits. 

  • Seizure Management: If a seizure occurs, anti-seizure medications may be used to control the seizure and prevent it from recurring. Intravenous benzodiazepines (such as diazepam or lorazepam) are often used as the first choice in the treatment of epilepsy. 

2. Symptomatic Management 

The clinical management of West Nile fever is supportive of treatment; here is how:   

  • Fever Reduction: Over-the-counter fever medications such as acetaminophen (acetaminophen) or non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen may reduce fever and discomfort associated with febrile cough and headache. 

  • Hydration: It is essential to stay hydrated, especially if you have a fever, sweat, or gastrointestinal symptoms such as nausea and vomiting. Drinking fluids, including water, electrolyte solutions, and clear soups, can help prevent dehydration. 

3. Respiratory Support 

West Nile fever treatment may include intensive supportive therapy like: 

  • Ventilatory Support: Patients with severe neuro-invasive disease may need a ventilator to support breathing if they have breathing difficulties such as respiratory failure or difficulty breathing due to muscle weakness. 

4. Fluid and Electrolyte Management 

Fluid intervention has been one of the effective treatments for the management of West Nile fever. 

  • Intravenous Fluids: In cases of severe dehydration, electrolyte deficiency, or inability to take fluids orally, intravenous fluids can be administered to maintain fluid and electrolyte balance. 

5. Nutritional Support 

When suffering from West Nile Fever, your health deteriorates, so you must prioritise nutrition-dense food to help you regain your immunity.   

  • Dietary Support: A healthy diet containing immune system strengthening foods that provides adequate nutrients is essential to support immunity and promote healing. If there is difficulty swallowing, feeding via nasogastric or orogastric tube is required.  

6. Physical Therapy 

Physical therapy works best when done consistently. You may indulge in physical therapy based on how much your body supports it. It involves: 

  • Rehabilitation: For patients with weakness, paralysis, or other mental disorders due to the West Nile virus, physical therapy and rehabilitation can help support recovery, function, and improve quality of life. 

7. Experimental Therapies 

This involves: 

  • Investigational Treatments: Various clinical trials aimed at reactivating the West Nile virus or altering the immune system have been studied in clinical and clinical trials. These include monoclonal antibodies and vaccines. However, these treatments still need to be approved for routine clinical use, and their effectiveness needs to be determined by further research 

It is important to remember that West Nile fever treatment should be individualised based on the severity of symptoms, complications, and the patient's overall health. Particularly in severe neuro-invasive diseases, close clinical surveillance and follow-up are essential to quickly detect and control problems and ensure that patients achieve good outcomes. Preventive measures such as avoiding mosquito bites and vector control are critical to reducing the risk of West Nile virus and its transmission. 

Expert’s Advice  

A healthy, nutritious diet is essential for people recovering from West Nile fever to boost immunity and promote recovery. Focus on eating fruits, vegetables, whole grains, protein, and healthy fats to provide vitamins, minerals, and antioxidants. Drink plenty of water to stay hydrated. Choose foods rich in vitamin C, E, zinc, and omega-3 fatty acids to help prevent inflammation and speed healing. Do not eat a lot of sweets, processed foods, and alcohol, which can weaken the body. Consult a registered healthcare professional for personalised nutritional recommendations based on individual needs and health. 

 Health Expert  
Akshata Gandevikar 

The Final Say 

With the recent rise in West Nile fever cases in India, particularly in Kerala, staying informed is crucial. This blog provided a snapshot of the current situation, highlighting the key symptoms like fever, headache, muscle weakness, and, in severe cases, neurological complications.  

West Nile fever, while a concern, can be effectively managed with early diagnosis and supportive care. By staying informed about the symptoms, understanding preventive measures, and seeking medical attention if needed, we can navigate this situation effectively. Let's prioritise personal hygiene and mosquito control measures and remain vigilant to ensure the well-being of ourselves and our communities.  

FAQs 

1. Mention the symptoms of West Nile fever. 

Here are some common symptoms of West Nile fever: 

  • Lack of appetite 

  • Nausea, vomiting, and diarrhoea 

  • Fever, headache, and sore throat 

  • Abdominal pain 

 
2. What is the best West Nile fever treatment? 

There is currently no vaccination or treatment for West Nile virus infection. Viruses cannot be treated with antibiotics. Certain symptoms may be relieved by rest, water, and over-the-counter painkillers. 

 

References 

 

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