The epidemiology and early clinical features of West Nile virus infection.
Mazurek-JM; Winpisinger-K; Mattson-BI; Duffy-R; Moolenaar-RL
Am J Emerg Med 2005 Jul; 23(4):536-543
We studied early clinical features of the West Nile virus (WN-V) infection. Case patients were Ohio residents who reported to the Ohio Department of Health from August 14 to December 31, 2002, with a positive serum or cerebrospinal fluid for anti-WNV IgM. Of 441 WN-V cases, medical records of 224 (85.5%) hospitalized patients were available for review. Most frequent symptoms were fever at a temperature of 38.0 degrees C or higher (n = 155; 69.2%), headache (n = 114; 50.9%), and mental status changes (n = 113; 50.4%). At least one neurological symptom, one gastrointestinal symptom, and one respiratory symptom was present in 186 (83.0%), 119 (53.1%), and 46 (20.5%) patients, respectively. Using multivariate logistic regression and controlling for age, we found that the initial diagnosis of encephalitis (P =.001) or reporting abdominal pain (P <.001) was associated with death. Because initial symptoms of WNV infection are not specific, physicians should maintain a high index of suspicion during the epidemic season, particularly in elderly patients with compatible symptoms.
Mathematical-models; Statistical-analysis; Statistical-quality-control; Viral-diseases; Viral-infections; Respiratory-infections; Encephalopathy; Age-factors; Abdomen; Brain-disorders; Mental-health; Temperature-measurement; Gastrointestinal-system
JM Mazurek, NIOSH, DRDS, Surveillance Branch, Mailstop HG 900-2, Morgantown, WV 26506
The American Journal of Emergency Medicine