Abstract
West Nile virus (WNV) exists in a bird–mosquito–bird cycle, with humans and horses as incidental hosts. The global epidemiology follows several patterns (1) widespread enzootic transmission throughout tropical Africa, the Caribbean, Central America, and northern South America without significant human or equine morbidity; (2) periodic human and equine outbreaks in the Mediterranean Basin, Russia, and South Africa separated by years of low-level enzootic activity; (3) sporadic human disease in India; (4) little or no WNV enzootic activity in Southeast and East Asia and no human cases; (5) sporadic human disease and small outbreaks in Australia; and (6) repeated annual outbreaks in North America. The biology underlying these patterns is poorly understood, but probably results from a complex interaction of climate and weather, mosquito vectors, avian hosts, viral strain, other circulating flaviviruses, and other undefined factors. The virus was first detected in the Americas in New York City in 1999 and spread to Argentina within 7 years. The high infection incidence in North America has resulted in new modes of transmission, such as blood transfusion and organ donation. Older age and certain immunosuppressive conditions confer a high risk of neuroin-vasive disease after infection.
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References
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Petersen, L.R. (2009). Global Epidemiology of West Nile Virus. In: West Nile Encephalitis Virus Infection. Emerging Infectious Diseases of the 21st Century. Springer, New York, NY. https://doi.org/10.1007/978-0-387-79840-0_1
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