Abstract
Since its introduction to North America in 1999, West Nile virus (WNV) has established itself as an endemic pathogen with regular seasonal outbreaks. The single-stranded RNA flavivirus is primarily transmitted by mosquitoes in the genus Culex and maintained in an enzootic transmission cycle by a diverse assemblage of avian hosts. Humans, equines, and other mammals serve as incidental or dead-end hosts. WNV is a significant threat to public health, with estimates indicating that more than seven million individuals have been infected. Although the majority of these individuals are asymptomatic, approximately 20% develop a febrile illness or neuroinvasive disease, the latter associated with high rates of mortality in the elderly and immunocompromised. Disease-associated pathology of the central nervous system is prevalent not only during the acute phase of WNV infection but also as significant long-term sequelae. Although vaccine and therapeutic research progressed over the last 20 years, no agents are licensed for use in humans, and treatment depends on supportive care. Mitigation efforts are instead directed towards the elimination and control of mosquito vectors. Future research will need to leverage technological and epidemiological advances to overcome a host of challenges in order to alleviate the immense economic and human costs of this endemic zoonotic disease.
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Gulas-Wroblewski, B.E., Saldaña, M.A., Murray, K.O., Ronca, S.E. (2021). West Nile Virus. In: Weatherhead, J.E. (eds) Neglected Tropical Diseases - North America. Neglected Tropical Diseases. Springer, Cham. https://doi.org/10.1007/978-3-030-63384-4_10
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