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==Overview==
==Overview==
The first isolation of West Nile Virus (WNV) occurred in 1937 in a [[febrile]] woman in the province of Uganda<ref name="pmid15068983">{{cite journal |author=Gea-Banacloche J, Johnson RT, Bagic A, Butman JA, Murray PR, Agrawal AG |title=West Nile virus: pathogenesis and therapeutic options |journal=[[Annals of Internal Medicine]] |volume=140 |issue=7 |pages=545–53 |year=2004 |month=April |pmid=15068983 |doi= |url=http://www.annals.org/cgi/pmidlookup?view=long&pmid=15068983 |accessdate=2012-03-27}}</ref>. Further investigations showed that the [[virus]] cycled in Africa between species of birds and species of mosquitoes<ref name="pmid15068983">{{cite journal |author=Gea-Banacloche J, Johnson RT, Bagic A, Butman JA, Murray PR, Agrawal AG |title=West Nile virus: pathogenesis and therapeutic options |journal=[[Annals of Internal Medicine]] |volume=140 |issue=7 |pages=545–53 |year=2004 |month=April |pmid=15068983 |doi= |url=http://www.annals.org/cgi/pmidlookup?view=long&pmid=15068983 |accessdate=2012-03-27}}</ref>.  In the 1950s, there were also outbreaks of West Nile Virus.<ref name="pmid15068983">{{cite journal |author=Gea-Banacloche J, Johnson RT, Bagic A, Butman JA, Murray PR, Agrawal AG |title=West Nile virus: pathogenesis and therapeutic options |journal=[[Annals of Internal Medicine]] |volume=140 |issue=7 |pages=545–53 |year=2004 |month=April |pmid=15068983 |doi= |url=http://www.annals.org/cgi/pmidlookup?view=long&pmid=15068983 |accessdate=2012-03-27}}</ref>  In New York City, in 1952, there was the first documented case of human encephalitis caused by West Nile Virus.<ref name="pmid15068983">{{cite journal |author=Gea-Banacloche J, Johnson RT, Bagic A, Butman JA, Murray PR, Agrawal AG |title=West Nile virus: pathogenesis and therapeutic options |journal=[[Annals of Internal Medicine]] |volume=140 |issue=7 |pages=545–53 |year=2004 |month=April |pmid=15068983 |doi= |url=http://www.annals.org/cgi/pmidlookup?view=long&pmid=15068983 |accessdate=2012-03-27}}</ref>
WNV was first isolated in 1937 in Uganda from a hospitalized patient who presented with isolated [[fever]]. Between 1950 and 1960, small villages in the Mediterranean basin had repeated outbreaks, especially in Israel and Egypt. These [[outbreaks]] allowed researchers to study the molecular and clinical features of the disease and further understand its mode of [[transmission]] and [[natural history]]. Several WNV outbreaks were recorded in the second half of the 20th century in Europe, Middle East, Far East, and Africa. It was not until 1999 when the first WNV outbreak was documented in USA, making WNV a worldwide infection. Perhaps the most severe outbreak documented was in 2002 in USA, recording the highest number of [[meningoencephalitis]] from a single WNV outbreak. The first description of a person-to-person transmission was reported in 2002 among patients with [[blood transfusions]] and [[tissue transplantation]].


==History==
==Discovery==
Studies of phylogenetic lineages have determined that WNV emerged as a distinct virus around 1000 years ago.<ref>Galli M, Bernini F, Zehender G A. "The Great and West Nile virus encephalitis." ''Emerging Infectious Diseases Journal'' 2004 ; 10: 1332-1333</ref> This initial virus developed into two distinct lineages, Lineage 1 and its multiple profiles is the source of the epidemic transmission in Africa and throughout the world, while Lineage 2 remains as an Africa zoonose.
WNV was first discovered following its isolation in 1937 from a hospitalized patient presenting with isolated fever in the West Nile district of Northern Uganda.<ref name="pmid21765761">{{cite journal| author=Sejvar JJ| title=West nile virus: an historical overview. | journal=Ochsner J | year= 2003 | volume= 5 | issue= 3 | pages= 6-10 | pmid=21765761 | doi= | pmc=PMC3111838 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi? dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21765761  }} </ref> Initial reports described a virus whose physical and pathological characteristics resemble that of  [[St. Louis encephalitis virus]] and [[Japanese B encephalitis virus]]. Early studies noted the frequent involvement of the CNS among infected patients, suggesting neurotropism of the virus. It was not until the 1950-1960 Mediterranean basin outbreaks in small towns that clinical and pathological features of West Nile virus were really revealed.  


WNV was first isolated from a feverish adult woman in the West Nile District of Uganda in 1937 during research on [[yellow fever]]. A series of serosurveys in 1939 in central Africa found anti-WNV positive results ranging from 1.4% (Congo) to 46.4% (White Nile region, Sudan). It was subsequently identified in Egypt (1942) and India (1953), a 1950 serosurvey in Egypt found 90% of those over 40 years in age had WNV antibodies. The ecology was characterized in 1953 with studies in Egypt<ref>Work T H, Hurlbut H S, Taylor R M. "Isolation of West Nile virus from hooded crow and rock pigeon in the Nile delta." ''Proceedings of the Society for Experimental Biology and Medicine'' 1953; 84: 719-722.</ref> and Israel.<ref>Bernkopf H, Levine S, Nerson R. "Isolation of West Nile virus in Israel." ''Journal of Infectious Diseases'' 1953; 93: 207-218.</ref> The virus became recognized as a cause of severe human [[meningoencephalitis]] in elderly patients during an outbreak in Israel in 1957. The disease was first noted in horses in Egypt and France in the early 1960s and found to be widespread in southern Europe, southwest Asia and Australia.
==Famous outbreaks==
The first epidemic was documented in 1951 in Isreal, when Bernkopf and colleagues isolated WNV among 123 cases.<ref name="pmid11797769">{{cite journal| author=Murgue B, Murri S, Triki H, Deubel V, Zeller HG| title=West Nile in the Mediterranean basin: 1950-2000. | journal=Ann N Y Acad Sci | year= 2001 | volume= 951 | issue=  | pages= 117-26 | pmid=11797769 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11797769  }} </ref><ref>{{cite journal| author=Bernkopf H, Levine S, Nerson R| title=Isolation of West Nile virus in Israel| journal=J Infect Dis | year= 1953| volume= 7| issue=  | pages= 128-132| pmid= | doi= | pmc= | url= }} </ref> Further understanding of the viral pattern, mode of transmission, and pathogenesis was conducted by studies in 1951-1954 following outbreaks in Cairo, Egypt.<ref name="pmid11797769">{{cite journal| author=Murgue B, Murri S, Triki H, Deubel V, Zeller HG| title=West Nile in the Mediterranean basin: 1950-2000. | journal=Ann N Y Acad Sci | year= 2001 | volume= 951 | issue=  | pages= 117-26 | pmid=11797769 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11797769  }} </ref><ref name="pmid13354882">{{cite journal| author=HURLBUT HS, RIZK F, TAYLOR RM, WORK TH| title=A study of the ecology of West Nile virus in Egypt. | journal=Am J Trop Med Hyg | year= 1956 | volume= 5 | issue= 4 | pages= 579-620 | pmid=13354882 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=13354882  }} </ref><ref>{{cite journal| author=Philip CB, Samdel JE| title=Transmission of West Nile virus by infected Aedes albopictus| journal=Proc Soc Exp Biol Med | year= 1943 | volume= 53 | issue= | pages= 49-50 | pmid= | doi= | pmc= | url= }} </ref> The first report of neurological sequelae following WNV infection was documented in 1957 during an outbreak in Israel.<ref name="pmid21765761">{{cite journal| author=Sejvar JJ| title=West nile virus: an historical overview. | journal=Ochsner J | year= 2003 | volume= 5 | issue= 3 | pages= 6-10 | pmid=21765761 | doi= | pmc=PMC3111838 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21765761  }} </ref> Other outbreaks in other regions, such as Europe, India, South Africa, were later described in the 1970s and 1980s.<ref name="pmid21765761">{{cite journal| author=Sejvar JJ| title=West nile virus: an historical overview. | journal=Ochsner J | year= 2003 | volume= 5 | issue= 3 | pages= 6-10 | pmid=21765761 | doi= | pmc=PMC3111838 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21765761  }} </ref> In 1996, an outbreak of WNV in Romania in Europe spiraled a series of outbreaks in the Middle East, North Africa, and Europe region.<ref name="pmid9737281">{{cite journal| author=Tsai TF, Popovici F, Cernescu C, Campbell GL, Nedelcu NI| title=West Nile encephalitis epidemic in southeastern Romania. | journal=Lancet | year= 1998 | volume= 352 | issue= 9130 | pages= 767-71 | pmid=9737281 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9737281  }} </ref><ref name="pmid11797808">{{cite journal| author=Campbell GL, Ceianu CS, Savage HM| title=Epidemic West Nile encephalitis in Romania: waiting for history to repeat itself. | journal=Ann N Y Acad Sci | year= 2001 | volume= 951 | issue=  | pages= 94-101 | pmid=11797808 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11797808  }} </ref> Unlike early reports that mostly included children, these outbreaks unveiled adult preponderance and an increased rate of CNS complications associated with the disease.<ref name="pmid9737281">{{cite journal| author=Tsai TF, Popovici F, Cernescu C, Campbell GL, Nedelcu NI| title=West Nile encephalitis epidemic in southeastern Romania. | journal=Lancet | year= 1998 | volume= 352 | issue= 9130 | pages= 767-71 | pmid=9737281 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9737281  }} </ref><ref name="pmid11797808">{{cite journal| author=Campbell GL, Ceianu CS, Savage HM| title=Epidemic West Nile encephalitis in Romania: waiting for history to repeat itself. | journal=Ann N Y Acad Sci | year= 2001 | volume= 951 | issue=  | pages= 94-101 | pmid=11797808 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11797808  }} </ref>


The first appearance of West Nile virus in the Western hemisphere was in 1999 with encephalitis reported in humans and horses, and the subsequent spread in the [[United States]] may be an important milestone in the evolving history of this virus. The American outbreak began in the New York City area, including New Jersey and Connecticut, and the virus is believed to have entered in an infected bird or mosquito, although there is no clear evidence.<ref>Calisher C H. "West Nile virus in the New World: appearance, persistence, and adaptation to a new econiche - an opportunity taken." ''Viral Immunology'' 2000; 13: 411-414.</ref> The US virus was very closely related to a lineage 1 strain found in Israel in 1998. Since the first North American cases in 1999, the virus has been reported throughout the United States, Canada, Mexico, the Caribbean and Central America. There have been human cases and horse cases, and many birds are infected. Both the US and Israeli strains are marked by high mortality rates in infected avian populations, the presence of dead birds - especially corvidae - can be an early indicator of the arrival of the virus.
In 1999, the first outbreak in USA initially described 8 cases, most of which had neurological symptoms, in Queens, New York City.<ref name="pmid11407341">{{cite journal| author=Nash D, Mostashari F, Fine A, Miller J, O'Leary D, Murray K et al.| title=The outbreak of West Nile virus infection in the New York City area in 1999. | journal=N Engl J Med | year= 2001 | volume= 344 | issue= 24 | pages= 1807-14 | pmid=11407341 | doi=10.1056/NEJM200106143442401 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11407341  }} </ref> The 1999 outbreak in USA finally marked the global spread of the virus. The outbreak eventually infected a total of 62 individuals, whose symptoms were mostly severe and necessitated hospitalization. Although initially believed to be caused by an endemic [[arbovirus]], WNV was eventually demonstrated to be the agent responsible for the outbreak after the discovery of a coinciding outbreak among infected birds within the same geographical region and during the same time frame<ref name="pmid11585528">{{cite journal| author=Giladi M, Metzkor-Cotter E, Martin DA, Siegman-Igra Y, Korczyn AD, Rosso R et al.| title=West Nile encephalitis in Israel, 1999: the New York connection. | journal=Emerg Infect Dis | year= 2001 | volume= 7 | issue= 4 | pages= 659-61 | pmid=11585528 | doi=10.3201/eid0704.010410 | pmc=PMC2631756 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11585528  }} </ref><ref name="pmid10520637">{{cite journal| author=Briese T, Jia XY, Huang C, Grady LJ, Lipkin WI| title=Identification of a Kunjin/West Nile-like flavivirus in brains of patients with New York encephalitis. | journal=Lancet | year= 1999 | volume= 354 | issue= 9186 | pages= 1261-2 | pmid=10520637 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10520637  }} </ref><ref name="pmid10622305">{{cite journal| author=Jia XY, Briese T, Jordan I, Rambaut A, Chi HC, Mackenzie JS et al.| title=Genetic analysis of West Nile New York 1999 encephalitis virus. | journal=Lancet | year= 1999 | volume= 354 | issue= 9194 | pages= 1971-2 | pmid=10622305 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10622305  }} </ref><ref name="pmid10600742">{{cite journal| author=Lanciotti RS, Roehrig JT, Deubel V, Smith J, Parker M, Steele K et al.| title=Origin of the West Nile virus responsible for an outbreak of encephalitis in the northeastern United States. | journal=Science | year= 1999 | volume= 286 | issue= 5448 | pages= 2333-7 | pmid=10600742 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10600742  }} </ref><ref name="pmid11589170">{{cite journal| author=Weiss D, Carr D, Kellachan J, Tan C, Phillips M, Bresnitz E et al.| title=Clinical findings of West Nile virus infection in hospitalized patients, New York and New Jersey, 2000. | journal=Emerg Infect Dis | year= 2001 | volume= 7 | issue= 4 | pages= 654-8 | pmid=11589170 | doi=10.3201/eid0704.010409 | pmc=PMC2631758 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11589170  }} </ref> Only 3 years after its documented presence in USA, the clinically most severe WNV outbreak occurred in North America in 2002, where the largest number of [[meningoencephalitis]] from a single outbreak was recorded. In the same year, the first human-to-human transmission was discovered; it was attributed to transmission via [[blood transfusion]] and [[tissue transplantation]].<ref name="pmid12228130">{{cite journal| author=Charatan F| title=Organ transplants and blood transfusions may transmit West Nile virus. | journal=BMJ | year= 2002 | volume= 325 | issue= 7364 | pages= 566 | pmid=12228130 | doi= | pmc=PMC1169473 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12228130  }} </ref>


A very high level of media coverage through 2001/2002 raised public awareness of West Nile virus. This disproportionate coverage was most likely the result of successive appearances of the virus in new areas.
==Development of diagnostic and treatment strategies==
*The first WNV MAC-ELISA-based commercial diagnostic test for arboviruses was also developed and later commercialized to assays that may be used in the field.<ref name="pmid24335779">{{cite journal| author=Roehrig JT| title=West nile virus in the United States - a historical perspective. | journal=Viruses | year= 2013 | volume= 5 | issue= 12 | pages= 3088-108 | pmid=24335779 | doi=10.3390/v5123088 | pmc=PMC3967162 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24335779  }} </ref>


[[Environmentalist]]s have condemned attempts to control the transmitting mosquitoes by spraying [[pesticide]], saying that the detrimental health effects of spraying outweigh the relatively few lives which may be saved, and that there are more environmentally friendly ways of controlling mosquitoes. They also question the effectiveness of insecticide spraying, as they believe mosquitoes that are resting or flying above the level of spraying will not be killed; the most common vector in the northeastern U.S., ''Culex pipiens'', is a canopy feeder.
*Following the 1999 outbreak in USA, the first animal vaccine was developed and later approved by the U.S. department of agriculture (USDA). The WNV-DNA virus is considered the only USDA-approved vaccine.<ref name="pmid24335779">{{cite journal| author=Roehrig JT| title=West nile virus in the United States - a historical perspective. | journal=Viruses | year= 2013 | volume= 5 | issue= 12 | pages= 3088-108 | pmid=24335779 | doi=10.3390/v5123088 | pmc=PMC3967162 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24335779  }} </ref><ref name="pmid11287553">{{cite journal| author=Davis BS, Chang GJ, Cropp B, Roehrig JT, Martin DA, Mitchell CJ et al.| title=West Nile virus recombinant DNA vaccine protects mouse and horse from virus challenge and expresses in vitro a noninfectious recombinant antigen that can be used in enzyme-linked immunosorbent assays. | journal=J Virol | year= 2001 | volume= 75 | issue= 9 | pages= 4040-7 | pmid=11287553 | doi=10.1128/JVI.75.9.4040-4047.2001 | pmc=PMC114149 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11287553  }} </ref>
WNV was first isolated in the WN province of Uganda in 1937. Human and equine outbreaks have been recorded in portions of Africa, southern Europe, North America, and Asia.


In late summer 1999, the first domestically acquired human cases of West Nile (WN) encephalitis were documented in the U.S. The discovery of virus-infected, overwintering mosquitoes during the winter of 1999-2000 presaged renewed virus activity for the following spring and precipitated early season vector control and disease surveillance in New York City (NYC) and the surrounding areas. These surveillance efforts were focused on identifying and documenting WN virus (WNV) infections in birds, mosquitoes and equines as sentinel animals that could alert health officials to the occurrence of human disease. Surveillance tracked the spread of WNV throughout much of the U.S. between 2000 and 2002. By the end of 2002, WNV activity had been identified in 44 states and the District of Columbia. The 2002 WNV epidemic and epizootic resulted in reports of 4,156 reported human cases of WN disease (including 2,942 meningoencephalitis cases and 284 deaths), 16,741 dead birds, 6,604 infected mosquito pools, and 14,571 equine cases. The 2002 WNV epidemic was the largest recognized arboviral meningoencephalitis epidemic in the Western Hemisphere and the largest WN meningoencephalitis epidemic ever recorded. Significant human disease activity was recorded in Canada for the first time, and WNV activity was also documented in the Caribbean basin and Mexico. In 2002, 4 novel routes of WNV transmission to humans were documented for the first time: 1) blood transfusion, 2) organ transplantation, 3) transplacental transfer, and 4) breast-feeding.
==Impact on cultural history==
*The 1999 outbreak in New York in USA drove the Center of Disease Control (CDC) to fund its own Zoo Surveillance Program at Cornell University School of Veterinary Medicine. During the outbreak, CDC assigned other channels to test infected bird species that might help in identifying the virus. The delay in diagnosis was presumed to be a significant element for the outbreak's detrimental outcomes.<ref name="pmid12037534">{{cite journal| author=Knight J| title=US zoos keep watch for cross-species killer. | journal=Nature | year= 2002 | volume= 417 | issue= 6888 | pages= 477 | pmid=12037534 | doi=10.1038/417477a | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12037534  }} </ref>
 
*Following the 1999 outbreak, WNV was considered a nationally reportable disease in USA. Annual meetings were held in USA to provide public health information about WNV, and guidelines for surveillance, prevention, and control of WNV were developed and frequently updated.<ref name="pmid24335779">{{cite journal| author=Roehrig JT| title=West nile virus in the United States - a historical perspective. | journal=Viruses | year= 2013 | volume= 5 | issue= 12 | pages= 3088-108 | pmid=24335779 | doi=10.3390/v5123088 | pmc=PMC3967162 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24335779  }} </ref>
 
*ArboNET, a real-time disease reporting network developed by CDC, was first launched in 2000 after the 1999 outbreak to follow WNV disease in humans and animals.<ref name="pmid24335779">{{cite journal| author=Roehrig JT| title=West nile virus in the United States - a historical perspective. | journal=Viruses | year= 2013 | volume= 5 | issue= 12 | pages= 3088-108 | pmid=24335779 | doi=10.3390/v5123088 | pmc=PMC3967162 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24335779  }} </ref>
*Funding to the CDC - Enhanced Laboratory Capacity (ELC) cooperative agreement program reached $2.7 million dollars in 2000. In a few years, the program's funding was higher than $20 million dollars. Grants were utilized to train arbovirologists and to fund research programs, lab diagnosis, and surveillance programs.<ref name="pmid24335779">{{cite journal| author=Roehrig JT| title=West nile virus in the United States - a historical perspective. | journal=Viruses | year= 2013 | volume= 5 | issue= 12 | pages= 3088-108 | pmid=24335779 | doi=10.3390/v5123088 | pmc=PMC3967162 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24335779  }} </ref>
 
==References==
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==References==
==References==
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[[Category:Disease]]
[[Category:Disease]]
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[[Category:Neurology]]
[[Category:Neurology]]

Latest revision as of 19:11, 18 September 2017

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Yazan Daaboul, M.D.

Overview

WNV was first isolated in 1937 in Uganda from a hospitalized patient who presented with isolated fever. Between 1950 and 1960, small villages in the Mediterranean basin had repeated outbreaks, especially in Israel and Egypt. These outbreaks allowed researchers to study the molecular and clinical features of the disease and further understand its mode of transmission and natural history. Several WNV outbreaks were recorded in the second half of the 20th century in Europe, Middle East, Far East, and Africa. It was not until 1999 when the first WNV outbreak was documented in USA, making WNV a worldwide infection. Perhaps the most severe outbreak documented was in 2002 in USA, recording the highest number of meningoencephalitis from a single WNV outbreak. The first description of a person-to-person transmission was reported in 2002 among patients with blood transfusions and tissue transplantation.

Discovery

WNV was first discovered following its isolation in 1937 from a hospitalized patient presenting with isolated fever in the West Nile district of Northern Uganda.[1] Initial reports described a virus whose physical and pathological characteristics resemble that of St. Louis encephalitis virus and Japanese B encephalitis virus. Early studies noted the frequent involvement of the CNS among infected patients, suggesting neurotropism of the virus. It was not until the 1950-1960 Mediterranean basin outbreaks in small towns that clinical and pathological features of West Nile virus were really revealed.

Famous outbreaks

The first epidemic was documented in 1951 in Isreal, when Bernkopf and colleagues isolated WNV among 123 cases.[2][3] Further understanding of the viral pattern, mode of transmission, and pathogenesis was conducted by studies in 1951-1954 following outbreaks in Cairo, Egypt.[2][4][5] The first report of neurological sequelae following WNV infection was documented in 1957 during an outbreak in Israel.[1] Other outbreaks in other regions, such as Europe, India, South Africa, were later described in the 1970s and 1980s.[1] In 1996, an outbreak of WNV in Romania in Europe spiraled a series of outbreaks in the Middle East, North Africa, and Europe region.[6][7] Unlike early reports that mostly included children, these outbreaks unveiled adult preponderance and an increased rate of CNS complications associated with the disease.[6][7]

In 1999, the first outbreak in USA initially described 8 cases, most of which had neurological symptoms, in Queens, New York City.[8] The 1999 outbreak in USA finally marked the global spread of the virus. The outbreak eventually infected a total of 62 individuals, whose symptoms were mostly severe and necessitated hospitalization. Although initially believed to be caused by an endemic arbovirus, WNV was eventually demonstrated to be the agent responsible for the outbreak after the discovery of a coinciding outbreak among infected birds within the same geographical region and during the same time frame[9][10][11][12][13] Only 3 years after its documented presence in USA, the clinically most severe WNV outbreak occurred in North America in 2002, where the largest number of meningoencephalitis from a single outbreak was recorded. In the same year, the first human-to-human transmission was discovered; it was attributed to transmission via blood transfusion and tissue transplantation.[14]

Development of diagnostic and treatment strategies

  • The first WNV MAC-ELISA-based commercial diagnostic test for arboviruses was also developed and later commercialized to assays that may be used in the field.[15]
  • Following the 1999 outbreak in USA, the first animal vaccine was developed and later approved by the U.S. department of agriculture (USDA). The WNV-DNA virus is considered the only USDA-approved vaccine.[15][16]

Impact on cultural history

  • The 1999 outbreak in New York in USA drove the Center of Disease Control (CDC) to fund its own Zoo Surveillance Program at Cornell University School of Veterinary Medicine. During the outbreak, CDC assigned other channels to test infected bird species that might help in identifying the virus. The delay in diagnosis was presumed to be a significant element for the outbreak's detrimental outcomes.[17]
  • Following the 1999 outbreak, WNV was considered a nationally reportable disease in USA. Annual meetings were held in USA to provide public health information about WNV, and guidelines for surveillance, prevention, and control of WNV were developed and frequently updated.[15]
  • ArboNET, a real-time disease reporting network developed by CDC, was first launched in 2000 after the 1999 outbreak to follow WNV disease in humans and animals.[15]
  • Funding to the CDC - Enhanced Laboratory Capacity (ELC) cooperative agreement program reached $2.7 million dollars in 2000. In a few years, the program's funding was higher than $20 million dollars. Grants were utilized to train arbovirologists and to fund research programs, lab diagnosis, and surveillance programs.[15]

References

  1. 1.0 1.1 1.2 Sejvar JJ (2003). dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21765761 "West nile virus: an historical overview" Check |url= value (help). Ochsner J. 5 (3): 6–10. PMC 3111838. PMID 21765761.
  2. 2.0 2.1 Murgue B, Murri S, Triki H, Deubel V, Zeller HG (2001). "West Nile in the Mediterranean basin: 1950-2000". Ann N Y Acad Sci. 951: 117–26. PMID 11797769.
  3. Bernkopf H, Levine S, Nerson R (1953). "Isolation of West Nile virus in Israel". J Infect Dis. 7: 128–132.
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References


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