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| {{West nile virus}}
| | #redirect [[West nile virus infection medical therapy]] |
| {{CMG}}; {{AE}} {{AL}}
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| ==Overview==
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| There is no specific [[antiviral]] treatment for west nile virus infection. Current management of these patients is based on supportive care towards [[symptom]] relief and prevention of [[complications]].
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| ==Medical Therapy==
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| ====Supportive care <small><small><small><small>Adapted from CDC<ref name="CDC">{{cite web| url= http://www.cdc.gov/westnile/healthCareProviders/healthCareProviders-TreatmentPrevention.html| title= CDC Treatment and Prevention}}</ref></small></small></small></small>====
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| * There is no specific [[antiviral]] therapy indicated in patients with west nile virus infection.
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| * Treatment consist of supportive measurements and prevention of complications.
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| * In severe cases, patients often need to be hospitalized to receive supportive treatment, such as [[intravenous fluids]], [[analgesics]], and nursing care.
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| *Patients with severe meningeal symptoms often require pain control for [[headaches]] and antiemetic therapy and rehydration for associated [[nausea]] and [[vomiting]].
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| *Patients with [[encephalitis]] require close monitoring for the development of elevated [[intracranial pressure]] and [[seizures]].
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| *Patients with [[encephalitis]] or [[paralysis]] should be monitored for inability to protect their airway.
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| *Acute neuromuscular [[respiratory failure]] may develop rapidly and prolonged ventilatory support may be required.
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| ===Medications===
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| *Although various drugs have been evaluated or empirically used for WNV disease, none have shown specific benefit to date.
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| * [[Ribavirin]] has been used in cases of west nile virus [[CNS]] involvement, as it has demonstrated inhibition of the [[virus]] in human neural cells ''in vitro''.<ref>{{Cite journal
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| | author = [[I. Jordan]], [[T. Briese]], [[N. Fischer]], [[J. Y. Lau]] & [[W. I. Lipkin]]
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| | title = Ribavirin inhibits West Nile virus replication and cytopathic effect in neural cells
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| | journal = [[The Journal of infectious diseases]]
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| | volume = 182
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| | issue = 4
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| | pages = 1214–1217
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| | year = 2000
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| | month = October
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| | doi = 10.1086/315847
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| | pmid = 10979920
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| }}</ref><ref>{{Cite journal
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| | author = [[S. Ia Loginova]], [[S. V. Borisevich]], [[Iu A. Pashchenko]] & [[V. P. Bondarev]]
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| | title = [Ribavirin prophylaxis and therapy of experimental West Nile fever]
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| | journal = [[Antibiotiki i khimioterapiia = Antibiotics and chemoterapy [sic] / Ministerstvo meditsinskoi i mikrobiologicheskoi promyshlennosti SSSR]]
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| | volume = 54
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| | issue = 11-12
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| | pages = 17–20
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| | year = 2009
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| | month =
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| | pmid = 20583562
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| }}</ref>
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| *[[Interferon alfa-2b]] has also shown benefit in ''in vitro'' studies against west nile virus [[CNS]] infection.<ref name="Anderson2002">{{cite journal|last1=Anderson|first1=John F.|title=Efficacy of Interferon -2b and Ribavirin Against West Nile Virus In Vitro|journal=Emerging Infectious Diseases|volume=8|issue=1|year=2002|pages=107–108|issn=10806040|doi=10.3201/eid0801.010252}}</ref>
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| *There are no guidelines that recommend the use of [[ribavirin]] or [[interferon-alfa 2b]] for the treatment of west nile virus encephalitis or meningitis.<ref name="TunkelGlaser2008">{{cite journal|last1=Tunkel|first1=Allan R.|last2=Glaser|first2=Carol A.|last3=Bloch|first3=Karen C.|last4=Sejvar|first4=James J.|last5=Marra|first5=Christina M.|last6=Roos|first6=Karen L.|last7=Hartman|first7=Barry J.|last8=Kaplan|first8=Sheldon L.|last9=Scheld|first9=W. Michael|last10=Whitley|first10=Richard J.|title=The Management of Encephalitis: Clinical Practice Guidelines by the Infectious Diseases Society of America|journal=Clinical Infectious Diseases|volume=47|issue=3|year=2008|pages=303–327|issn=1058-4838|doi=10.1086/589747}}</ref>
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| *Further studies need to be done to determine the efficacy and safety of [[ribavirin]] and [[interferon alfa-2b]] in west nile virus infection.
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| ==References==
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| {{Reflist|2}}
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