International Journal of Research Studies in Medical and Health Sciences Volume 3, Issue 9, 2018, PP 01-03 ISSN : 2456-6373 A Few Words about a West Nile Virus Siniša Franjić Faculty of Law, International University of Brcko District, Brcko, Bosnia and Herzegovina *Corresponding Author: Sinisa Franjic, Faculty of Law, International University of Brcko District, Brcko, Bosnia and Herzegovina, EDITORIAL (Japanese encephalitis). Symptoms seen in 20– 40% of infections. Presentations: a self- limiting West Nile Virus (WNV) can cause neurological febrile illness and arthropathy (very much like disease and death in people. WNV is commonly dengue), meningitis (especially children), found in Africa, Europe, the Middle East, North encephalitis (especially adults), flaccid paralysis America and West Asia. WNV is maintained in or mixed. Elderly people are at increased risk of nature in a cycle involving transmission severe disease, including hepatitis, pancreatitis, between birds and mosquitoes. Humans, horses and myocarditis. Severe neurological disease and other mammals can be infected. leads to death in 5% of cases. It is transmitted On web page of World Health Organisation [1], between Culex mosquitoes and birds, and is the can be read how approximately 80% of people most widespread of the arboviruses (Africa, who are infected will not show any symptoms. Europe, Asia, America, the Middle East). While West Nile virus is mainly transmitted to people a role for IFN- α and ribavirin has been through the bites of infected mosquitoes. The suggested, there are no controlled trials virus can cause severe disease and death in supporting efficacy and anecdotal evidence of horses. Vaccines are available for use in horses harm with the latter. but not yet available for people. Birds are the West Nile virus is a member of the Japanese natural hosts of West Nile virus. encephalitis antigenic complex in the family Human infection is most often the result of bites Flaviviridae, genus Flavivirus [3]. Since the from infected mosquitoes. Mosquitoes become mid-1990s the incidence of West Nile infected when they feed on infected birds, which neuroinvasive disease has increased and the circulate the virus in their blood for a few days. geographic range of the virus has expanded The virus eventually gets into the mosquito's significantly. This collection of widely salivary glands. During later blood meals (when geographically distributed genotypes has mosquitoes bite), the virus may be injected into facilitated research on the molecular humans and animals, where it can multiply and epidemiology and genetic variation of the virus, possibly cause illness. and important population parameters such as the The virus may also be transmitted through mutation rate and natural selective forces. Novel contact with other infected animals, their blood, insights have been gained regarding the or other tissues. evolution of a mosquito-borne zoonotic virus on A very small proportion of human infections a regional and intercontinental scale. have occurred through organ transplant, blood Symptoms transfusions and breast milk. There is one reported case of transplacental (mother-to-child) Infection with WNV is either asymptomatic (no WNV transmission. symptoms) in around 80% of infected people, or To date, no human-to-human transmission of can lead to West Nile fever or severe West Nile WNV through casual contact has been disease [1]. documented, and no transmission of WNV to About 20% of people who become infected with health care workers has been reported when WNV will develop West Nile fever. Symptoms standard infection control precautions have been include fever, headache, tiredness, and body put in place. aches, nausea, vomiting, occasionally with a West Nile fever— the leading cause of epidemic skin rash (on the trunk of the body) and swollen viral encephalitis in the USA [2]. Related to JE lymph glands. International Journal of Research Studies in Medical and Health Sciences V3 ● I9 ● 2018 1 A Few Words about a West Nile Virus The symptoms of severe disease (also called overburdened public health infrastructure in new neuroinvasive disease, such as West Nile ways [5]. Every public health function will be encephalitis or meningitis or West Nile called on, but disaster preparedness and poliomyelitis) include headache, high fever, response, disease surveillance, infectious neck stiffness, stupor, disorientation, coma, disease control, and vector control will be tremors, convulsions, muscle weakness, and particularly salient. Whether or not they actually paralysis. It is estimated that approximately 1 in offer evidence of anthropogenic climate change, 150 persons infected with the West Nile virus natural disasters like hurricanes Katrina, Irene, will develop a more severe form of disease. and Sandy, and the emergence of vector-borne Serious illness can occur in people of any age, diseases like West Nile virus and zoonotic however people over the age of 50 and some diseases like hantavirus, provide a glimpse of immunocompromised persons (for example, the health hazards that global climate change transplant patients) are at the highest risk for will bring. The lessons learned are crucial to getting severely ill when infected with WNV. ongoing adaptation. The incubation period is usually 3 to 14 days. Several recent problems highlight the urgent Prevention need for the development of new and improved No specific therapy is available for infection vaccines [6]. These problems include (1) the with West Nile virus [4]. In the case of West lack of success of traditional vaccine approaches Nile encephalitis, intensive supportive therapy against ‘difficult’ organisms, for example HIV may be required– such as hospitalization, and HCV; (2) the emergence of new diseases, intravenous fluids, respiratory support for example Ebola,West Nile, and Hanta (ventilator), prevention of secondary infections viruses; (3) the reemergence of ‘old’ infections, (such as pneumonia, urinary tract infections, for example TB; (4) the continuing spread of etc.) and good nursing care. antibiotic-resistant bacteria; and (5) the potential use of microorganisms for bioterrorism. The Efforts to prevent transmission should first induction of CTL responses may be necessary focus on personal and community protection for some vaccines, including HIV, but against mosquito bites through the use of accumulated information shows that induction mosquito nets, personal insect repellent, by of potent CTL is difficult with protein-based wearing light coloured clothing (long-sleeved vaccines. shirts and trousers) and by avoiding outdoor Development and testing of various methods for activity at peak biting times. In addition treatment and prevention of WNV infection, community programmes should encourage such as protective vaccines, therapeutic communities to destroy mosquito breeding sites antibodies, antiviral compounds, peptides, and in residential areas. siRNA have been proposed and intensively Gloves and other protective clothing should be studied [7]. Although a number of WNV worn while handling sick animals or their veterinary vaccines have already been licensed tissues, and during slaughtering and culling and are in use for years, human vaccine procedures. candidates are still in various stages of Blood and organ donation restrictions and development and testing. Some therapeutic laboratory testing should be considered at the antibodies that show excellent efficacy in small time of the outbreak in the affected areas after animal models and are currently being tested in assessing the local/regional epidemiological clinical trials represent a promising class of situation. WNV therapeutic. Recent technological advancement and increased understanding of the Health care workers caring for patients with biology of WNV and other flaviviruses along suspected or confirmed WNV infection, or with structural/functional characterization of handling specimens from them, should viral proteins have provided a solid foundation implement standard infection control for the development of small molecule precautions. Samples taken from people and inhibitors as future WNV therapeutics. animals with suspected WNV infection should However, efforts for development of an be handled by trained staff working in suitably effective drug for prevention or control of WNV equipped laboratories. infection in human still remain unsuccessful. Development of New Vaccines Is Need Vaccination refers to the introduction of a The health effects of climatic and environmental potentially disease-causing substance into the changes will challenge our nation’s already body to produce immunity to a disease [8]. It 2 International Journal of Research Studies in Medical and Health Sciences V3 ● I9 ● 2018 A Few Words about a West Nile Virus has been the pinnacle of infectious disease in Diamond M. S. (ed): „West Nile Encephalitis prevention and treatment for the last century. Virus Infection - Viral Pathogenesis and the The development of vaccines against many Host Immune Response“, Springer Science+ diseases has helped essentially eradicate certain Business Media, New York, pp. 24. pathogens from the planet, such as the smallpox [4] Parker J. N.; Parker P. M. (eds) (2003.): „The virus and the poliovirus. However, vaccine Official Patient's Sourcebook on West Nile development is not easy or simple. A vaccine Virus - A Revised and Updated Directory for the Internet Age“, ICON Group International, must be both safe for the person receiving it and Inc., San Diego,