Epidemic diseases pose a constant threat to humanity, and among these diseases, West Nile fever, also called Nile River fever, stands out as one of the health mysteries that occupies the minds of scientists and societies alike. In this article, through the Dalili Medical website, we address the conversation about West Nile fever, aiming to educate individuals about this tropical fever.West Nile fever is a medical condition caused by the West Nile virus. Here is the most important information about it in this article

**What is West Nile fever?**

 

West Nile fever is a disease caused by the West Nile virus, which is transmitted to humans through the bites of mosquitoes carrying the virus. This virus is widely spread in regions such as Africa, Europe, the Middle East, North America, and Western Asia. It was first discovered in the West Nile region of Uganda, hence its name. The virus may cause serious neurological diseases in humans, but about 80% of those infected do not show any symptoms. The virus also affects animals, especially horses, where it can have serious and fatal effects. Vaccines against West Nile virus are available for horses only.

**Where was West Nile virus first discovered?**

 

The first case of West Nile virus infection was recorded in Uganda in 1937.

**Can West Nile virus cause death?**

 

Yes, in severe cases, West Nile virus can cause death, with fatality rates estimated at 3% to 15%.

**What is the reason for the recent spread of West Nile virus?**

 

A study published in February 2024 indicated that climate changes played a role in increasing the spread of West Nile virus in some European countries, as high temperatures in the spring and summer, in addition to warm and dry winters, contributed to enhancing the spread of the virus.

**Is there a vaccine against West Nile virus?**

 

To date, there is no officially approved vaccine for West Nile fever.

**When does the disease spread and how long does the infection last?**

 

It usually takes 2 to 14 days for symptoms to appear after infection. Infected people do not transmit the infection, as West Nile virus does not reproduce well in the human body, which means that mosquitoes cannot transmit the virus from one infected person to another.

**Who are most at risk?**

 

The probability of contracting West Nile fever increases in areas where the virus is widespread and where mosquitoes are abundant. Cases are reported most frequently in southern France, northern Italy, Greece, and large parts of the Balkans, Turkey, and the Middle East, as well as some areas in the northern Czech Republic, Hungary, Slovakia, and Austria. Cases of infection are also recorded in North America, Africa, and Australia. In Germany, West Nile fever can occur during the summer and fall, especially in the southeastern regions of the country.

Older adults and immunocompromised people are most at risk of serious complications. These individuals, as well as those with a history of cardiovascular disease, face a greater risk of death from severe West Nile fever.

**Is West Nile fever contagious?**

 

West Nile fever is not a contagious disease and is not transmitted from person to person through direct contact. The virus is transmitted mainly through the bites of infected mosquitoes. There are rare cases in which transmission of the virus can occur through blood transfusion, organ transplantation, or from mother to child during pregnancy or breastfeeding. However, West Nile fever cannot be transmitted through normal contact, breathing, or daily activities between individuals.

**What are the symptoms of West Nile fever?**

 

West Nile Virus is a disease that can be transmitted by mosquitoes, and in most cases (70-80%) it does not cause any symptoms. If symptoms appear, their severity can range from mild to severe.

**Mild symptoms:**

When symptoms of West Nile fever appear, they are often mild, and fever is one of the most prominent symptoms, occurring in 1 in 5 people infected with this virus.

Fever can be accompanied by other mild symptoms, such as:

- headache.

- Excessive sweating.

- Body pain, including joint, back, and muscle pain.

- Sleepy.

- Mild skin rash.

- Swollen lymph nodes.

- nausea.

- Vomiting.

- Diarrhea.

- Loss of appetite.

- Fatigue and weakness.

What tests detect West Nile fever?

 

In addition to asking the doctor about the symptoms the patient is experiencing and whether he has been exposed to a mosquito bite, the doctor may order the following tests to determine whether the person has West Nile fever and the extent to which it has spread in the body:

- **Blood tests**: reveal the presence of antibodies to West Nile virus.

- **CT or MRI of the head**: It can sometimes reveal inflammation or swelling in the brain.

- **Lumbar puncture**: Helps diagnose meningitis, as cerebrospinal fluid analysis can show an increase in the number of white cells, which indicates the presence of an infection in the central nervous system.

**Diagnosis of West Nile fever**

 

The virus causing West Nile fever can be diagnosed through a combination of different tests:

- Detection of IgG antibodies using laboratory tests known as enzyme-linked immunosorbent assay (ELISA).

- Neutralisation assays and techniques.

- Viral detection using reverse transcription polymerase chain reaction (RT-PCR) technology.

- Virus isolation through cell culture technology.

**Is West Nile virus dangerous?**

 

The danger of West Nile fever is that the virus can spread to the central nervous system, which may lead to meningitis, encephalitis, or acute flaccid paralysis. Statistics show that 1 in 150 people infected with West Nile fever may experience these serious symptoms and complications. It is considered the elderly and people with aphidsThe vulnerable population is more vulnerable to serious neurological complications resulting from West Nile virus. A review published in 2017 in the journal BMC Infectious Diseases also showed that diabetes, high blood pressure, and cancer may be factors that increase the risk of contracting the virus.

**Who is most at risk of contracting West Nile fever?**

 

People over 50 years of age are most at risk of developing West Nile fever. Other risk factors include:

- Cardiovascular diseases

- Cancer diseases

- Kidney disease

- diabetes

- Weak immune system

- Excessive alcohol consumption

**How ​​does West Nile fever develop?**

 

Among 99% of those infected, West Nile fever is either asymptomatic or has mild symptoms, without causing any nerve damage. In these cases, the disease usually resolves without complications or long-term effects. However, 5 to 10% of people with acute West Nile fever with encephalitis may die. For those who survive, one in two may develop late consequences, such as fatigue, weakness, headaches, and problems with balance and memory.

**Treatment of West Nile fever**

 

There is no treatment that eliminates the virus, but symptoms can be treated using:

- Analgesic and antipyretic medications such as ibuprofen and aspirin to relieve pain and fever.

- Palliative care in severe cases that require hospitalization to receive intravenous fluids and pain relievers.

**Comfort**

Rest is one of the essential elements in treating West Nile fever, as the patient must adhere to complete bed rest to give the body the opportunity to recover from the effects of the virus. This rest requires a comfortable and quiet environment, far from noise and psychological stress, preferably in a dark or semi-dark room with good ventilation.

Rest contributes to directing the body's energy towards fighting viruses and reducing stress levels, which enhances the effectiveness of the immune system.

**Liquids**

Staying hydrated is key to treating West Nile fever. Fever can lead to rapid fluid loss due to excessive sweating and natural evaporation from the skin and respiratory system. Therefore, the patient should drink sufficient amounts of fluids to compensate for this loss. Necessary fluids include:

- **Water**: Drinking abundant amounts of pure water is crucial to maintaining the body’s hydration.

- **Natural juices**: such as orange or lemon juice, as they contain vitamins and minerals that support the immune system.

- **Sports drinks**: They contain electrolytes such as sodium, potassium, and magnesium, which help prevent dehydration and restore fluid balance in the body.

**Herbal tea**: Some herbs such as peppermint or chamomile can be soothing and have anti-inflammatory properties.

**Painkillers**

Pain and fever are common symptoms of West Nile fever, and pain relievers can be used to relieve these symptoms. Among the painkillers that can be taken without a prescription:

- **Paracetamol (acetaminophen)**: It is a safe and effective option to relieve pain and reduce fever. The usual dose for adults is 500-1000 mg every 4-6 hours, with the maximum daily dose not exceeding 4000 mg.

- **Ibuprofen**: It is another effective analgesic that can be used to relieve pain and reduce inflammation and fever. The usual dose for adults is 200-400 mg every 4-6 hours, with the maximum daily dose not exceeding 3200 mg.

It is important for patients to avoid taking aspirin in some cases, as it should not be given to children and adolescents who are recovering from fever symptoms, because it may be associated with Reye's syndrome, which is a rare but serious condition.

**Proper nutrition**

Good nutrition plays an essential role in strengthening the immune system and supporting the body against viruses. It is essential that diets are balanced and rich in vitamins and minerals:

**Vegetables and fruits**: They are rich sources of vitamins, such as vitamin C found in citrus fruits, red peppers, and broccoli, and vitamin A found in carrots, sweet potatoes, and spinach.

- **Proteins**: Protein is essential for tissue repair and strengthening the immune system. It can be obtained from lean meat, fish, eggs, legumes, and nuts.

- **Foods rich in zinc**: Zinc plays an important role in enhancing immune function, and can be found in meat, shellfish, nuts, and seeds.

- **Complex carbohydrates**: Complex carbohydrates provide sustainable energy for the body, and are found in brown rice, whole grain bread, and oats.

- **Healthy fats**: Unsaturated fats, such as olive oil, avocados, and nuts, are beneficial for promoting overall health.

**Vitamins and minerals**

 

Besides eating foods rich in vitamins and minerals, it may be helpful to use vitamin and mineral supplements if natural nutrition does not fully meet the body's needs. It is best to consult a doctor before starting to take any nutritional supplements to ensure the appropriate dosage and avoid negative interactions.

**Other palliative treatments**

 

In addition to the above measures, it may be necessary to control other symptoms of West Nile fever, which include:

**Treatment of nausea and vomiting**: Prescription anti-nausea medications can be used, while avoiding fatty or spicy foods.

- **Treatment of cough and sore throat**: Medical preparations such as cough syrup or lozenges can be helpful.

**Home care and psychological support**

 

Home care and psychological support are important factors in the patient's recovery. Providing compassionate care and emotional support can help relieve anxiety and enhance overall psychological well-being, contributing to rapid recovery.

The patient and his family members must be fully aware of the painTrauma and ways to prevent it. Education on how to prevent transmission of the virus via mosquito bites is crucial. It may be suggested that you distribute educational brochures or use online resources to enhance understanding.

**Advanced care for severe cases**

 

In cases that develop into serious infections of the central nervous system, treatment requires advanced and immediate medical intervention, such as:

- **Intensive Care**: Some patients may need to be admitted to the intensive care unit to receive intensive care.

- **Intravenous fluids**: to ensure that the body remains hydrated and to compensate for fluid loss resulting from fever.

- **Anticonvulsants**: If convulsions occur, anticonvulsant medications can be used.

- **Breathing support**: If there is difficulty breathing, the patient may need a ventilator to support the breathing process.

**After recovery from West Nile fever**

 

After recovering from West Nile fever, some patients may need physical therapy and rehabilitation to regain physical strength and improve nervous system function. Available options include:

- **Physical therapy**: It contributes to enhancing movement and flexibility and increasing muscle strength.

- **Occupational therapy**: It helps patients regain the ability to perform daily activities normally.

- **Psychotherapy**: It can play an important role in treating the psychological effects that may result from severe illness, such as anxiety and depression.

**How ​​to prevent West Nile fever**

 

The best way to prevent West Nile fever virus is to avoid mosquito bites. Here are some effective ways of prevention:

- **Using insect repellents**: You should avoid using insect repellents for children under two months of age, and it is preferable not to apply them to skin covered by clothing. If you use sunscreen, apply sunscreen first and then insect repellent over it.

- **Wear long clothes**: It is recommended to wear long clothes and spray them with permethrin or buy clothes treated with it. Permethrin is an insecticide and repellent that provides protection even after washing clothes several times, but you should avoid using it directly on the skin.

- **Prevention steps inside and outside the home**:

 

 - Use clamps on doors and windows and patch any holes.

 - Use air conditioning if available.

 - Prevent mosquitoes from laying eggs in places where water collects near the house by emptying and cleaning tools that contain stagnant water on a weekly basis or removing them from the house.

Using mosquito nets while sleeping outdoors is an important preventive measure, and it is preferable to choose mosquito nets treated with permethrin.

When traveling to areas susceptible to West Nile virus, it is recommended to choose accommodations with air conditioning and door and window grilles.

You should avoid going out during times when mosquitoes are most active, as their activity is at its peak from the end of August until early September, at night until the morning.

**How ​​West Nile fever virus is transmitted**

 

Birds are the main carrier of West Nile virus. The virus is transmitted from birds to mosquitoes, and it takes several days to reach the mosquito's salivary glands, which transmit the virus to humans through bites. Dr. Dirar Balawi, a professor and consultant in the treatment of infectious diseases, explains that the virus is spread mainly through the bite of infected mosquitoes, which usually belong to the “Aedes” genus. These mosquitoes acquire the virus by feeding on infected birds.

**Summer months: period of infection spread**

 

that mosquitoes carrying the virus are more active during the warm months, which makes the summer season the most recorded cases of infection among humans.

**Birds of prey as a vector of the virus**

 

 health economics and epidemiology, adds that the virus can also be transmitted through some species of birds of prey, such as eagles or crows, which may become infected when they eat infected or dead birds carrying the virus. Transmission of the virus can also occur in rare cases while handling it in laboratories, or through blood transfusions and organ transplants from infected people, or from mother to child during pregnancy, childbirth, or breastfeeding.

**Precautions**

 the virus is not transmitted through coughing, sneezing, touching, or handling infected birds, whether alive or dead, but he advises wearing gloves when disposing of dead birds. He also confirms that eating infected birds or animals does not transmit the virus, provided that the meat is well cooked.