West nile virus medical therapy: Difference between revisions
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===Medications=== | ===Medications=== | ||
* | *Although various drugs have been evaluated or empirically used for WNV disease, none have shown specific benefit to date. | ||
* [[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 | * [[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 | ||
| author = [[I. Jordan]], [[T. Briese]], [[N. Fischer]], [[J. Y. Lau]] & [[W. I. Lipkin]] | | author = [[I. Jordan]], [[T. Briese]], [[N. Fischer]], [[J. Y. Lau]] & [[W. I. Lipkin]] | ||
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}}</ref> | }}</ref> | ||
*[[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> | *[[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> | ||
*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> | |||
*Further studies need to be done to determine the efficacy and safety of [[ribavirin]] and [[interferon alfa-2b]] in west nile virus infection. | *Further studies need to be done to determine the efficacy and safety of [[ribavirin]] and [[interferon alfa-2b]] in west nile virus infection. | ||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Revision as of 16:17, 11 September 2014
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Alejandro Lemor, M.D. [2]
Overview
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.
Medical Therapy
Supportive care Adapted from CDC[1]
- There is no specific antiviral therapy indicated in patients with west nile virus infection.
- Treatment consist of supportive measurements and prevention of complications.
- In severe cases, patients often need to be hospitalized to receive supportive treatment, such as intravenous fluids, analgesics, and nursing care.
- Patients with severe meningeal symptoms often require pain control for headaches and antiemetic therapy and rehydration for associated nausea and vomiting.
- Patients with encephalitis require close monitoring for the development of elevated intracranial pressure and seizures.
- Patients with encephalitis or paralysis should be monitored for inability to protect their airway.
- Acute neuromuscular respiratory failure may develop rapidly and prolonged ventilatory support may be required.
Medications
- Although various drugs have been evaluated or empirically used for WNV disease, none have shown specific benefit to date.
- 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.[2][3]
- Interferon alfa-2b has also shown benefit in in vitro studies against west nile virus CNS infection.[4]
- There are no guidelines that recommend the use of ribavirin or interferon-alfa 2b for the treatment of west nile virus encephalitis or meningitis.[5]
- Further studies need to be done to determine the efficacy and safety of ribavirin and interferon alfa-2b in west nile virus infection.
References
- ↑ "CDC Treatment and Prevention".
- ↑ I. Jordan, T. Briese, N. Fischer, J. Y. Lau & W. I. Lipkin (2000). "Ribavirin inhibits West Nile virus replication and cytopathic effect in neural cells". The Journal of infectious diseases. 182 (4): 1214–1217. doi:10.1086/315847. PMID 10979920. Unknown parameter
|month=ignored (help) - ↑ S. Ia Loginova, S. V. Borisevich, Iu A. Pashchenko & V. P. Bondarev (2009). "[Ribavirin prophylaxis and therapy of experimental West Nile fever]". [[Antibiotiki i khimioterapiia = Antibiotics and chemoterapy [sic] / Ministerstvo meditsinskoi i mikrobiologicheskoi promyshlennosti SSSR]]. 54 (11–12): 17–20. PMID 20583562.
- ↑ Anderson, John F. (2002). "Efficacy of Interferon -2b and Ribavirin Against West Nile Virus In Vitro". Emerging Infectious Diseases. 8 (1): 107–108. doi:10.3201/eid0801.010252. ISSN 1080-6040.
- ↑ Tunkel, Allan R.; Glaser, Carol A.; Bloch, Karen C.; Sejvar, James J.; Marra, Christina M.; Roos, Karen L.; Hartman, Barry J.; Kaplan, Sheldon L.; Scheld, W. Michael; Whitley, Richard J. (2008). "The Management of Encephalitis: Clinical Practice Guidelines by the Infectious Diseases Society of America". Clinical Infectious Diseases. 47 (3): 303–327. doi:10.1086/589747. ISSN 1058-4838.