West nile virus medical therapy: Difference between revisions

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==Medical therapy==
==Medical therapy==
===Supportive care===
:* '''West nile virus<ref name=CDC West nile virus>{{cite web | title = CDC West nile virus | url =http://www.cdc.gov/westnile/symptoms/index.html }}</ref>'''
*There is no specific [[antiviral]] therapy indicated for patients with WNV infection.
::* 1.1. '''Prevention'''
*Treatment is aimed at supportive measurements and prevention of complications.
:::* No WNV vaccines are licensed for use in humans. In the absence of a vaccine, prevention of WNV disease depends on community-level mosquito control programs to reduce vector densities, personal protective measures to decrease exposure to infected mosquitoes, and screening of blood and organ donors.  
*In mild cases, patients may be followed-up as out-patients. On the other hand, severe cases often require hospitalization to receive supportive treatment, such as [[intravenous fluids]], [[analgesics]], and nursing care.
:::* Personal protective measures include use of mosquito repellents, wearing long-sleeved shirts and long pants, and limiting outdoor exposure from dusk to dawn. Using air conditioning, installing window and door screens, and reducing peridomestic mosquito breeding sites, can further decrease the risk for WNV exposure.
*Patients with severe meningeal symptoms often require pain control for [[headaches]], along with antiemetic therapy and rehydration for associated [[nausea]] and [[vomiting]].
:::* Blood and some organ donations in the United States are screened for WNV infection; health care professionals should remain vigilant for the possible transmission of WNV through blood transfusion or organ transplantation. Any suspected WNV infections temporally associated with blood transfusion or organ transplantation should be reported promptly to the appropriate state health department.
*Patients with [[encephalitis]] require close monitoring for possible development of elevated [[intracranial pressure]] and [[seizures]]. They should also be closely monitored for possible mechanical ventilation in cases where patients are unable to protect their airways.
::* 1.2. '''Treatment'''
*Acute neuromuscular [[respiratory failure]] may rapidly develop and ventilatory support may be required.
:::* There is no specific treatment for WNV disease; clinical management is supportive. 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 poliomyelitis should be monitored for inability to protect their airway. Acute neuromuscular respiratory failure may develop rapidly and prolonged ventilatory support may be required.


===Pharmacologic therapy===
*Although various drugs have been evaluated or empirically administered to patients with WNV disease, none has shown specific benefit.
*Despite common practice, there are no guidelines that recommend the use of [[ribavirin]] or [[interferon alfa-2b]] for the treatment of WNV 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>


==References==
{{Reflist|2}}
{{Reflist|2}}
[[Category: Disease]]
[[Category: Disease]]
[[Category: Infectious disease]]
[[Category: Infectious disease]]
[[Category: Infectious Disease Project]]
[[Category: Infectious Disease Project]]

Revision as of 14:14, 10 August 2015

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Alejandro Lemor, M.D. [2]

Overview

There is currently no specific antiviral pharmacologic therapy indicated for patients with WNV infection, but interferon-alpha-2b or ribavirin have been used. Patients with mild disease may be followed-up as outpatients; whereas patients with severe disease require hospitalization and close monitoring. Current management of infected patients is based on supportive care aimed at symptom relief and prevention of complications.

Medical therapy

  • West nile virus
  • 1.1. Prevention
  • No WNV vaccines are licensed for use in humans. In the absence of a vaccine, prevention of WNV disease depends on community-level mosquito control programs to reduce vector densities, personal protective measures to decrease exposure to infected mosquitoes, and screening of blood and organ donors.
  • Personal protective measures include use of mosquito repellents, wearing long-sleeved shirts and long pants, and limiting outdoor exposure from dusk to dawn. Using air conditioning, installing window and door screens, and reducing peridomestic mosquito breeding sites, can further decrease the risk for WNV exposure.
  • Blood and some organ donations in the United States are screened for WNV infection; health care professionals should remain vigilant for the possible transmission of WNV through blood transfusion or organ transplantation. Any suspected WNV infections temporally associated with blood transfusion or organ transplantation should be reported promptly to the appropriate state health department.
  • 1.2. Treatment
  • There is no specific treatment for WNV disease; clinical management is supportive. 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 poliomyelitis should be monitored for inability to protect their airway. Acute neuromuscular respiratory failure may develop rapidly and prolonged ventilatory support may be required.