West nile virus medical therapy

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

• 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.
• There are no guidelines that recommend the use of ribavirin or interferon alfa-2b for the treatment of west nile virus encephalitis or meningitis.