West Nile Virus–associated Flaccid Paralysis

作者：James J. Sejvar, Amy V. Bode, Anthony A. Marfin, Grant L. Campbell, D J Ewing, Michael Mazowiecki, Pierre V. Pavot, Joseph M. Schmitt, John Pape, Brad J. Biggerstaff, Lyle R. Petersen · 发表于：Emerging infectious diseases · 年份：2005 · DOI：10.3201/eid1107.040991 · 被引用次数：214 · 研究领域：Mosquito-borne diseases and control、Viral Infections and Outbreaks Research、Virology and Viral Diseases

The causes and frequency of acute paralysis and respiratory failure with West Nile virus (WNV) infection are incompletely understood.During the summer and fall of 2003, we conducted a prospective, population-based study among residents of a 3-county area in Colorado, United States, with developing WNV-associated paralysis.Thirtytwo patients with developing paralysis and acute WNV infection were identified.Causes included a poliomyelitislike syndrome in 27 (84%) patients and a Guillain-Barré-like syndrome in 4 (13%); 1 had brachial plexus involvement alone.The incidence of poliomyelitislike syndrome was 3.7/100,000.Twelve patients (38%), including 1 with Guillain-Barré-like syndrome, had acute respiratory failure that required endotracheal intubation.At 4 months, 3 patients with respiratory failure died, 2 remained intubated, 25 showed various degrees of improvement, and 2 were lost to followup.A poliomyelitislike syndrome likely involving spinal anterior horn cells is the most common mechanism of WNV-associated paralysis and is associated with significant short-and long-term illness and death. A cute paralysis associated with West Nile virus (WNV)infection (1-8) has been attributed to Guillain-Barré syndrome (3), a poliomyelitislike syndrome (2,4-6,8), and a generalized myeloradiculitis (1,7).Several reports have described acute respiratory failure occurring with WNVassociated paralysis (5,7).However, the frequency of acute paralysis in WNV neuroinvasive disease remains unkno...