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West Nile Virus

What is West Nile virus?

West Nile virus (WNV) is a viral illness you can get from a mosquito bite. Most of the time the illness is mild, but sometimes it can cause inflammation of the brain (encephalitis) or inflammation of the membranes that cover the brain and spinal cord (meningitis). The risk of severe infection is greatest for people who are over 70 years old or who have a weakened immune system.

What is the cause?

Wild and domestic birds, mainly crows, carry the West Nile virus. Mosquitoes become carriers of the virus when they bite infected birds. You can then get the virus if you are bitten by an infected mosquito. There are no known cases people getting WNV directly from an infected bird.

The risk of West Nile virus is seasonal in the northern states of the US and usually starts in the spring. The peak time for infection is mid to late August. In milder southern climates, the infection may occur year-round.

The infection is not spread by normal person-to-person contact like touching, kissing, or caring for someone who is infected. It can be spread through blood transfusions and organ transplants. However, blood centers and hospitals screen for West Nile Virus in donated blood and organs. The virus might also be transmitted through breast milk. However, the risk of spread of the virus to the baby is believed to be very low. If you are breast-feeding and you have a WNV infection, the American Academy of Pediatrics and the CDC say that it’s OK to keep breast-feeding.

What are the symptoms?

Often there are no symptoms. Children are more likely to have symptoms than adults. When symptoms do occur, they usually start 3 to 14 days after you are bitten by an infected mosquito. They are usually mild and last a few days. Symptoms may include:

  • Fever
  • Headache
  • Body aches
  • Nausea or vomiting
  • Rash
  • Swollen lymph glands

When WNV affects the brain, symptoms may include:

  • Tremors, like a shaking of your hands that you cannot control
  • Stiff neck
  • High fever
  • Severe headache
  • Paralysis
  • Weakness
  • Confusion
  • Seizures
  • Coma

How is it diagnosed?

Your child's healthcare provider will ask about the symptoms and your child’s medical history. Your provider will examine your child. Tests may include:

  • Blood tests
  • Spinal tap (lumbar puncture), which uses a needle (after the skin is numbed) to get a sample of fluid from the spine to test for meningitis
  • EEG, a test that measures the electrical activity of the brain (brain waves)
  • CT or MRI scan to get detailed pictures of the brain

How is it treated?

There is no medicine that cures West Nile virus. If your child’s symptoms are mild, they will usually go away on their own. In most cases you can care for your child at home. If the infection is serious, your child may need to stay at the hospital. At the hospital, your child may be given IV fluids, pain relievers, or other treatments.

Most people infected with WNV, including nearly all children, don’t get seriously ill, and they recover fully. Symptoms usually last 3 to 6 days, but they can last as long as several weeks or months.

If your child has a serious infection, your child may be sick for weeks or months. In the most serious cases, the nervous system or brain may be injured.

How can I take care of my child?

Here are some things you can do to take care of your child during the illness:

  • Let your child rest if he or she is tired.
  • Give acetaminophen for fever or an anti-inflammatory medicine, such as ibuprofen, if your child also has a headache or muscle aches.
    • Check with your healthcare provider before you give any medicine that contains aspirin or salicylates to a child or teen. This includes medicines like baby aspirin, some cold medicines, and Pepto-Bismol. Children and teens who take aspirin are at risk for a serious illness called Reye's syndrome.
    • Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, may cause stomach bleeding and other problems. These risks increase with age. Read the label and take as directed. Unless recommended by your healthcare provider, don’t give them for more than 10 days for any reason.

Follow your child’s healthcare provider's instructions. Ask your provider:

  • How and when you will hear your child’s test results
  • How long it will take for your child to recover
  • What activities your child should avoid and when your child can return to normal activities
  • How to take care of your child at home
  • What symptoms or problems you should watch for and what to do if your child has them

Make sure you know when your child should come back for a checkup.

How can I help prevent West Nile virus?

WNV can be prevented by taking precautions to avoid exposure to mosquitoes:

  • Stay indoors at dawn, dusk, and in the early evening, when mosquitoes are most likely to be around.
  • Wear long pants and long-sleeved shirts, especially from dusk to dawn. This is the time when you are most likely to get bitten.
  • Use an insect repellent whenever you are outdoors. Don't use more repellent than recommended in the package directions. Don't put repellent on open wounds or rashes. Don’t put it on your eyes or mouth. When using sprays for the skin, don’t spray the repellent directly on your face. Spray the repellent on your hands first and then put it on your face. Then wash the spray off your hands.
    • Adults should use repellent products with no more than 35% DEET. Children older than 2 months can use repellents with no more than 30% DEET. DEET should be applied just once a day. Wash it off your body when you go back indoors.
    • Picaridin may irritate the skin less than DEET and appears to be just as effective.
    • Spray clothes with repellents because mosquitoes may bite through thin clothing. Products containing permethrin are recommended for use on clothing, shoes, bed nets, and camping gear. Permethrin-treated clothing repels and kills ticks, mosquitoes, and other insects and can keep working after laundering. Permethrin should be reapplied to clothing according to the instructions on the product label. Some commercial products are available pretreated with permethrin. Permethrin does not work as a repellent when it is put on the skin.
    • In some studies, oil of lemon eucalyptus, a plant-based repellent, provided as much protection as repellents with low concentrations of DEET, but it hasn't been as well tested as DEET. Oil of lemon eucalyptus should not be used on children under age 3.
    • Some repellents can make children ill if they put it in their mouth or swallow it. Never let young children play with or put repellent on themselves. Adults should put repellent on their own hands, and then put the repellent on the child’s body.
  • Install or repair window and door screens so it is harder for mosquitoes to get indoors.
  • Mosquitoes lay eggs in water. To reduce mosquito breeding, drain standing water. Routinely empty water from flowerpots, pet bowls, clogged rain gutters, swimming pool covers, buckets, barrels, cans, and other items that collect water.
Developed by RelayHealth.
Pediatric Advisor 2013.2 published by RelayHealth.
Last modified: 2012-07-02
Last reviewed: 2012-03-02
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
© 2013 RelayHealth and/or its affiliates. All rights reserved.
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