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As the name suggests, West Nile virus (WNV) and its associated disease, West Nile encephalitis (WNE) , did not originate in North America. Until 1999, it was endemic in the Middle East, Africa, and Asia; however, the first US cases were identified in New York in 1999, and by 2004, the virus had spread across the entire continental United States. Over 35,000 cases, including 1400 deaths, were confirmed in the five-year period between 1999 and 2004. WNV infection remains reportable to the CDC.

WNV is transmitted to humans by Culex mosquitoes from its natural reservoir, infected birds, with 70–80% of infected patients experiencing no symptoms. Most symptomatic cases involve only mild, flu-like symptoms, but fewer than 1% of infected people develop severe and sometimes fatal encephalitis or meningitis. The mortality rate in WNV patients who develop neurological disease is about 10%. More information about West Nile virus can be found in Modes of Disease Transmission .

  • Why is it unlikely that arboviral encephalitis viruses will be eradicated in the future?
  • Which is the most common form of viral encephalitis in the United States?

Part 2

Levofloxacin is a quinolone antibiotic that is often prescribed to treat bacterial infections of the respiratory tract, including pneumonia and bronchitis. But after taking the medication for a week, David returned to his physician sicker than before. He claimed that the antibiotic had no effect on his earlier symptoms. In addition, he now was experiencing headaches, a stiff neck, and difficulty focusing at work. He also showed the doctor a rash that had developed on his arms over the past week. His doctor, more concerned now, began to ask about David's activities over the past two weeks.

David explained that he had been recently working on a project to disassemble an old barn. His doctor collected sputum samples and scrapings from David’s rash for cultures. A spinal tap was also performed to examine David’s CSF. Microscopic examination of his CSF revealed encapsulated yeast cells. Based on this result, the doctor prescribed a new antimicrobial therapy using amphotericin B and flucytosine.

  • Why was the original treatment ineffective?
  • Why is the presence of a capsule clinically important?

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Zika virus infection

Zika virus infection is an emerging arboviral disease associated with human illness in Africa, Southeast Asia, and South and Central America; however, its range is expanding as a result of the widespread range of its mosquito vector. The first cases originating in the United States were reported in 2016.The Zika virus was initially described in 1947 from monkeys in the Zika Forest of Uganda through a network that monitored yellow fever. It was not considered a serious human pathogen until the first large-scale outbreaks occurred in Micronesia in 2007; Sikka, Veronica, Vijay Kumar Chattu, Raaj K. Popli, Sagar C. Galwankar, Dhanashree Kelkar, Stanley G. Sawicki, Stanislaw P. Stawicki, and Thomas J. Papadimos, “The Emergence of Zika Virus as a Global Health Security Threat: A Review and a Consensus Statement of the INDUSEM Joint Working Group (JWG),” Journal of Global Infectious Diseases 8, no. 1 (2016): 3. however, the virus has gained notoriety over the past decade, as it has emerged as a cause of symptoms similar to other arboviral infections that include fever, skin rashes, conjunctivitis, muscle and joint pain, malaise, and headache. Mosquitoes of the Aedes genus are the primary vectors, although the virus can also be transmitted sexually, from mother to baby during pregnancy, or through a blood transfusion.

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Source:  OpenStax, Microbiology. OpenStax CNX. Nov 01, 2016 Download for free at http://cnx.org/content/col12087/1.4
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