Follow-up study of Greek patients with West Nile virus neuroinvasive disease

Abstract

Objectives: To investigate the extent to which Greek patients with West Nile virus neuroinvasive disease (WNND) recovered from the initial infection in 2010, when a West Nile virus (WNV) lineage 2 outbreak took place.

Methods: Twenty-two patients with WNND were examined 16 months after the onset of symptoms. The physical and mental function of the 22 survivors was evaluated.

Results: A considerable persistent morbidity and long length of time to recovery was observed. The most common symptoms were anorexia (77.3%) and muscle weakness (72.7%), followed by memory impairment (36.4%) and depression (22.7%). Older age was correlated with memory impairment, muscle weakness, and permanent damage. A complete recovery was seen in 7/22 (31.8%) patients, while three patients presented permanent damage. The critical time-point was 1 year after the onset of symptoms; at that time the patient's health status was either highly improved or had deteriorated irreversibly.

Conclusions: WNND is associated with considerable short- and long-term morbidity and mortality. Lineage 2 strains need further scientific attention. Public health measures are needed to prevent the infection, especially in the elderly with underlying diseases.