MEDIX, God. 19 Br. 107/108  •  Pregledni članak  •  Infektologija HR ENG

Infekcija virusom Zapadnog NilaWest Nile virus infection

Vladimir Krajinović

Virus Zapadnog Nila (ZN) jedan je od najrasprostranjenijih arbovirusa uopće. Gotovo sve infekcije virusom ZN-a u ljudi posljedica su uboda komarca zaraženog virusom, obično iz roda culex. Drugi rjeđi putevi prijenosa su transfuzijom krvnih pripravaka i transplantacijom organa. Glavni domaćin su divlje ptice koje razvijaju visok stupanj viremije, ali one ostaju asimptomatske. Infekcija virusom ZN-a uzrokuje akutnu febrilnu bolest koja povremeno uzrokuje neuroinvazivnu bolest, osobito u starijih i imunokompromitiranih bolesnika. Karakterizirana je vrućicom, glavoboljom, slabošću, bolovima u leđima i mišićima, gubitkom teka, a ponekad i makulopapuloznim osipom. Infekcija virusom ZN-a može se prezentirati i kao meningitis, encefalitis ili akutna asimetrična mlohava kljenut. Kod bolesnika koji se prezentiraju sa sindromom koji sliči infekciji ZN-om dijagnoza se postavlja serološki detekcijom specifičnih IgM-protutijela. Kod oboljelih sa znakovima neuroinvazivne bolesti, u cerebrospinalnom likvoru vidi se pleocitoza s predominacijom limfocita kao i povišena koncentracija proteina. Liječenje infekcije ZN-om je simptomatsko. Prognoza bolesti je dobra kod bolesnika s kliničkom slikom vrućice, ali u slučaju neuroinvazivne bolesti smrtnost doseže oko 10%. Osobne mjere zaštite su korištenje repelenata protiv komaraca. Opće mjere za zaštitu stanovništva uključuju program nadzora nad komarcima i testiranje darovatelja krvi. 

Ključne riječi:
vrućica Zapadnog Nila; encefalitis; meningitis

Članak u cijelosti pročitajte u tiskanom izdanju MEDIX, God. 19 Br. 107/108

The West Nile (WN) virus is one of the most widely distributed arboviruses. Nearly all infections caused by the WN virus in humans are due to mosquito bites, usually of the Culex species. The less common ways of contracting the virus are through blood transfusion and organ transplants. Wild birds develop high levels of viremia and serve as amplifying hosts but generally remain asymptomatic. The West Nile virus infection is associated with an acute febrile illness that occasionally causes neuroinvasive disease, particularly in the elderly or immunosuppressed patients. It is characterized by fever, headache, weakness, back and muscular pain, loss of appetite, as well as a maculopapular rash. The WN virus infection can present itself as meningitis, encephalitis or an acute asymmetric flaccid paralysis. In patients with symptoms resembling those of the WN virus, diagnosis is through serologic detection of specific IgM antibodies. In cases where signs of neuroinvasive disease are present pleocytosis is seen in the cerebrospinal fluid, often with a predominance of lymphocytes as well as an elevated protein concentration. The WN virus infection treatment is symptomatic. Prognosis for patients with the WN viral infection is good if the main concern is a fever, however, neuroinvasive disease reaches mortality of approximately 10%. Personal protection measures include the use of mosquito repellents. General measures used to protect the population include mosquito control programs and blood donor screenings. 

Key words:
encephalitis; meningitis; West Nile fever