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West Nile Virus: The Most Important Questions and Answers – Health and Medicine



Berlin. For the first time in Germany, human disease through the West Nile virus (WNV) has become known. Robert Koch, Bernhard Necht and the Friedrich Löfler Institute communicated this in a joint communication. The patient is a 70-year-old man from Saxony who was infected by mosquito bites and subsequently suffered from encephalitis. He has recovered in the meantime, it is said.

Last year, there were the first cases of dead birds in Germany following infection with the virus – the main host of the pathogen. Now, too, the first case in which one person has been infected with the virus has occurred. How dangerous is the West Nile virus? Answers to the most important questions:

West Nile Virus in Horse – What are the Hosts?

The West Nile virus belongs to the so-called arboviruses (arthropod-borne virus) that are transmitted by arthropods as mosquitoes or ticks.
The hosts are mainly birds, horses and humans can be infected by mosquito bites. The virus is transmitted through blood-sucking mosquitoes, mainly Kukes. Cuckoo species are also native to Germany, such as the common mosquito (Culex pipiens), which has already been discovered in other regions of Europe as a transmitter.

For the first time in 1937, WNV was discovered in Uganda by a sick woman. In 1999, the first case was in the United States. There is currently no vaccine or therapy.

How is the virus transmitted?

The typical cycle of viruses lasts between mosquitoes that suck blood
and birds. The insect infects the bird, the next mosquito that will sting the bird collects the virus and spreads it.

Rarely, mosquitoes can transmit the West Nile virus to humans, horses or other mammals. "Humans and horses are a dead end, a bad host," said Elke Reinking of the Friedrich Löfler Institute (CLI) on the island of Rome. "But they do not help spread the virus."

Basically, several conditions must be assembled so that the pathogen can spread. For example, not every bird is susceptible to a virus. Rats, crows, jams and some species of predatory birds and owls, such as the gray owl from the Halle Zoo, where the virus was first discovered in a bird in Germany last year, are thought to be easy to infect.

Temperature also plays a role in portability. "The virus has an optimal 'operating temperature,'" Reinking says. Long dry summers are a good environment.

How is the infection in humans?

Most people don't notice an infection: According to the Robert Koch Institute, 80 percent of those infected with VND have no symptoms. Twenty percent develop West Nile fever after two to 14 days, which subsides after a few days and whose symptoms are reminiscent of the flu. Those affected get fever, headache and body aches, are ejected, lymph nodes swell, some get rash.

However, less than one percent of the course is very difficult, some of it ending up fatal. With age and in people with certain existing conditions that affect the immune system, the risk of severe flow increases.

Because the virus can cross the so-called blood-brain barrier and enter the brain, it can cause meningitis (meningitis), in rare cases – as in a man in Saxony – an inflammation of the brain (encephalitis). Paralysis and permanent disability are also possible.

West Nile virus: is Germany a risky area?

Since 2009 in Germany, infection with the West Nile virus in a horse or bird has been identified in animal disease. Since 2016, there has been compulsory reporting of so-called Arbovirus infections in humans.

Since the introduction of this registration obligation, no case of WNV has been reported in 2016/2017; in 2018 there were eleven reported cases that, according to the Robert Koch Institute, were imported from abroad, unlike the current case. The Saxony case is now the first WNV disease in humans due to mosquitoes in Germany. In the region, FLI has already detected cases of birds and horses in the West Nile.

As the number of mosquitoes declines in the fall, the risk of further cases is currently decreasing, said RKI President Lothar H. Wheeler. "In the coming summers, however, we must expect further infections of the West Nile virus," Wheeler said.

How can you protect yourself from infection?

Since there is no vaccine or therapy, the only mosquito protection. This also applies to trips to countries such as Greece, Italy and Serbia. Confirmed cases of West Nile fever have also been reported from other countries such as Romania, Kosovo and Hungary. The Federal Foreign Office is providing a leaflet for the West Nile virus online.


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