title: Severe West Nile virus disease in healthy adults.
abstract: The inpatient records of 44 case patients with West Nile virus infection hospitalized in 2002 were reviewed. Sixty-five percent of the case patients had encephalitis, and 35% had aseptic meningitis. There was no significant difference in the distribution of aseptic meningitis versus encephalitis among adults aged < or =50 years compared with adults aged > or =65 years. Focal weakness, likely due to anterior horn cell involvement, was present in 10 case patients (overall rate, 23%; rate among patients with encephalitis, 34%). Case patients with focal weakness who were aged < or =50 years had monoparesis, whereas those aged > or =65 years had paraparesis or quadriparesis. The overall mortality rate was 14%, and the mortality rate in patients aged > or =65 years was 35%. Increased age was associated with an increased mortality rate. The presence of paraparesis or quadriparesis was not independently predictive of mortality.
authors.affiliation: Grand Rapids Infectious Diseases, Grand Rapids, Michigan 49503, USA. DrEmig@sbcglobal.net
authors.forename: Mimi
authors.initials: M
authors.lastname: Emig
authors.forename: Douglas J
authors.initials: DJ
authors.lastname: Apple
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D020335:Paraparesis / Q000209:etiology; D010291:Paresis / Q000209:etiology; D012189:Retrospective Studies; D014901:West Nile Fever / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000503:physiopathology; D014902:West Nile virus