title: West Nile virus-associated flaccid paralysis.
abstract: The causes and frequency of acute paralysis and respiratory failure with West Nile virus (WNV) infection are incompletely understood. During the summer and fall of 2003, we conducted a prospective, population-based study among residents of a 3-county area in Colorado, United States, with developing WNV-associated paralysis. Thirty-two patients with developing paralysis and acute WNV infection were identified. Causes included a poliomyelitislike syndrome in 27 (84%) patients and a Guillain-Barré-like syndrome in 4 (13%); 1 had brachial plexus involvement alone. The incidence of poliomyelitislike syndrome was 3.7/100,000. Twelve patients (38%), including 1 with Guillain-Barré-like syndrome, had acute respiratory failure that required endotracheal intubation. At 4 months, 3 patients with respiratory failure died, 2 remained intubated, 25 showed various degrees of improvement, and 2 were lost to followup. A poliomyelitislike syndrome likely involving spinal anterior horn cells is the most common mechanism of WNV-associated paralysis and is associated with significant short- and long-term illness and death.
authors: Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. JSejvar@cdc.gov
authors: James J
authors: JJ
authors: Sejvar
authors: Amy V
authors: AV
authors: Bode
authors: Anthony A
authors: AA
authors: Marfin
authors: Grant L
authors: GL
authors: Campbell
authors: David
authors: D
authors: Ewing
authors: Michael
authors: M
authors: Mazowiecki
authors: Pierre V
authors: PV
authors: Pavot
authors: Joseph
authors: J
authors: Schmitt
authors: John
authors: J
authors: Pape
authors: Brad J
authors: BJ
authors: Biggerstaff
authors: Lyle R
authors: LR
authors: Petersen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D020275:Guillain-Barre Syndrome / Q000821:virology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009123:Muscle Hypotonia / Q000821:virology*; D016017:Odds Ratio; D010243:Paralysis / Q000821:virology*; D012131:Respiratory Insufficiency / Q000821:virology; D014901:West Nile Fever / Q000134:cerebrospinal fluid / Q000150:complications*