title: Follow-up study of Greek patients with West Nile virus neuroinvasive disease.
abstract: OBJECTIVE
  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.
authors: Internal Medicine Clinic, Giannitsa General Hospital, Giannitsa, Greece.
authors: Afroditi
authors: A
authors: Anastasiadou
authors: Ioannis
authors: I
authors: Kakoulidis
authors: Dimitrios
authors: D
authors: Butel
authors: Emmanuilia
authors: E
authors: Kehagia
authors: Anna
authors: A
authors: Papa
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D004196:Disease Outbreaks; D018792:Encephalitis, Viral / Q000453:epidemiology* / Q000517:prevention & control; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D006115:Greece / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012737:Sex Factors; D014901:West Nile Fever / Q000453:epidemiology* / Q000517:prevention & control; D014902:West Nile virus / Q000302:isolation & purification*; D044465:White People; D055815:Young Adult