title: A fatal neuroinvasive West Nile virus infection in a traveler returning from Madagascar: clinical, epidemiological and veterinary investigations.
abstract: Abstract. A 58-year-old woman living in Reunion Island and returning from Madagascar was hospitalized for neuroinvasive encephalitis and died 1 month later. West Nile virus (WNV) infection was biologically confirmed by detection of immunoglobulin M (IgM) reactive with WNV antigens in both cerebrospinal fluid and serum, and weak neutralizing activity was also detected. A veterinary survey performed in her traveling area showed a seroprevalence of WNV of 28.7% (95% confidence interval [CI] = 21.1-36.3) in adult poultry, confirming an active circulation of the virus. Development of a severe form could be related to a weak antibody response, because the patient presented low IgM and IgG titers. This case report underlines the constant risk of emergence of West Nile in Indian Ocean territories, including Reunion Island where competent vectors are widely present during the whole year.
authors.affiliation: Cellule Interrégionale d'Épidémiologie Océan Indien (Cire OI), Institut de Veille Sanitaire, Saint Denis, La Réunion, France. sophie.larrieu@ars.sante.fr
authors.forename: Sophie
authors.initials: S
authors.lastname: Larrieu
authors.forename: Eric
authors.initials: E
authors.lastname: Cardinale
authors.forename: Philippe
authors.initials: P
authors.lastname: Ocquidant
authors.forename: Matthieu
authors.initials: M
authors.lastname: Roger
authors.forename: Richard
authors.initials: R
authors.lastname: Lepec
authors.forename: Hélène
authors.initials: H
authors.lastname: Delatte
authors.forename: Guillaume
authors.initials: G
authors.lastname: Camuset
authors.forename: Philippe
authors.initials: P
authors.lastname: Desprès
authors.forename: Elise
authors.initials: E
authors.lastname: Brottet
authors.forename: Cyril
authors.initials: C
authors.lastname: Charlin
authors.forename: Alain
authors.initials: A
authors.lastname: Michault
mesh_terms: D000330:Aedes / Q000821:virology; D000818:Animals; D003465:Culex / Q000821:virology; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood / Q000134:cerebrospinal fluid; D007303:Insect Vectors / Q000821:virology; D008270:Madagascar / Q000453:epidemiology; D008875:Middle Aged; D011200:Poultry; D011201:Poultry Diseases / Q000453:epidemiology / Q000276:immunology / Q000821:virology; D017508:Reunion; D014195:Travel; D014901:West Nile Fever / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology / Q000662:veterinary; D014902:West Nile virus
chemical_list: D007075:Immunoglobulin M