title: West Nile virus: should pediatricians care?
abstract: Given the recurrent serious outbreaks of West Nile Virus (WNV) in the United States over the past decade, the spread to Canada and South America, the recurrent outbreaks in Europe, and the potential for serious neurological disease even in children under 18 years, paediatricians in affected areas must consider WNV in the differential diagnosis of all children presenting with aseptic meningitis, encephalitis and acute flaccid paralysis. Additionally, given that WNV encephalitis can occur after WNV infection, suspicion for neurological WNV disease must remain high even after otherwise benign febrile illnesses if the child lives in or has traveled to an affected region. Under-diagnosis in the pediatric population is likely a serious problem, necessitating further educational efforts. More follow-up studies of WNV neurological disease in children and youth are needed to better understand the potential long-term sequelae during vulnerable times of neurodevelopment and neural remodeling. Similarly, more research is need on short and long-term fetal outcomes of maternal WNV infection.
authors.affiliation: Paediatric Infectious Diseases, Paediatrics Dalhousie University, IWK Health Center, 5850/5980 University Ave, Halifax, Nova Scotia B3K 6R8, Canada. Electronic address: jaurora777@yahoo.ca.
authors.forename: Jennifer C
authors.initials: JC
authors.lastname: Smith
authors.affiliation: Paediatrics and Microbiology, Dalhousie University, IWK Health Center, 5850/5980 University Ave, Halifax, Nova Scotia B3K 6R8, Canada. Electronic address: tim.mailman@iwk.nshealth.ca.
authors.forename: Tim
authors.initials: T
authors.lastname: Mailman
authors.affiliation: Paediatrics, Dalhousie University, IWK Health Center, 5850/5980 University Ave, Halifax, Nova Scotia B3K 6R8, Canada. Electronic address: noni.macdonald@dal.ca.
authors.forename: Noni E
authors.initials: NE
authors.lastname: MacDonald
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D011247:Pregnancy; D014901:West Nile Fever / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission / Q000821:virology*; D014902:West Nile virus / Q000502:physiology*
keywords: Arbovirus; Encephalitis; Meningitis; West Nile poliomyelitis; West Nile virus; West Nile virus epidemiology; West Nile virus fever