Gastrointestinal manifestations of acute West Nile virus infection in humans
Background and Aim: Both West Nile fever and West Nile neuroinvasive disease have been associated with gastrointestinal manifestations including nausea, vomiting, diarrhea, and abdominal pain (Murray et al., 2008). No publications to date have specifically focused on the gastrointestinal manifestations in acute West Nile disease, even with a high prevalence of gastrointestinal disease within the study populations (Murray et al., 2008). Therefore, the aim of this study was to determine the prevalence of gastrointestinal manifestations, and to assess the association between gastrointestinal manifestations and West Nile neuroinvasive disease.^ Methods: All probable and confirmed West Nile illness cases reported to Harris County Public Health and Environmental Services (HCPHES) as a part of routine surveillance between 2002 and 2014 were used in this study. Descriptive demographic characteristics were summarized and their analysis stratified by West Nile fever and West Nile neuroinvasive disease (Including encephalitis, meningitis, and meningoencephalitis). The prevalence of gastrointestinal manifestations including nausea, vomiting, diarrhea, and abdominal pain in WNV disease patients was calculated. Multiple logistic regression models were used to assess the association between the presence of gastrointestinal manifestations and WNV neuroinvasive disease, and disease outcomes (recovered, continued morbidity, and death). Multiple linear regression was used to assess the association between delay in diagnosis (the number of days between date of symptom onset and date of specimen collection), and the presence of gastrointestinal manifestations. ^ Results: There were 261 probable and confirmed West Nile disease patients reported to HCPHES between 2002 and 2014. 75.5% of the patients reported gastrointestinal manifestations. Multiple logistic regression indicated that the odds of prevalent West Nile neuroinvasive disease in patients with gastrointestinal manifestations increased by 114 percent when compared to patients without gastrointestinal manifestations. Other multiple logistic regression models indicated that there was no significant association between the presence of gastrointestinal manifestations and the various disease outcomes (continued morbidity, death, or recovery). Multiple linear regression indicated no significant difference delayed diagnosis and presence of gastrointestinal manifestations.^ Conclusions: Due to the findings in this study, patients who are suspected of having West Nile illness and gastrointestinal manifestations should be warned about the potential neurological complications. Proper education on the signs and symptoms of West Nile neuroinvasive disease should be provided for these patients by the medical provider.^
Harris, Kristofer, "Gastrointestinal manifestations of acute West Nile virus infection in humans" (2016). Texas Medical Center Dissertations (via ProQuest). AAI10182180.