West Nile virus

West Nile virus (WNV) is a flavivirus maintained in nature through alternate cycles of infection in wild birds and haematophagus mosquitoes, mainly Culex sp. Natural infection by WNV has been demonstrated in more than 200 bird species, which present variable susceptibility to infection and disease. Corvids and passeriformes are particularly susceptible and develop high levels of viremia and mortality. Occasionally, the virus may be transmitted to mammals by mosquitoes feeding previously on viremic birds. Human and horses are highly susceptible to WNV infection and often develop fever, which may be followed by neurological infection and fatal meningoencephalitis. Originally identified in Uganda (1937), WNV infection remained for decades restricted to North Africa, East Asia, Middle East and Mediterranean Europe. In these areas, isolated cases of human and horse disease, or small outbreaks were occasionally reported. In 1999, the virus was introduced in New York, USA, where it caused mortality in thousands of wild and captive birds and infected hundreds of people, killing 21. Thereafter, the infection rapidly spread out over the US territory, causing thousands of human infections (more than 27.000 - around 1100 deaths) and equine infections (more than 25.000 cases). WNV infection has also been detected in wild and domestic birds, horses and other mammals across Mexico, Central America and the Caribbean, and northern South America, indicating its dissemination southwards. In 2006, WNV was first identified as the agent of fatal neurological disease in three horses in Argentina, where it has been shown to be circulating in wild birds at least since 2005. Brazilian's human and animal health authorities are concerned with a possible introduction of the virus in the country, where it would find ideal ecological conditions for transmission and spread. This article presents a brief review on the main epidemiological and clinico-pathological aspects of WNV infection, with emphasis to human, horse and avian infections.