加拿大的西尼罗病毒神经侵袭病。萨斯喀彻温省的经验。

Neuroinvasive West Nile virus disease in Canada. The Saskatchewan experience.

机构信息

Division of Neurology, Department of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.

出版信息

Can J Neurol Sci. 2013 Jul;40(4):580-4. doi: 10.1017/s0317167100014700.

DOI:10.1017/s0317167100014700

PMID:23786744

Abstract

BACKGROUND

West Nile virus (WNV) is a virus of the family Flaviviridae. The main route of human infection is through the bite of an infected mosquito. Approximately 90% of WNV infections in humans are asymptomatic, but neurologic manifestations can be severe.

METHODS

This study reviews the clinical profile of cases with neuroinvasive West Nile infection (NWNI) reported by the Surveillance program of the government of Saskatchewan in the Saskatoon Health Region (SHR). In 2007, 1456 cases of human West Nile cases were reported by the government of Saskatchewan in the whole province. One hundred and thirteen cases had severe symptoms of NWNI (8%), 1172 (80%) cases had mild symptoms of WNI and 171 (12%) had asymptomatic disease. Three hundred and fifty six cases were reported in the SHR, where 57 (16%) fulfilled criteria for NWNI.

RESULTS

From the 57 cases, 39 (68%) were females. Nine (16%) patients had a history of recent camping, two (4%) reported outdoor sports and four (8%) reported outdoor activities not otherwise specified. Twenty five patients had headache (43.9%), 25 confusion (42.1%), 23 meningitis (40.4%), 17 encephalitis (29.8%), 14 encephalopathy (24.6%), 11 meningoencephalitis (19.3%), 10 tremor (17.5%), acute flaccid paralysis 10 (17.5%), myoclonus 1 (1.8%), nystagmus 2 (3.5%), diplopia 2 (3.5%), dizziness 2 (3.5%). Three patients died related with comorbidities during admission.

CONCLUSION

During a year of high occurrence of WNI in Saskatchewan, 16% of cases developed NWNI. The recognition of neurological complications associated with WNI is important to improve their referral to tertiary centers.

摘要

背景

西尼罗河病毒（WNV）是黄病毒科的一种病毒。人类感染的主要途径是被感染的蚊子叮咬。大约 90%的人类 WNV 感染无症状，但神经表现可能很严重。

方法

本研究回顾了萨斯喀彻温省政府在萨斯卡通卫生区（SHR）监测计划中报告的神经侵袭性西尼罗河感染（NWNI）病例的临床特征。2007 年，萨斯喀彻温省政府在全省报告了 1456 例人类西尼罗河病例。113 例有严重的 NWNI 症状（8%），1172 例（80%）有轻度 WNI 症状，171 例（12%）无症状。在 SHR 报告了 356 例病例，其中 57 例（16%）符合 NWNI 标准。

结果

在 57 例病例中，39 例（68%）为女性。9 例（16%）患者有近期露营史，2 例（4%）报告有户外运动史，4 例（8%）报告有其他户外活动史。25 例患者有头痛（43.9%），25 例有意识混乱（42.1%），23 例有脑膜炎（40.4%），17 例有脑炎（29.8%），14 例有脑病（24.6%），11 例有脑膜炎脑炎（19.3%），10 例有震颤（17.5%），急性弛缓性麻痹 10 例（17.5%），肌阵挛 1 例（1.8%），眼球震颤 2 例（3.5%），复视 2 例（3.5%），头晕 2 例（3.5%）。3 例患者因合并症在入院期间死亡。