Emerg Infect Dis. 2024 Oct;30(10):2090-2098. doi: 10.3201/eid3010.240595.
West Nile virus (WNV) is the most common cause of human arboviral disease in the contiguous United States, where only lineage 1 (L1) WNV had been found. In 2023, an immunocompetent patient was hospitalized in Nebraska with West Nile neuroinvasive disease and multisystem organ failure. Testing at the Centers for Disease Control and Prevention indicated an unusually high viral load and acute antibody response. Upon sequencing of serum and cerebrospinal fluid, we detected lineage 3 (L3) and L1 WNV genomes. L3 WNV had previously only been found in Central Europe in mosquitoes. The identification of L3 WNV in the United States and the observed clinical and laboratory features raise questions about the potential effect of L3 WNV on the transmission dynamics and pathogenicity of WNV infections. Determining the distribution and prevalence of L3 WNV in the United States and any public health and clinical implications is critical.
西尼罗河病毒（WNV）是美国连续地区人类虫媒病毒病最常见的病因，此前仅发现 L1 株 WNV。2023 年，内布拉斯加州 1 位免疫功能正常的患者因西尼罗河神经侵袭性疾病和多系统器官衰竭住院。疾病预防控制中心的检测表明病毒载量异常高，急性抗体反应。对血清和脑脊液进行测序后，我们检测到了 3 型（L3）和 L1 WNV 基因组。L3 WNV 此前仅在中欧的蚊子中发现过。L3 WNV 在美国的出现以及观察到的临床和实验室特征，引发了对 L3 WNV 对 WNV 感染传播动力学和致病性潜在影响的疑问。确定 L3 WNV 在美国的分布和流行程度及其对公共卫生和临床的影响至关重要。
