West Nile virus (WNV) is a mosquito-borne flavivirus contributing yearly, to birds, horses and human morbidity and mortality throughout the world. WNV is transmitted mainly by mosquitoes, predominantly by Culex species, to avian hosts and other vertebrates. Since the mid-1990s, WNV outbreaks and severe human cases (i.e., West Nile neuroinvasive disease) have increased throughout the North hemisphere. The absence of human vaccine and effective therapy needs to understand the pathogenesis of WN severe disease as well as factors participating in WNV transmission and mosquito exposure. The exploration of the host/vector interaction at the individual level using host antibody response against mosquito salivary proteins has open news research opportunities aiming to increase the impact of surveillance and WNV vector control strategies. This review describes Culex saliva specific biomarkers as a helpful tool to estimate exposure to vector bites and risk for WNV infection, summarizes recent advances regarding WNV vector control strategies and highlights potential specific biomarkers of WN disease severity.