Evaluation of Prolonged Fatigue Post–West Nile Virus Infection and Association of Fatigue with Elevated Antiviral and Proinflammatory Cytokines

Abstract

This study aimed to characterize fatigue postinfection among study participants with a history of West Nile virus (WNV) infection and determine whether antiviral and pro-inflammatory cytokines were significantly elevated in those reporting prolonged fatigue. We found that 31% (44/140) of study participants experienced prolonged (more than 6 months) fatigue postinfection, with an average length of fatigue duration of 5 years. Females, those younger than 50 years of age, and those with symptomatic clinical WNV disease were significantly more likely to report fatigue. Pro-inflammatory and antiviral cytokines (granulocyte macrophage colony stimulating factor, interferon-c, interferon-c inducing protein 10, interleukin 2, interleukin 6, and interleukin 12p70) were significantly elevated in those reporting fatigue postinfection compared to those not reporting fatigue. Clinicians should consider history of WNV infection as a possible factor when evaluating causes of prolonged fatigue following a febrile viral illness in their patients.

Chronic fatigue syndrome and circulating cytokines: A systematic review

“…Hand searching through both the papers included and reviews did not reveal any additional studies. However, authors' knowledge of other studies involving cytokine measurement in CFS provided an additional three studies (Garcia et al, 2014;Hornig et al, 2015;Nakatomi et al, 2014).…”

“…In 12 studies there was no matching of controls to cases (Buchwald et al, 1997;Garcia et al, 2014;Khaiboullina et al, 2014;Linde et al, 1992;Maes et al, 2013;Maes et al, 2012;Neu et al, 2014;Patarca et al, 1994;Smylie et al, 2013;Spence et al, 2008;White et al, 2010;Wyller et al, 2015). The factors that were matched including age, activity level, gender, body mass index, ethnicity, neighbourhood and menstrual cycle stage.…”

Long-term Assessment of Fatigue in Patients with Culture-confirmed Lyme Disease

“…1 Among US patients with early Lyme disease who present with the characteristic skin lesion erythema migrans, approximately 45% have fatigue concomitantly. 2 Fatigue also is thought of as a prominent symptom in some patients with Lyme disease who have residual symptoms despite antibiotic therapy and resolution of the objective manifestations of Lyme disease, such as erythema migrans.…”

Does astroglial protein S100B contribute to West Nile neuro-invasive syndrome?

“…One way ANOVA was used for statistical analysis (Prism 6.0, GraphPad software). There was a statistically significant difference between the C8 groups as determined by one-way ANOVA [F [5,30] = 36.75, P b 0.0001]. A statistically significant difference was also observed between primary astrocyte data groups as determined by one-way ANOVA [F [5,30] = 34.51, P b 0.0001).Overall in A and B, the glutamate uptake decreased with increasing concentration of S100B, except at 0.01 μM S100B in case of C8 cells.…”

“…Humans suffering from acute WNV infection present with various symptoms, ranging from a mild, flu-like illness to neuro-invasive forms, such as encephalitis, meningitis, and/or acute flaccid paralysis due to the loss of spinal motor neurons [4]. The recovery from WNV infection may be prolonged and incomplete with many infected persons complaining of lingering or delayed-onset symptoms, from non-specific subjective fatigue to persistent neurologic impairments [5][6][7].…”