Rehabilitation outcomes of 5 patients with severe West Nile virus infection: A case series

Rao, Noel; Char, David; Gnatz, Steve M.

doi:10.1016/j.apmr.2004.10.019

Cited by 16 publications

(8 citation statements)

References 7 publications

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“…Since few studies ( n = 2) [28, 29] reported outcomes specific to WNME (not in combination with other syndromes), it was grouped with WNE due of their clinical similarities [30]. …”

Section: Resultsmentioning

confidence: 99%

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Epidemiologic and clinical parameters of West Nile virus infections in humans: a scoping review

et al. 2017

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BackgroundClinical syndromes associated with West Nile virus (WNV) infection range from fever to neuroinvasive disease. Understanding WNV epidemiology and disease history is important for guiding patient care and healthcare decision-making. The objective of this review was to characterize the existing body of peer-reviewed and surveillance literature on WNV syndromes and summarize epidemiologic and clinical parameters.MethodsWe followed scoping review methodology described by the Joanna Briggs Institute. Terms related to WNV epidemiology, hospitalization, and surveillance were searched in four bibliographic databases (MEDLINE, EMBASE, Scopus, and CINAHL) for literature published from January 1999 to December 2015.ResultsIn total, 2334 non-duplicated titles and abstracts were screened; 92 primary studies were included in the review. Publications included one randomized controlled trial and 91 observational studies. Sample sizes ranged from under 25 patients (n = 19) to over 400 patients (n = 28). Eight studies were from Canada, seven from Israel, and the remaining (n = 77) from the United States. N = 17 studies were classified as outbreak case investigations following epidemics; n = 37 with results of regional/national surveillance and monitoring programs.Mean patient ages were > 40 years old; three studies (3%) focused on the pediatric population. Patients with encephalitis fared worse than patients with meningitis and fever, considering hospitalization, length of stay, discharge, recovery, and case-fatality. Several studies examined risk factors; however, age was the only risk factor for neuroinvasive disease/death consistently identified. Overall, patients with acute flaccid paralysis or encephalitis fared worse than patients with meningitis and West Nile fever in terms of hospitalization and mortality. Among the included studies, proportion hospitalized, length of stay, proportion discharged home and case-fatality ranged considerably.ConclusionOur review highlights the heterogeneity among reporting clinical WNV syndromes and epidemiologic parameters of WNV-related illness. Presently, there is potential for further synthesis of the risk factors of WNV-illness and mortality; undertaking further analysis through a systematic review and meta-analysis may benefit our understanding of risk factors for emerging mosquito-borne diseases. Future research on the burden of WNV can build on existing evidence summarized in this review, not only to support our understanding of endemic WNV, but also to strengthen research on emerging arboviruses with similar clinical manifestations.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-017-2637-9) contains supplementary material, which is available to authorized users.

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“…Since few studies ( n = 2) [28, 29] reported outcomes specific to WNME (not in combination with other syndromes), it was grouped with WNE due of their clinical similarities [30]. …”

Section: Resultsmentioning

confidence: 99%

“…Among patients with WNE, 20–33% were discharged home [44–46]. One outlier was in a case series where 80% were discharged home, but patients required oral feedings and were at a modified independent level [29]. Patients with WNM had the highest home dispositions (77–90%) [45, 46] and reached up to 100% among children [36].…”

Section: Resultsmentioning

confidence: 99%

Epidemiologic and clinical parameters of West Nile virus infections in humans: a scoping review

et al. 2017

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“…7 Prognostic data on WNV neuroinvasive disease are currently rather limited. [54][55][56][57] Most patients with WNV meningitis and no associated focal neurological deficits make a complete recovery. Long-term outcomes and sequelae from WNV meningoencephalitis are highly variable, but severe neurological deficits have been reported to persist for months or even years and, in some cases, are likely to be lifelong.…”

Section: Laboratory Findingsmentioning

confidence: 99%

“…56 In a retrospective case series of five patients with severe WNV disease, all patients demonstrated some degree of functional improvement, with the lowest functional outcomes noted in patients with severe muscle weakness and axonal neuropathy. 57 …”

Section: Laboratory Findingsmentioning

confidence: 99%

West Nile virus meningoencephalitis

2006

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SUMMARYSince its first appearance in the US in 1999, West Nile virus (WNV) has emerged as the most common cause of epidemic meningoencephalitis in North America. In the 6 years following the 1999 outbreak, the geographic range and burden of the disease in birds, mosquitoes and humans has greatly expanded to include the 48 contiguous US and 7 Canadian provinces, as well as Mexico, the Caribbean islands and Colombia. WNV has shown an increasing propensity for neuroinvasive disease over the past decade, with varied presentations including meningitis, encephalitis and acute flaccid paralysis. Although neuroinvasive disease occurs in less than 1% of infected individuals, it is associated with high mortality. From 1999-2005, more than 8,000 cases of neuroinvasive WNV disease were reported in the US, resulting in over 780 deaths. In this review, we discuss epidemiology, risk factors, clinical features, diagnosis and prognosis of WNV meningoencephalitis, along with potential treatments.

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“…In a study of five adults with West Nile Virus who received inpatient rehabilitation, all patients demonstrated functional improvements. [18] In a case series of 7 adults and 1 child with viral or presumed viral encephalitis who participated in inpatient rehabilitation, all individuals displayed functional improvement but rate of recovery was variable. [19] The one pediatric patient had a low FIM score at admission (<30), and compared to the adults, the pediatric patient showed the most drastic improvement in FIM scores.…”

Section: Introductionmentioning

confidence: 99%

Functional status of children with encephalitis in an inpatient rehabilitation setting: A case series

Tailor

Suskauer

Sepeta

et al. 2013

Journal of Pediatric Rehabilitation Medicine

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INTRODUCTION: Patterns and predictors of recovery from encephalitis are poorly understood. METHODS: This study examined functional status and reviewed charts of all children who presented to a pediatric inpatient rehabilitation facility with encephalitis between 1996 and 2010. Functional status at admission and discharge from inpatient rehabilitation was evaluated using the Functional Independence Measure for Children (WeeFIM) Self-care, Mobility, Cognitive, and Total Developmental Functional Quotient scores (DFQ, % of age-appropriate function). Charts were reviewed to characterize key clinical features and findings. RESULTS: Of the 13 children identified, the mean age was 9 years (range 5-16) with 54% males. Mean WeeFIM Total DFQ at admission was 37 (range: 15-90) and at discharge was 64 (range: 16-96). Average change in WeeFIM Total DFQ from admission to discharge was 26.7 (range 0-55, p < 0.001). WeeFIM domain scores improved between admission and discharge (Self-Care: p < 0.001, Cognition: p < 0.01, Mobility: p < 0.001). Eleven children displayed significant impairments in functional skills, defined as DFQ of 85, at discharge. Key clinical features and findings were diverse and not related to functional outcome. CONCLUSIONS: Results suggest that significant functional improvement in children with encephalitis occurs during inpatient rehabilitation. Further research is necessary to identify predictors of outcome in children with encephalitis.

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Rehabilitation outcomes of 5 patients with severe West Nile virus infection: A case series

Cited by 16 publications

References 7 publications

Epidemiologic and clinical parameters of West Nile virus infections in humans: a scoping review

Epidemiologic and clinical parameters of West Nile virus infections in humans: a scoping review

West Nile virus meningoencephalitis

Functional status of children with encephalitis in an inpatient rehabilitation setting: A case series

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