Systemic and Ophthalmic Manifestations of West Nile Virus Infection

Yos Priestley; Marcia Thiel; Steven B. Koevary

Disclosures

Expert Rev Ophthalmol. 2008;3(3):279-292. 

In This Article

Prevention

Exposure to WNV can be limited in a variety of ways. Personal protection, mosquito control programs, and screening of blood and organs for transplantation are central to reducing risk. Personal protection during the months of August and September includes staying indoors between dusk and dawn when mosquitoes are most active, wearing protective clothing when outdoors (i.e., long sleeves and pants with socks and shoes), and using mosquito repellants. The most effective mosquito repellant for use on skin is N,N-diethyl-m-toluamide (DEET).[36] Other substances can be used, including repellants containing picaridin and oil of lemon eucalyptus.[37] The CDC recommends three types of mosquito control: larvicide, adulticide and breeding site reduction. Larviciding involves using chemicals that are toxic to mosquito larvae while adulticiding involves the use of chemicals which are toxic to adult mosquitoes. Removal of standing water in barrels, buckets, gutters and flowerpots, which can be used as breeding sites, also helps to reduce the mosquito population.[37]

In addition, as mentioned above, those receiving blood transfusions and organ transplants face the risk of acquiring the disease from infected donors. The first US FDA-approved stand-alone test for screening the blood of donors was the Procleix® WNV Assay, approved in 2005.[95] The Procleix assay is able to detect WNV RNA, and can therefore identify infected donor blood and tissues before antibodies are present. The Procleix® TIGRIS® is a fully automated test approved in March of 2007 for blood, tissue and organ screening.[96] As a fully automated system, the TIGRIS is especially useful during times of high WNV activity and reduces the risk of human error. Shortly thereafter, the FDA approved the cobas TaqScreen WNV test, a second test for screening donated tissues.[97] The cobas TaqScreen WNV test can detect viral RNA in plasma specimens from donors of whole blood and blood components as well as donor cells and other tissues. Additionally, the test can be used to test the plasma of organ donors, but only when specimens are obtained while the donor's heart is still beating.[97]

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