Abstract
When West Nile virus was discovered in Uganda in 1937, it caused a mild, febrile illness. Over the next few decades, it expanded its range and increased its virulence and is now found throughout most of the world. A pathogenic form of WNV entered the United States in 1999 and spread from coast to coast within years. In under 1% of those infected, life-threatening neurological symptoms develop, including encephalitis, meningitis, and a polio-like disease. Transmission usually occurs via a mosquito bite. Culex species mosquitoes, including Cx. pipiens, Cx. restuans, Cx. quinquefasciatus, Cx. tarsalis, and Cx. nigripalpus, serve as vectors in the United States, and house sparrows, American robins, and geese are the primary reservoir hosts. Fatal infection occurs in horses and some birds, including blackbirds and jays. In most of the United States, infection levels peaked 2003–2006, despite the lack of an approved vaccine for humans or specific treatment protocols.
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