The clinical response of West Nile virus neuroinvasive disease to intravenous immunoglobulin therapy.

Zvi Shimoni,Paul Froom,Ella Mendelson,Shlomo Bulvik,Rawi Hazzan,Hanna Bin,Mark Niven

doi:10.4081/cp.2012.e18

Abstract

The aim of the study was to determine whether intravenous gamma globulin (IVIG) treatment is effective in patients with West Nile Virus (WNV) neuroinvasive disease.We contacted hospital based infectious disease experts in Israeli hospitals to identify patients with WNV neuroinvasive disease who were treated with IVIG. The main outcome measure was neurological response after treatment. There were 12 patients who received IVIG and four improved within 48 h. Three patients died, 6 had partial recovery, and 3 recovered completely. Eleven of the 12 patients were infected with Israeli genotypes that are highly homologous to Europe/Africa viruses. The rapid response in some patients suggests that IVIG is effective, and might be used to treat patients with WNV neuroinvasive disease with IVIG.

Highlights

We contacted hospital based infectious dism ease experts in Israeli hospitals to identify m patients with West e Nile Virus (WNV) neuroinvasive disease who were treated with intravenous immunoglobulin (IVIG)
Eleven of the 12 N patients were infected with Israeli genotypes urgently needed because of the high morbidity and mortality rates of neuroinvasive WNV
We summarize the clinical course of all patients known to have received intravenous immunoglobulin for WNV neuroinvasive disease in Israel until the end of 2007

Summary

Introduction

We contacted hospital based infectious dism ease experts in Israeli hospitals to identify m patients with WNV neuroinvasive disease who were treated with IVIG. There were 12 patients who received IVIG and four improved within 48 h. N Three patients died, 6 had partial recovery, and o 3 recovered completely. Eleven of the 12 N patients were infected with Israeli genotypes urgently needed because of the high morbidity and mortality rates of neuroinvasive WNV. We summarize the clinical course of all patients known to have received intravenous immunoglobulin for WNV neuroinvasive disease in Israel until the end of 2007. We characterized the prevalent genotypes found in mosquitoes (highly correlated with human infection) according to time and place in order to determine if there is a relationship to the outcome according to the various genotypes

Objectives

Methods

Results