Abstract
We investigated West Nile virus (WNV) as a possible disease etiology in persons hospitalized in South Africa. Of 206 specimens tested, 36 had WNV neutralizing antibodies, significantly more than in similar earlier serosurveys. Seven probable acute WNV cases were identified, suggesting WNV may be overlooked as an etiology of severe disease in South Africa.
Highlights
Detection of IgM in serum or cerebrospinal fluid (CSF) is the preferred method for diagnosing West Nile virus (WNV) infection; because of cross-reactivity between flaviviruses, positive results should be confirmed by virus neutralization assay
In 1947, one of the largest WNV epidemics recorded occurred in the Karoo region of South Africa [5], and another occurred in combination with a Sindbis virus epidemic in 1983–84 in the Witwatersrand–Pretoria region of South Africa
We conducted a retrospective investigation of patients hospitalized with febrile illness or neurologic disease of unknown etiology in the Pretoria region of South Africa
Summary
We investigated West Nile virus (WNV) as a possible disease etiology in persons hospitalized in South Africa. Detection of IgM in serum or cerebrospinal fluid (CSF) is the preferred method for diagnosing WNV infection; because of cross-reactivity between flaviviruses, positive results should be confirmed by virus neutralization assay. We determined whether WNV is being overlooked as a possible cause of disease in persons hospitalized in South Africa. The Study Serum and CSF samples were obtained from the National Health Laboratory Service, Thswane Academic Division, Thswane, South Africa, which serves public sector hospitals in northern South Africa. A total of 206 patient samples (15 CSF and 191 serum) were selected. We detected WNV neutralizing antibodies in serum and CSF samples by using a modified method [10]. The positive CSF samples (4/15) had antibody titers of 4 (Table 1).
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