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15 January 2004

Volume 38, Number 2
Clinical Infectious Diseases 2004;38:289–292
1058-4838/2004/3802-0016$15.00
DOI: 10.1086/380458
BRIEF REPORT

Severe West Nile Virus Disease in Healthy Adults

Mimi Emig and

Douglas J. Apple

Grand Rapids Infectious Diseases, Grand Rapids, Michigan

The inpatient records of 44 case patients with West Nile virus infection hospitalized in 2002 were reviewed. Sixty‐five percent of the case patients had encephalitis, and 35% had aseptic meningitis. There was no significant difference in the distribution of aseptic meningitis versus encephalitis among adults aged 50 years compared with adults aged 65 years. Focal weakness, likely due to anterior horn cell involvement, was present in 10 case patients (overall rate, 23%; rate among patients with encephalitis, 34%). Case patients with focal weakness who were aged 50 years had monoparesis, whereas those aged 65 years had paraparesis or quadriparesis. The overall mortality rate was 14%, and the mortality rate in patients aged 65 years was 35%. Increased age was associated with an increased mortality rate. The presence of paraparesis or quadriparesis was not independently predictive of mortality.

Received 10 June 2003; accepted 25 August 2003; electronically published 16 December 2003.

Reprints or correspondence: Dr. Mimi Emig, Grand Rapids Infectious Diseases P.C., 515 Michigan Ave NE, Grand Rapids, MI 49503 ().

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