../ West Nile Virus strikes Romania
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Credit Photo Illustration by Simona Ivana

By Simona Ivana / Sept. 8, 2018

West Nile Virus strikes Romania

West Nile Fever (WNF) is a mosquito-borne flavivirus infection epidemic in Africa and Asia. West Nile Virus (WNV) was first identified in 1937 from a native woman of the West Nile province of Uganda.

Since then, both sporadic cases and major outbreaks of West Nile Disease (WND) were reported in Africa, Middle East, Europe, and Asia. In Europe, the first significant urban epidemic occurred in Bucharest (Romania) in 1996.

WNV circulation in Europe is probably greatly influenced by the flyways of migratory bird species. WNV is maintained in nature by a primary transmission cycle between mosquitoes and several bird species, which play the role of amplifying hosts.

Human, horses and other mammals may be infected by the bite of infected mosquitoes, but they are incidental and dead-end hosts. Human-to-human transmission may occur only through blood transfusion or organ transplants.

In Southern Romania the first large outbreak of West Nile Neuroinvasive Disease (WNND) was reported in 1996, albeit the virus circulation was firstly detected in 1955 in Central Transylvania and in 1964 in Banat country.

From 2008 to 2009, viral circulation was detected in Braila and Dolj countries, were 4 human cases were reported. In 2010 human cases were distributed in 19 districts all over the country, with clusters of infection in the Southeastern district of Constanta and in the urban areas of Blaj (in the western Romania) and Bucharest. In 2011 and 2012, most of the cases were recorded in Bucharest urban area. From August to October 2013, 24 human cases were reported from different municipalities of Romania: Bacau, Braila, Bucharest, Constanta, Galati, Ialomita, Iasi, Ilfov, Mures, Sibiu and Tulcea. In Romania, during 2016-2017, a significant increase in the number of WNND cases was reported at the national level, associated with high mortality rates (25.5%). Comma, confusion, obtundation, sleepiness and depressed deep tendon reflexes were symptoms predicting a severe outcome. In July 27, 2018, 5 Romanians have been diagnosed with meningitis caused by the West Nile Virus.

80% of infected people have no symptoms. High fever and headaches are the signs that require the urgent presentation at the nearest clinic. The Romanians was advised to avoid exposure to mosquitoes, to wear long-sleeved clothing and long pants and to prevent mosquitoes from accessing the house (The Romania Journal).

Symptoms: No symptoms in most people; Febrile illness (fever) in some people (about 1 in 5); Serious symptoms in a few people. About 1 in 150 people who are infected develop a severe illness: encephalitis (inflammation of the brain) or meningitis (inflammation of the membranes that surround the brain and spinal cord). People over 60 years of age and people with certain medical conditions (cancer, diabetes, hypertension, kidney disease) are at greater risk.

Prevention: No WNV vaccines are licensed for use in humans. Prevention of WNVD depends on community-level mosquito central programs to reduce vector densities personal protective measures to decrease exposure to infected mosquitoes, and screening of blood and organ donors.

Personal protective measures include use of mosquito repellents, wearing long-sleeved shirts and long pants, and limiting outdoor exposure from dusk to dawn.

Using air conditioning, installing window and door screens, and reducing peridomestic mosquito breeding sites can further decrease the risk for WNV exposure.

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Credit Photo Illustration by Simona Ivana