West Nile Virus Follow-up

Updated: Apr 02, 2018
  • Author: Jess D Salinas, Jr, MD; Chief Editor: Elizabeth A Moberg-Wolff, MD  more...
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Follow-up

Further Outpatient Care

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  • Consultation with a psychologist or neuropsychologist may be helpful. [31]

  • The neuropsychologist's role includes developing behavioral treatment plans, assessing the patient's cognitive and emotional function, and providing individual, group, and family therapy.

  • The neuropsychologist also assesses the patient's attention, executive functions, personality, and memory, language, and visual-spatial abilities by using various specialized tests.

  • Although the literature concerning the neuropsychologic assessment and cognitive rehabilitation of patients with encephalitis is limited, neurocognitive testing may be useful in identifying deficits, and neurocognitive therapy to treat those deficits plays a significant part in the rehabilitation process.

  • The primary cognitive consequences of encephalitis involve attention, memory, information processing speed, and cognitive efficiency.

  • As a part of a rehabilitation team, the neuropsychologist also collaborates with the speech therapist and occupational therapist to maximize the interplay between cognitive rehabilitation and function. [32]

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Deterrence

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  • The Centers for Disease Control and Prevention (CDC) offer the following 3 major suggestions to help prevent West Nile virus infection [33] :

    • Avoid mosquito bites.

    • Mosquito-proof the home.

    • Support community-based efforts in mosquito control and the prevention of West Nile virus infection. [34, 35]

  • Avoiding mosquito bites

    • Individuals should apply insect repellent containing N,N -diethyl-meta-toluamide (DEET) to exposed skin whenever they go outdoors. In addition, using permethrin on clothing is very effective as an insecticide and as a repellent.

    • When possible, people should wear long sleeves, long pants, and socks when outdoors.

    • Mosquitoes can bite through thin clothing, so spraying clothes with repellent containing permethrin or DEET provides additional protection. However, repellents containing permethrin should not be applied directly to the skin, and repellent containing DEET should not be applied to skin under clothing.

    • The peak hours for mosquito bites are from dusk to dawn. Individuals are advised to use repellent and protective clothing in the evening and early morning or to consider avoiding outdoor activities during these times.

  • Mosquito-proofing homes

    • Because mosquitoes lay their eggs in standing water, containers or bodies of standing water should be drained if possible.

    • People can help prevent mosquitoes from entering their homes by repairing or installing screens on their doors and windows.

  • Supporting community-based efforts

    • Dead birds can indicate the presence of the West Nile virus in a community and should be reported to local health authorities.

    • Some communities have initiated mosquito-control programs. Local governments should have additional information about these programs.

    • Keeping the community clean by picking up garbage and draining standing water from vacant areas and parks can help to eliminate mosquito breeding grounds.

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Prognosis

The prognosis in West Nile virus is generally good. However, the elderly and persons with multiple medical complications have a poorer prognosis.

A study by Yeung et al suggested that patients with acute West Nile virus score low with regard to health-related quality of life (HRQoL) but experience significant postacute improvement in HRQoL within 6 months. The investigators also reported that neuroinvasive disease, after adjusting for confounding, did not, either during up to 3-year follow-up or postacute infection, significantly predict HRQoL. The study did, however, find number of comorbidities and baseline utility scores to be predictors. [36]

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