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Review Article

Pathogenicity and virulence of West Nile virus revisited eight decades after its first isolation

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Pages 1145-1173 | Received 27 Nov 2020, Accepted 23 Mar 2021, Published online: 12 Apr 2021
 

ABSTRACT

West Nile virus (WNV) is a flavivirus which transmission cycle is maintained between mosquitoes and birds, although it occasionally causes sporadic outbreaks in horses and humans that can result in serious diseases and even death. Since its first isolation in Africa in 1937, WNV had been considered a neglected pathogen until its recent spread throughout Europe and the colonization of America, regions where it continues to cause outbreaks with severe neurological consequences in humans and horses. Although our knowledge about the characteristics and consequences of the virus has increased enormously lately, many questions remain to be resolved. Here, we thoroughly update our knowledge of different aspects of the WNV life cycle: virology and molecular classification, host cell interactions, transmission dynamics, host range, epidemiology and surveillance, immune response, clinical presentations, pathogenesis, diagnosis, prophylaxis (antivirals and vaccines), and prevention, and we highlight those aspects that are still unknown and that undoubtedly require further investigation.

Graphical abstract

This article is part of the following collections:
Emerging Haemorrhagic Fever Viruses

Disclosure statement

No potential conflict of interest was reported by the author(s).

Author contributions

“Conceptualization and resources J-C.S.; writing—original draft preparation, J-C.S, M.A.M-A, A-B.B., E.E-R., T.P, N.JO; writing—review and editing, J-C.S, N.JO; funding acquisition, J-C.S, M.A.M-A.”

Additional information

Funding

This work was supported by the Comunidad de Madrid [S2018/BAA-4370-ZOOVIR (PLATESA2-CM]; Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria [RTA2015-00009-00-00]; Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria [E-RTA2017-00003-C02-01]; Instituto de Salud Carlos III [COV20/00183]; Agencia Estatal de Investigación (ES) [PID2019-105117RR-C21/AEI/10.13039/501100011033].