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Health Agencies Update
June 21, 2000

Nailing West Nile Virus

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JAMA. 2000;283(23):3060. doi:10.1001/jama.283.23.3060-JHA00004-2-1

New York City public health officials may have been caught off guard last year by an unprecedented outbreak of West Nile virus (WNV) encephalitis. This season, however, along with heightened mosquito-control efforts, they have a new tool available to make their job easier: a rapid diagnostic test that can identify the infection within hours.

The report of the new diagnostic method, which was developed by scientists funded by the National Institute of Neurological Disorders and Stroke, appeared in the May 6 Lancet.

The test uses a technique called real-time polymerase chain reaction, which can detect minute amounts of WNV genetic material in samples of cerebrospinal fluid (CSF) from infected patients. Although the method did not detect WNV in the CSF of all infected patients who were tested, the study's findings suggest that the presence of the virus in spinal fluid is correlated with a higher risk of dying from the infection, the researchers said.

The procedure, which can be conducted in a standard microbiological laboratory, allows clinicians to make a diagnosis within 5 hours of receiving the sample. In contrast, the traditional method of diagnosing WNV takes 3 to 4 days and can be carried out only in certain laboratories.

The rapid diagnostic method is expected to allow physicians to offer early intervention with antiviral therapy to people who test positive for WNV and may help public health authorities take measures to prevent further spread of the infection.