Evidence of Lineage 1 and 3 West Nile Virus in Person with Neuroinvasive Disease, Nebraska, USA, 2023

• Published in: Emerging infectious diseases Vol. 30; no. 10; pp. 2090 - 2098
• Main Authors: Davis, Emily, Velez, Jason, Hamik, Jeff, Fitzpatrick, Kelly, Haley, Jacki, Eschliman, Jeremy, Panella, Amanda, Staples, J. Erin, Lambert, Amy, Donahue, Matthew, Brault, Aaron C., Hughes, Holly R.
• Format: Journal Article
• Language: English
• Published: United States U.S. National Center for Infectious Diseases 01.10.2024; Centers for Disease Control and Prevention
• Subjects: Asymptomatic; Cardiovascular disease; Case studies; Central nervous system diseases; co-infection; Disease transmission; Evidence of Lineage 1 and 3 West Nile Virus in Person with Neuroinvasive Disease, Nebraska, USA, 2023; Genetic aspects; Genome, Viral; Genomics; Health aspects; Hospitals; Humans; Infections; lineage 3; Medical laboratories; Medical research; Medicine, Experimental; Nebraska - epidemiology; Ostomy; Phylogeny; Physiological aspects; Proteins; Public health; Rabensburg virus; Risk factors; Type 2 diabetes; Vector-borne diseases; Viruses; West Nile fever; West Nile Fever - epidemiology; West Nile Fever - virology; West Nile virus; West Nile virus - genetics; zoonoses; Nebraska; United States; Colorado; United States > US; Europe; Africa; Rabensburg virus; viruses; vector-borne infections; co-infection; United States; West Nile virus; lineage 3; West Nile neuroinvasive disease; zoonoses; genomic surveillance
• ISSN: 1080-6040; 1080-6059; 1080-6059
• DOI: 10.3201/eid3010.240595

West Nile virus (WNV) is the most common cause of human arboviral disease in the contiguous United States, where only lineage 1 (L1) WNV had been found. In 2023, an immunocompetent patient was hospitalized in Nebraska with West Nile neuroinvasive disease and multisystem organ failure. Testing at the Centers for Disease Control and Prevention indicated an unusually high viral load and acute antibody response. Upon sequencing of serum and cerebrospinal fluid, we detected lineage 3 (L3) and L1 WNV genomes. L3 WNV had previously only been found in Central Europe in mosquitoes. The identification of L3 WNV in the United States and the observed clinical and laboratory features raise questions about the potential effect of L3 WNV on the transmission dynamics and pathogenicity of WNV infections. Determining the distribution and prevalence of L3 WNV in the United States and any public health and clinical implications is critical.