Use of Testing for West Nile Virus and Other Arboviruses.
Use of Testing for West Nile Virus and Other Arboviruses.
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DOI：
10.3201/eid2209.152050
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发表时间：
2016-09
影响因子：
11.8
通讯作者：
Hasbun R
中科院分区：
文献类型：
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作者：
Vanichanan J;Salazar L;Wootton SH;Aguilera E;Garcia MN;Murray KO;Hasbun R
对于脑膜炎和脑炎患者，这些病毒的检测没有得到充分利用。在美国，最常见的虫媒病毒病是西尼罗河病毒(WNV)感染。通过检测血清或脑脊液中的西尼罗河病毒免疫球蛋白或病毒基因组序列进行诊断。为了确定这种检测在西尼罗河病毒流行地区的频率，我们检查了美国得克萨斯州休斯敦9家医院为脑膜炎和脑炎患者订购的检测比例。我们确定了751名患者(567名成人，184名儿童)，其中390名(52%)在西尼罗河病毒季节(6-10月)发病。751人中有281人(37%)接受了西尼罗河病毒检测；结果显示有32人(11%)受到急性感染。与西尼罗河病毒检测相关的特征包括急性局灶性神经功能障碍；年龄较大；磁共振成像；经验性抗病毒治疗；较差的临床结果：以及伴随的分枝杆菌、真菌或其他病毒感染检测。对西尼罗河病毒的检测没有得到充分利用，对病情更严重的患者的检测增加了流行病学研究中诊断偏差的可能性。
For patients with meningitis and encephalitis, testing for these viruses is underutilized. In the United States, the most commonly diagnosed arboviral disease is West Nile virus (WNV) infection. Diagnosis is made by detecting WNV IgG or viral genomic sequences in serum or cerebrospinal fluid. To determine frequency of this testing in WNV-endemic areas, we examined the proportion of tests ordered for patients with meningitis and encephalitis at 9 hospitals in Houston, Texas, USA. We identified 751 patients (567 adults, 184 children), among whom 390 (52%) experienced illness onset during WNV season (June–October). WNV testing was ordered for 281 (37%) of the 751; results indicated acute infection for 32 (11%). Characteristics associated with WNV testing were acute focal neurologic deficits; older age; magnetic resonance imaging; empirically prescribed antiviral therapy; worse clinical outcomes: and concomitant testing for mycobacterial, fungal, or other viral infections. Testing for WNV is underutilized, and testing of patients with more severe disease raises the possibility of diagnostic bias in epidemiologic studies.