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Death due to West Nile Virus in India?

At the end of April, India witnessed its first death due to the West Nile virus. Thus far the disease has only ever been sporadic, typically only associated with fevers.

Public domain image, wikimedia commonsWhile it is being reported that this is the only death associated with disease, this may not be the case. Reporting of the disease is often minimal. It is also easily misdiagnosed. The disease can be severe if it becomes neuroinvasive. This may have occurred before in India and simply been misdiagnosed.

The death was particularly concerning to the public as the victim was a child. The seven-year-old boy from the Malappuram district in Kerala was taken into hospital due to a severe fever and flu-like symptoms.

Though the virus is typically non-fatal, as has been the case of every instance of the disease in India so far, resultant complications led to the death of the child. “The virus seemed to have affected his nervous system and this led to complications due to which he suffered a cardiac arrest and succumbed to it,” said Sakeena K, the district medical officer of Malappuram.

The death has spurred health authorities to ensure more rigorous analysis of cases that could potentially be West Nile fever. The prior lack of serious complications has left health authorities complacent, however, this appears to be changing as more cases are emerging that would otherwise have been left undetected.

The West Nile virus is most commonly transferred to humans through bites from an infected mosquito. As is the case with many other mosquito-borne infections such as malaria and dengue fever, this opens up the possibility of infection throughout most of India.

Humans, however, are not the primary hosts of the virus’s breeding cycle. The virus’s natural hosts are birds. Due to mosquitoes feeding on humans and other mammals, the virus may be transferred to these incidentally.

Experts studying the West Nile virus in Punjab following the death of the boy in Kerala have found another potential avenue of infection in humans. They uncovered a number of cases of blood donations that had been harbouring the virus.

Three blood donor specimens tested positive for West Nile virus in Punjab, these results had not shown up in studies of the local mosquito populations. “This suggests that acute West Nile virus infections may remain undetected and have the potential to be transmitted through blood transfusion,” said the study.

Though the condition is not often serious, the recent fatality has demonstrated that it is always a possibility. Knowledge that the condition may be passed on in blood and organ transplants indicates that constant vigilance must be maintained and investigations into these other avenues of infection must begin. To not do so risks more deaths due to the disease.

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