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Neurocognitive and functional outcomes in persons recovering from West Nile virus illness
Authors:James J. Sejvar  Aaron T. Curns  Leonie. Welburg  James F. Jones  Louisa M. Lundgren  Lucile. Capuron  John. Pape  William C. Reeves  Grant L. Campbell
Affiliation:1. Division of Vector‐Borne Infectious Diseases, National Center for Zoonotic, Vector‐Borne, and Enteric Diseases (NCZVED), Centers for Disease Control and Prevention (CDC), Fort Collins, Colorado, USA;2. Division of Viral and Rickettsial Diseases, NCZVED, CDC, Atlanta, Georgia, USA;3. Division of Viral Diseases, National Center for Immunizations and Respiratory Diseases, CDC, Atlanta, Georgia, USA;4. Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia, USA;5. Laboratory of Psychoneuroimmunology, Nutrition and Genetic, INRA UMR 1286, University of Bordeaux 2, CNRS 5226, Bordeaux, France;6. Colorado Department of Health and Environment, Denver, Colorado, USA
Abstract:Long‐term neurocognitive and functional impairments following West Nile virus (WNV) disease are poorly understood. We assessed quality‐of‐life indices and neurocognitive performance in a cohort of 54 persons recovering from one of three WNV disease syndromes (fever [WNF], meningitis [WNM], or encephalitis [WNE]) approximately 1.5 years following acute illness. We compared findings between the three syndromic groups; the study cohort and a demographically similar group of 55 controls from a study of chronic fatigue syndrome (CFS); and the study cohort and a ‘normative’ control population based on cognitive test data. Persistent symptoms, diminished quality of life, and functional impairment were reported by 50% of WNF patients, and 75% each of WNM and WNE patients. Overall, objective neurocognitive performance did not differ significantly between the three syndromic groups, or between the study cohort and the CFS controls or the normative controls. In some neurocognitive subtests, the study cohort scored below the 15th percentile when compared with normative control data. Most persons who returned to independent living following hospitalization for WNV illness had persistent subjective complaints, but had normal cognitive function. However, a minority displayed subtle neurocognitive deficits more than 18 months following acute disease.
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