Demographic characteristics associated with West Nile virus neuroinvasive disease – A retrospective study on the wider European area 2006–2021

• Published in: PloS one 2023-09, Vol.18 (9), p.e0292187-e0292187
• Main Authors: Riccetti, Nicola, Ferraccioli, Federico, Fasano, Augusto, Stilianakis, Nikolaos I
• Format: Article
• Language: English
• Subjects: Age; Analysis; Biology and life sciences; Complications; Confidence intervals; Criteria; Death; Diagnosis; Disease; Disease control; Disease transmission; Earth Sciences; Encephalitis; Epidemiology; Fatalities; Fever; Health aspects; Health care access; Hospitalization; Immunoglobulins; Infection; Infections; Invasiveness; Medical research; Medicine and health sciences; Medicine, Experimental; Meningitis; Mortality; Mosquitoes; People and places; Population; Population studies; Prevention; Prophylaxis; Public health; Regression analysis; Regression models; Risk factors; Sex; Social Sciences; Surveillance systems; Variables; Vector-borne diseases; Viruses; West Nile fever; West Nile virus
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0292187

With a case-fatality-risk ranging from 3.0 to >20.0% and life-long sequelae, West Nile neuroinvasive disease (WNND) is the most dangerous outcome of West Nile virus (WNV) infection in humans. As no specific prophylaxis nor therapy is available for these infections, focus is on preventive strategies. We aimed to find variables associated with WNND diagnosis, hospitalisation or death, to identify high-risk sub-groups of the population, on whom to concentrate these strategies. We used data from The European Surveillance System-TESSy, provided by National Public Health Authorities, and released by the European Centre for Disease Prevention and Control (ECDC). In two Firth-penalised logistic regression models, we considered age, sex, clinical criteria, epidemiological link to other cases (epi-link), calendar year, and season as potential associated variables. In one model we considered also the rural/urban classification of the place of infection (RUC), while in the other the specific reporting country. Among confirmed West Nile Virus cases, 2,916 WNND cases were registered, of which 2,081 (71.4%), and 383 (13.1%) resulted in the hospitalisation and death of the patient, respectively. Calendar year, RUC/country, age, sex, clinical criteria, and epi-link were associated with WNND diagnosis. Hospitalisation was associated with calendar year and RUC/country; whereas death was associated with age, sex and country.