Clinical findings of West Nile virus infection in hospitalized patients, New York and New Jersey, 2000

Outbreaks of West Nile (WN) virus occurred in the New York metropolitan are a in 1999 and 2000. Nineteen patients diagnosed with WN infection were hosp italized in New York and New Jersey in 2000 and were included in this revie w. Eleven patients had encephalitis or meningoencephalitis, and eight had m eningitis alone. Ages of patients ranged from 36 to 87 years (median 63 yea rs). Fever and neurologic and gastrointestinal symptoms predominated. Sever e muscle weakness on neurologic examination was found in three patients. Ag e was associated with disease severity. Hospitalized cases and deaths were lower in 2000 than in 1999, although the case-fatality rate was unchanged. Clinicians in the Northeast should maintain a high level of suspicion durin g the summer when evaluating older patients with febrile illnesses and neur ologic symptoms, especially if associated with gastrointestinal complaints or muscle weakness.