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Virus del oeste del Nilo: ecología y epidemiología de un patógeno emergente en Colombia
West Nile virus; ecology and epidemiology of an emerging pathogen in Colombia
Palabras clave:
Virus del oeste del Nilo, ecología, epidemiología, Colombia (es)West Nile virus, ecology, epidemiology, Colombia (en)
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El virus del oeste del Nilo (VON) es mantenido en la naturaleza en un ciclo enzoótico ave-mosquito-ave. Los principales vectores son los mosquitos del genero Culex. Las aves son los huéspedes amplificadores primarios. Humanos y caballos son huéspedes incidentales finales. En humanos las infecciones por VON se presentan como enfermedad febril autolimitada. En los casos de enfermedad neurológica se puede presentar encefalitis, meningitis o meningoencefalitis, con mayor incidencia y mortalidad por encefalitis en personas de mayor edad y pacientes inmunocomprometidos. Se han reportado brotes en África, Medio Oriente, Europa y Asia. El virus apareció por primera vez en Estados Unidos en 1999 y se ha documentado su circulación en México, Islas Caimán, Jamaica, Republica Dominicana, Martinica, Guadalupe, Cuba, Puerto Rico, El Salvador y recientemente Colombia. La importancia en salud pública de VON si es introducido en áreas de Centro y Sur América dependerá del resultado de la interacción de múltiples factores. Colombia reúne las condiciones que favorecen su entrada y desarrollo. Se pueden postular dos hipótesis: el virus podría llegar a ser enzoótico y endémico y causar limitada enfermedad humana, o podría llegar a ser epidémico y causar brotes anuales que afecten humanos y animales. Esto dependerá de la susceptibilidad de las especies aviares colombianas al virus por las diferencias en su biología, y a las variaciones geográficas intraespecificas en la competencia de las diferentes especies de mosquito y los efectos de las condiciones medioambientales sobre su habilidad para transmitir el virus, y estos factores son determinantes en el ciclo de amplificación primario.
West Nile virus (WNV) has an enzootic mosquito-bird-mosquito cycle in nature, Culex sp mosquitoes being the main vectors. Birds are the main amplifying hosts. Humans and horses are incidental dead-end hosts. It produces a flu-like or a self-limited febrile disease in most humans. It can cause encephalitis, meningitis or meningoencephalitis in cases of neurological disease, having greater incidence and mortality from encephalitis in older people and immune-compromised patients. Outbreaks have been reported in Africa, the Middle-east, Europe and Asia. WNV first appeared in North-America in 1999 and its circulation has been documented in Mexico, the Caiman islands, Jamaica, the Dominican Republic, Martinique, Guadalupe, Cuba, Puerto Rico, El Salvador and more recently in Colombia. The public health concern regarding WNV if it becomes introduced into Middle- and South-America will depend upon the interaction of several factors. The prevailing conditions in Colombia are apt for its spread and development. There are two main hypotheses; the virus could become enzootic and endemic and cause limited human disease, or it could become epidemic and cause annual outbreaks affecting large numbers of humans and animals. It will depend upon Colombian birds' susceptibility to the virus because of biological differences and intra-specific geographical variations in mosquitoe species' vector competence and the environmental effects on its ability to transmit the virus; such factors are determinant in the primary amplifying cycle.
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