Table 5.

Criteria for the WNV NID.

European Union clinical and laboratory criteria for WNV [40]. Laboratory diagnosis was confirmed by detecting WNV RNA in CSF (n = 3), WNV IgM in CSF (n = 5), WNV IgM/IgG in serum (n = 15), and confirmed by a Virus Neutralization Test (VNT), and 1 of the following:

Clinical evidence of meningitis (one or more of the following)

Positive meningeal signs

Pleocytosis in cerebrospinal fluid

Brain CT or MR finding consistent with inflammation

Clinical evidence of encephalitis (1 or more of the following)

Altered level of consciousness lasting at least 24 h

Focal neurological deficit

Seizure

Brain CT or MR finding consistent with brain inflammation

Abnormal electroencephalography

Acute-onset asymmetric limb weakness progressing over 48 h, and 2 or more of the following:

Hyporeflexia or areflexia of affected limbs

No pain or paresthesia of affected limbs

Pleocytosis ≥ 5 cells/mm3 , and elevated protein in cerebrospinal fluid

Spinal cord MR finding showing inflammation in anterior horns