Background: West Nile virus (WNV) is one of the most widely distributed arboviruses in the world. WNV disease is now an established infection in the western hemisphere. Severe disease usually occurs in the elderly and immuno-compromised individuals, but it can also affect healthy adults and children. Although WNV encephalitis has been reported in children, such reports are rare. No specific drug treatment is available at present, and vaccines are still experimental.Active bird and mosquito surveillance, and mosquito control are the most effective ways to prevent transmission of WNV.Case Report: We describe here a four-year-old boy from the Washington, D.C. area who presented with high fever, severe headache, cough, lethargy, irritability, vomiting and a stiff neck. The diagnosis of WNV was confirmed by a very strongly positive serum WNV IgM performed at the Center for Disease Control in Atlanta. He had complete recovery.Conclusions: Pediatricians and practicing physicians in the United States should consider the diagnosis of West Nile virus disease when evaluating febrile patients in the summer months, particularly those with associated neurological and gastrointestinal symptoms. Physicians are reminded that WNV disease does affect healthy children.

Keywords: West Nile virus, Encephalitis