West Nile virus (WNV) has caused human infection in Africa, Europe, the Middle East, west and central Asia, Oceania, and North America. It first appeared in the western hemisphere as an outbreak of encephalitis in New York City in 1999. Between 1999 and 2004, the disease spread across the US, into Canada, and to the Caribbean islands and Latin America. Even in areas with abundant WNV-carrying mosquitoes, the overall prevalence of infection has not exceeded 5%.
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