West Nile Virus in a changing climate: epidemiology, pathology, advances in diagnosis and treatment, vaccine designing and control strategies, emerging public health challenges – a comprehensive review

<b>ABSTRACT</b>West Nile Virus (WNV), first identified in Uganda in 1937, remains a significant global health threat, adapting across diverse ecosystems and expanding geographically, particularly into temperate regions of Europe and North America. This review provides a comprehensive exploration of the latest insights and challenges in WNV management, focusing on epidemiological trends, molecular advancements, and public health implications. Recent data highlight WNV's expansion, driven by climate changes such as milder winters and longer warm seasons that increase mosquito activity and enable the virus to overwinter within mosquito populations. This facilitates year-round transmission and challenges current control strategies. Molecularly, advancements in genomic and proteomic technologies have deepened our understanding of WNV's replication and pathogenesis, identifying new therapeutic targets and improving diagnostic methods. However, the absence of an approved human vaccine leaves management dependent on supportive care, particularly for severe neurological cases. Effective vector control remains crucial, with innovative strategies including genetically modified mosquitoes and novel insecticides being pivotal. Furthermore, environmental factors like climate change and urbanization are altering vector behaviors and WNV transmission dynamics, necessitating adaptive public health strategies to manage these evolving threats. The review underscores the need for ongoing research, vaccine and therapeutic development, and enhanced public health infrastructures to better respond to WNV challenges. It stresses the critical role of integrating scientific research, public health policy, and community engagement to effectively address the persistent threat of WNV.