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We found that 31% (44\/140) of study participants experienced prolonged (more than 6 months) fatigue postinfection, with an average length of fatigue duration of 5 years. Females, those younger than 50 years of age, and those with symptomatic clinical WNV disease were significantly more likely to report fatigue. Pro-inflammatory and antiviral cytokines (granulocyte macrophage colony stimulating factor, interferon-\u03b3, interferon-\u03b3 inducing protein 10, interleukin 2, interleukin 6, and interleukin 12p70) were significantly elevated in those reporting fatigue postinfection compared to those not reporting fatigue. Clinicians should consider history of WNV infection as a possible factor when evaluating causes of prolonged fatigue following a febrile viral illness in their patients.<\/jats:p>","DOI":"10.1089\/vim.2014.0035","type":"journal-article","created":{"date-parts":[[2014,7,25]],"date-time":"2014-07-25T16:52:33Z","timestamp":1406307153000},"page":"327-333","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":69,"title":["Evaluation of Prolonged Fatigue Post\u2013West Nile Virus Infection and Association of Fatigue with Elevated Antiviral and Proinflammatory Cytokines"],"prefix":"10.1177","volume":"27","author":[{"given":"Melissa N.","family":"Garcia","sequence":"first","affiliation":[{"name":"Baylor College of Medicine"},{"name":"University of Texas Health Science Center at Houston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne M.","family":"Hause","sequence":"additional","affiliation":[{"name":"University of Texas Health Science Center at Houston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher M.","family":"Walker","sequence":"additional","affiliation":[{"name":"University of Texas Health Science Center at Houston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordan S.","family":"Orange","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodrigo","family":"Hasbun","sequence":"additional","affiliation":[{"name":"University of Texas Health Science Center at Houston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristy O.","family":"Murray","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine"},{"name":"University of Texas Health Science Center at Houston"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2014,9,1]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mehy.2011.03.030"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1086\/506939"},{"key":"e_1_3_3_4_2","first-page":"510","article-title":"West Nile Virus disease and other arboviral diseases\u2014United States, 2011","volume":"61","author":"Centers for Disease Control and Prevention","year":"2012","unstructured":"Centers for Disease Control and Prevention. 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