One in five infections results in West Nile fever. Once considered a relatively mild illness, the CDC now says people with West Nile fever can be quite ill for quite a long time.

The symptoms of West Nile fever include:

• Fever  
  
• Headache   
  
• Fatigue   
  
• Skin rash on the trunk of the body (in some cases but not in others)   
  
• Swollen lymph glands (in some cases but not in others)   
  
• Eye pain (in some cases but not in others)
  

In one in every 150 infections, the virus gets into the brain (encephalitis) or into the tissues covering the brain and spinal cord (meningitis). This is what the CDC calls "neuroinvasive" West Nile disease.

About 10% of people who get West Nile encephalitis or West Nile meningitis die. Most people with neuroinvasive disease have either encephalitis or both encephalitis and meningitis. Some 25% to 35% get meningitis only.

The symptoms of West Nile meningitis include:

• Fever
  
• Headache
  
• Stiff neck
  

The symptoms of West Nile meningitis include:

• Changes in consciousness ranging from mild (sluggishness) to severe (mental confusion, convulsions, or coma).
  
• Fever and headache.
  
• Neurological symptoms, including paralysis of one or more limbs or palsy, may occur.
  
• Tremors and movement problems sometimes occur.
  

Some people with West Nile infection become weak or paralyzed in one or more limbs. Two-thirds of these people are left with permanent weakness or paralysis. It's not yet clear what percentage of people with neuroinvasive West Nile disease get this syndrome, known as West Nile poliomyelitis.

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