Methylene blue photoinactivation abolishes West Nile virus infectivity in vivo

The prevalence of West Nile virus (WNV) infections and associated morbidity has accelerated in recent years. Of particular concern is the recent demonstration that this virus can be transmitted by blood products and can cause severe illness and mortality in transfusion recipients. We have evaluated methylene blue (MB) + light as a safe and cost-effective means to inactivate WNV in vitro. This regimen inactivated WNV with an IC50 of 0.10 μM. Up to 107 pfu/ml of WNV could be inactivated by MB + light with no residual infectivity. MB + light inactivated three primary WNV isolates from the years 1999, 2002 and 2003 and prevented mortality in a murine model for WNV infection. Since MB is already approved for human use at a dose of 100 mg/kg/day, we conjecture that MB + light treatment of blood products for high-risk patients will be efficacious and suitable for use in resource-limited settings.