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Review
. 2014 Sep;134(3):e642-50.
doi: 10.1542/peds.2014-0498. Epub 2014 Aug 11.

Neuroinvasive arboviral disease in the United States: 2003 to 2012

James T Gaensbauer  1 , Nicole P Lindsey  2 , Kevin Messacar  1 , J Erin Staples  2 , Marc Fischer  3
Affiliations
Review

Neuroinvasive arboviral disease in the United States: 2003 to 2012

James T Gaensbauer et al. Pediatrics. 2014 Sep.

Abstract

Objective: To describe the epidemiologic and clinical syndromes associated with pediatric neuroinvasive arboviral infections among children in the United States from 2003 through 2012.

Methods: We reviewed data reported by state health departments to ArboNET, the national arboviral surveillance system, for 2003 through 2012. Children (<18 years) with neuroinvasive arboviral infections (eg, meningitis, encephalitis, or acute flaccid paralysis) were included. Demographic, clinical syndrome, outcome, geographic, and temporal data were analyzed for all cases.

Results: During the study period, 1217 cases and 22 deaths due to pediatric neuroinvasive arboviral infection were reported from the 48 contiguous states. La Crosse virus (665 cases; 55%) and West Nile virus (505 cases; 41%) were the most common etiologies identified. Although less common, Eastern equine encephalitis virus (30 cases; 2%) resulted in 10 pediatric deaths. La Crosse virus primarily affected younger children, whereas West Nile virus was more common in older children and adolescents. West Nile virus disease cases occurred throughout the country, whereas La Crosse and the other arboviruses were more focally distributed.

Conclusions: Neuroinvasive arboviral infections were an important cause of pediatric disease from 2003 through 2012. Differences in the epidemiology and clinical disease result from complex interactions among virus, vector, host, and the environment. Decreasing the morbidity and mortality from these agents depends on vector control, personal protection to reduce mosquito and tick bites, and blood donor screening. Effective surveillance is critical to inform clinicians and public health officials about the epidemiologic features of these diseases and to direct prevention efforts.

Keywords: United States; arboviruses; child; epidemiology.

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Conflict of interest statement

FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose.

POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

Figures

FIGURE 1
FIGURE 1
Incidence per million children (<18 years) of reported neuroinvasive arboviral disease due to West Nile, La Crosse, and Eastern equine encephalitis viruses, by year: United States, 2003 through 2012.
FIGURE 2
FIGURE 2
Average annual incidence per million children (<18 years) of neuroinvasive arboviral disease reported in the United States from 2003 through 2012, by state. A, West Nile virus; B, La Crosse virus; C, eastern equine encephalitis virus; and D, Powassan virus.
FIGURE 3
FIGURE 3
Number of reported pediatric neuroinvasive arboviral disease cases due to La Crosse and West Nile viruses, by age at illness onset: United States, 2003–2012.
FIGURE 4
FIGURE 4
Number of reported pediatric neuroinvasive arboviral disease cases due to La Crosse and West Nile viruses, by month of illness onset: United States, 2003–2012.
See this image and copyright information in PMC

References

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