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The following text is from an archived Red Book® edition and may not reflect current recommendations or information. To view the current edition, click here.

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Section 3. Summaries of Infectious Diseases

Arboviruses (also see West Nile Virus, p 729)

(Including California Serogroup [Primarily La Crosse] Encephalitis, Eastern and Western Equine Encephalitis, Powassan Encephalitis, St Louis Encephalitis, Venezuelan Equine Encephalitis, Colorado Tick Fever, Dengue Fever, Japanese Encephalitis, and Yellow Fever)

Clinical Manifestations
Etiology
Epidemiology
Diagnostic Tests
Treatment
Isolation of the Hospitalized Patient
Control Measures

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CLINICAL MANIFESTATIONS: Arboviruses (arthropodborne viruses) (Table 3.1) are spread by mosquitoes, ticks, sandflies, or other biting arthropods (eg, midges) and produce 4 principal clinical syndromes: (1) central nervous system (CNS) disease (including encephalitis, aseptic meningitis, and flaccid paralysis); (2) an undifferentiated febrile illness, often with rash and headache; (3) acute polyarthropathy; and (4) acute hemorrhagic fever, sometimes accompanied by hepatitis. Some arboviruses can cause congenital infection.


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  		Table 3.1. Taxonomy of Major Arboviruses

Selected arboviruses that cause encephalitis in the Western hemisphere are shown in Table 3.2 (p 213). When present, clinical illness ranges in severity from a self-limited febrile illness with headache to a syndrome of aseptic meningitis or acute encephalitis. La Crosse virus produces aseptic meningitis or encephalitis with acute seizures and focal neurologic findings in more than 25% of cases, stupor or coma in 50%, and death in less than 1%. Eastern equine encephalitis (EEE) typically is a fulminant illness leading to coma and death in 40% to 70% of cases and serious neurologic sequelae in one third; the highest mortality rates are in infants and children. Western equine encephalitis (WEE) is associated with a case-fatality rate of 5%; neurologic impairment is common in infants, and congenital infection resulting in mental retardation has been described. Powassan encephalitis is associated with long-term morbidity and has a case-fatality rate of 10% to 15%. Characteristics of symptomatic infection caused . . . [Go to Full Text]


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