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The first 300 words of the full text of this section appear below.

Section 3. Summaries of Infectious Diseases

Arboviruses (also see West Nile Virus, p 730)

(Including Colorado Tick Fever, Dengue, Eastern Equine Encephalitis, California, Powassan, St. Louis Encephalitis, Western Equine Encephalitis, Chikungunya, Japanese Encephalitis, Tickborne Encephalitis, Venezuelan Equine Encephalitis, and Yellow Fever)

Clinical Manifestations
Etiology
Epidemiology
Diagnostic Tests
Treatment
Isolation of the Hospitalized Patient
Control Measures
Yellow Fever Vaccine
Japanese Encephalitis (JE) Vaccine
Other Arboviral Vaccines
Reporting

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CLINICAL MANIFESTATIONS

More than 150 arthropodborne viruses (arboviruses) are known to cause human disease. Although most infections are subclinical, symptomatic illness manifests as 1 of 3 primary clinical syndromes: systemic febrile illness, neuroinvasive disease, or hemorrhagic fever (Table 3.1).


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  		Table 3.1. Clinical Manifestations for Select Domestic and International Arboviral Diseases

  1. Systemic febrile illness. Most arboviruses are capable of causing a systemic febrile illness that often includes headache, arthralgia, myalgia, and rash. Some viruses also can cause more severe, prolonged, or characteristic clinical manifestations, including severe joint pain (eg, chikungunya) or jaundice (yellow fever).

  2. Neuroinvasive disease. Many arboviruses cause neuroinvasive diseases, including aseptic meningitis, encephalitis, or acute flaccid paralysis. Illness usually presents with a prodrome similar to the systemic febrile illness followed by neurologic symptoms. The specific symptoms vary by virus and clinical syndrome but can include vomiting, stiff neck, mental status changes, seizures, or focal neurologic deficits. The severity and long-term outcome of the illness vary by etiologic agent and the underlying characteristics of the host, such as age, immune status, and preexisting medical condition.

  3. Hemorrhagic fever. Hemorrhagic fevers can be caused by dengue or yellow fever viruses. After several days of nonspecific febrile illness, the patient may develop overt signs of hemorrhage (eg, petechiae, ecchymoses, bleeding from the nose and gums, hematemesis, and melena) and septic . . . [Go to Full Text]


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