Jamestown Canyon Virus: A Potential Cause for Acute Inflammatory Polyneuropathy? (P03.256)

Abstract

Objective: To describe the first case reports of human infections with Jamestown Canyon virus (JCV), an emerging viral pathogen, in Nova Scotia. Background JCV is a mosquito-borne zoonosis belonging to the California serogroup of bunyaviruses, endemic in North America. Although seroprevalence data suggests that up to 88% of deer along the south shore region of Nova Scotia (NS) have been infected by JCV, human infections have not been reported. Design/Methods: The clinical and demographic data of our cases were reviewed. Serologic testing for JCV infection was done at the National Microbiology Laboratory using plaque reduction neutralization (PRNT). PubMed search was performed to determine the typical clinical manifestations of JCV in humans. Results: Two human cases of probable JCV infection were identified in 2010 and 2011 in NS presenting as acute polyneuropathies with cognitive changes. CSF showed an inflammatory reaction with lymphocytic pleocytosis and elevated protein. Electromyography and nerve conduction studies demonstrated acute polyneuropathy in both, with prominent demyelination in one. Microbiologic investigations including culture, PCR for HSV, and enteroviruses were negative. Serology for typical arboviruses were negative. Serum IgM and PRNT for JCV was positive. Both cases were treated with intravenous immunoglobulin with improvement, but deficits from the polyneuropathy persisted. Literature review indicated that JCV infection is often limited to a mild febrile illness which can progress to an encephalitis and/or meningitis. No reports of demyelinating polyneuropathy as a result of JCV were previously identified. Conclusions: These are the first reported probable cases in humans in NS. The atypical nature of these presentations suggests that JCV may cause a greater spectrum of neurologic disease than previously described. Clinicians should consider JCV in their differential of patients presenting with inflammatory polyneuropathies in NS and other areas with high prevalence in their zoonotic reservoir. Disclosure: Dr. Rasool has nothing to disclose. Dr. Benstead has nothing to disclose. Dr. Drebot has nothing to disclose. Dr. Hatchette has nothing to disclose.