Abstract
BackgroundAlthough La Crosse virus (LACV) is one of the most common causes of pediatric arboviral infections in the United States, little has been done to assess its geographic distribution, identify areas of higher risk of disease, and to provide a national picture of its clinical presentation. Therefore, the objective of this study was to investigate the geographic distribution of LACV infections reported in the United States, to identify hot-spots of infection, and to present its clinical picture.Methods and FindingsDescriptive and cluster analyses were performed on probable and confirmed cases of LACV infections reported to the Centers for Disease Control and Prevention from 2003–2007. A total of 282 patients had reported confirmed LACV infections during the study period. Of these cases the majority (81 percent) presented during the summer, occurred in children 15 years and younger (83.3 percent), and were found in male children (64.9 percent). Clinically, the infections presented as meningioencephalitis (56.3 percent), encephalitis (20.7 percent), meningitis (17.2 percent), or uncomplicated fever (5 percent). Deaths occurred in 1.9 percent of confirmed cases, and in 8.6 percent of patients suffering from encephalitis. The majority of these deaths were in patients 15 years and younger. The county-level incidence risk among counties (n = 136) reporting both probable and confirmed cases for children 15 years and younger (n = 355) ranged from 0.2 to 228.7 per 100,000 persons. The southern United States experienced a significantly higher (p<0.05) incidence risk during the months of June, July, August, and October then the northern United States. There was significant (p<0.05) clustering of high risk in several geographic regions with three deaths attributed to complications from LAC encephalitis occurring in two of these hot-spots of infections.ConclusionsBoth the incidence risk and case fatality rates were found to be higher than previously reported. We detected clustering in four geographic regions, a shift from the prior geographic distributions, and developed maps identifying high-risk areas. These findings are useful for raising awareness among health care providers regarding areas at a high risk of infections and for guiding targeted multifaceted interventions by public health officials.
Highlights
La Crosse virus (LACV) is a member of the genus Orthobunyavirus, family Bunyaviridae, and is the causative agent of LACV infections
Unlike West Nile virus (WNV) infections that are more severe in the adults [15], the majority of severe LACV cases occur in children 15 years and younger [11,16,17,18], with an average of 79 nationally reported cases per year since 1964, though pockets of higher infection risk have been reported [19]
Descriptive analyses of cases A total of 282 patients had confirmed LACV infections reported to the Centers for Disease Control and Prevention (Table 2)
Summary
La Crosse virus (LACV) is a member of the genus Orthobunyavirus, family Bunyaviridae, and is the causative agent of LACV infections. LACV was first isolated in 1964 [1], and has become one of most common causes of pediatric arboviral infections in the United States [2,3]. We examined probable and confirmed cases of LACV infections from 2003–2007, to determine incidence risk, case fatality rates, and to assess the current spatial patterns of disease risk so as to identify those areas of highest risk for the implementation of future disease control strategies. La Crosse virus (LACV) is one of the most common causes of pediatric arboviral infections in the United States, little has been done to assess its geographic distribution, identify areas of higher risk of disease, and to provide a national picture of its clinical presentation. The objective of this study was to investigate the geographic distribution of LACV infections reported in the United States, to identify hot-spots of infection, and to present its clinical picture
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