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Epidemiology of Neuroinvasive Arboviral Disease in the United States, 1999–2007

From 1999–2007, the most common causes of neuroinvasive arboviral disease in the United States, after West Nile virus (WNV), were California (CAL) serogroup viruses, St. Louis encephalitis virus (SLEV), and eastern equine encephalitis virus (EEEV). The CAL serogroup virus disease was primarily reported from Appalachia and the upper Midwest, SLEV disease from southern states, and EEEV disease from areas along the Atlantic and Gulf coasts. Children accounted for 88% of CAL serogroup virus disease, whereas 75% of SLEV disease occurred among older adults. The EEEV disease had the highest case-fatality rate (42%). The incidence of CAL serogroup virus and EEEV disease remained stable before and after the detection of WNV in the United States in 1999. The SLEV disease declined 3-fold after 1999; however, SLEV disease has occurred in sporadic epidemics that make trends difficult to interpret. The CAL serogroup virus, SLEV, and EEEV disease are persistent public health concerns in the United States warranting ongoing prevention efforts.

Received May 16, 2008. Accepted for publication July 27, 2008.

Acknowledgments: The authors thank Peggy Collins, Erin Staples, and all the state and local health department staff who perform surveillance for arboviral diseases for their contributions to this manuscript.

Financial support: This work was funded by the Centers for Disease Control and Prevention.

Disclosure: Carolyn Reimann is a Lieutenant Commander in the United States Navy. The views expressed in this article are those of the authors and do not necessarily reflect the official policy or views of the U.S. Department of the Navy, U.S. Department of Defense, or U.S. Department of Health and Human Services.

^* Address correspondence to Marc Fischer, Arboviral Diseases Branch, CDC, 3150 Rampart Road, Fort Collins, CO 80521. E-mail: mfischer{at}cdc.gov

Authors’ addresses: Carolyn A. Reimann, Carolyn DiGuiseppi, and Richard Hoffman, Department of Epidemiology, Colorado School of Public Health, 4200 East Ninth Avenue, B-119, Denver, CO 80262, Tel: 303-315-7605, Fax: 303-315-1010, E-mail: carolyn.diguiseppi{at}uchsc.edu. Edward B. Hayes, Jennifer A. Lehman, Nicole P. Lindsey, Grant L. Campbell, and Marc Fischer, Arboviral Diseases Branch, Division of Vector-Borne Infectious Diseases, Centers for Disease Control and Prevention, 3150 Rampart Road, Fort Collins, CO 80521, Tel: 970-221-6400, Fax: 970-266-3568, E-mail: mfischer{at}cdc.gov.

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