La Crosse Virus Disease in the United States, 2003–2019

Grace M. Vahey Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, Colorado;
Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia

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Nicole P. Lindsey Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, Colorado;

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J. Erin Staples Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, Colorado;

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Susan L. Hills Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, Colorado;

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ABSTRACT.

La Crosse virus (LACV) is an arthropod-borne virus that can cause a nonspecific febrile illness, meningitis, or encephalitis. We reviewed U.S. LACV surveillance data for 2003–2019, including human disease cases and nonhuman infections. Overall, 318 counties in 27 states, principally in the Great Lakes, mid-Atlantic, and southeastern regions, reported LACV activity. A total of 1,281 human LACV disease cases were reported, including 1,183 (92%) neuroinvasive disease cases. The median age of cases was 8 years (range: 1 month–95 years); 1,130 (88%) were aged < 18 years, and 754 (59%) were male. The most common clinical syndromes were encephalitis (N = 960; 75%) and meningitis (N = 219, 17%). The case fatality rate was 1% (N = 15). A median of 74 cases (range: 35–130) was reported per year. The average annual national incidence of neuroinvasive disease cases was 0.02 per 100,000 persons. West Virginia, North Carolina, Tennessee, and Ohio had the highest average annual state incidences (0.16–0.61 per 100,000), accounting for 80% (N = 1,030) of cases. No animal LACV infections were reported. Nine states reported LACV-positive mosquito pools, including three states with no reported human disease cases. La Crosse virus is the most common cause of pediatric neuroinvasive arboviral disease in the United States. However, surveillance data likely underestimate LACV disease incidence. Healthcare providers should consider LACV disease in patients, especially children, with febrile illness, meningitis, or encephalitis in areas where the virus circulates and advise their patients on ways to prevent mosquito bites.

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Author Notes

Address correspondence to Susan L. Hills, Arboviral Diseases Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, 3156 Rampart Rd, Fort Collins, CO 80521. E-mail: shills@cdc.gov

Financial support: This work was completed as part of official duties of staff at the Centers for Disease Control and Prevention.

Disclaimer: The findings and conclusions of this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Authors’ addresses: Grace M. Vahey, Nicole P. Lindsey, J. Erin Staples, and Susan L. Hills, Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, CO, E-mails: gvahey@cdc.gov, nplindsey@cdc.gov, estaples@cdc.gov, and shills@cdc.gov.

  • 1.

    Hughes HR , Lanciotti RS , Blair CD , Lambert AJ , 2017. Full genomic characterization of California serogroup viruses, genus Orthobunyavirus, family Peribunyaviridae including phylogenetic relationships. Virology 512: 201210.

    • Search Google Scholar
    • Export Citation
  • 2.

    Tsai TF , 1991. Arboviral infections in the United States. Infect Dis Clin North Am 5: 73102.

  • 3.

    Calisher CH , 1994. Medically important arboviruses of the United States and Canada. Clin Microbiol Rev 7: 89116.

  • 4.

    Grimstad PR , Barrett CL , Humphrey RL , Sinsko MJ , 1984. Serologic evidence for widespread infection with La Crosse and St. Louis encephalitis viruses in the Indiana human population. Am J Epidemiol 119: 913930.

    • Search Google Scholar
    • Export Citation
  • 5.

    Thompson WH , Kalfayan B , Anslow RO , 1965. Isolation of California encephalitis group virus from a fatal human illness. Am J Epidemiol 81: 245253.

    • Search Google Scholar
    • Export Citation
  • 6.

    Harding S , Greig J , Mascarenhas M , Young I , Waddell LA , 2018. La Crosse virus: a scoping review of the global evidence. Epidemiol Infect 14: 113.

    • Search Google Scholar
    • Export Citation
  • 7.

    Gaensbauer JT , Lindsey NP , Messacar K , Staples JE , Fischer M , 2014. Neuroinvasive arboviral disease in the United States: 2003 to 2012. Pediatrics 134: e642e650.

    • Search Google Scholar
    • Export Citation
  • 8.

    Reimann CA , Hayes EB , DiGuiseppi C , Hoffman R , Lehman JA , Lindsey NP , Campbell GL , Fischer M , 2008. Epidemiology of neuroinvasive arboviral disease in the United States, 1999–2007. Am J Trop Med Hyg 79: 974979.

    • Search Google Scholar
    • Export Citation
  • 9.

    Centers for Disease Control and Prevention , 2015. Arboviral Diseases, Neuroinvasive and Non-neuroinvasive 2015 Case Definition. Available at: https://wwwn.cdc.gov/nndss/conditions/arboviral-diseases-neuroinvasive-and-non-neuroinvasive/case-definition/2015/. Accessed November 18, 2019.

  • 10.

    United States Census Bureau , 2018. State Population Totals. Available at: census.gov. Accessed November 18, 2019.

  • 11.

    Kappus KD , Monath TP , Kaminski RM , Calisher CH , 1983. Reported encephalitis associated with California serogroup virus infections in the United States, 1963–1981. Prog Clin Biol Res 123: 3141.

    • Search Google Scholar
    • Export Citation
  • 12.

    Taylor KG , Woods TA , Winkler CW , Carmody AB , Peterson KE , 2014. Age-dependent myeloid dendritic cell responses mediate resistance to La Crosse virus-induced neurological disease. J Virol 88: 1107011079.

    • Search Google Scholar
    • Export Citation
  • 13.

    Winkler CW , Myers LM , Woods TA , Carmody AB , Taylor KG , Peterson KE , 2017. Lymphocytes have a role in protection, but not in pathogenesis, during La Crosse virus infection in mice. J Neuroinflammation 14: 62.

    • Search Google Scholar
    • Export Citation
  • 14.

    Hasbun R , Wootton SH , Rosenthal N , Balada-Llasat JM , Chung J , Duff S , Bozzette S , Zimmer L , Ginocchio CC , 2019. Epidemiology of meningitis and encephalitis in infants and children in the United States, 2011–2014. Pediatr Infect Dis J 38: 3741.

    • Search Google Scholar
    • Export Citation
  • 15.

    Erwin PC , Jones TF , Gerhardt RR , Halford SK , Smith AB , Patterson LE , Gottfried KL , Burkhalter KL , Nasci RS , Schaffner W , 2002. La Crosse encephalitis in eastern Tennessee: clinical, environmental, and entomological characteristics from a blinded cohort study. Am J Epidemiol 155: 10601065.

    • Search Google Scholar
    • Export Citation
  • 16.

    Byrd BD , Williams CJ , Staples JE , Burkhalter KL , Savage HM , Doyle MS , 2018. Notes from the field: spatially associated coincident and noncoincident cases of La Crosse encephalitis - North Carolina, 2002–2017. MMWR Morb Mortal Wkly Rep 67: 11041105.

    • Search Google Scholar
    • Export Citation
  • 17.

    Hayes EB , Komar N , Nasci RS , Montgomery SP , O’Leary DR , Campbell GL , 2005. Epidemiology and transmission dynamics of West Nile virus disease. Emerg Infect Dis 11: 11671173.

    • Search Google Scholar
    • Export Citation
  • 18.

    Lambert AJ , Fryxell RT , Freyman K , Ulloa A , Velez JO , Paulsen D , Lanciotti RS , Moncayo A , 2015. Comparative sequence analyses of La Crosse virus strain isolated from patient with fatal encephalitis, Tennessee, USA. Emerg Infect Dis 21: 833836.

    • Search Google Scholar
    • Export Citation
  • 19.

    Huang C , Thompson WH , Karabatsos N , Grady L , Campbell WP , 1997. Evidence that fatal human infections with La Crosse virus may be associated with a narrow range of genotypes. Virus Res 48: 143148.

    • Search Google Scholar
    • Export Citation
  • 20.

    Pastula DM , Hoang Johnson DK , White JL , Dupuis AP 2nd , Fischer M , Staples JE , 2015. Jamestown Canyon Virus Disease in the United States—2000–2013. Am J Trop Med Hyg 93: 384389.

    • Search Google Scholar
    • Export Citation
  • 21.

    Committee on Infectious Diseases, American Academy of Pediatrics , Kimberlin DW , Brady MT , Jackson MA , Long SS , 2018. Repellents for Use on Skin. Red Book: Report of the Committee on Infectious Diseases. Itasca, IL: American Academy of Pediatrics, 197199.

    • Search Google Scholar
    • Export Citation
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