北卡罗来纳州居民中流行的拉克罗斯病毒神经侵入性疾病：2000-2020

Q2 Medicine

North Carolina Medical Journal Pub Date : 2024-06-05 DOI:10.18043/001c.118585

Joseph Davis, Chelsea Atkins, Michael S. Doyle, Carl J Williams, Ross Boyce, Brian D. Byrd

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引用次数: 0

摘要

拉克罗斯病毒性神经侵袭病（LACVND）是美国儿童中最常见的虫媒病毒性脑炎病因；在北卡罗来纳州，它是人类中最流行的蚊媒地方病。在此，我们利用北卡罗来纳州电子疾病监测系统的数据，报告了 2000-2020 年期间确诊和疑似 LACVND 的监测总结，并描述了相关的人口特征、时空分布、临床特征和死亡率。北卡罗来纳州 41 个县共报告了 355 例病例（74.9% 为确诊病例）；大多数病例（92%）发生在北卡罗来纳州西部的 19 个县。每年平均报告 17 例病例，大多数病例（94%）发生在 6 月中旬至 10 月初（第 25-41 周）。病例年龄中位数为 9 岁（范围：1-95 岁），79% 的病例年龄小于 18 岁，56.6% 为男性。病例通常表现为头痛（95.4%）、发热（95.1%）和精神状态改变（80.8%）；脑炎（82.0%）和脑膜炎（45.9%）是常见的诊断病症。脑炎在儿童中的发病率（87%）高于成人（62%）（P < .001）。同样，癫痫发作在儿童中的发病率（54%）也高于成人（27%）（P < .01）。病例死亡率为 1.4%，但不同年龄段的病例死亡率存在差异。病例定义和报告要求的变化、数据缺失、不同的报告来源以及本研究的回顾性质都是我们研究的重要局限性。鉴于拉克罗斯病毒在北卡罗来纳州西部的持续流行，临床医生和公共卫生服务提供者应考虑对所有有相应症状和流行县旅行史的人，尤其是儿童，进行拉克罗斯病毒疾病的筛查。预防措施和教育宣传/公共卫生信息应重点关注北卡罗来纳州西部各县的护理人员和儿童以及传播风险较高的时期（如夏季和初秋）。

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Endemic La Crosse Virus Neuroinvasive Disease in North Carolina Residents: 2000–2020

La Crosse virus neuroinvasive disease (LACVND) is the most common cause of arboviral encephalitis in children within the United States; in North Carolina, it is the most prevalent endemic mosquito-borne disease in humans. Here we report a surveillance summary of confirmed and probable LACVND during 2000–2020 using North Carolina Electronic Disease Surveillance System data, and we describe associated demographic characteristics, spatiotemporal distribution, clinical features, and mortality rates. A total of 355 cases (74.9% confirmed) were reported from 41 North Carolina counties; most cases (92%) occurred in 19 Western North Carolina counties. An average of 17 cases were reported annually with the majority (94%) of cases occurring between mid-June and early October (epiweeks 25–41). The median case age was nine years (range: 1–95 years), 79% were aged ≤ 18 years, and 56.6% were male. Cases commonly presented with headache (95.4%), fever (95.1%), and altered mental status (80.8%); encephalitis (82.0%) and meningitis (45.9%) were frequently diagnosed. Encephalitis was more common in children (87%) than adults (62%) (P < .001). Similarly, seizures were more common in children (54%) than adults (27%) (P < .01). The case fatality rate was 1.4%; however, differences in age-specific rates were observed. Changes in case definitions and reporting requirements, missing data, different reporting sources, and the retrospective nature of this study are all important limitations of our study. Given the persistent endemicity of La Crosse virus in Western North Carolina, clinicians and public health providers should consider La Crosse virus disease in all individuals, especially children, with compatible symptoms and a travel history to endemic counties. Prevention measures and educational outreach/public health messaging should focus on caregivers and children in Western North Carolina counties and during times when transmission risk is higher (i.e., summer and early fall).

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来源期刊

North Carolina Medical Journal Medicine-Medicine (all)

CiteScore

1.40

自引率

0.00%

发文量

121

期刊介绍： NCMJ, the North Carolina Medical Journal, is meant to be read by everyone with an interest in improving the health of North Carolinians. We seek to make the Journal a sounding board for new ideas, new approaches, and new policies that will deliver high quality health care, support healthy choices, and maintain a healthy environment in our state.