Division of Pediatric Infectious Diseases, Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado; and.
Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, Colorado.
Pediatrics. 2014 Sep;134(3):e642-50. doi: 10.1542/peds.2014-0498. Epub 2014 Aug 11.
To describe the epidemiologic and clinical syndromes associated with pediatric neuroinvasive arboviral infections among children in the United States from 2003 through 2012.
We reviewed data reported by state health departments to ArboNET, the national arboviral surveillance system, for 2003 through 2012. Children (<18 years) with neuroinvasive arboviral infections (eg, meningitis, encephalitis, or acute flaccid paralysis) were included. Demographic, clinical syndrome, outcome, geographic, and temporal data were analyzed for all cases.
During the study period, 1217 cases and 22 deaths due to pediatric neuroinvasive arboviral infection were reported from the 48 contiguous states. La Crosse virus (665 cases; 55%) and West Nile virus (505 cases; 41%) were the most common etiologies identified. Although less common, Eastern equine encephalitis virus (30 cases; 2%) resulted in 10 pediatric deaths. La Crosse virus primarily affected younger children, whereas West Nile virus was more common in older children and adolescents. West Nile virus disease cases occurred throughout the country, whereas La Crosse and the other arboviruses were more focally distributed.
Neuroinvasive arboviral infections were an important cause of pediatric disease from 2003 through 2012. Differences in the epidemiology and clinical disease result from complex interactions among virus, vector, host, and the environment. Decreasing the morbidity and mortality from these agents depends on vector control, personal protection to reduce mosquito and tick bites, and blood donor screening. Effective surveillance is critical to inform clinicians and public health officials about the epidemiologic features of these diseases and to direct prevention efforts.
描述 2003 年至 2012 年期间美国儿童感染神经侵袭性虫媒病毒的流行病学和临床综合征。
我们回顾了 2003 年至 2012 年期间各州卫生部门向国家虫媒病毒监测系统（ArboNET）报告的数据。包括患有神经侵袭性虫媒病毒感染（如脑膜炎、脑炎或急性弛缓性麻痹）的儿童。分析了所有病例的人口统计学、临床综合征、结局、地理位置和时间数据。
在研究期间，来自 48 个相邻州报告了 1217 例儿童神经侵袭性虫媒病毒感染病例和 22 例死亡病例。拉科斯特病毒（665 例；55%）和西尼罗河病毒（505 例；41%）是最常见的病原体。虽然不太常见，但东部马脑炎病毒（30 例；2%）导致 10 例儿童死亡。拉科斯特病毒主要影响年幼的儿童，而西尼罗河病毒则更常见于年龄较大的儿童和青少年。西尼罗河病毒病例发生在全国各地，而拉科斯特病毒和其他虫媒病毒的分布则更加集中。
2003 年至 2012 年期间，神经侵袭性虫媒病毒感染是儿童疾病的一个重要原因。病毒、媒介、宿主和环境之间的复杂相互作用导致了流行病学和临床疾病的差异。减少这些病原体引起的发病率和死亡率取决于媒介控制、个人保护以减少蚊虫和蜱虫叮咬，以及献血者筛查。有效的监测对于向临床医生和公共卫生官员提供这些疾病的流行病学特征信息，并指导预防工作至关重要。
