Arboviral diseases, neuroinvasive and non-neuroinvasive -2015 Case Definition

Now we`re getting really technical so I`ve copied the entire definition. The important thing you need to know is this “Arthropod-borne viruses (arboviruses) are transmitted to humans primarily through the bites of infected mosquitoes, ticks, sand flies, or midges. Other modes of transmission for some arboviruses include blood transfusion, organ transplantation, perinatal transmission, breast feeding, and laboratory exposures.” Click here to read the full article or an excerpt below.

 

CSTE Position Statement(s)

  • 14-ID-04

Subtype(s)

  • California Serogroup Virus Diseases
  • Chikungunya Virus Disease
  • Eastern Equine Encephalitis Virus Disease
  • Powassan Virus Disease
  • St. Louis Encephalitis Virus Disease
  • West Nile Virus Disease
  • Western Equine Encephalitis Virus Disease
  • Zika Virus Disease

Background

Arthropod-borne viruses (arboviruses) are transmitted to humans primarily through the bites of infected mosquitoes, ticks, sand flies, or midges. Other modes of transmission for some arboviruses include blood transfusion, organ transplantation, perinatal transmission, breast feeding, and laboratory exposures.

More than 130 arboviruses are known to cause human disease. Most arboviruses of public health importance belong to one of three virus genera:Flavivirus, Alphavirus, and Orthobunyavirus.

California serogroup viruses include:

  • California encephalitis
  • Jamestown Canyon
  • Keystone
  • La Crosse
  • Snowshoe hare
  • Trivittatus viruses

Clinical Description

Most arboviral infections are asymptomatic. Clinical disease ranges from mild febrile illness to severe encephalitis. For the purpose of surveillance and reporting, based on their clinical presentation, arboviral disease cases are often categorized into two primary groups: neuroinvasive disease and nonneuroinvasive disease.

Neuroinvasive disease
Many arboviruses cause neuroinvasive disease such as aseptic meningitis, encephalitis, or acute flaccid paralysis (AFP). These illnesses are usually characterized by the acute onset of fever with headache, myalgia, stiff neck, altered mental status, seizures, limb weakness, or cerebrospinal fluid (CSF) pleocytosis. AFP may result from anterior (“polio”) myelitis, peripheral neuritis, or post-infectious peripheral demyelinating neuropathy (i.e., Guillain-Barre’ syndrome). Less common neurological manifestations, such as cranial nerve palsies, also occur.

Non-neuroinvasive disease
Most arboviruses are capable of causing an acute systemic febrile illness (e.g., West Nile fever) that may include headache, myalgias, arthralgia, rash, or gastrointestinal symptoms. Some viruses also can cause more characteristic clinical manifestations, such as severe polyarthralgia or arthritis due to Chikungunya virus or other alphaviruses (e.g., Mayaro, Ross River, O’nyong-nyong).

Clinical Criteria

A clinically compatible case of arboviral disease is defined as follows:

Neuroinvasive disease

  • Meningitis, encephalitis, acute flaccid paralysis, or other acute signs of central or peripheral neurologic dysfunction, as documented by a physician,AND
  • Absence of a more likely clinical explanation. Other clinically compatible symptoms of arbovirus disease include: headache, myalgia, rash, arthralgia, vertigo, vomiting, paresis and/ or nuchal rigidity.

Non-neuroinvasive disease

  • Fever (chills) as reported by the patient or a health-care provider, AND
  • Absence of neuroinvasive disease, AND
  • Absence of a more likely clinical explanation. Other clinically compatible symptoms of arbovirus disease include: headache, myalgia, rash, arthralgia, vertigo, vomiting, paresis and/ or nuchal rigidity.

Comments

NOTE: Zika virus disease had been added to the list of subtypes for Arboviral diseases, neuroinvasive and non-neuroinvasive based on the implicit inclusion of this subtype in the Arboviral diseases category as referenced in CSTE Position Statement 14-ID-04. Office of Management and Budget approval of the NNDSS Revision, 0920-0728 on January 21, 2016, authorized CDC to receive case notifications for Arboviral diseases, including Zika virus disease.

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s