Neuroinvasive arboviral disease in the United States: 2003 to 2012.
Neuroinvasive arboviral disease in the United States: 2003 to 2012.
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DOI：
10.1542/peds.2014-0498
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发表时间：
2014-09
期刊：
影响因子：
8
通讯作者：
Fischer M
中科院分区：
文献类型：
--
作者：
Gaensbauer JT;Lindsey NP;Messacar K;Staples JE;Fischer M
描述2003年至2012年美国儿童中与小儿神经侵袭性虫媒病毒感染相关的流行病学和临床综合征。我们回顾了2003年至2012年各州卫生部门向国家虫媒病毒监测系统ArboNET报告的数据。研究纳入了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（<18岁）。对所有病例进行人口统计学、临床综合征、结局、地理和时间数据分析。在研究期间，48个相邻州报告了1217例和22例因小儿神经侵袭性虫媒病毒感染而死亡的病例。拉克罗斯病毒（665例; 55%）和西尼罗河病毒（505例; 41%）是最常见的病因。尽管不太常见，但东部马脑炎病毒（30例; 2%）导致10名儿童死亡。拉克罗斯病毒主要影响年幼的儿童，而西尼罗河病毒更常见于年龄较大的儿童和青少年。西尼罗河病毒病病例发生在全国各地，而拉克罗斯和其他虫媒病毒的分布更集中。从2003年到2012年，神经侵入性虫媒病毒感染是儿科疾病的重要原因。流行病学和临床疾病的差异是病毒、媒介、宿主和环境之间复杂相互作用的结果。降低这些病原体的发病率和死亡率取决于病媒控制、减少蚊虫和蜱虫叮咬的个人防护以及献血者筛查。有效的监测对于向临床医生和公共卫生官员通报这些疾病的流行病学特征和指导预防工作至关重要。
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.