Arboviral Encephalitis
1995 Case Definition
1995 Case Definition
Subtype(s)
- California serogroup encephalitis
- Eastern equine encephalitis
- St. Louis encephalitis
- Western equine encephalitis
Clinical Description
Arboviral infection may result in a febrile illness of variable severity associated with neurologic symptoms ranging from headache to aseptic meningitis or encephalitis. Arboviral encephalitis cannot be distinguished clinically from other central nervous system infections. Symptoms may include headache; confusion or other alteration in sensorium; nausea; or vomiting. Signs may include fever, meningismus, cranial nerve palsies, paresis or paralysis, sensory deficits, altered reflexes, convulsions, abnormal movements, and coma of varying degree.
Laboratory Criteria For Diagnosis
- Four-fold or greater change in serum antibody titer, OR
- Isolation of virus from or demonstration of viral antigen or genomic sequences in tissue, blood, cerebrospinal fluid (CSF), or other body fluid, OR
- Specific Immunoglobulin M antibody in CSF
Case Classification
Probable
A clinically compatible illness occurring during a period when arboviral transmission is likely, and with the following supportive serology: a stable (less than two-fold change) elevated antibody titer to an arbovirus (e.g., greater than 320 by hemagglutination inhibition, greater than 128 by complement fixation, greater than 256 by immunofluorescence, and greater than160 by neutralization), or a positive serologic result by enzyme immunoassay (EIA).
Confirmed
A clinically compatible illness that is laboratory confirmed
Comments
The seasonality of arboviral transmission is variable and depends on the geographic location of exposure, the specific cycles of viral transmission, and local climatic conditions. Reporting should be etiology specific (see below—the first four encephalitides are nationally reportable to CDC):
- St. Louis encephalitis
- Western equine encephalitis
- Eastern equine encephalitis
- California encephalitis (includes infections from the following viruses: LaCrosse, Jamestown Canyon, Snowshoe Hare, Trivittatus, Keystone, and California encephalitis viruses)
- Powassan encephalitis
- Other central nervous system infections transmitted by mosquitoes, ticks, or midges (e.g. Venezuelan equine encephalitis, Cache Valley encephalitis)