Epidemiology of neuroinvasive arboviral disease in the United States, 1999-2007

Carolyn A. Reimann, Edward B. Hayes, Carolyn DiGuiseppi, Richard Hoffman, Jennifer A. Lehman, Nicole P. Lindsey, Grant L. Campbell, Marc Fischer*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

121 Scopus citations


From 1999-2007, the most common causes of neuroinvasive arboviral disease in the United States, after West Nile virus (WNV), were California (CAL) serogroup viruses, St. Louis encephalitis virus (SLEV), and eastern equine encephalitis virus (EEEV). The CAL serogroup virus disease was primarily reported from Appalachia and the upper Midwest, SLEV disease from southern states, and EEEV disease from areas along the Atlantic and Gulf coasts. Children accounted for 88% of CAL serogroup virus disease, whereas 75% of SLEV disease occurred among older adults. The EEEV disease had the highest case-fatality rate (42%). The incidence of CAL serogroup virus and EEEV disease remained stable before and after the detection of WNV in the United States in 1999. The SLEV disease declined 3-fold after 1999; however, SLEV disease has occurred in sporadic epidemics that make trends difficult to interpret. The CAL serogroup virus, SLEV, and EEEV disease are persistent public health concerns in the United States warranting ongoing prevention efforts.

Original languageEnglish
Pages (from-to)974-979
Number of pages6
JournalAmerican Journal of Tropical Medicine and Hygiene
Issue number6
StatePublished - Dec 2008
Externally publishedYes


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