What is the role of arboviruses in the etiology of aseptic meningitis?

Updated: Jul 17, 2018
  • Author: Tarakad S Ramachandran, MBBS, MBA, MPH, FAAN, FACP, FAHA, FRCP, FRCPC, FRS, LRCP, MRCP, MRCS; Chief Editor: Niranjan N Singh, MBBS, MD, DM, FAHS, FAANEM  more...
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Answer

Aseptic meningitis from arboviruses follows geographic and seasonal patterns determined by the life cycle of arthropod vectors, animal reservoirs, and their contact with human subjects. Eastern equine encephalitis virus (EEEV) usually is observed in Atlantic and Gulf regions, whereas western equine encephalitis virus (WEEV) is prevalent in the western part of the United States. WEEV is responsible for more aseptic meningitis cases than EEEV.

Approximately 15% of St Louis encephalitis virus (SLEV) infections result in meningitis. In children, this incidence is as high as 60%. SLEV infection can occur in both rural and urban areas. In the rural setting, the infection from SLEV tends to follow the same pattern as WEEV infection. Conversely, in urban settings, outbreaks tend to be more explosive.

Approximately 18% of people infected with Colorado tick fever develop meningitis. This disease primarily occurs in the Rocky Mountain region, which is the habitat of Dermacentor andersoni ticks whose bite transmits the virus.

Infection with Venezuelan equine encephalitis virus initially leads to influenza-like illness in most people. Only 3% of infected persons are known to develop acute meningitis. This virus has spread into Florida and some southwestern states. LCMV, an arenavirus, is an extremely rare cause of meningitis. Transmission of LCMV infection occurs by contact with dust or food contaminated by excreta of rodents. Cases tend to be more common in the winter. Human infections have been seen in both laboratory and home settings.


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