11 The Arboviruses

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On a global scale, the public health danger posed by the arboviruses is massive. Probably no area in virology is as daunting for the practicing clinician as are the arboviruses. Much of the problem comes from the sheer number—now over 530 known arboviruses. Astrocytic infection without preceding endothelial infection is described in experimental studies of eastern equine encephalitis (EEE) virus (EEEV). One experimental study of the virus causing St. Louis encephalitis (SLE), in which low levels of viremia were produced in an effort to simulate conditions occurring in human infection, suggested that virus may gain access to the brain following preliminary invasion of and multiplication in olfactory neuroepithelium. Inflammation was similarly suppressed by cyclophosphamide, but without increasing mortality, in experimental infection with western equine encephalitis virus (WEEV) and EEEV, Sindbis virus, and Semliki Forest virus. During the acute disease, a peripheral leukocytosis has been noted in most patients, with neutrophils often predominating. Initial lumbar punctures were characterized by elevated cerebrospinal fluid (CSF) pressure, protein and white blood cells (WBC), with neutrophils again predominating. In the absence of a vaccine for SLE virus (SLEV), prevention depends on several factors, including sanitary management of water courses and sewage in urban settings. Provisional viral diagnosis during life depends on immunoglobulin M (IgM) capture enzyme-linked immunosorbent assay (ELISA) during acute illness or on elevations in other antibody titers.

Citation: Booss J, Esiri M. 2003. 11 The Arboviruses, p 163-189. In Viral Encephalitis in Humans. ASM Press, Washington, DC. doi: 10.1128/9781555817831.ch11
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Image of FIGURE 11.1

Section of the brain stem from a case of acute JE immunostained with an antibody to the virus. Immunostaining is seen in scattered neuronal cell bodies (arrows). Courtesy of T. Solomon.

Citation: Booss J, Esiri M. 2003. 11 The Arboviruses, p 163-189. In Viral Encephalitis in Humans. ASM Press, Washington, DC. doi: 10.1128/9781555817831.ch11
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Image of FIGURE 11.2

Low-power view of a section of cerebral cortex from a case of acute JE. Pale foci (arrows) represent foci of a cellular necrosis. PTAH stain.

Citation: Booss J, Esiri M. 2003. 11 The Arboviruses, p 163-189. In Viral Encephalitis in Humans. ASM Press, Washington, DC. doi: 10.1128/9781555817831.ch11
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Image of FIGURE 11.3

MRI of acute JE. Axial FLAIR image discloses hyperintensity of the basal ganglia bilaterally, right greater than left, with mild mass effect. Courtesy of Minh Dung and Bridget Wills, University of Oxford Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam.

Citation: Booss J, Esiri M. 2003. 11 The Arboviruses, p 163-189. In Viral Encephalitis in Humans. ASM Press, Washington, DC. doi: 10.1128/9781555817831.ch11
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TABLE 11.1

Taxonomic classification of the arboviruses discussed in this chapter

Citation: Booss J, Esiri M. 2003. 11 The Arboviruses, p 163-189. In Viral Encephalitis in Humans. ASM Press, Washington, DC. doi: 10.1128/9781555817831.ch11
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TABLE 11.2

Summary of pathological features in various forms of arbovirus encephalitis

Citation: Booss J, Esiri M. 2003. 11 The Arboviruses, p 163-189. In Viral Encephalitis in Humans. ASM Press, Washington, DC. doi: 10.1128/9781555817831.ch11
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TABLE 11.3

Epidemiologic features of EEE a

Citation: Booss J, Esiri M. 2003. 11 The Arboviruses, p 163-189. In Viral Encephalitis in Humans. ASM Press, Washington, DC. doi: 10.1128/9781555817831.ch11
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TABLE 11.4

Epidemiologic features of WEE a

Citation: Booss J, Esiri M. 2003. 11 The Arboviruses, p 163-189. In Viral Encephalitis in Humans. ASM Press, Washington, DC. doi: 10.1128/9781555817831.ch11
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TABLE 11.5

Epidemiologic features of VEE a

Citation: Booss J, Esiri M. 2003. 11 The Arboviruses, p 163-189. In Viral Encephalitis in Humans. ASM Press, Washington, DC. doi: 10.1128/9781555817831.ch11
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TABLE 11.6

Epidemiologic features of SLE a

Citation: Booss J, Esiri M. 2003. 11 The Arboviruses, p 163-189. In Viral Encephalitis in Humans. ASM Press, Washington, DC. doi: 10.1128/9781555817831.ch11
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TABLE 11.7

Epidemiologic features of WNVE a

Citation: Booss J, Esiri M. 2003. 11 The Arboviruses, p 163-189. In Viral Encephalitis in Humans. ASM Press, Washington, DC. doi: 10.1128/9781555817831.ch11
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TABLE 11.8

Epidemiologic features of MVE a

Citation: Booss J, Esiri M. 2003. 11 The Arboviruses, p 163-189. In Viral Encephalitis in Humans. ASM Press, Washington, DC. doi: 10.1128/9781555817831.ch11
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TABLE 11.9

Epidemiologic features of JE a

Citation: Booss J, Esiri M. 2003. 11 The Arboviruses, p 163-189. In Viral Encephalitis in Humans. ASM Press, Washington, DC. doi: 10.1128/9781555817831.ch11
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TABLE 11.10

Epidemiologic features of dengue fever and DHF, including DSS a

Citation: Booss J, Esiri M. 2003. 11 The Arboviruses, p 163-189. In Viral Encephalitis in Humans. ASM Press, Washington, DC. doi: 10.1128/9781555817831.ch11
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TABLE 11.11

Cerebral complications in dengue virus infection

Citation: Booss J, Esiri M. 2003. 11 The Arboviruses, p 163-189. In Viral Encephalitis in Humans. ASM Press, Washington, DC. doi: 10.1128/9781555817831.ch11
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TABLE 11.12

Endemic characteristics of La Crosse virus encephalitis of the Cal serogroup a

Citation: Booss J, Esiri M. 2003. 11 The Arboviruses, p 163-189. In Viral Encephalitis in Humans. ASM Press, Washington, DC. doi: 10.1128/9781555817831.ch11
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TABLE 11.13

Epidemiologic features of RFV a

Citation: Booss J, Esiri M. 2003. 11 The Arboviruses, p 163-189. In Viral Encephalitis in Humans. ASM Press, Washington, DC. doi: 10.1128/9781555817831.ch11
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TABLE 11.14

Epidemiologic features of TBE a

Citation: Booss J, Esiri M. 2003. 11 The Arboviruses, p 163-189. In Viral Encephalitis in Humans. ASM Press, Washington, DC. doi: 10.1128/9781555817831.ch11

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