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Published Date: 2018-10-08 10:33:47
Subject: PRO/AH/EDR> La Crosse encephalitis - USA (02): (OH)
Archive Number: 20181008.6077031
LA CROSSE ENCEPHALITIS - USA (02): (OHIO)
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Date: Sun 7 Oct 2019 2:53 PM
Source: IndeOnline [edited]
https://www.indeonline.com/news/20181007/stark-family-warns-of-dangerous-mosquito-virus-after-rare-diagnosis


During her career as an emergency room nurse at Aultman Hospital [Canton, Ohio] she has taken care of many sick kids. But when her youngest son fell seriously ill, she was unable to help.

That's because the 7-year-old was stricken with La Crosse encephalitis, a rare and dangerous virus that's on the increase.

She said it started on 27 Aug [2018] after her son played soccer. "On [Wed 29 Aug 2018], he woke up with a headache," she said. "I checked him for a fever and took him to school. The teacher sent me an email later saying he had a fever."

The mom gave him Children's Tylenol and Children's Motrin. After school, the boy went to his father's house, where he spent the night. The next morning his fever had reached 104.2 deg F [40.1 deg C]. The mother came over and gave him more Tylenol and Motrin. "I thought it was just an early flu or back-to-school germs," she said. "There was noting out of the ordinary," said the boy's dad. "We didn't have a reason to suspect anything."

But on 30 Aug [2018], after the mother picked up the boy, the fever returned. She decided to keep him home from school. Later, as went to check on him, she called his name, but he didn't respond. She thought he was just being a kid. "I came into his room and called him, but he was unresponsive," she said. "He was having a focal seizure."

The mother said when she turned her boy on his side, he vomited. She called 911 and he was transported to Aultman's emergency department.

Once there, the boy continued to suffer seizures. Dr Will Clark, suspecting more than the flu, ordered tests. Clark had the boy transported to Akron Children's Hospital's pediatric intensive care unit, where he eventually was diagnosed with La Crosse encephalitis.

"This has been a parent's worst nightmare, the things that have happened and the fears that we had," the woman said. "I am an emergency room nurse at Aultman and see awful things all the time. However, it is 100 percent different when it is your own child."

La Crosse encephalitis is caused by infected eastern treehole mosquitoes [_Aedes triseriatus_], which lay their eggs in the holes of trees and in containers. It has a 5-15-day incubation period, with most severe cases often found in children under 16.

The virus can cause seizures, and in some cases, coma and paralysis. It strikes boys 5-9 in particular, Gambs said. Though most patients recover, it can cause some cognitive and neuro-behavioral problems that require occupational therapy.

There is no cure for the virus, however, symptoms are treatable.

"This is not a typical mosquito," the boy's father said. "Ohio's the no. 1 state for these mosquitoes. They did tell us they're seeing an uptick."

According to the US Centers for Disease Control and Prevention, Ohio has seen 179 cases of La Crosse encephalitis between 2008 and 2017, followed by North Carolina, at 175 cases.

A report published by the Stark County Health Department's website confirms that the number of La Crosse encephalitis cases in Ohio is growing. So far, 10 have been reported this year [2018].

[Byline: Charita Goshay]

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Communicated by:
ProMED-mail
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[Because Aultman Hospital is located in Canton, Ohio, the boy presumably acquired his infection in the general Canton area.

As noted earlier, La Crosse encephalitis virus (LACV) is a member of the California serogroup of arboviruses. A map of the distribution of California virus serogroup neuroinvasive disease cases (mainly LACV cases) shows 3 major focal geographic areas: (1) in the unglaciated areas of south eastern Minnesota/south western Wisconsin/north western Illinois, (2) Ohio, where this case occurred, and (3) the central Appalachian Mountain areas of Virginia/West Virginia and North Carolina/Tennessee, (see the CDC map at http://www.cdc.gov/lac/tech/epi.html). Severe neurological cases occur, mainly in pre-school age children. They are seldom fatal, but prolonged hospitalization and sequelae including personality changes, may occur.

Cases may occur earlier in the summer season than other arthropod-borne viruses because the virus can be transovarially transmitted by the infected female to her eggs, so that emerging adults may already be infected and ready to transmit the virus without the need to take an infectious blood meal from an infected forest mammal. Eliminating fresh water catchments that are breeding sites of _Ochlerotatus (Aedes) triseriatus_, the La Crosse virus vector mosquito, is wise. The Asian tiger mosquito _Aedes albopictus_ can also transmit the virus.

The CDC has a good summary of LACV, its epidemiology, geographic distribution, and clinical characteristics at https://www.cdc.gov/lac/tech/epi.html.

An image of _O. (Aedes) triseriatus_ can be seen at http://phil.cdc.gov/phil/details.asp?pid=2166. - Mod.TY

HealthMap/ProMED map available at:
Canton, Ohio, United States: http://healthmap.org/promed/p/8384]

See Also

La Crosse encephalitis - USA: (NC) 20180812.5961195
2017
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La Crosse encephalitis - USA (05): (IN) 20171012.5374899
La Crosse encephalitis - USA (04): (TN) 20170907.5301633
La Crosse encephalitis - USA (03): (TN) 20170808.5237130
La Crosse encephalitis - USA (02): (OH) 20170727.5207810
La Crosse encephalitis - USA: (OH) 20170715.5177421
2016
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La Crosse encephalitis - USA: (NC) 20160816.4416493
2015
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La Crosse encephalitis - USA (02): (OH) 20150816.3581104
La Crosse encephalitis - USA: (NC) 20150806.3562446
2011
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La Crosse encephalitis - USA: (NC) 20110723.2222
2010
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La Crosse encephalitis - USA (02): (MN) 20100805.2643
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