Socioeconomic impacts of La Crosse encephalitis in western North Carolina
Grant
Overview
abstract
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La Crosse virus (LACV, family Peribunyaviridae, genus Orthobunyavirus) is the leading cause of arboviral pediatric encephalitis (neuroinvasive LACV disease; NLACVD) in the United States (US) and is endemic in western North Carolina (WNC). Major goals of this project include a) Assess acute and persistent medical, social, and cognitive LACVD/NLACVD impacts; b) Determine and quantify economic hardship in LACVD/NLACVD survivors & families; c) Assess environmental risk factors at LACVD/NLACVD case residences.
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The mosquito-borne pathogen La Crosse virus (LACV) is the most common cause of arboviral pediatric encephalitis in the United States. North Carolina (NC) bears a disproportionate burden of La Crosse encephalitis (LACE), with 23% of 1,281 cases reported from 2003-2019 nationally. Most cases occur in rural western NC (WNC) where vectors are commonly found peridomestically. The economic wellbeing of rural counties is low; with most classified as Tier 1 (most distressed) or 2, contributing to disparities in risk awareness, poor adherence to personal protection, and limited clinical recognition without severe disease. This is exacerbated by inadequate public health interventions, including lack of surveillance and control. Children are most likely to experience neuroinvasive La Crosse virus disease (NLACVD), characterized by meningitis/encephalitis or other acute central/peripheral neurologic dysfunction. NLACVD may result in long-term neurological sequelae and developmental delay. Thus, while the number of cases is relatively low, the cumulative lifetime SE burden is substantial. Little is known about the incidence/manifestations and risk factors for post-NLACVD sequelae, let alone interventions to reduce risk. We will determine clinical/developmental/SE impact of LACE in survivors and families in WNC. LACE's SE impact is significant and community education (risk/prevention/treatment/recovery resources) is needed.
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