{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T06:00:15Z","timestamp":1792130415147,"version":"4.4.0"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2022,5,24]],"date-time":"2022-05-24T00:00:00Z","timestamp":1653350400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100011500","name":"Research Institute Nationwide Children\u2019s Hospital","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100011500","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000071","name":"National Institute of Child Health and Human Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000071","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["T32HD094671"],"award-info":[{"award-number":["T32HD094671"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,2,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>La Crosse virus (LACV) is the most common neuroinvasive arboviral infection in children in the United States. However, data regarding predictors of disease severity and neurologic outcome are limited. Additionally, long-term neurologic and neurobehavioral outcomes remain relatively sparse.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This was a single-center, retrospective cohort study, followed by recruitment for a cross-sectional analysis of long-term neurobehavioral outcomes, among children aged 0\u201318 years with proven or probable LACV neuroinvasive disease (LACV-ND) between January 2009 and December 2018. Case ascertainment was assured by International Classification of Diseases, Ninth and Tenth Revision, Clinical Modification codes cross-referenced with laboratory results detecting LACV. Demographics, diagnostics, radiographs, and outcomes were evaluated. Recruitment of patients with prior diagnosis of LACV-ND occurred from January 2020 to March 2020, with assessment performed by validated pediatric questionnaires.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>One-hundred fifty-two children (83 males; median age, 8 years [interquartile range, 5\u201311.5 years]) were diagnosed with proven (n = 61 [47%]) and probable (n = 91 [60%]) LACV-ND. Sixty-five patients (43%) had severe disease. Altered mental status (AMS) (odds ratio [OR], 6.36 [95% confidence interval {CI}, 2.03\u201319.95]; P = .0002) and seizures at presentation (OR, 10.31 [95% CI, 3.45\u201330.86]; P = .0001) were independent predictors of severe disease. Epileptiform discharges on electroencephalogram (EEG) were independently associated with epilepsy diagnosis at follow-up (OR, 13.45 [95% CI, 1.4\u2013128.77]; P = .024). Fifty-four patients were recruited for long-term neurobehavioral follow-up, with frequent abnormal assessments identified (19%\u201354%) irrespective of disease severity.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Severe disease was observed frequently among children with LACV-ND. Seizures and AMS at presentation were independent predictors of severe disease. EEG may help determine long-term epilepsy risk. Long-term neurobehavioral issues are frequent and likely underrecognized among children with LACV-ND.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciac403","type":"journal-article","created":{"date-parts":[[2022,5,24]],"date-time":"2022-05-24T06:36:51Z","timestamp":1653374211000},"page":"e1114-e1122","source":"Crossref","is-referenced-by-count":34,"title":["La Crosse Virus Neuroinvasive Disease in Children: A Contemporary Analysis of Clinical\/Neurobehavioral Outcomes and Predictors of Disease Severity"],"prefix":"10.1093","volume":"76","author":[{"given":"Angelique E","family":"Boutzoukas","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Duke University , Durham, North Carolina , USA"},{"name":"Duke Clinical Research Institute , Durham, North Carolina , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel A","family":"Freedman","sequence":"additional","affiliation":[{"name":"Department of Neurology, Dell Medical School , Austin, Texas , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Koterba","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Nationwide Children\u2019s Hospital and The Ohio State University , Columbus, Ohio , USA"},{"name":"Division of Psychology and Neuropsychology, Nationwide Children's Hospital , Columbus, OH , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Garrett W","family":"Hunt","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Nationwide Children\u2019s Hospital and The Ohio State University , Columbus, Ohio , USA"},{"name":"Division of Infectious Diseases, Nationwide Children's Hospital , Columbus, OH , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathy","family":"Mack","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Nationwide Children\u2019s Hospital and The Ohio State University , Columbus, Ohio , USA"},{"name":"Division of Laboratory Medicine, Nationwide Children's Hospital , Columbus, OH , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Cass","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Nationwide Children\u2019s Hospital and The Ohio State University , Columbus, Ohio , USA"},{"name":"Division of Psychology and Neuropsychology, Nationwide Children's Hospital , Columbus, OH , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vedat O","family":"Yildiz","sequence":"additional","affiliation":[{"name":"Center for Biostatistics, Department of Biomedical Informatics, The Ohio State University College of Medicine , Columbus, Ohio , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"de los Reyes","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Nationwide Children\u2019s Hospital and The Ohio State University , Columbus, Ohio , USA"},{"name":"Division of Neurology, Nationwide Children's Hospital , Columbus, OH , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaime","family":"Twanow","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Nationwide Children\u2019s Hospital and The Ohio State University , Columbus, Ohio , USA"},{"name":"Division of Neurology, Nationwide Children's Hospital , Columbus, OH , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa G","family":"Chung","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Nationwide Children\u2019s Hospital and The Ohio State University , Columbus, Ohio , USA"},{"name":"Division of Neurology, Nationwide Children's Hospital , Columbus, OH , USA"},{"name":"Division of Critical Care Medicine, Nationwide Children's Hospital , Columbus, OH , 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