{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T06:00:02Z","timestamp":1792130402684,"version":"4.4.0"},"reference-count":32,"publisher":"North Carolina Institute of Medicine","issue":"4","license":[{"start":{"date-parts":[[2024,6,5]],"date-time":"2024-06-05T00:00:00Z","timestamp":1717545600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec id=\"background\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>La Crosse virus neuroinvasive disease (LACVND) is the most common cause of arboviral encephalitis in children within the United States; in North Carolina, it is the most prevalent endemic mosquito-borne disease in humans.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Here we report a surveillance summary of confirmed and probable LACVND during 2000\u20132020 using North Carolina Electronic Disease Surveillance System data, and we describe associated demographic characteristics, spatiotemporal distribution, clinical features, and mortality rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 355 cases (74.9% confirmed) were reported from 41 North Carolina counties; most cases (92%) occurred in 19 Western North Carolina counties. An average of 17 cases were reported annually with the majority (94%) of cases occurring between mid-June and early October (epiweeks 25\u201341). The median case age was nine years (range: 1\u201395 years), 79% were aged \u2264 18 years, and 56.6% were male. Cases commonly presented with headache (95.4%), fever (95.1%), and altered mental status (80.8%); encephalitis (82.0%) and meningitis (45.9%) were frequently diagnosed. Encephalitis was more common in children (87%) than adults (62%) (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001). Similarly, seizures were more common in children (54%) than adults (27%) (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .01). The case fatality rate was 1.4%; however, differences in age-specific rates were observed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"limitations\">\n                    <jats:title>Limitations<\/jats:title>\n                    <jats:p>Changes in case definitions and reporting requirements, missing data, different reporting sources, and the retrospective nature of this study are all important limitations of our study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"conclusion\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Given the persistent endemicity of La Crosse virus in Western North Carolina, clinicians and public health providers should consider La Crosse virus disease in all individuals, especially children, with compatible symptoms and a travel history to endemic counties. Prevention measures and educational outreach\/public health messaging should focus on caregivers and children in Western North Carolina counties and during times when transmission risk is higher (i.e., summer and early fall).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.18043\/001c.118585","type":"journal-article","created":{"date-parts":[[2024,6,5]],"date-time":"2024-06-05T11:34:01Z","timestamp":1717587241000},"source":"Crossref","is-referenced-by-count":4,"title":["Endemic La Crosse Virus Neuroinvasive Disease in North Carolina Residents: 2000\u20132020"],"prefix":"10.18043","volume":"85","author":[{"given":"Joseph","family":"Davis","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/010h78f45","id-type":"ROR","asserted-by":"publisher"}],"name":"Western Carolina University","department":["Mosquito and Vector-borne Infectious Disease Laboratory"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chelsea","family":"Atkins","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01vx35703","id-type":"ROR","asserted-by":"publisher"}],"name":"East Carolina University","department":["Department of Public Health"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Doyle","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/034t5cp02","id-type":"ROR","asserted-by":"publisher"}],"name":"North Carolina Division of Public Health","department":["Communicable Disease Branch, Epidemiology Section"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carl","family":"Williams","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/034t5cp02","id-type":"ROR","asserted-by":"publisher"}],"name":"North Carolina Division of Public Health","department":["Communicable Disease Branch, Epidemiology Section"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ross","family":"Boyce","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/0130frc33","id-type":"ROR","asserted-by":"publisher"}],"name":"University of North Carolina at Chapel Hill","department":["School of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Byrd","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/010h78f45","id-type":"ROR","asserted-by":"publisher"}],"name":"Western Carolina University","department":["School of Health Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"7507","published-online":{"date-parts":[[2024,6,5]]},"reference":[{"issue":"39","key":"ref1","doi-asserted-by":"publisher","first-page":"1104","DOI":"10.15585\/mmwr.mm6739a8","article-title":"Notes from the field: Spatially associated coincident and noncoincident cases of La Crosse encephalitis - North Carolina, 2002\u20132017","volume":"67","author":"B. 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Pantuwatana","year":"1972","journal-title":"Am J Trop Med Hyg"},{"issue":"4117","key":"ref32","doi-asserted-by":"publisher","first-page":"1140","DOI":"10.1126\/science.182.4117.1140","article-title":"Transovarial transmission of LaCrosse virus (California encephalitis group) in the mosquito, Aedes triseriatus","volume":"182","author":"D. M. Watts","year":"1973","journal-title":"Science"}],"container-title":["North Carolina Medical Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ncmedicaljournal.com\/article\/118585-endemic-la-crosse-virus-neuroinvasive-disease-in-north-carolina-residents-2000-2020","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T20:12:37Z","timestamp":1780603957000},"score":1,"resource":{"primary":{"URL":"https:\/\/ncmedicaljournal.com\/article\/118585-endemic-la-crosse-virus-neuroinvasive-disease-in-north-carolina-residents-2000-2020"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,5]]},"references-count":32,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024]]}},"URL":"https:\/\/doi.org\/10.18043\/001c.118585","relation":{},"ISSN":["2379-4313","0029-2559"],"issn-type":[{"value":"2379-4313","type":"electronic"},{"value":"0029-2559","type":"print"}],"subject":[],"published":{"date-parts":[[2024,6,5]]}}}