Recommendations Regarding Interventions to Increase Appropriate Vaccination — Community Preventive Services Task Force
Authors: Nicole Lindsey, Jennifer Lehman, ; Staples, Marc Fischer, Thomas Frieden, Harold Jaffe, Joanne Cono, Chesley Richards, Michael Iademarco, Sonja Rasmussen, Charlotte Kent, Jacqueline Gindler, Acting Editor, Teresa Rutledge, Douglas Weatherwax, Teresa Hood, Jude Rutledge, Martha Boyd, Maureen Leahy, Julia Martinroe, Stephen Spriggs, Brian Wood, Quang Doan, Phyllis King, Teresa Moreland, Terraye Starr, Timothy Jones, Matthew Boulton, Ann Arbor, Virginia Mi, Jonathan Caine, Los Fielding, David Angeles, William Fleming, King Halperin, Rima Khabbaz, Patricia Quinlisk, Patrick Remington, William Roper, William Schaffner, Jennifer Liang
Journal: MMWR Morbidity and Mortality Weekly Report (2015)

Arthropod-borne viruses (arboviruses) are transmitted to humans primarily through the bites of infected mosquitoes and ticks.West Nile virus (WNV) is the leading cause of domestically acquired arboviral disease in the United States (1).However, several other arboviruses also cause sporadic cases and seasonal outbreaks.This report summarizes surveillance data reported to CDC in 2014 for WNV and other nationally notifiable arboviruses, excluding dengue.Forty-two states and the District of Columbia (DC) reported 2,205 cases of WNV disease.Of these, 1,347 (61%) were classified as WNV neuroinvasive disease (e.g., meningitis, encephalitis, or acute flaccid paralysis), for a national incidence of 0.42 cases per 100,000 population.After WNV, the next most commonly reported cause of arboviral disease was La Crosse virus (80 cases), followed by Jamestown Canyon virus (11), St. Louis encephalitis virus (10), Powassan virus (8), and Eastern equine encephalitis virus (8).WNV and other arboviruses cause serious illness in substantial numbers of persons each year.Maintaining surveillance programs is important to help direct prevention activities.In the United States, most arboviruses are maintained in transmission cycles between arthropods and vertebrate hosts (typically birds or small mammals).Humans usually become infected when bitten by infected mosquitoes or ticks.Personto-person transmission also occurs rarely through blood transfusion and organ transplantation.The majority of human arboviral infections are asymptomatic.Symptomatic infections most often manifest as a systemic febrile illness and, less commonly, as neuroinvasive disease.Most endemic arboviral diseases are nationally notifiable and are reported to CDC through ArboNET, a national arboviral surveillance system managed by CDC and state health departments (2,3).Using standard definitions, human cases with laboratory evidence of recent arboviral infection are classified as neuroinvasive disease or nonneuroinvasive disease (2).Cases reported as encephalitis, meningitis, or acute flaccid paralysis are collectively referred to as neuroinvasive disease; others are considered nonneuroinvasive disease.Acute flaccid paralysis can occur with or without encephalitis or meningitis.In this report, any case reported as acute flaccid paralysis (with or without another clinical syndrome) was classified as acute flaccid paralysis and not included in the other categories.Because of the substantial associated morbidity, detection and reporting of neuroinvasive disease cases is assumed to be more consistent and complete than that of nonneuroinvasive disease cases.Therefore, incidence rates were calculated for neuroinvasive disease cases using U.S. Census 2014 mid-year population estimates.