title: Emerging Causes of Arbovirus Encephalitis in North America: Powassan, Chikungunya, and Zika Viruses.
abstract: Arboviruses are arthropod-borne viruses transmitted by the bite of mosquitoes, ticks, or other arthropods. Arboviruses are a common and an increasing cause of human illness in North America. Powassan virus, Chikungunya virus, and Zika virus are arboviruses that have all recently emerged as increasing causes of neurologic illness. Powassan virus almost exclusively causes encephalitis, but cases are rare, sporadic, and restricted to portions of North America and Russia. Chikungunya virus has spread widely across the world, causing millions of infections. Encephalitis is a rare manifestation of illness but is more common and severe in neonates and older adults. Zika virus has recently spread through much of the Americas and has been associated mostly with microcephaly and other congenital neurologic complications. Encephalitis occurring in infected adults has also been recently reported. This review will discuss the neuropathogenesis of these viruses, their transmission and geographic distribution, the spectrum of their neurologic manifestations, and the appropriate method of diagnosis.
authors.affiliation: Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.|Division of Neurological Infections and Inflammatory Diseases, Department of Neurology, Brigham and Women's Hospital, 45 Francis Street, Boston, MA, 02115, USA.|Harvard Medical School, Boston, MA, USA.
authors.forename: Christopher T
authors.initials: CT
authors.lastname: Doughty
authors.affiliation: Harvard Medical School, Boston, MA, USA.|Division of Infectious Disease, Department of Internal Medicine, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: Sigal
authors.initials: S
authors.lastname: Yawetz
authors.affiliation: Division of Neurological Infections and Inflammatory Diseases, Department of Neurology, Brigham and Women's Hospital, 45 Francis Street, Boston, MA, 02115, USA. jlyons5@partners.org.|Harvard Medical School, Boston, MA, USA. jlyons5@partners.org.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Lyons
mesh_terms: D000818:Animals; D065632:Chikungunya Fever / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy / Q000635:transmission; D004199:Disease Vectors; D004675:Encephalitis, Tick-Borne / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy / Q000635:transmission; D006801:Humans; D009656:North America / Q000453:epidemiology; D000071243:Zika Virus Infection / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy / Q000635:transmission
keywords: Arboviruses; Chikungunya virus; Encephalitis; Powassan virus; Zika virus