Jamestown Canyon encephalitis

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Jamestown Canyon encephalitis
Specialty Infectious disease

Jamestown Canyon encephalitis is an infectious disease caused by the Jamestown Canyon virus, an orthobunyavirus of the California serogroup. It is mainly spread during the summer by different mosquito species in the United States and Canada.

Contents

The virus is one of a group of mosquito-borne or arthropod-borne viruses, also called arboviruses, that can cause fever and meningitis or meningoencephalitis, mostly in adults. Jamestown Canyon virus disease is relatively rare; in the United States, the CDC found only 31 disease cases from 2000 to 2013, but it is likely under-recognized and probably endemic throughout most of the United States and parts of Canada.

Signs and symptoms

About 2 days to 2 weeks after the bite of an infected mosquito, disease symptoms of a nonspecific summertime illness with sore throat, runny nose and cough, followed by fever, headache, nausea and vomiting can develop. Many cases are asymptomatic, although the ratio of symptomatic to asymptomatic cases is unknown. [1] Neuroinvasive disease occurs in two thirds of reported cases and is characterized by severe headache and neck stiffness as in meningitis or increasing lethargy and altered mental status up to coma as in meningoencephalitis. Roughly half of reported cases are hospitalized, but deaths from the virus are rare. [1] No acquisition from a blood transfusion has been reported. [2]

Virology

Jamestown Canyon orthobunyavirus
Virus classification OOjs UI icon edit-ltr.svg
(unranked): Virus
Realm: Riboviria
Kingdom: Orthornavirae
Phylum: Negarnaviricota
Class: Ellioviricetes
Order: Bunyavirales
Family: Peribunyaviridae
Genus: Orthobunyavirus
Species:
Jamestown Canyon orthobunyavirus

The Jamestown Canyon virus is an orthobunyavirus and was first isolated in 1961 from Culiseta mosquitoes in Jamestown, Colorado. Since then it has been found in Aedes , Coquillettidia perturbans , Culex , Culiseta and Ochlerotatus species in northern states of the mainland US, in various mammals throughout mainland North America, and identified in humans throughout the United States. [3] [4]

Lifecycle

The virus is transmitted in saliva to a vertebrate host when an infected mosquito takes a blood meal. It thus cycles between mosquito and vertebrate amplifier hosts, mainly white-tailed deer. In a study from Newfoundland, JCV was significantly associated with large mammals such as sheep, cattle and horses. In Michigan and Ontario moose and bison are believed to be the primary reservoir. [5]

The virus winters in mosquito eggs, which it reaches by transovarial transmission. The female mosquito lays eggs that carry the virus, and the offspring can transmit the virus to deer or ruminants and humans. Infected mosquitoes were found equally distributed throughout the state of Connecticut, irrespective of land use. [6]

Molecular biology

The full genome has been sequenced. The authors found a relatively high level of amino acid sequence conservation from viruses isolated 57 years apart "indicating that the virus is in relative evolutionary stasis". They also found JCV to be genetically similar to Ingå virus in Northern Europe (Finland, Sweden), "suggesting that much of the northern hemisphere contains JCV or similar variants". [7] The negative sense RNA genome is in three segments. The L segment encodes the L endonuclease (an RNA-dependent RNA polymerase enzyme) for genome replication and mRNA synthesis. The M segment encodes a polyprotein, further cleaved in the Gn and Gc surface glycoproteins for attachment and the NSm nonstructural protein that influences virulence. The S segment encodes the NSs protein for immune suppression and virulence, and the N structural nucleocapsid protein. [8]

Diagnosis

The Centers for Disease Control and Prevention considers a person with JCV infection laboratory-confirmed if: JCV isolated from or JCV-specific antigen or genomic sequences detected in tissue, blood, cerebrospinal fluid, or other body fluids; 2) equal or more than 4-fold change in JCV-specific neutralizing antibody titers between acute and convalescent samples; or 3) JCV or LACV IgM antibodies in serum with JCV-specific neutralizing antibodies equal or more than 4-fold higher than LACV-specific neutralizing antibody titers in the same specimen or a later specimen. [3]

JCV-antibody testing has only been available at the CDC and the New York State Department of Health. The CDC has used plaque reduction neutralization tests to detect JCV neutralizing antibodies since 1995. The test is automatically done on all samples testing positive or equivocal for La Crosse Virus IgM antibodies by ELISA. In 2010 CDC developed an ELISA also for JCV IgM . Similarly, the New York State Department of Health has performed JCV plaque reduction neutralization tests since 2000 on samples positive for California serogroup IgG antibodies. It does the latter by an immunofluorescence assay. [3] Prior to the 1990s, the only tests for California serogroup virus infections performed by most state diagnostic laboratories were complement-fixation test and hemagglutination inhibition tests with La Crosse virus, but these failed to detect antibody to Jamestown Canyon virus. [9]

Differential diagnosis

Besides La Crosse virus, other arboviruses producing similar disease in a similar geographic location include first and foremost West Nile virus, Powassan virus, Eastern equine encephalitis virus, Saint Louis encephalitis and Western equine encephalitis virus, the latter two not being reportable to CDC. For 2013, CDC reported that of 22 JCV disease cases, 15 (68%) were neuroinvasive, which is a slightly higher percentage than for West Nile virus (51%), but less common than for the other arboviruses, with La Crosse virus being 91%, Eastern equine encephalitis virus 100% and Powassan virus 80% neuroinvasive. [2]

Treatment and prevention

No specific therapy exists for arboviral infections; treatment is limited to supportive care and managing complications, such as relieving increased intracranial pressure. Preventing and decreasing the morbidity from JCV disease depends on control of the mosquito vectors and personal protection to reduce mosquito bites. [2]

The NIAID reported in 2012, that it had constructed a candidate virus for a live attenuated virus vaccine. [10]

Epidemiology

Since 2004, the disease must be reported to CDC (passive surveillance, ArboNET). [3] JCV has been mostly reported in adults rather than in children (median age 48 years versus 8 years), and is more likely to cause meningitis than encephalitis compared to illness caused by La Crosse virus. [3] It also occurs throughout the summer (May until September), [3] or even throughout the year [2] rather than mostly in August, which may be due to the diversity of mosquitoes it can infect. [5]

Increasing awareness and more testing

In the latest US review covering 2000–2013, more than half of cases were identified in 2013 alone, the first year the CDC implemented routine JCV IgM antibody testing. [3]

Geography

Historically, most cases of encephalitis reported to the CDC occurred in the north of the mainland United States. JCV disease most likely has a broader distribution, but is unidentified and under-reported, because testing is not considered and not straightforward. [3] In 2013, of 10 states reporting cases, eight states reported their first JCV cases: Georgia, Idaho, Massachusetts, Minnesota, New Hampshire, Oregon, Pennsylvania, and Rhode Island. [2] In August 2015, the Iowa Department of Public Health confirmed one case of JCV. [11] In July 2017, the Maine Center for Disease Control announced what is believed to be Maine's first known case. [12]

Season

Historically disease was reported to occur from late spring through early fall. [3] However, for 2013, dates of illness onset ranged from January through November, with 14 (64%) of the 22 cases occurring during July until September. [2]

Related Research Articles

<span class="mw-page-title-main">West Nile fever</span> Human disease caused by West Nile virus infection

West Nile fever is an infection by the West Nile virus, which is typically spread by mosquitoes. In about 80% of infections people have few or no symptoms. About 20% of people develop a fever, headache, vomiting, or a rash. In less than 1% of people, encephalitis or meningitis occurs, with associated neck stiffness, confusion, or seizures. Recovery may take weeks to months. The risk of death among those in whom the nervous system is affected is about 10 percent.

<span class="mw-page-title-main">Arbovirus</span> Common name for several species of virus

Arbovirus is an informal name for any virus that is transmitted by arthropod vectors. The term arbovirus is a portmanteau word. Tibovirus is sometimes used to more specifically describe viruses transmitted by ticks, a superorder within the arthropods. Arboviruses can affect both animals and plants. In humans, symptoms of arbovirus infection generally occur 3–15 days after exposure to the virus and last three or four days. The most common clinical features of infection are fever, headache, and malaise, but encephalitis and viral hemorrhagic fever may also occur.

La Crosse encephalitis is an encephalitis caused by an arbovirus which has a mosquito vector.

<i>Bunyavirales</i> Order of RNA viruses

Bunyavirales is an order of segmented negative-strand RNA viruses with mainly tripartite genomes. Member viruses infect arthropods, plants, protozoans, and vertebrates. It is the only order in the class Ellioviricetes. The name Bunyavirales derives from Bunyamwera, where the original type species Bunyamwera orthobunyavirus was first discovered. Ellioviricetes is named in honor of late virologist Richard M. Elliott for his early work on bunyaviruses.

<span class="mw-page-title-main">Japanese encephalitis</span> Infection of the brain caused by the Japanese encephalitis virus

Japanese encephalitis (JE) is an infection of the brain caused by the Japanese encephalitis virus (JEV). While most infections result in little or no symptoms, occasional inflammation of the brain occurs. In these cases, symptoms may include headache, vomiting, fever, confusion and seizures. This occurs about 5 to 15 days after infection.

<span class="mw-page-title-main">Oropouche fever</span> Medical condition

Oropouche fever is a tropical viral infection transmitted by biting midges and mosquitoes from the blood of sloths to humans. This disease is named after the region where it was first discovered and isolated at the Trinidad Regional Virus Laboratory in 1955 by the Oropouche River in Trinidad and Tobago. Oropouche fever is caused by a specific arbovirus, the Oropouche virus (OROV), of the Bunyaviridae family.

<i>Alphavirus</i> Genus of viruses

Alphavirus is a genus of RNA viruses, the sole genus in the Togaviridae family. Alphaviruses belong to group IV of the Baltimore classification of viruses, with a positive-sense, single-stranded RNA genome. There are 32 alphaviruses, which infect various vertebrates such as humans, rodents, fish, birds, and larger mammals such as horses, as well as invertebrates. Alphaviruses that could infect both vertebrates and arthropods are referred dual-host alphaviruses, while insect-specific alphaviruses such as Eilat virus and Yada yada virus are restricted to their competent arthropod vector. Transmission between species and individuals occurs mainly via mosquitoes, making the alphaviruses a member of the collection of arboviruses – or arthropod-borne viruses. Alphavirus particles are enveloped, have a 70 nm diameter, tend to be spherical, and have a 40 nm isometric nucleocapsid.

California encephalitis orthobunyavirus type strain California encephalitis virus was discovered in Kern County, California, and causes encephalitis in humans. Encephalitis is an acute inflammation of the brain that can cause minor symptoms, such as headaches, to more severe symptoms such as seizures. Mosquitoes serve as its carrier and for this reason this virus is known as an arbovirus.

<span class="mw-page-title-main">Viral encephalitis</span> Medical condition

Viral encephalitis is inflammation of the brain parenchyma, called encephalitis, by a virus. The different forms of viral encephalitis are called viral encephalitides. It is the most common type of encephalitis and often occurs with viral meningitis. Encephalitic viruses first cause infection and replicate outside of the central nervous system (CNS), most reaching the CNS through the circulatory system and a minority from nerve endings toward the CNS. Once in the brain, the virus and the host's inflammatory response disrupt neural function, leading to illness and complications, many of which frequently are neurological in nature, such as impaired motor skills and altered behavior.

Powassan virus (POWV) is a Flavivirus transmitted by ticks, found in North America and in the Russian Far East. It is named after the town of Powassan, Ontario, where it was identified in a young boy who eventually died from it. It can cause encephalitis, an infection of the brain. No approved vaccine or antiviral drug exists. Prevention of tick bites is the best precaution.

<i>Orthobunyavirus</i> Genus of viruses

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<span class="mw-page-title-main">Mosquito-borne disease</span> Diseases caused by bacteria, viruses or parasites transmitted by mosquitoes

Mosquito-borne diseases or mosquito-borne illnesses are diseases caused by bacteria, viruses or parasites transmitted by mosquitoes. Nearly 700 million people get a mosquito-borne illness each year resulting in over 725,000 deaths.

<i>Zika virus</i> Species of flavivirus

Zika virus is a member of the virus family Flaviviridae. It is spread by daytime-active Aedes mosquitoes, such as A. aegypti and A. albopictus. Its name comes from the Ziika Forest of Uganda, where the virus was first isolated in 1947. Zika virus shares a genus with the dengue, yellow fever, Japanese encephalitis, and West Nile viruses. Since the 1950s, it has been known to occur within a narrow equatorial belt from Africa to Asia. From 2007 to 2016, the virus spread eastward, across the Pacific Ocean to the Americas, leading to the 2015–2016 Zika virus epidemic.

Mayaro virus disease is a mosquito-borne zoonotic pathogen endemic to certain humid forests of tropical South America. Infection with Mayaro virus causes an acute, self-limited dengue-like illness of 3–5 days' duration. The causative virus, abbreviated MAYV, is in the family Togaviridae, and genus Alphavirus. It is closely related to other alphaviruses that produce a dengue-like illness accompanied by long-lasting arthralgia. It is only known to circulate in tropical South America.

<i>Usutu virus</i> Species of virus

Usutu virus (USUV) is a flavivirus belonging to the Japanese encephalitis complex, which is an emerging zoonotic arbovirus of concern because of its pathogenicity to humans and its similarity in ecology with other emerging arboviruses such as West Nile virus. It mainly infects Culex mosquitoes and birds; humans form a dead-end host. First identified in South Africa in 1959, the virus has caused outbreaks in birds across Europe since 1996. Nearly 50 cases in humans have been reported as of 2019, mainly in Europe. These are predominantly asymptomatic, but some people experience neurological symptoms.

Tahyna orthobunyavirus ("TAHV") is a viral pathogen of humans classified in the California encephalitis virus (CEV) serogroup of the Orthobunyavirus family in the order Bunyavirales, which is endemic to Europe, Asia, Africa and possibly China.

Cache Valley orthobunyavirus (CVV) is a member of the order Bunyavirales, genus Orthobunyavirus, and serogroup Bunyamwera, which was first isolated in 1956 from Culiseta inornata mosquitos collected in Utah's Cache Valley. CVV is an enveloped arbovirus, nominally 80–120 nm in diameter, whose genome is composed of three single-stranded, negative-sense RNA segments. The large segment of related bunyaviruses is approximately 6800 bases in length and encodes a probable viral polymerase. The middle CVV segment has a 4463-nucleotide sequence and the smallest segment encodes for the nucleocapsid, and a second non-structural protein. CVV has been known to cause outbreaks of spontaneous abortion and congenital malformations in ruminants such as sheep and cattle. CVV rarely infects humans, but when they are infected it has caused encephalitis and multiorgan failure.

Tensaw orthobunyavirus is a virus in the genus Orthobunyavirus of the Bunyamwera arbovirus group, order Bunyavirales. It is named for the river bordering the area in south Alabama where the prototype strain was discovered. It is abbreviated TEN, TENV, and TSV in the scientific literature.

<i>West Nile virus</i> Species of flavivirus causing West Nile fever

West Nile virus (WNV) is a single-stranded RNA virus that causes West Nile fever. It is a member of the family Flaviviridae, from the genus Flavivirus, which also contains the Zika virus, dengue virus, and yellow fever virus. The virus is primarily transmitted by mosquitoes, mostly species of Culex. The primary hosts of WNV are birds, so that the virus remains within a "bird–mosquito–bird" transmission cycle. The virus is genetically related to the Japanese encephalitis family of viruses. Humans and horses both exhibit disease symptoms from the virus, and symptoms rarely occur in other animals.

Maguari orthobunyavirus, abbreviated MAGV, is a negative-sense, single-stranded RNA virus in the Bunyavirales order, genus Orthobunyavirus, Bunyamwera serogroup, that has been shown to be capable of causing human disease. MAGV is related to Cache Valley virus and Tensaw virus.

References

  1. 1 2 "Jamestown Canyon virus - Information for Healthcare Providers". CDC. Retrieved 7 August 2021.
  2. 1 2 3 4 5 6 Lindsey NP, Lehman JA, Staples JE, Fischer M (20 June 2014). Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC. "West nile virus and other arboviral diseases – United States, 2013". Morbidity and Mortality Weekly Report. 63 (24): 521–526. PMC   5779373 . PMID   24941331.
  3. 1 2 3 4 5 6 7 8 9 Pastula DM, Hoang Johnson DK, White JL, Dupuis AP 2nd, Fischer M, Staples JE (5 August 2015). "Jamestown Canyon Virus Disease in the United States—2000–2013". Am J Trop Med Hyg. 93 (2): 384–9. doi:10.4269/ajtmh.15-0196. PMC   4530766 . PMID   26033022.
  4. Kinsella CM, Paras ML, Smole S, Mehta S, Ganesh V, Chen LH, McQuillen DP, Shah R, Chan J, Osborne M, Hennigan S, Halpern-Smith F, Brown CM, Sabeti P, Piantadosi A (December 2020). "Jamestown Canyon virus in Massachusetts: clinical case series and vector screening". Emerg Microbes Infect. 9 (1): 903–912. doi:10.1080/22221751.2020.1756697. PMC   7273174 . PMID   32302268.
  5. 1 2 Goff G, Whitney H, Drebot MA (2012). "Roles of host species, geographic separation, and isolation in the seroprevalence of Jamestown Canyon and snowshoe hare viruses in Newfoundland". Appl. Environ. Microbiol. 78 (18): 6734–40. Bibcode:2012ApEnM..78.6734G. doi:10.1128/AEM.01351-12. PMC   3426688 . PMID   22798366.
  6. Andreadis TG, Anderson JF, Armstrong PM, Main AJ (2008). "Isolations of Jamestown Canyon virus (Bunyaviridae: Orthobunyavirus) from field-collected mosquitoes (Diptera: Culicidae) in Connecticut, USA: a ten-year analysis, 1997–2006". Vector Borne Zoonotic Dis. 8 (2): 175–88. doi:10.1089/vbz.2007.0169. PMID   18386967.
  7. Bennett RS, Nelson JT, Gresko AK, Murphy BR, Whitehead SS (2011). "The full genome sequence of three strains of Jamestown Canyon virus and their pathogenesis in mice or monkeys". Virol. J. 8: 136. doi: 10.1186/1743-422X-8-136 . PMC   3076256 . PMID   21435230.
  8. Liu D, Austin FW. "California Group Seroviruses". In Liu D (ed.). Molecular Detection of Human Viral Pathogens. CRC Press, Boca Raton, FL. pp. 609–610.
  9. Grimstad PR, Calisher CH, Harroff RN, Wentworth BB (1986). "Jamestown Canyon virus (California serogroup) is the etiologic agent of widespread infection in Michigan humans". The American Journal of Tropical Medicine and Hygiene. 35 (2): 376–386. doi:10.4269/ajtmh.1986.35.376. PMID   3953951.
  10. Bennett RS, Gresko AK, Nelson JT, Murphy BR, Whitehead SS (2012). "A recombinant chimeric La Crosse virus expressing the surface glycoproteins of Jamestown Canyon virus is immunogenic and protective against challenge with either parental virus in mice or monkeys". J. Virol. 86 (1): 420–6. doi:10.1128/JVI.02327-10. PMC   3255902 . PMID   22013033.
  11. "Late Summer Mosquitoes Still Carry West Nile Threat". IDPH News. Iowa Department of Public Health. 27 August 2015. Archived from the original on 5 September 2015. Retrieved 1 September 2015.
  12. St. Amour, Madeline (13 July 2017). "Maine CDC: Rare mosquito virus reported in Kennebec County". CentralMaine.com. Retrieved 15 July 2017.

Further reading