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Viral meningitis and encephalitis: traditional and emerging viral agents
José R Romero1, Jason G Newland
1Combined Division of Pediatric Infectious Diseases, Associate Professor of Pediatrics, Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE 68178, USA. jrromero@unmc.edu
Abstract:
In the United States, the annual number of central nervous system (CNS) infections that occur as a result of viral agents far exceeds that of infections caused by bacteria, yeast, molds, and protozoa combined. The recent incursion of West Nile virus (WNV) into North America has led to a dramatic change in the incidence and epidemiology of summer-associated viral CNS disease. As a result of increased testing for WNV, lesser known viral causes of CNS infection have been identified. Even the epidemiology of such traditional viral neuropathogens as rabies has changed in recent years. This review provides an overview of viruses traditionally associated with meningitis and encephalitis (enteroviruses, La Crosse virus, St. Louis encephalitis virus, eastern and western equine viruses, varicella-zoster virus), as well as several of the less common (Powassan virus, lymphocytic choriomeningitis virus, Colorado tick fever virus, rabies virus, influenza viruses, etc.) and emerging (West Nile virus) viral pathogens.
Insights
Viral central nervous system (CNS) infections are more common than other causes in the US. The emergence of West Nile virus (WNV) has impacted CNS disease epidemiology, leading to identification of various viral pathogens.
Area of Science:
- Neurology
- Infectious Diseases
- Virology
Background:
- Viral central nervous system (CNS) infections are more prevalent than bacterial, fungal, or protozoal infections in the United States.
- The introduction of West Nile virus (WNV) has significantly altered the landscape of viral CNS diseases, particularly during summer months.
- Increased WNV surveillance has also led to the identification of other less common viral etiologies of CNS infections.
Purpose of the Study:
- To provide a comprehensive overview of viral pathogens causing meningitis and encephalitis.
- To discuss both traditional and emerging viral agents responsible for CNS infections.
- To highlight the changing epidemiology of viral neuropathogens, including rabies.
Main Methods:
- Literature review of viral meningitis and encephalitis.
- Analysis of epidemiological data for CNS viral infections.
- Synthesis of information on traditional, less common, and emerging viral pathogens.
Main Results:
- Viruses are the leading cause of CNS infections in the US.
- West Nile virus (WNV) has become a significant emerging pathogen.
- Traditional pathogens like enteroviruses and arboviruses remain important, with changing epidemiology.
- Less common viruses such as Powassan virus and lymphocytic choriomeningitis virus are also discussed.
Conclusions:
- Viral infections represent the predominant cause of CNS infections in the US.
- The epidemiology of viral CNS diseases is dynamic, influenced by emerging pathogens like WNV.
- Understanding the spectrum of viral pathogens is crucial for diagnosis and management of meningitis and encephalitis.