From Bite to Brain: Arboviral Neuropathogenesis

Neuropathogenic arboviruses cause a substantial burden of human disease throughout the world. However, diagnosing and treating arboviral neurologic disease remains difficult, largely due to the similar clinical presentation of many neuropathogenic arboviruses, a lack of quick and specific diagnostic assays for many viruses, and limited knowledge about the molecular pathogenesis of these viruses. These limitations pose great challenges to the treatment of neuropathogenic arboviral disease. This is likely to become an even greater problem as the arthropod vectors for these viruses expand into new geographic regions due to climate change, possibly leading to new and larger outbreaks. This review summarizes current knowledge of the mechanisms of pathogenesis for the genetically diverse neuropathogenic arboviruses endemic to the United States, as well as their epidemiology, clinical presentations, and outcomes.