Arboviral Central Nervous System Infections

Arboviruses are transmitted to humans by the bites of infected arthropods, such as mosquitoes and ticks. While most arboviral infections are asymptomatic or result in a non-specific febrile illness, a small proportion cause neuroinvasive disease, presenting most often as meningitis, encephalitis, or myelitis. Some viruses also can cause immune-mediated neurologic complications, such as Guillain-Barre syndrome. Certain viruses and patient characteristics, particularly age and immunosuppression, can lead to greater risk of neuroinvasive disease. The major domestic neurotropic arboviruses are classified in the families Flaviviridae, Peribunyaviridae, and Togaviridae. There are no proven treatments for or licensed vaccines to prevent infections with the domestic arboviruses, and treatment is supportive. Human vaccines are available for a limited number of international neurotropic arboviruses. Prevention of arboviral infection primarily involves using personal protective measures to avoid exposure to the arthropod vectors.