Clinical Information

California (La Crosse) virus is a member of the Bunyaviridae family, and it is one of the arthropod-borne encephalitides. It is transmitted by various Aedes and Culex mosquitoes and is found in such intermediate hosts as rabbits, squirrels, chipmunks, and field mice.

California meningoencephalitis is usually mild and occurs in late summer. Ninety percent of infections are seen in children and adolescents younger than 15 years, usually from rural areas. The incubation period is estimated to be 7 days, and acute illness lasts 10 days or less in most instances. Typically, the first symptoms are nonspecific, lasting 1 to 3 days, and are followed by the appearance of central nervous system (CNS) signs and symptoms, such as stiff neck, lethargy, and seizures, which usually abate within 1 week. Symptomatic infection is almost never recognized in those older than 18 years. The most important sequela of California virus encephalitis is epilepsy, which occurs in about 10% of children and almost always in patients who have had seizures during the acute illness. An estimated 2% of patients have persistent paresis. Learning disabilities or other objective cognitive deficits have been reported in a small proportion (<2%) of patients. Learning performance and behavior of most recovered patients are not distinguishable from comparison groups in these same areas.

Infections with arboviruses can occur at any age. The age distribution depends on the degree of exposure to the specific transmitting arthropod relating to age, sex, and occupational, vocational, and recreational habits of the individuals. Once humans have been infected, the severity of the host response may be influenced by age. Serious California (La Crosse) virus infections primarily involve children, especially boys. Men exposed to California viruses have high prevalence rates of antibody but usually show no serious illness. Infection among men is primarily due to working conditions and sports activities taking place where the vector is present.