W. Va. Study Says La Crosse Encephalitis Under-Diagnosed

La Crosse is a mosquito-borne virus which has been found in most states east of the Mississippi River. It is especially prevalent in the region from Wisconsin to West Virginia and is most often found in hardwood forested areas because the trees support the life cycle of the "treehole mosquito."

"We advise physicians to consider diagnosing La Crosse when a child who is living in or traveled through mid-Atlantic or Midwestern states is diagnosed with meningoencephalitis in the summer or early fall," said Dr. James McJunkin, professor of pediatrics at WVU Charleston Division.

Pediatricians and staff at West Virginia University Charleston Division and Charleston Area Medical Center Women and Children's Hospital in Charleston, W. Va. cared for 128 patients- the largest single series of reported cases.

This is also the first study which includes experience with intracranial pressure monitoring and specific antiviral therapy. About half the children required treatment for seizures or coma, and more than half of the sample required intensive care. Three patients with severe brain swelling were managed with a pressure monitoring device inside the skull and with intravenous ribavirin, an antiviral drug approved for emergency use by the Food and Drug Administration.

Except for the first case in 1987, all patients survived their bouts with La Crosse. Researchers also concluded the virus can be diagnosed early using specific laboratory tests.

The WVU Charleston and CAMC team is continuing its study with a randomized clinical trial of intravenous ribavirin for severe cases of La Crosse infection. Dr. McJunkin and his colleagues have also actively worked with West Virginia public health officials and media representatives to alert parents to symptoms of the disease and supply facts about how to interrupt the breeding patterns of the disease-carrying pests.