Many arboviruses cause a systemic illness similar to a flu-like infection. A small number of infections progress to neurologic disease that can range from encephalitis to meningitis (see Table 2).
These diseases are spread by mosquitoes and ticks. They tend to occur during warm weather months. They include California encephalitis, Chikungunya, dengue, Eastern equine encephalitis, Powassan, and West Nile viruses.
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A fever is one of the most common symptoms of an Arbovirus infection. It may be mild, or it can be severe, depending on the virus and how the body is fighting it. Mild cases often cause a low fever, headache, muscle and joint pain, nausea, vomiting, or a rash. Severe infections are marked by a rapid onset, high fever, confusion, tremors, paralysis, coma or death.
Viral encephalitis, an inflammation of the brain, is another symptom of some types of Arboviruses. This can occur due to direct viral invasion of the brain or because of immune-mediated destruction of neurons. Either way, this condition can be serious, and it is more likely to develop in older adults, infants, or people who have underlying health problems.
A nucleic acid amplification test can be used to detect the presence of an Arbovirus in the blood, especially if a person has recently traveled to a region where that particular virus is endemic. This test can detect a current infection before antibodies to the virus are developed, and it can also be useful in determining which type of vaccine is most appropriate for someone with a specific disease.
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Diarrhea is when you have loose and watery stools. It can also make you need to go to the bathroom more often. This is usually a sign that you have an infection, such as a virus. Kids who have diarrhea should drink extra fluids to stay hydrated. If you have severe diarrhea, you may need to be treated at the hospital with IV fluids (given into a vein).
The viruses that cause encephalitis are usually passed on to people by ticks and mosquitoes. They are most common in rural areas. Some of the most common arboviruses that cause encephalitis include Japanese encephalitis, tick-borne encephalitis, Venezuelan encephalitis, and yellow fever.
These infections usually happen during warm weather when mosquitoes are most active. Symptoms of the disease can range from mild to severe. Some of the symptoms include a high fever, headache, body aches, and a rash. Some people get a serious illness, including meningoencephalitis, which can lead to seizures and a coma. People who are infected with some of the arboviruses that can cause encephalitis also have a condition called Guillain-Barre syndrome, which is when your immune system attacks your nervous system.
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Joint pain is an Arbovirus symptom that affects the knees, elbows, wrists, ankles and feet. The pain may be mild or severe. In the most serious cases, it is accompanied by fever, headache and body aches. Some viruses, such as chikungunya, can also cause polyarthralgia — pain in more than one joint. The pain can linger for months after infection.
Most people recover without treatment. However, if the virus causes a more severe infection, it can lead to encephalitis or meningitis. In these cases, symptoms include a sudden onset of fever and headache, stiff neck, confusion, tremors or altered mental status, limb weakness and sometimes coma or death.
Typically, doctors treat the underlying condition to relieve the pain and other symptoms. Medicines like acetaminophen (Tylenol) or nonsteroidal anti-inflammatory drugs can help reduce the pain and fever. They might recommend steroid injections into the affected joints or platelet-rich plasma (PRP) to improve recovery. Doctors can also recommend lifestyle changes or physical therapy.
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Itching is a common symptom of arbovirus infections and is often the reason people seek medical help. The itching can last for a long time and may be intense. It also can become a vicious cycle because the more you scratch, the more itchy your skin becomes.
Most people get infected with arboviruses when a mosquito, tick or sand fly bites them and spreads the virus. Some diseases, such as dengue, chikungunya, powassan, St. Louis encephalitis, West Nile, yellow fever, and Zika are spread this way. Other ways people can get infected with arboviruses include blood transfusion, organ transplantation and from mother to child during pregnancy or birth.
Most people who get the dengue, chikungunya, and powassan viruses will only experience mild illness with a fever, rash, joint pain, and itching. However, people who are infected with Zika can experience more severe symptoms, including a high fever, headache, body aches, nausea and vomiting and a coma. People who have these symptoms after traveling to areas where the Zika virus is endemic need to see a doctor right away.
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Depending on the infection, a rash may be mild or severe. It often starts at the face, chest and back and spreads downward. It may be fine and like sandpaper (typical of scarlet fever), circular with a central depression (typical of molluscum contagiosum) or plaques with silver scales (typical of psoriasis). It is important to note that the rash in CHIKV and ZIKV infections can cause itching and inflammation of the eye (conjunctivitis).
Some arboviral diseases cause meningitis. These symptoms include fever, headache and stiff neck. The cerebrospinal fluid may show lymphocytic pleocytosis, unlike typical aseptic meningitis.
Health care providers should maintain a high index of suspicion for arboviral encephalitis in travelers returning from areas where the diseases are endemic. Travelers should use insect repellent and wear long-sleeved shirts and pants, especially when outdoors. They should avoid standing water and empty and clean containers where mosquitoes breed. They should also take care to remove or empty cisterns, rain barrels, cesspools, tires, tin cans, fire pits and trash containers that may harbor mosquitoes. They should use screens on doors and windows.