Domestic arthropod-borne viruses (arboviruses) are single-stranded RNA viruses, the most common of which include the mosquito-borne West Nile virus, St. Louis encephalitis virus, La Crosse virus, Jamestown Canyon virus, and eastern equine encephalitis virus, as well as the tick-borne Powassan virus. Previously considered rare infections, they have been detected with increasing frequency over the past 2 decades. Here, we present an overview of the domestic arboviruses listed above and describe the modalities employed to diagnose infection. Global arboviruses, including dengue virus, Zika virus, and chikungunya virus, have also been increasingly detected in the United States within the last 5 years but are not a focus of this minireview. Typical manifestations of arbovirus infection range from no symptoms, to meningitis or encephalitis, to death. Serologies are the standard means of diagnosis in the laboratory, since most viruses have a short period of replication, limiting the utility of molecular tests. The interpretation of serologies is confounded by antibody cross-reactivity with viruses belonging to the same serogroup and by long-lasting antibodies from prior infections. Next-generation assays have improved performance by increasing antigen purity, selecting optimal epitopes, and improving interpretive algorithms, but challenges remain. Due to cross-reactivity, a positive first-line serology test requires confirmation by either a plaque reduction neutralization test or detection of seroconversion or a 4-fold rise in virus-specific IgM or IgG antibody titers from acute- and convalescent-phase sera. The use of molecular diagnostics, such as reverse transcription PCR or unbiased metagenomic sequencing, is limited to the minority of patients who present with ongoing viremia or central nervous system replication. With the continued expansion of vector range, the diagnosis of domestic arboviruses will become an increasingly important task for generalists and specialists alike.

中文翻译：

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在美国，虫媒病毒感染的诊断方法。

国内节肢动物传播的病毒（虫媒病毒）是单链RNA病毒，最常见的包括蚊子传播的西尼罗河病毒，圣路易斯脑炎病毒，拉克罗斯病毒，詹姆斯敦峡谷病毒和东部马脑炎病毒，例如以及the传播的Powassan病毒。以前被认为是罕见的感染，在过去的20年中，发现它们的频率越来越高。在这里，我们概述了上面列出的家用虫媒病毒，并描述了用于诊断感染的方式。在过去的5年中，全球登革热病毒，包括登革热病毒，寨卡病毒和基孔肯雅病毒，在美国也得到越来越多的检测，但并不是本综述的重点。虫媒病毒感染的典型表现范围从无症状到脑膜炎或脑炎再到死亡。血清学是实验室诊断的标准方法，因为大多数病毒的复制期很短，从而限制了分子检测的实用性。通过与属于同一血清群的病毒的抗体交叉反应性和来自先前感染的长效抗体，会混淆血清学的解释。下一代测定法通过提高抗原纯度，选择最佳表位和改进解释算法来提高性能，但挑战仍然存在。由于交叉反应，一线血清学阳性试验需要通过噬斑减少中和试验或血清转化或从急性期和恢复期血清中病毒特异性IgM或IgG抗体滴度升高4倍来确认。使用分子诊断，例如逆转录PCR或无偏基因组测序，仅限于少数出现病毒血症或中枢神经系统复制的患者。随着载体范围的不断扩大，对于普通人和专家而言，国产虫媒病毒的诊断将变得越来越重要。