110 - Mending the Safety Net, Willing Hands at Work: An Assessment of La Crosse Virus Prevention, Detection, and Response Capacity in Western North Carolina Health Departments

Wednesday, March 25, 2026

9:30 AM - 9:40 AM PDT

Location: B119

Presenter(s)

Michael S. Ratliff, MPH (he/him/his)

Program Coordinator
Western Carolina University, North Carolina, United States

Co-Author(s)

ST

Sarah Thach, MPH

Co-Director | Concentration lead | Assistant professor
UNC Asheville – UNC Gillings Master of Public Health Program, North Carolina, United States
AL

Amy Lanou, PhD

Director North Carolina Institute for Public Health
UNC Asheville – UNC Gillings Master of Public Health Program, North Carolina, United States
CW

Carl Williams, DVM, DACVPM

State Public Health Veterinarian
North Carolina Department of Health and Human Services, North Carolina, United States
Brian Byrd, PhD, MSPH

Professor
Western Carolina University, North Carolina, United States

Abstract: La Crosse encephalitis (LACE), caused by La Crosse virus (LACV), remains the leading cause of pediatric arboviral encephalitis in the United States. Despite endemic transmission in Western North Carolina (WNC), regional mosquito-borne disease (MBD) control capacity is not well characterized.

An electronic survey was distributed to communicable disease nurses (CDNs), registered environmental health specialists (REHS), and health directors across 10 WNC health departments with the highest reported incidence of LACE. The instrument assessed MBD knowledge, surveillance, and control capacity according to respondents’ professional public health job role. All 10 local health departments responded, with 46 participants (16 CDNs, 23 REHS, 8 health directors; overall response rate: 36.7%). Only one department (10%) met national standards designating it as “fully capable” having both core and supplemental capacities as previously defined by CDC/NACCHO. Furthermore, respondents identified gaps in understanding of LACE case definitions, serologic interpretation, environmental and behavioral risk factors, and vector control resources. While most recognized the importance of MBD prevention, perceived response capacity varied by professional role. While the sample size, moderate response rate, and use of self-reported data may influence generalizability, the findings provide valuable insight into local capacity in WNC.

This study provides a foundational assessment of MBD preparedness in a LACE endemic region of WNC. Results indicate the need for enhanced education, resources, and a coordinated regional framework to strengthen prevention against, detection of, and response to LACV and other mosquito-borne threats.