Ohio Amish may be disproportionately at risk for La Crosse virus infection

La Crosse virus (LACV) causes the majority of pediatric arboviral encephalitis cases in the United States, with Ohio historically reporting the highest incidence of LACV neuroinvasive disease (LACV-ND). To identify county-level risk factors, we analyzed two decades (2003-2023) of Ohio surveillance data across all 88 counties using spatial statistical methods. Land-use correlation screening identified deciduous forest cover (ρ = 0.36, adjusted p = 0.006) and pasture/hay cover (ρ = 0.37, adjusted p = 0.004) as significant environmental correlates. However, Amish population share emerged as a substantially stronger predictor (ρ = 0.71, p