Video:Eastern equine encephalitis

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Description

Eastern equine encephalitis, commonly called Triple E, is a disease caused by a zoonotic mosquito vectored Togavirus that is present in North, Central, and South America, as well as the Caribbean. EEE was first recognized in Massachusetts, United States.[1]In the evaluation a biopsy of the cerebral spinal fluid is taken, and it is sent to a specialized laboratory for testing.[2]No cure for EEE has been found.[3]

Presentation

Symptoms can include high fever, muscle pain, altered mental status, headache, meningeal irritation, and photophobia, which occur 3 to 10 days after the bite of an infected mosquito.[4]

Complications

As to the complications exhibited by the affected individual we find the following: seizures, paralysis, intellectual disability and behavioral changes.[4]

Cause

Alphavirus is a genus of RNA viruses, the sole genus in the Togaviridae family. Alphaviruses belong to group 4 of the Baltimore classification of viruses, with a positive-sense, single-stranded RNA genome. There are 32 alphaviruses, which infect various vertebrates such as humans.[5]

Mechanism

Transmission of EEEV to mammals (including humans) occurs via certain mosquito species, which feed on the blood of both birds and mammals. These other mosquitoes are referred to as "bridge vectors" because they carry the virus from the avian hosts to other types of hosts, particularly mammals. The bridge vectors include Aedes taeniorhynchus , Aedes vexans, Coquillettidia perturbans, Ochlerotatus canadensis, and Ochlerotatus sollicitans. Ochlerotatus canadensis also frequently bites turtles.[6][7][8][9]

Diagnosis

In terms of the evaluation of EEE we find the following is done: PCR analysis (blood or CSF), MRI or immunoassay.[4]

Differential diagnosis

As to the differential diagnosis of EEE we find the following: Measles, Mumps, Echovirus and Creutzfeldt–Jakob disease.[4]

Treatment

No cure for EEE currently exists. Treatment consists of corticosteroids, anticonvulsants, and supportive measures [3] such as intravenous fluids, tracheal intubation, and antipyretics.

Epidemiology 1

Several states in the Northeast U.S. have had increased virus activity since 2004. Between 2004 and 2006, at least ten human cases of EEE were reported in Massachusetts. In 2006, about half a million acres in southeastern Massachusetts were treated with mosquito adulticides to reduce the risk of humans contracting EEE. Several human cases were reported in New Hampshire, as well.[10][11]

Epidemiology 2

On September 2019, a notable uptick in cases erupted in New England and Michigan, prompting some health departments to declare an outbreak.[12][13][14][15] As of 31 October 2019, five people died in Michigan,[16][17] three people died in Connecticut,[18] one person died in Rhode Island,[15] one person died in Alabama,[19] one person died in Indiana,[20] and three people died in Massachusetts.[21][22][23] The virus was also found in goats,[24] in turkeys,[25] in deer,[25] and in horses.[17][26][15][25]As of September 9, 2020, there were 5 confirmed human cases between Massachusetts and Wisconsin.[27]

History

Eastern equine encephalitis was first isolated and identified in 1933 by Giltner and Shahan. The virus was first recognized in horses in 1831 in Massachusetts.[28]

References

  1. ↑ "Eastern Equine Encephalomyelitis" (PDF). United States Department of Agriculture Animal and Plant Health Inspection Service. United States Department of Agriculture (USDA). Archived from the original (PDF) on 3 February 2017. Retrieved 1 May 2017.
  2. ↑ Deresiewicz RL, Thaler SJ, Hsu L, Zamani AA (1997). "Clinical and neuroradiographic manifestations of eastern equine encephalitis". N. Engl. J. Med. 336 (26): 1867–74. doi:10.1056/NEJM199706263362604. PMID 9197215.
  3. ↑ 3.0 3.1 "Eastern Equine Encephalitis". Centers for Disease Control and Prevention (CDC). 16 August 2010. Archived from the original on 10 March 2020. Retrieved 7 August 2012.
  4. ↑ 4.0 4.1 4.2 4.3 Banda, Cecilia; Samanta, Debopam (2025). "Eastern Equine Encephalitis". StatPearls. StatPearls Publishing. Retrieved 25 January 2025.
  5. ↑ Elrefaey AM, Abdelnabi R, Rosales Rosas AL, Wang L, Basu S, Delang L (2020-08-31). "Understanding the Mechanisms Underlying Host Restriction of Insect-Specific Viruses". Viruses. 12 (9): 964. doi:10.3390/v12090964. PMC 7552076. PMID 32878245.
  6. ↑ Kelser, R.A. (1937). "Transmission of the Virus of Equine Encephalomy-elîtis by Aëdes taeniorhynchus". Science (Washington). 85–2198 (2198): 178. Bibcode:1937Sci....85..178K. doi:10.1126/science.85.2198.178. PMID 17732932. Archived from the original on 15 April 2020. Retrieved 26 September 2022 – via cabdirect.org.
  7. ↑ "Eastern Equine Encephalitis (EEE) – Epidemiology". Virginia.gov. Retrieved 15 January 2025.
  8. ↑ Corrin, Tricia; Ackford, Rachel; Mascarenhas, Mariola; Greig, Judy; Waddell, Lisa A. (1 May 2021). "Eastern Equine Encephalitis Virus: A Scoping Review of the Global Evidence". Vector-Borne and Zoonotic Diseases. 21 (5): 305–320. doi:10.1089/vbz.2020.2671. ISSN 1530-3667. PMC 8086401. PMID 33332203.
  9. ↑ Armstrong, Philip M.; Andreadis, Theodore G. (December 2010). "Eastern Equine Encephalitis Virus in Mosquitoes and Their Role as Bridge Vectors". Emerging Infectious Diseases. 16 (12): 1869–1874. doi:10.3201/eid1612.100640. ISSN 1080-6040. PMC 3294553. PMID 21122215.
  10. ↑ Zheng Y (16 August 2008). "Mosquito-borne virus infects 2d in Mass". The Boston Globe. Archived from the original on 3 March 2016. Retrieved 26 September 2022.
  11. ↑ Zheng Y (31 August 2006). "Middleborough boy with EEE dies". The Boston Globe. Archived from the original on 2 September 2006. Retrieved 31 August 2006.
  12. ↑ Seltz J (13 August 2019). "It's code red for EEE in nine communities south of Boston". The Boston Globe. Archived from the original on 15 August 2019. Retrieved 22 August 2019.
  13. ↑ Congi S (13 August 2019). "Massachusetts man infected with EEE now in coma, family says". WCVB-TV. Archived from the original on 23 August 2019. Retrieved 22 August 2019.
  14. ↑ LaPook J (21 September 2019). "7 dead from rare disease spread by mosquitoes". CBS News. Archived from the original on 21 September 2019. Retrieved 2019-09-21.
  15. ↑ 15.0 15.1 15.2 Almasy S (2 October 2019). "Connecticut Eastern equine encephalitis death is 10th nationwide". CNN. Archived from the original on 14 November 2019. Retrieved 14 November 2019.
  16. ↑ Miller K (2019-10-02). "Fourth person dies from mosquito-borne illness in Michigan". mlive. Archived from the original on 17 August 2022. Retrieved 2019-10-03.
  17. ↑ 17.0 17.1 Mahieu D (15 October 2019). "Fifth person in Michigan dies from Eastern Equine Encephalitis". UpNorthLive. Archived from the original on 14 November 2019. Retrieved 14 November 2019.
  18. ↑ Cuda A (1 September 2019). "Third person in state dies from EEE". Connecticut Post. Archived from the original on 17 October 2019. Retrieved 16 October 2019.
  19. ↑ Gore L (28 October 2019). "Mosquito-borne virus kills 1 in Alabama: What to know about EEE". al. Archived from the original on 14 November 2019. Retrieved 14 November 2019.
  20. ↑ "1st Eastern Equine Encephalitis Human Death Reported in Indiana". News18. 20 October 2019. Archived from the original on 14 November 2019. Retrieved 14 November 2019.
  21. ↑ Klein A (26 September 2019). "Mass. Health Officials Say 12th Person Has EEE, 1 Fewer Death". NBC10 Boston. Archived from the original on 14 November 2019. Retrieved 14 November 2019.
  22. ↑ Pescaro M, Klein A (25 September 2019). "UPDATE: Mass. Health Officials Give New Info on EEE-Related Deaths". NBC10 Boston. Archived from the original on 14 November 2019. Retrieved 14 November 2019.
  23. ↑ "Mass. retracts number of EEE deaths; confirms 12th human case of virus". The Boston Globe. 26 September 2019. Archived from the original on 14 November 2019. Retrieved 14 November 2019.
  24. ↑ Anderson DJ (17 August 2019). "A 2nd Person In Mass. Is Diagnosed With Mosquito-Linked EEE Disease". WBUR-FM. Archived from the original on 23 August 2019. Retrieved 22 August 2019.
  25. ↑ 25.0 25.1 25.2 "Pennsylvania Game Commission advises hunters to take precautions against EEE virus". Pittsburgh Tribune-Review. 22 October 2019. Archived from the original on 14 November 2019. Retrieved 14 November 2019.
  26. ↑ Mulder J (1 October 2019). "Eastern equine encephalitis kills another horse in Oswego County". syracuse. Archived from the original on 14 November 2019. Retrieved 14 November 2019.
  27. ↑ "Michiganders urged to stay indoors as officials race to stop the spread of a dangerous mosquito-borne disease". CNN. 17 September 2020. Archived from the original on 9 December 2021. Retrieved 2020-10-26.
  28. ↑ Armstrong, Philip M; Andreadis, Theodore G (1 January 2022). "Ecology and Epidemiology of Eastern Equine Encephalitis Virus in the Northeastern United States: An Historical Perspective". Journal of Medical Entomology. 59 (1): 1–13. doi:10.1093/jme/tjab077. ISSN 0022-2585. PMID 34734628. Archived from the original on 8 October 2024. Retrieved 10 January 2025.
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