Eastern equine encephalitis

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Eastern equine encephalitis virus (EEEV) was first isolated in 1933 from horses in Virginia and New Jersey. It has a positive-strand RNA genome. When transmitted to man it causes Eastern equine encephalitis with a case-fatality rate estimated in the range of 50–70%.[1]

Contents

Epidemiology

Complex due to the number of known host species and vectors. However preferential hosts are birds such as northern cardinals (Cardinalis cardinalis) and particular vector mosquitos such as Culiseta melanura in Florida[2].

Human illness

  • 4–10 day incubation period
  • Sudden onset fever
  • Symptoms include:
    • Muscle pains
    • Increasing headache
  • Progression in over half cases to
    • Encephalitis and vasculitis
    • Vomiting
    • Respiratory symptoms
    • Leucocytosis
    • Haematuria
    • Seizures and coma

Imaging

Changes basal ganglia and thalamus consistent with cerebral oedema, ischaemia and hypoperfusion early progressing to necrosis and cerebral haemorrhage.

Diagnosis

  • IgM in serum and CSF
  • PCR

References