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Cited by 130Mosquito-borne diseases and controlViral Infections and VectorsInfectious Encephalopathies and Encephalitis

Eastern equine encephalitis in Latin America

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Carrera, Jean-Paul, Forrester, Naomi, Wang, Eryu, Vittor, Amy Y., Haddow, Andrew D., López-Vergès, Sandra, Abadía, Ivan, Castaño, Elizabeth +12 more·2013·New England Journal of Medicine
DOI 10.1056/nejmoa1212628PMC PMC3839813
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Abstract

BACKGROUND: The eastern equine encephalitis (EEE) and Venezuelan equine encephalitis (VEE) viruses are pathogens that infect humans and horses in the Americas. Outbreaks of neurologic disease in humans and horses were reported in Panama from May through early August 2010. METHODS: We performed antibody assays and tests to detect viral RNA and isolate the viruses in serum samples from hospitalized patients. Additional cases were identified with enhanced surveillance. RESULTS: A total of 19 patients were hospitalized for encephalitis. Among them, 7 had confirmed EEE, 3 had VEE, and 1 was infected with both viruses; 3 patients died, 1 of whom had confirmed VEE. The clinical findings for patients with EEE included brain lesions, seizures that evolved to status epilepticus, and neurologic sequelae. An additional 99 suspected or probable cases of alphavirus infection were detected during active surveillance. In total, 13 cases were confirmed as EEE, along with 11 cases of VEE and 1 case of dual infection. A total of 50 cases in horses were confirmed as EEE and 8 as VEE; mixed etiologic factors were associated with 11 cases in horses. Phylogenetic analyses of isolates from 2 cases of equine infection with the EEE virus and 1 case of human infection with the VEE virus indicated that the viruses were of enzootic lineages previously identified in Panama rather than new introductions. CONCLUSIONS: Cases of EEE in humans in Latin America may be the result of ecologic changes that increased human contact with enzootic transmission cycles, genetic changes in EEE viral strains that resulted in increased human virulence, or an altered host range. (Funded by the National Institutes of Health and the Secretaría Nacional de Ciencia, Tecnología e Innovación, Panama.).

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  • Among the enduring neurological consequences experienced by VEEV survivors, symptoms such as paralysis, sensory impairments, headaches, fatigue, depression, seizures, neuropsychological alterations, and changes in mental status have been most frequently reported.

    “Among the enduring neurological consequences experienced by VEEV survivors, symptoms such as paralysis, sensory impairments, headaches, fatigue, depression, seizures, neuropsychological alterations, and changes in mental status have been most frequently reported (Bowen et al., 1976; Carrera et al., 2013; Rivas et al., 1997).”

    From Arbovirus infection increases the risk for the development of neurodegenerative disease pathology in the murine model (2024) · cites this paper as Carrera et al., 2013

    The Results (Initial Human Cases of Viral Encephalitis; page unavailable) report seizures, hemiparesis and psychomotor retardation as sequelae at discharge, but identify the patients with reported sequelae as having EEE, including one dual EEE–VEE infection. The paper does not establish these as enduring or frequently reported consequences among VEEV survivors, or report the other listed symptoms as such. (LLM, conf=0.85)

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References 29 · Cited by 130

Research works printed but not linked: 25

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Authors
Carrera, J.-P., Forrester, N., Wang, E., Vittor, A. Y., Haddow, A. D., López-Vergès, S., Abadía, I., Castaño, E., Sosa, N., Báez, C., Estripeaut, D., Díaz, Y., Beltrán, D., Cisneros, J., Cedeño, H. G., Travassos da Rosa, A. P., Hernandez, H., Martínez-Torres, A. O., Tesh, R. B., & Weaver, S. C.
Affiliations
  • Universidad de Panamá (PA)
  • The University of Texas Medical Branch at Galveston (US)
  • Instituto Nacional de Salud del Niño (PE)
  • Ministry of Health of the Russian Federation (RU)
ORCID
Venue
New England Journal of Medicine
Publisher
Massachusetts Medical Society
Published
2013-08-22
Volume
369
Issue
8
Pages
732-744
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
DOI
10.1056/nejmoa1212628
PMC
PMC3839813
OpenAlex
W2136137139
Cited by
130
References
29
Citations by year
2026: 9 · 2025: 11 · 2024: 12 · 2023: 9 · 2022: 13 · 2021: 8 · 2020: 16 · 2019: 8 · 2018: 10 · 2017: 9 · 2016: 6 · 2015: 10 · 2014: 7 · 2013: 2
FWCI
8.52
Type
journal article
Language
en
Open access
Locations
  • New England Journal of Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • Secretaría Nacional de Ciencia, Tecnología e Innovación
  • National Institutes of Health
  • U.S. Public Health Service (HHSN27200004/DO4, HHSN27220100004OI)
  • National Institute of Allergy and Infectious Diseases (HHSN272201000040C, HHSN272201000040I, U54AI057156)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Mosquito-borne diseases and control
  • Health Sciences › Medicine › Infectious Diseases › Viral Infections and Vectors
  • Health Sciences › Medicine › Infectious Diseases › Infectious Encephalopathies and Encephalitis
Keywords
eastern equine encephalitis, Venezuelan equine encephalitis, alphavirus, encephalitis outbreak, horses, human encephalitis, enzootic transmission, viral phylogeny, status epilepticus, Latin America, zoonotic transmission
MeSH terms
Adolescent, Animals, Antibodies, Viral, Child, Child, Preschool, Disease Outbreaks, Encephalitis Virus, Eastern Equine, Encephalitis Virus, Venezuelan Equine, Encephalomyelitis, Venezuelan Equine, Female, Horse Diseases, Horses, Humans, Infant, Male, Panama, Phylogeny, RNA, Viral, Fatal Outcome, Encephalomyelitis, Eastern Equine

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