Abstract
Studies have suggested that enzootic strains of Venezuelan equine encephalitis (VEE) subtype ID in the Amazon region, Peru, may be less pathogenic to humans than are epizootic variants. Deaths of 2 persons with evidence of acute VEE virus infection indicate that fatal VEEV infection in Peru is likely. Cases may remain underreported.
Highlights
Studies have suggested that enzootic strains of Venezuelan equine encephalitis (VEE) subtype ID in the Amazon region, Peru, may be less pathogenic to humans than are epizootic variants
We recently described a severe infection in a 3-yearold boy who had VEE virus (VEEV) subtype ID [14]
VEEV subtype ID infection (Panama/Peru genotype) was confirmed. Because her viremia titer was similar to titers of other patients who did not have neurologic complications and survived VEEV infection, viremia levels alone may not account for the difference in disease outcome
Summary
Author affiliations: Naval Medical Research Center Detachment, Lima, Peru Yurimaguas with fever, dehydration, stupor, and signs of respiratory distress along with tonic–clonic seizures. Later that day the patient was considered to have a complicated, febrile, neurologic illness, and a blood sample was sent for advanced analysis at the NMRCD in Lima, Peru, and the National Institute of Health of Peru. On June 21, seizures persisted, and the patient became comatose and later died of respiratory arrest. Examination of the girl’s serum in Vero cells identified VEEV, and sequencing and phylogenetic analyses using previously described methods further identified it as subtype ID Panama/Peru genotype (Figure 2) [15]. On the day the serum was collected (1 day after onset of signs), viremia titer was 1.8 ×104 PFU/mL, similar to titers from other VEEV-infected study patients who did not have neurologic complications (Table 2). Blood and cerebrospinal fluid cultures for bacteria were not attempted
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