Abstract
Venezuelan equine encephalitis (VEE) is a reemerging, mosquito-borne viral disease of the neotropics that is severely debilitating and sometimes fatal to humans. Periodic epidemics mediated by equine amplification have been recognized since the 1920s, but interepidemic disease is rarely recognized. We report here clinical findings and genetic characterization of 42 cases of endemic VEE detected in Panama from 1961–2004. Recent clusters of cases occurred in Darien (eastern Panama) and Panama provinces (central Panama) near rainforest and swamp habitats. Patients ranged from 10 months to 48 years of age, and the more severe cases with neurological complications, including one fatal infection, were observed in children. The VEE virus strains isolated from these cases all belonged to an enzootic, subtype ID lineage known to circulate among sylvatic vectors and rodent reservoir hosts in Panama and Peru. These findings underscore endemic VEE as an important but usually neglected arboviral disease of Latin America.
Highlights
Venezuelan equine encephalitis virus (VEEV) is the most important alphaviral (Togaviridae: Alphavirus) pathogen of humans and domestic animals in the western hemisphere [1,2]
To further characterize human disease caused by enzootic VEEV, we studied 42 cases of VEEV infection characterized by virus isolation, some accompanied by neurological disease, detected in Panama from 1961–2004
Venezuelan equine encephalitis (VEE) is a mosquito-borne viral disease that has caused major epidemics in many parts of Latin America and has even spread into Texas on one occasion. These epidemics result from spillover to humans of a horse-mosquito-horse amplification cycle that has occurred periodically since the 1920s
Summary
Venezuelan equine encephalitis virus (VEEV) is the most important alphaviral (Togaviridae: Alphavirus) pathogen of humans and domestic animals in the western hemisphere [1,2]. Most human and animal disease occurs when VEEV undergoes an amplification cycle where equids (horses, donkeys and mules) become infected and develop high titer viremia, facilitating transmission by Aedes and Psorophora spp. mosquitoes to susceptible equids or people. The VEEV strains involved in this equid amplification cycle belong to subtypes IAB and IC, and are called epizootic or epidemic ( called epidemic). These strains arise periodically and repeatedly via mutation of enzootic VEEV subtypes [3]. The resulting epidemics typically involve tens-tohundreds of thousands of cases in humans and equids. VEEV causes mortality in roughly half of infected animals, resulting in major effects on agricultural activities that rely on these animals in many parts of Latin America
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