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Eastern equine encephalitis
Eastern equine encephalitis is a rare but often severe mosquito-borne alphavirus infection that can progress from a nonspecific febrile illness to fulminant encephalitis with high morbidity and mortality
Prevalence
< 1 / 100 000
5 - 10
US Estimated
0 - 1
Europe Estimated
Age of Onset
All ages
ICD-10
A83.2
Inheritance Pattern
Autosomal dominant
Autosomal recessive
Mitochondrial/Multigenic
X-linked dominant
X-linked recessive
5 Facts you should know
FACT
EEE is a mosquito-borne alphavirus causing severe encephalitis with high mortality and neurologic sequelae
FACT
Seasonal outbreaks occur in endemic regions; birds/horses are amplifying hosts and humans are dead-end hosts
FACT
Diagnosis relies on IgM serology and PCR in CSF/serum; imaging may show thalamic/basal ganglia involvement
FACT
There is no specific antiviral therapy; management is supportive with seizure control and ICP management
FACT
5
Prevention focuses on vector control, repellents, protective clothing, and community abatement programs
Interest over time
Google searches
Common signs & symptoms
Systemic phase
- Fever, chills, malaise, myalgias, headache, vomiting
Neuroinvasive disease
- Altered mental status, seizures, focal neurologic deficits
Meningoencephalitis signs
- Nuchal rigidity, photophobia, decreased consciousness
CSF
- Lymphocytic pleocytosis often; imaging may show encephalitic changes
Rapid progression possible; high ICU need in severe cases
Current treatments
No antiviral shown effective; treatment is supportive care (often ICU-level)
Airway/ventilation support as needed; seizure management; ICP monitoring/management in severe encephalitis
Public health prevention
- Mosquito avoidance, vector control; exposure counseling
References:
- Banda C, et al. Eastern Equine Encephalitis. StatPearls. 2023.