Professional Documents
Culture Documents
Viral Encephalitis
History
History
1925
First
1930
WEE
History
1932
Aedes aegypti replicate and transmit WEE in
the laboratory
St. Louis encephalitis identified in causing
human disease
1933
St. Louis encephalitis virus isolated from
human brain
Eastern equine encephalitis virus
History
1938
WEE
1941
Culex
tarsalis mosquitoes
found to be naturally infected
with WEE
Transmission
Transmission
Vertebrate
Hosts
Virus
Particles
Transovarial &
Venereal
Mosquito Vector
Center for Food Security a
4 stages
Aedes species
Lay single eggs
Damp soil, later flooded
Culex species
100-300 eggs in raft
Lay eggs at night on water surface
Larva
Pupa
Attractants
for biting
Arboviruses Indigenous
to the United States
Disease Mosquito Vector
Culiseta melanura, Aedes spp.,
EEE
WEE
SLE
LAC
Ochleratatus triseriatus
VEE
Sudden
neurological damage
Death
Human Treatment
Manage symptoms
Reduce
fever
Maintain hydration and electrolytes
Maintain blood oxygen levels
Anticonvulsants
Osmotic diuretics for intracranial
pressure
Physical therapy
Summary of
Encephalitis Viruses
Within the U.S.
Arboviruses Indigenous
to the United States
Dz
Family, Genus
Distribution
Eastern U.S.
Western U.S.
United States
St. Louis
Encephalitis (SLE)
Most common
Elderly most at risk
Case fatality rate:
5-15%
La Crosse
Encephalitis (LAC)
Children <16 years
most at risk
Human fatalities
less than 1%
Average 73 cases/year
Eastern Equine
Encephalitis (EEE)
WEE
VEE
Average 19 cases/year;
< 1/year last 10 years
~ 90%
VEE ~ 40-80%
WEE ~ 20-50%
formalin-inactivated
California Serogroup
(CAL)
La Crosse virus
Jamestown Canyon virus
Cache Valley
Others
California Serogroup
14 known viruses
La Crosse virus
Only
Reported Cases
40
30
20
10
0
1993
1994
1995
1996
1997 1998
1999 2000
2001
2002
Year (Month)
MMWR
CAL Epidemiology
Primarily in Western Hemisphere
Can occur in Africa, Asia, Europe
Virus transmission and amplification
Occurs
Domestic
1963
Discovered
in La Crosse, WI
Causes human mortality
4-year-old girl died of acute encephalitis
LAC Transmission
Newly
infected
transmits to
vertebrate
host
Ochleratatus
(Aedes)
triseriatus
Vertebrate
host
transovarial
Virus
present
in new
adult
LAC Epidemiology
Human cases
75
Average 73 cases/year
La Crosse in Humans
sequelae
Death less than 1% of cases
Not often correctly diagnosed
La Crosse in Humans
Diagnosis
Hemagglutination inhibition
Paired sera monitoring for rise in
antibody titer
Treatment
Supportive
Eastern Equine
Encephalitis
EEE History
1831
Massachusetts
1933
First
1942-1943
Michigan
epidemic
EEE History
83% fatality
1951
Isolated
Last 25 years
Most
EEE History
182 cases
1937
Disease
identified in ring-necked
pheasants
Also occurs in sparrows, pigeons,
partridges, emus and ostriches
EEE Transmission
Aedes spp.
Coquilletidia
perturbans
Pecking
transmission
Summer
Swampy
areas
Culiseta
melanura
Over wintering?
Bird migration
EEE Epidemiology
1964-2002
182
Case-fatality rates
Human:
30-70%
Equine: 90%
as sentinels
Center for Food Security a
Reported Cases
5
4
3
2
1
0
1993 1994
1995
1999
2000
2001
2002
Year (Month)
MMWR
Human EEE
Human EEE
in young adults-70%
Lower in children-60%
Lowest in elderly-30%
Animal EEE
disease
Animal EEE
Treatment difficult
Poor prognosis
Vaccination available
Two
Animal EEE
somnolence
Emus, ostriches
Death
Vaccination
Emus
Western Equine
Encephalitis
Forage poisoning,
Cerebrospinal meningitis,
Corn-stalk disease,
Harvest disease,
Sleeping sickness
WEE History
1930
Isolated from horse brain
6,000 horses affected in California
1933
1938
WEE History
1941
1941
Major epidemic in Canada and north central
United States
High fatality rates
1942
1943
Prairie Dog
WEE Transmission
Primary Vertebrate
Hosts
Secondary
Amplifiers
Culex
tarsalis
B. Lundrigan
Blacktail
Jackrabbit
P. Myers
P. Myers
Primary
Vector
Dead-end hosts:
Horses, humans
House Sparrow
House Finch
Center for Food Security a
WEE Transmission
State
Vector
Avian host
Mammal
Host
CO
Culex tarsalis
House sparrow,
Red-winged
blackbird,
Magpie
Blacktail
jackrabbit,
Kangaroo rat
CA
Culex tarsalis
Aedes melanimon
House sparrow
House finch
Blacktail
jackrabbit,
Western gray
squirrel
TX
NM
Aedes dorsalis,
Ae. campestris
Blacktail
jackrabbit,
Prairie dog
WEE Epidemiology
Culex tarsalis
Reaches
high populations
in mid to late summer
Epidemics associated with
cool, wet spring
Wind can carry mosquitoes
800 miles in less than 24 hours
Average 19 cases/year;
<1/year last 10 years
Reported Cases
0
MMWR
1993
2001
2002
Human WEE
5-30%
deficits
Human WEE
Prognosis
Poor
Animal WEE
Asymptomatic
Blacktail
Animal WEE
Diagnosis
Virus
Immunize
St. Louis
Encephalitis
SLE History
1932
1933
Outbreak in St. Louis, MO
1,000 clinical cases - 20% mortality
Virus isolated in human brain tissue
1940s
1954
SLE History
1964
Widespread
1975
Largest
U.S. epidemic
1,800 cases
Central U.S. from Canada to Texas
SLE Transmission
Migratory
Vertebrate
Hosts
birds
Spring Introduction
Culex
tarsalis
Primary
Vector
Transovarial
Dead-end
hosts:
Humans
Center for Food Security a
SLE Transmission
Geographic Area
Primary Vector
Western U.S.
Culex tarsalis
Midwest &
Southern U.S.
Northern U.S.
Culex pipiensquinquifasciatus
Culex pipiens
Florida &
Caribbean
Culex nigripalpus
Center for Food Security a
SLE Epidemiology
cases undiagnosed
Most cases
Central
Reported Cases
45
30
15
1993
1994
1995 1996
1997
1998
1999
2000
2001
2002
Year (Month)
MMWR
Human SLE
cases asymptomatic
Less than 1% of cases are clinically
apparent
Fever, headache, altered mental status
60% of patients have tremors
Human SLE
Diagnosis is by serology
IgM
Animal SLE
Birds
Asymptomatic
vertebrate hosts
24
people hospitalized
patients total
14 females, 8 males
All worked or resided in Pine Bluff
3 had neurological sequelae
1 died due to leukemia
Center for Food Security a
Venezuelan Equine
Encephalitis
Peste loca,
Derrengadera
Viral Strains
Subtype
I-A
I-B
I-C
I-D
II
I-E
III
I-F
IV
V
VI
Cycle
Epizootic/
Epidemic
Pathogenic
Highly virulent
for equines
Enzootic/
Endemic
Epizootic/Epidemic
I-A, I-B and I-C
Disease in humans
and horses
Transmission by
many mosquito
species
Natural reservoir
unknown
Horses and donkeys
act as amplifiers
Enzootic/Endemic
Disease in humans
Transmission mainly
by Culex
(Melanoconion)
species
Natural reservoir is
rodents living in
swamps and forests
VEE History
in Venezuela
1967
Outbreak
in Colombia
VEE History
1969-1971
Largest
and Colombia
Primary Vector
multiple
mosquito species
Dead-end hosts:
Humans
Vertebrate
Host:
Horses
Dead end
hosts:
Humans
Vertebrate
Host:
Rodents
VEE Epidemiology
1971
Only
Human VEE
Initial signs
Last
24-48 hours
Fever, malaise, dizziness, chills,
headaches, anorexia, severe myalgia,
arthralgia, nausea, vomiting
Human VEE
In utero death
Diagnosis
Paired sera with rising titer
ELISA IgG or IgM
Animal VEE
Incubation period: 1-5 days
Horses most susceptible
Fever,
anorexia, depression,
flaccid lips, droopy eyelids and ears,
incoordination and blindness
Death 5-14 days after clinical onset
Animal VEE
Most domestic animals do not show
clinical signs or amplify the virus
Experimentally
Infected
Act as sentinels
Guinea pigs, mice, hamsters
Animal VEE
Diagnosis
Paired
Trivalent,
formalin inactivated
Annual
or biannual booster
Center for Food Security a
Aerosolized VEE
Human and equine disease occur
simultaneously
Flu-like symptoms in humans
Possible neurological signs in horses
Large number of cases in a given
geographic area
Prevention and
Control
Management of
Mosquito-Borne Diseases
Source reduction
Surveillance
Biological control
Chemical control
Larvicide
Adulticide
to protect themselves
Center for Food Security a
Source Reduction
Avoid
stagnant water
to deep water
habitats and flood occasionally
Fish access
Center for Food Security a
Surveillance
Record keeping
Weather
Surveillance
Mosquito trapping
and testing for viral
presence
Biological Control
fish
Chemical Control
Chemical Control
Rarely federal
Center for Food Security a
Larvicides
Use when source reduction and
biological control not feasible
More effective and target-specific
Less controversial than adulticides
Applied to smaller geographic areas
Larvae
Larvicides
Name
Product
(Larvae, Pupae, Adult)
Temephos
Abate (L)
Methoprene
Altosid (L)
Oils
Monomolecular film
Agnique (L, P)
Bacillus thuringiensis
israelensis (BTI)
Bacillus sphaericus
VectoLex (L)
Pyrethrins
Adulticides
Adulticides
Chemical Name
Product
Malathion
Naled
Dibrom, Trumpet
Fenthion
Batex
Permethrin
Permanone, AquaResilin,
Biomist, Mosquito Beater
Resmethrin
Scourge
Sumithrin
Anvil
Personal Protection
Stay inside during the evening when
mosquitoes are most active
Wear long pants and sleeves
Use mosquito repellent when
necessary
Follow
label directions
DEET
Personal Protection
Make sure window and door screens
are "bug tight"
Replace your outdoor lights with
yellow "bug" lights
Bug
150,000
people exposed
30,000 people ill
300 deaths
Internet Resources
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Acknowledgments
Development of this
presentation was funded
by a grant from the
Centers for Disease Control
and Prevention to the
Center for Food Security
and Public Health at Iowa
State University.
Acknowledgments
Author:
Co-author:
Jean Gladon, BS