Endemic Venezuelan Equine Encephalitis in the Americas: Hidden Under The Dengue Umbrella

Abstract

Venezuelan equine encephalitis (VEE) is an emerging infectious disease in Latin America. Outbreaks have been recorded for decades in countries with enzootic circulation, and the recent implementation of surveillance systems has allowed the detection of additional human cases in countries and areas with previously unknown VEE activity. Clinically, VEE is indistinguishable from dengue and other arboviral diseases and confirmatory diagnosis requires the use of specialized laboratory tests that are difficult to afford in resource-limited regions. Thus, the disease burden of endemic VEE in developing countries remains largely unknown, but recent surveillance suggests that it may represent up to 10% of the dengue burden in neotropical cities, or tens-of-thousands of cases per year throughout Latin America. The potential emergence of epizootic viruses from enzootic progenitors further highlights the need to strengthen surveillance activities, identify mosquito vectors and reservoirs and develop effective strategies to control the disease. In this article, we provide an overview of the current status of endemic VEE that results from spillover of the enzootic cycles, and we discuss public health measures for disease control as well as future avenues for VEE research.

Keywords:

• alphavirus
• encephalitis
• endemic
• epizootic
• mosquito
• surveillance

Acknowledgements

The authors would like to thank Rubing Chen for assistance with the phylogenetic tree in Figure 2.

Financial & competing interests disclosure

SC Weaver is an applicant for the patent of a vaccine designed to protect against Venezuelan equine encephalitis. The authors‘ research is supported by NIH grants AI48807 and AI057156. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Additional information

Funding

SC Weaver is an applicant for the patent of a vaccine designed to protect against Venezuelan equine encephalitis. The authors‘ research is supported by NIH grants AI48807 and AI057156. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. No writing assistance was utilized in the production of this manuscript.