Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, Colorado.
Am J Trop Med Hyg. 2018 May;98(5):1472-1477. doi: 10.4269/ajtmh.17-0927. Epub 2018 Mar 15.
Eastern equine encephalitis virus (EEEV) is a mosquito-borne alphavirus found in the eastern United States. Eastern equine encephalitis virus disease in humans is rare but can result in severe, often fatal, illness. This report summarizes the national EEEV surveillance data for 2003 through 2016, including human disease cases and nonhuman infections. Over the 14-year period, 633 counties from 33 states reported EEEV activity; 88% of those counties reported EEEV activity only in nonhuman species. A total of 121 human cases of EEEV disease were reported, with a median of eight cases reported annually. The national average annual incidence of EEEV neuroinvasive disease was 0.03 cases per million population. States with the highest average annual incidence included New Hampshire, Massachusetts, Vermont, Maine, and Alabama. Eastern equine encephalitis virus neuroinvasive disease incidence was highest among males and among persons aged < 5 and > 60 years. Overall, 118 (98%) case patients were hospitalized and 50 (41%) died. The case fatality ratio was highest among case patients aged ≥ 70 years. Nonhuman surveillance data indicate that the geographic range of EEEV is much greater than human cases alone might suggest. In areas where the virus circulates, health-care providers should consider EEEV infection in the differential diagnosis for meningitis and encephalitis. Providers are encouraged to report suspected cases to their public health department to facilitate diagnosis and consider interventions to mitigate the risk of further transmission. Because human vaccines against EEEV are not available, prevention depends on community efforts to reduce mosquito populations and personal protective measures to decrease exposure to mosquitoes.
东部马脑炎病毒（EEEV）是一种在美国东部发现的蚊媒α病毒。人类感染东部马脑炎病毒的情况较为罕见，但可能导致严重，且常为致命的疾病。本报告总结了 2003 年至 2016 年期间全国范围内 EEEV 的监测数据，包括人类疾病病例和非人类感染情况。在 14 年期间，33 个州的 633 个县报告了 EEEV 活动；其中 88%的县仅报告了非人类物种中的 EEEV 活动。共报告了 121 例人类 EEEV 疾病病例，每年报告的中位数为 8 例。全国 EEEV 神经侵袭性疾病的年平均发病率为每百万人中有 0.03 例。发病率最高的州包括新罕布什尔州、马萨诸塞州、佛蒙特州、缅因州和阿拉巴马州。东部马脑炎病毒神经侵袭性疾病的发病率在男性以及年龄<5 岁和>60 岁的人群中最高。总体而言，118 例（98%）病例患者住院治疗，50 例（41%）死亡。病死率在年龄≥70 岁的病例患者中最高。非人类监测数据表明，EEEV 的地理范围比仅报告人类病例要广泛得多。在病毒流行的地区，医疗保健提供者应在脑膜炎和脑炎的鉴别诊断中考虑 EEEV 感染。鼓励提供者向公共卫生部门报告疑似病例，以促进诊断，并考虑采取干预措施，以降低进一步传播的风险。由于目前尚无针对 EEEV 的人用疫苗，因此预防措施取决于社区努力减少蚊子数量和个人采取的减少接触蚊子的防护措施。
