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Western Equine Encephalitis

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CLINICAL FEATURES 

   * Symptoms range from mild flu-like illness to frank encephalitis, coma and death

ETIOLOGIC AGENT 

   * Western equine encephalitis virus, member of the family Togaviridae, genus Alphavirus. Closely related to eastern and Venezuelan equine encephalitis viruses

INCIDENCE 

   * 639 confirmed cases in the U.S. since 1964

SEQUELAE 

   * Mild to severe neurologic deficits in survivors

COSTS 

   * Total case costs range from $21,000 for transiently infected individuals to $3 million for severely infected individuals
   * Insecticide applications can cost as much as $1.4 million depending on the size of area treated

TRANSMISSION 

   * Mosquito-borne

RISK GROUPS 

   * Residents of endemic areas and visitors
   * Persons with outdoor work and recreational activities

SURVEILLANCE 

   * National Notifiable Diseases Surveillance System

TRENDS 

   * Epidemic disease that is difficult to predict
   * Risk exposure increases as population expands into endemic areas

CHALLENGES 

   * No licensed vaccine for human use
   * No effective therapeutic drug
   * Unknown overwintering cycle
   * Control measures expensive
   * Limited financial support of surveillance and prevention

OPPORTUNITIES 

   * Mosquito control
   * Education of health-care workers and the public
   * Integrated State and Federal prevention efforts
   * Vaccine development
   * Therapeutic development

RESEARCH PRIORITIES 

   * Improve predictive capabilities
   * Develop and evaluate vaccines
   * Develop and evaluate therapeutics
   * Improve diagnostic and virus detection tests

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