Equine Viral Encephalitis Iowa State University：馬病毒性腦炎愛荷華州立大學(xué)課件

EquineEncephalitidesSleepingSicknessEasternEquineEncephalitis(EEE)WesternEquineEncephalitis(WEE)VenezuelanEquineEncephalitis(VEE)EquineEncephalitidesSleepingOverviewOrganismHistoryEpidemiologyTransmissionDiseaseinHumansDiseaseinAnimalsPreventionandControlActionstoTakeCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011OverviewOrganismCenterforFooEquineEncephalitidesEasternequineencephalitis(EEE)Westernequineencephalitis(WEE)Venezuelanequineencephalitis(VEE)CenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011EquineEncephalitidesEasterneTHEORGANISMTHEORGANISMTheVirusesEEE,WEE,andVEEvirusesFamilyTogaviridaeGenusAlphavirusMosquito-borneDiseaseEncephalitisinhumansandhorsesOthermammalsandbirdsareoccasionallyaffectedCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011TheVirusesEEE,WEE,andVEEvTRANSMISSIONTRANSMISSIONTransmissionCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011VirusParticlesDeadEndHostsVertebrateHostsMosquitoVectorTransmissionCenterforFoodSeMosquitoLifeCycleFour-stagelifecycleEgg,larva,pupa,adultAedesspeciesLaysingleeggsDampsoil,laterfloodedCulexspecies100-300eggsinraftLayeggsatnightonwatersurfaceSurvivalrequireswindprotectionOverwinterineggstageCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011MosquitoLifeCycleFour-stageMosquitoLifeCycleLarvaeliveupsidedowninwater;“wriggler”BreatheviasiphontubeMolt4timesPupalstageisrestful,non-feeding;“tumbler”Breathevia“trumpets”SplitstoallowadulttoemergeCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011LarvaPupaMosquitoLifeCycleLarvaeliveMosquitoLifeCycleNewlyemergedadultrestsFemaletakesbloodmealOnlyfemalesbiteAttractantsforbitingCarbondioxide,temperature,moisture,smell,color,movementMatingoccursafewdaysafterflightLifespanvariesfrom4to30daysCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011MosquitoLifeCycleNewlyemergVectorsofthe

EquineEncephalitidesDiseaseMosquitoVectorEEECulisetamelanuraAedesspp.Culex(Cx.)nigrapalpusCoquilletidiaspp.WEECulextarsalisAedesmelanimonAedesdorsalisAedescampestrisVEECulex(Melanoconion)spp.CenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011Vectorsofthe

EquineEncephaSUMMARYOFEQUINEENCEPHALITIDESDistribution,Magnitude,andOutcomesSUMMARYOFEQUINEENCEPHALITIDEquineEncephalitides:ClassificationandDistributionDiseaseFamily,GenusDistributionEEETogaviridaeAlphavirusEasternU.S.WEETogaviridaeAlphavirusWesternU.S.VEETogaviridaeAlphavirusSouthernU.S.CenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011EquineEncephalitides:ClassifHumanRisksandOutcomesEasternequineencephalitisElderlymostatriskCasefatalityrate:33%WesternequineencephalitisChildren<1yearmostatriskCasefatalityrate:3%VenezuelanequineencephalitisChildrenmostoftenaffectedFatalitiesarerareCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011HumanRisksandOutcomesEasterAnimalRisksandOutcomesCase-fatalityrateinhorsesEEE~90%VEE~50to90%WEE~<30%Vaccineavailable

intheU.SCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011AnimalRisksandOutcomesCase-EASTERNEQUINEENCEPHALITISEASTERNEQUINEENCEPHALITISEEEHistory1831UnknownencephalomyelitisvirusaffectshorsesinMassachusetts1933EEEfirstisolatedfromahorse1937EEEidentifiedinring-neckedpheasants1938EEEfirstisolatedfromhumanbrainCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011EEEHistory1831CenterforFoodEEEHistory1942-1943Michiganepidemic1947SouthernLouisiana

andTexas14,000cases83%casefatalityrate1951IsolatedfromCulisetamelanuraCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011EEEHistory1942-1943CenterforEEETransmissionCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011CulisetamelanuraPeckingtransmissionAedesspp.

CoquilletidiaperturbansDeadendhosts:

Horses,humans,othermammalsBirdmigrationOverwintering?SpringReintroductionSummer

SwampyareasEEETransmissionCenterforFooEEEEpidemiology1964-2010270casestotalAverage6caseseachyearAverage1to2deathseachyearCase-fatalityratesHuman:30to70%Equine:90%EquinecasesusuallyappearfirstServeassentinelsforhumandiseaseCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011EEEEpidemiology1964-2010CenteCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011EasternEquineEncephalitisVirusNeuroinvasiveDiseaseCasesReportedbyState,1964-2010CenterforFoodSecurityandPCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011EasternEquineEncephalitisVirusNeuroinvasiveDisease*CasesReportedbyYear,1964-2010*Neuroinvasivediseaseincludescasesreportedasencephalitis,meningoencephalitis,ormeningitis.CenterforFoodSecurityandPReportedU.S.equinecases

ofEEE,2003-2012CenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011ReportedU.S.equinecases

ofDistributionmapof

reportedequineEEEcases,2012CenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011209casestotalDistributionmapof

reportedEEEinHumansIncubationperiod:4to10daysMilddiseaseuncommonFever,myalgia,headache,nausea,vomiting,abdominalpain,andphotophobiaSeizureandcomainseverecasesLongerfeverandflu-likesymptomsbeforeCNSsignsresultsinabetteroutcomeCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011EEEinHumansIncubationperiodEEEinHumansSurvivalratesassociatedwithageHighestinyoungadults:70%Lowerinchildren:60%Lowestinelderly:30%RecoverycanresultinpermanentbraindamageDiagnosisbyserologyTreatmentissupportivecareCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011EEEinHumansSurvivalratesasEEEinHorsesIncubationperiod:5to14daysClinicalsignsinhorsesFever,anorexia,depressionCNSsignsHypersensitivity,aimlesswandering,headpressing,circling,ataxia,paresis,paralysisDeathmayoccurwithindaysAsymptomaticormildinfectionsalsooccurEquinevaccineavailableCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011EEEinHorsesIncubationperiodEEEinBirdsAsymptomaticinmostbirdspeciesClinicalsignsDepression,tremors,legparalysis,somnolenceEmus,ostrichesHemorrhagicenteritis,emesisDeath24hoursafteronsetVaccinationSomebirdsarevaccinatedforEEECenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011EEEinBirdsAsymptomaticinmoDiagnosisAntemortem:serologyVirusneutralizationHemagglutinationinhibitionELISAComplementfixationVirusisolationPostmortemVirusidentifiedintissues(brain)Immunohistochemistry,ELISA,RT-PCRCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011DiagnosisAntemortem:serologyWESTERNEQUINEENCEPHALITISWESTERNEQUINEENCEPHALITISWEEHistory1930IsolatedfromhorsebrainCalifornia;50%casefatalityrate1933AedesaegyptiexperimentallyinfectedwithWEEVirustransmittedtoguineapigsVirustransmittedtohorses(1936)1938IsolatedfromhumanbrainCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011WEEHistory1930CenterforFoodWEEHistory1941NaturalinfectionfoundinmosquitoCulextarsalisEpidemicinCanadaandnorthernU.S.1942Culextarsalisidentifiedasthevector1943Confirmedasmosquito-bornediseaseBirdsidentifiedasreservoirhostCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011WEEHistory1941CenterforFoodWEETransmissionCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011Dead-endhostsHorses,humansCulextarsalis

PrimaryVectorPrimaryVertebrateHostsHouseSparrowHouseFinchP.MyersSecondaryAmplifiersBlacktailJackrabbitPrairieDogB.LundriganP.MyersWEETransmissionCenterforFooWEETransmissionCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011StateVectorAvianhostMammalianHostCOCulextarsalisHousesparrow,Red-wingedblackbird,MagpieBlacktailjackrabbit,KangarooratCACulextarsalisAedesmelanimonHousesparrowHousefinchBlacktailjackrabbit,WesterngraysquirrelTXCulextarsalis,Cx.quinquefasciatusAedesvexansHousesparrowBlacktailjackrabbit,PrairiedogNMAedesdorsalis,Ae.campestrisWEETransmissionCenterforFooWEEEpidemiologyCulextarsalisHighpopulationsinmid-tolate-summerEpidemicsassociated

withcool,wetspringWindcancarrymosquitoes800milesinlessthan24hoursCasesappearinJune-August639casessince19641989-1997:NohumandeathsCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011WEEEpidemiologyCulextarsalisCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011CenterforFoodSecurityandPCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011WEEintheU.S.:1993-2002MMWR1993199419951996199719981999200020012002210ReportedCasesYearCenterforFoodSecurityandPWEEinHumansIncubation:5to10daysResemblesEEEbutusuallyasymptomaticormildinadultsClinicalsignsSuddenonsetoffever,headache,nausea,vomiting,anorexia,malaiseCNSsignsinchildrenlessthan1yearAlteredmentalstatus,weakness,irritability,stupor,comaCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011WEEinHumansIncubation:5toWEEinHumansPrognosisPoorforyoungclinicalpatientsCase-fatalityrate:3to15%DeathwithinoneweekofclinicalonsetDiagnosisdifficultfromblood,CSFPostmortemvirusisolationfrombrainTreatmentissupportivecareVaccineavailableformilitarypersonnelonlyCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011WEEinHumansPrognosisCenterfWEEinAnimalsAsymptomatic Blacktailjackrabbit,kangaroorat,Westerngraysquirrel,prairiedog,birdsHorseswithclinicalsigns Fever,depression,alteredmentation,headpressing,ataxia,dysphagiaProgresstoparalysis,convulsions,deathMortalityrate<30%CenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011WEEinAnimalsAsymptomatic CenWEEinAnimalsDiagnosis SerologyCandifferentiateEEEandWEEusingthevirusneutralizationorELISAtestsPostmortemImmunohistochemistry,ELISA,RT-PCRTreatmentissupportivecareVaccineavailableCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011WEEinAnimalsDiagnosis CenterVENEZUELANEQUINEENCEPHALITISVENEZUELANEQUINEENCEPHALITISViralStrainsSubtypeCyclePathogenicI-AI-BI-CEpizootic/EpidemicHighlyvirulentforequinesI-DIII-EIIII-FIVVVIEnzootic/EndemicNotforhorsesLimitedcasesinhumansCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011ViralStrainsSubtypeCyclePathoVEEViralStrainsEpizootic/EpidemicI-A,I-B,andI-CDiseaseinhumansandhorsesTransmissionbymanymosquitospeciesNaturalreservoirunknownHorsesanddonkeysactasamplifiersEnzootic/EndemicDiseaseinhumansTransmissionmainlybyCulex(Melanoconion)speciesNaturalreservoirisrodentslivinginswampsandforestsCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011VEEViralStrainsEpizootic/EpiVEEHistory1938Isolatedfromhorsebrain1962-1964OutbreakinVenezuela23,000humancases1967OutbreakinColombia220,000humancasesOver67,000horsedeathsCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011VEEHistory1938CenterforFoodVEEHistory1969-1971LargestrecordedoutbreakCoveredareafromCostaRicatoRioGrandeValleyinTexasThousandsofhumanencephalitiscasesOver100,000horsesdied1995VenezuelaandColombiaOver90,000humancasesCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011VEEHistory1969-1971CenterforVEEEpizooticTransmissionCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011PrimaryVector

multiplemosquitospecies

Dead-endhostsHumansVertebrateHost

HorsesOtherspeciesnaturallyinfectedbutnotamplifiersVEEEpizooticTransmissionCentVEEEnzooticTransmissionCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011PrimaryVectorCulex(Melanoconion)species

DeadendhostsHumansVertebrateHostRodentsP.MyersVEEEnzooticTransmissionCenteVEEinHumansIncubationperiod:1to6daysUsuallyacute,mild,systemicdiseaseClinicalsignsFever,chills,headache,myalgiaCoughing,vomiting,diarrheaCNSsignsEncephalitisoccursin4%ofchildrenLessthan1%ofsymptomaticadultsDeathisrareCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011VEEinHumansIncubationperiodVEEinHumansPregnantwomenFetalencephalitis,placentaldamage,abortion/stillbirth,congenitaldiseaseDiagnosisPairedserawithrisingtiterELISAIgGorIgMTreatmentSupportivecareNovaccineavailableCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011VEEinHumansPregnantwomenCenVEEinHorsesIncubationperiod:1to5daysHorsesmostsusceptibleFever,anorexia,depression,flaccidlips,droopyeyelidsandears,incoordination,andblindnessDeath5to14daysafterclinicalonsetCase-fatalityrate:50to90%Inuterotransmissionresultsinabortion,stillbirthCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011VEEinHorsesIncubationperiodVEEinAnimalsMostdomesticanimalsdonotshowclinicalsignsoramplifythevirusExperimentallyInfectedrabbitsanddogs

dieafterinoculationLaboratoryanimalssusceptibleActassentinelsGuineapigs,mice,hamstersEnzooticstrainsdonotcausediseaseinanimalsCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011VEEinAnimalsMostdomesticanVEEinAnimalsDiagnosisVirusisolationSerologyPairedsera

withrisingtiterELISAIgGorIgMTreatmentSupportivecareVaccineavailableforhorsesCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011VEEinAnimalsDiagnosisCenterVEEasaBiologicalWeaponAerosolizedVEEHumanandequinediseaseoccursimultaneouslyFlu-likesymptomsinhumansPossibleneurologicalsignsinhorsesLargenumberofcasesinagivengeographicareaCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011VEEasaBiologicalWeaponAeroPREVENTIONANDCONTROLPREVENTIONANDCONTROLManagementof

Mosquito-BorneDiseasesSourcereductionSurveillanceBiologicalcontrolChemicalcontrolLarvicideAdulticideEducatingthepublicHowtoprotectthemselvesCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011Managementof

Mosquito-BorneDSourceReductionCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011MosquitohabitatsMakeunavailableorunsuitableforegglayingandlarvaldevelopmentMinimizeirrigation

andlawnwateringPunchholesinoldtiresFilltreeholeswithcementCleanbirdbaths,outsidewaterers,fountainsSourceReductionCenterforFooSourceReductionCont’dDrainorfilltemporarypoolswithdirtKeepswimmingpools

treatedandcirculatingAvoidstagnantwaterOpenmarshwater

managementConnecttodeepwater

habitatsandfloodoccasionallyFishaccessCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011SourceReductionCont’dDrainoSurveillanceSentinelchickenflocksBloodtestandELISAtomonitorseroconversionCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011MosquitotrappingandtestingforviralpresenceRecordkeepingWeatherdata,mosquitolarvalpopulations,adultflightpatternsSurveillanceSentinelchickenfBiologicalControlPredators,naturalandintroduced,toeatlarvaeandpupaeMosquitofishGambusiaaffinis,

G.holbrooki

Fundulusspp.,

Rivulusspp.,killifishOtheragentshavebeenused

butarenotreadilyavailableCopepodsCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011BiologicalControlPredators,nChemicalControlEssentialwhen:SourcereductionnoteffectiveSurveillanceshowsincreasedpopulationofvirus-carryingmosquitoesRequiresproperlytrainedpersonnelLarvicides,adulticidesToxictomanybirds,fish,wildlife,aquaticinvertebrates,honeybeesHumanexposureisuncommonCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011ChemicalControlEssentialwhenChemicalControlFederalFoodDrugandCosmeticActlimitsthequantityofadulticideusedDuetowinddriftontoagriculturalcropsMethodusedvaries TypeoftargetmosquitoTypeoftargetedhabitatAerialsprayingcoverswideareaFundingprovidedbystateorlocalgovernmentRarelyfederalCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011ChemicalControlFederalFoodDLarvicidesUsewhensourcereductionandbiologicalcontrolnotfeasibleMoreeffectiveandtarget-specificLesscontroversialthanadulticidesAppliedtosmallergeographicareasLarvaeconcentrateinspecificlocationsCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011LarvicidesUsewhensourcereduLarvicidesCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011NameProduct

(Larvae,Pupae,Adult)TemephosAbate(L)MethopreneAltosid(L)OilsBVA,GoldenBear(L,P)MonomolecularfilmAgnique(L,P)Bacillusthuringiensisisraelensis(BTI)Aquabac,Bactimos,LarvX,Teknar,Dunks(L)BacillussphaericusVectoLex(L)PyrethrinsPyrenone,Pyronyl(A,L)LarvicidesCenterforFoodSecuAdulticidesNecessarywhenothercontrolmeasuresunsuccessfulLeastefficientPropertypeandtimeofapplicationhelpsefficacyUltralowvolume(ULV)foggers1ounceperacreSmalldropletscontactandkilladultsCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011AdulticidesNecessarywhenotheAdulticidesChemicalNameProductMalathionFyfanon,Atrapa,PrentoxNaledDibrom,TrumpetFenthionBatexPermethrinPermanone,AquaResilin,Biomist,MosquitoBeaterResmethrinScourgeSumithrinAnvilCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011AdulticidesChemicalNameProducPersonalProtectionStayinsideduringtheeveningwhenmosquitoesaremostactiveWearlongpantsandsleevesUsemosquitorepellentwhennecessaryFollowlabeldirectionsDEETDonotuseonpetsCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011PersonalProtectionStayinsidePersonalProtectionMakesurewindowanddoorscreensare"bugtight"Replaceyouroutdoorlightswithyellow"bug"lightsBugzappersarenotveryeffectiveULVfoggersforbackyarduseKeepvegetationandstandingwaterincheckaroundthedwellingCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011PersonalProtectionMakesurewInternetResourcesCDCDivisionofVectorBorneInfectiousDiseases-ArboviralEncephalitides/ncidod/dvbid/arbor//CenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011InternetResourcesCDCDivisionAcknowledgmentsDevelopmentofthispresentationwasmadepossiblethroughgrantsprovidedto

theCenterforFoodSecurityandPublicHealthatIowaStateUniversity,CollegeofVeterinaryMedicinefromtheCentersforDiseaseControlandPrevention,

theU.S.DepartmentofAgriculture,

theIowaHomelandSecurityand

EmergencyManagementDivision,andthe

Multi-StatePartnershipforSecurityinAgriculture.Authors:RadfordDavisDVM,MPH;DanelleBickett-Weddle,DVM,MPH,PhD,DACVPM;AnnaRovidSpickler,DVM,PhDReviewers:JeanGladon,BS;KatieSpaulding,BS;KerryLeedomLarson,DVM,MPH,PhD,DACVPM;GlendaDvorak,DVM,MPH,DACVPMCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011AcknowledgmentsDevelopmentofEquineEncephalitidesSleepingSicknessEasternEquineEncephalitis(EEE)WesternEquineEncephalitis(WEE)VenezuelanEquineEncephalitis(VEE)EquineEncephalitidesSleepingOverviewOrganismHistoryEpidemiologyTransmissionDiseaseinHumansDiseaseinAnimalsPreventionandControlActionstoTakeCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011OverviewOrganismCenterforFooEquineEncephalitidesEasternequineencephalitis(EEE)Westernequineencephalitis(WEE)Venezuelanequineencephalitis(VEE)CenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011EquineEncephalitidesEasterneTHEORGANISMTHEORGANISMTheVirusesEEE,WEE,andVEEvirusesFamilyTogaviridaeGenusAlphavirusMosquito-borneDiseaseEncephalitisinhumansandhorsesOthermammalsandbirdsareoccasionallyaffectedCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011TheVirusesEEE,WEE,andVEEvTRANSMISSIONTRANSMISSIONTransmissionCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011VirusParticlesDeadEndHostsVertebrateHostsMosquitoVectorTransmissionCenterforFoodSeMosquitoLifeCycleFour-stagelifecycleEgg,larva,pupa,adultAedesspeciesLaysingleeggsDampsoil,laterfloodedCulexspecies100-300eggsinraftLayeggsatnightonwatersurfaceSurvivalrequireswindprotectionOverwinterineggstageCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011MosquitoLifeCycleFour-stageMosquitoLifeCycleLarvaeliveupsidedowninwater;“wriggler”BreatheviasiphontubeMolt4timesPupalstageisrestful,non-feeding;“tumbler”Breathevia“trumpets”SplitstoallowadulttoemergeCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011LarvaPupaMosquitoLifeCycleLarvaeliveMosquitoLifeCycleNewlyemergedadultrestsFemaletakesbloodmealOnlyfemalesbiteAttractantsforbitingCarbondioxide,temperature,moisture,smell,color,movementMatingoccursafewdaysafterflightLifespanvariesfrom4to30daysCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011MosquitoLifeCycleNewlyemergVectorsofthe

EquineEncephalitidesDiseaseMosquitoVectorEEECulisetamelanuraAedesspp.Culex(Cx.)nigrapalpusCoquilletidiaspp.WEECulextarsalisAedesmelanimonAedesdorsalisAedescampestrisVEECulex(Melanoconion)spp.CenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011Vectorsofthe

EquineEncephaSUMMARYOFEQUINEENCEPHALITIDESDistribution,Magnitude,andOutcomesSUMMARYOFEQUINEENCEPHALITIDEquineEncephalitides:ClassificationandDistributionDiseaseFamily,GenusDistributionEEETogaviridaeAlphavirusEasternU.S.WEETogaviridaeAlphavirusWesternU.S.VEETogaviridaeAlphavirusSouthernU.S.CenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011EquineEncephalitides:ClassifHumanRisksandOutcomesEasternequineencephalitisElderlymostatriskCasefatalityrate:33%WesternequineencephalitisChildren<1yearmostatriskCasefatalityrate:3%VenezuelanequineencephalitisChildrenmostoftenaffectedFatalitiesarerareCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011HumanRisksandOutcomesEasterAnimalRisksandOutcomesCase-fatalityrateinhorsesEEE~90%VEE~50to90%WEE~<30%Vaccineavailable

intheU.SCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011AnimalRisksandOutcomesCase-EASTERNEQUINEENCEPHALITISEASTERNEQUINEENCEPHALITISEEEHistory1831UnknownencephalomyelitisvirusaffectshorsesinMassachusetts1933EEEfirstisolatedfromahorse1937EEEidentifiedinring-neckedpheasants1938EEEfirstisolatedfromhumanbrainCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011EEEHistory1831CenterforFoodEEEHistory1942-1943Michiganepidemic1947SouthernLouisiana

andTexas14,000cases83%casefatalityrate1951IsolatedfromCulisetamelanuraCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011EEEHistory1942-1943CenterforEEETransmissionCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011CulisetamelanuraPeckingtransmissionAedesspp.

CoquilletidiaperturbansDeadendhosts:

Horses,humans,othermammalsBirdmigrationOverwintering?SpringReintroductionSummer

SwampyareasEEETransmissionCenterforFooEEEEpidemiology1964-2010270casestotalAverage6caseseachyearAverage1to2deathseachyearCase-fatalityratesHuman:30to70%Equine:90%EquinecasesusuallyappearfirstServeassentinelsforhumandiseaseCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011EEEEpidemiology1964-2010CenteCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011EasternEquineEncephalitisVirusNeuroinvasiveDiseaseCasesReportedbyState,1964-2010CenterforFoodSecurityandPCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011EasternEquineEncephalitisVirusNeuroinvasiveDisease*CasesReportedbyYear,1964-2010*Neuroinvasivediseaseincludescasesreportedasencephalitis,meningoencephalitis,ormeningitis.CenterforFoodSecurityandPReportedU.S.equinecases

ofEEE,2003-2012CenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011ReportedU.S.equinecases

ofDistributionmapof

reportedequineEEEcases,2012CenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011209casestotalDistributionmapof

reportedEEEinHumansIncubationperiod:4to10daysMilddiseaseuncommonFever,myalgia,headache,nausea,vomiting,abdominalpain,andphotophobiaSeizureandcomainseverecasesLongerfeverandflu-likesymptomsbeforeCNSsignsresultsinabetteroutcomeCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011EEEinHumansIncubationperiodEEEinHumansSurvivalratesassociatedwithageHighestinyoungadults:70%Lowerinchildren:60%Lowestinelderly:30%RecoverycanresultinpermanentbraindamageDiagnosisbyserologyTreatmentissupportivecareCenterforFoodSecurityandPublicHealth,IowaStateUniversity,2011EEEinHumansSurvivalratesasEEEinHorsesIncubationperi