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Infectious medicine2025; 4(1); 100167; doi: 10.1016/j.imj.2025.100167

Eastern equine encephalitis virus: Pathogenesis, immune response, and clinical manifestations.

Abstract: Eastern equine encephalitis virus (EEEV) is a lethal transmitted by mosquitoes that primarily cycles between birds. Although rare, infections in humans and horses are associated with high mortality rates and severe neurological effects. Climate change appears to be increasing the spread of this virus. This study aims to provide a comprehensive analysis of EEEV, including its transmission dynamics, pathogenesis, induced host immune response, and long-term impacts on survivors. It also highlights the virus's unique immune evasion strategies that complicate disease management and contribute to severe clinical outcomes, such as encephalitis with fever, convulsions, and coma. Survivors often face chronic cognitive, motor, and psychosocial impairments. Despite these significant public health risks, gaps remain in understanding the molecular mechanisms underlying immune evasion and the long-term neurological sequelae in survivors. By collating current knowledge, this review underscores the urgent need for the development of targeted vaccines and therapeutic interventions to mitigate the growing threat of EEEV, particularly in the context of climate change-driven geographical expansion.
© 2025 The Author(s).
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Publication Date: 2025-01-17 PubMed ID: 40026316PubMed Central: PMC11869868DOI: 10.1016/j.imj.2025.100167Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

Overview

  • Eastern equine encephalitis virus (EEEV) is a mosquito-borne virus that primarily cycles between birds but can infect humans and horses, leading to severe neurological disease and high mortality.
  • The study provides a detailed review of EEEV’s transmission, pathogenesis, immune response, clinical symptoms, and implications for public health, emphasizing the need for better preventive measures due to climate change-driven spread.

Introduction to EEEV

  • EEEV is a highly lethal virus transmitted by mosquitoes, particularly those that bite birds, which serve as the natural reservoir.
  • Humans and horses are incidental hosts and do not significantly contribute to virus transmission.
  • Infections in humans and horses are infrequent but often deadly, with a high risk of severe neurological damage.
  • Climate change appears to be causing geographic expansion of EEEV, increasing the risk of outbreaks in previously unaffected regions.

Transmission Dynamics

  • The virus primarily cycles between birds and mosquito vectors, maintaining a natural enzootic cycle.
  • Mosquitoes act as vectors transferring EEEV from infected birds to horses or humans during blood meals.
  • Transmission among humans or horses does not occur because these hosts are dead ends for the virus.
  • Changes in temperature and precipitation due to climate change may increase mosquito populations and expand their range, enhancing transmission risk.

Pathogenesis and Immune Response

  • After transmission, EEEV infects cells and disseminates, especially affecting the central nervous system (CNS).
  • The virus invades neural tissue causing encephalitis characterized by inflammation, neuronal death, and brain swelling.
  • The host immune system responds to infection but the virus uses immune evasion strategies to reduce effectiveness of immune clearance.
  • These immune evasion mechanisms complicate disease management and contribute to severe clinical outcomes.

Clinical Manifestations

  • Symptoms include high fever, headache, convulsions, coma, and severe encephalitis.
  • Mortality rates are high in symptomatic cases, and survivors often endure long-lasting effects.
  • Long-term sequelae include chronic cognitive deficits, impaired motor function, and psychosocial challenges.
  • The severity and persistence of neurological damage make EEEV infections particularly concerning for survivors’ quality of life.

Knowledge Gaps and Research Needs

  • Current understanding of molecular strategies used by EEEV to evade the immune system is incomplete.
  • The mechanisms underlying prolonged neurological impairments in survivors remain poorly understood.
  • These gaps hinder development of effective vaccines and targeted therapies against EEEV.

Public Health Implications

  • EEEV represents a significant emerging health threat due to its lethality and neurological damage potential.
  • Climate change-driven expansion of mosquito vectors could increase incidence and geographic spread of EEEV infections.
  • Enhanced surveillance, vaccine research, and development of antiviral therapeutics are urgently needed.
  • This comprehensive review highlights the importance of addressing these challenges to mitigate EEEV risks globally.

Cite This Article

APA
Parashar B, Malviya R, Sridhar SB, Wadhwa T, Talath S, Shareef J. (2025). Eastern equine encephalitis virus: Pathogenesis, immune response, and clinical manifestations. Infect Med (Beijing), 4(1), 100167. https://doi.org/10.1016/j.imj.2025.100167

Publication

Infectious medicine
ISSN: 2772-431X
NlmUniqueID: 9918663679306676
Country: Netherlands
Language: English
Volume: 4
Issue: 1
Pages: 100167
PII: 100167

Researcher Affiliations

Parashar, Bhumika
  • Department of Pharmacy, School of Medical and Allied Sciences, Galgotias University, Greater Noida 201310, Uttar Pradesh, India.
Malviya, Rishabha
  • Department of Pharmacy, School of Medical and Allied Sciences, Galgotias University, Greater Noida 201310, Uttar Pradesh, India.
  • Galgotias Multi-Disciplinary Research & Development Cell (G-MRDC), Galgotias University, Greater Noida 201308, Uttar Pradesh, India.
Sridhar, Sathvik Belagodu
  • RAK College of Pharmacy, RAK Medical & Health Sciences University, Ras Al Khaimah 11172, United Arab Emirates.
Wadhwa, Tarun
  • RAK College of Pharmacy, RAK Medical & Health Sciences University, Ras Al Khaimah 11172, United Arab Emirates.
Talath, Sirajunisa
  • RAK College of Pharmacy, RAK Medical & Health Sciences University, Ras Al Khaimah 11172, United Arab Emirates.
Shareef, Javedh
  • RAK College of Pharmacy, RAK Medical & Health Sciences University, Ras Al Khaimah 11172, United Arab Emirates.

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Citations

This article has been cited 1 times.
  1. Guo M, Song L, Liu J, Hu Y, Chen Y, Fu G, Yuan H, Li J. Development of nanobody-based DAS-ELISA and Au nanoparticle-based immunochromatographic test strip for highly sensitive detection of Chikungunya virus.. Front Immunol 2025;16:1707358.
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