Lancet (London, England)1996; 348(9025); 436-440; doi: 10.1016/s0140-6736(96)02275-1

Re-emergence of epidemic Venezuelan equine encephalomyelitis in South America. VEE Study Group.

Abstract: Venezuelan equine encephalomyelitis (VEE) virus has caused periodic epidemics among human beings and equines in Latin America from the 1920s to the early 1970s. The first major outbreak since 1973 occurred in Venezuela and Colombia during 1995, and involved an estimated 75,000 to 100,000 people. We report an epidemiological and virological investigation of this epidemic. Methods: Virus isolates were made in cell culture from human serum, human throat swabs, and brain tissue from aborted and stillborn human fetuses, as well as from horse brain tissue and pooled mosquito collections. Human sera were also tested for VEE-specific antibodies. The serotypes of VEE isolates were identified by antigen assays, and viruses were characterised genetically by sequencing PCR products generated from the E3 and E2 genes. Phylogenetic analyses were done to determine evolutionary relations with respect to previous epidemic/epizootic and enzootic VEE virus isolates. Mosquito collections were made to identify possible vectors, and clinical findings were determined by direct observation of patients visiting hospitals and clinics in affected regions, and by inspecting patient records. Equine vaccination and vector control were used in an attempt to halt the spread of the outbreak. Results: Most affected people had an acute, self-limited febrile illness of 3 to 4 days duration. However, convulsions were often seen in children, and abortions and fetal deaths occurred in pregnant women infected with VEE virus. Antigenic characterisation of 12 virus isolates spanning the temporal and spatial range of the outbreak indicated that all are VEE serotype IC. Phylogenetic analysis revealed that all of the 1995 viruses were closely related to serotype IC viruses isolated during a large VEE outbreak that occurred in the same regions of Colombia and Venezuela from 1962-1964. A 1983 mosquito isolate from north central Venezuela was also closely related to the 1995 isolates. Conclusions: This outbreak was remarkably similar to one that occurred in same regions of Venezuela and Colombia during 1962-1964. Symptoms of infected patients, estimated mortality rates, meteorological conditions preceding the epidemic, and seasonal patterns of transmission were all very similar to those reported in the previous outbreak. In addition, viruses isolated during 1995 were antigenically and genetically nearly identifical to those obtained during 1962-1964. These findings suggest that the epidemic resulted from the re-emergence of an epizootic serotype IC VEE virus. Identification of a similar virus isolate in mosquitoes in Venezuela in 1983, 10 years after epidemic/epizootic VEE activity ceased, raises the possibility of a serotype IC enzootic transmission cycle in northern Venezuela.
Publication Date: 1996-08-17 PubMed ID: 8709783DOI: 10.1016/s0140-6736(96)02275-1Google Scholar: Lookup
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  • Journal Article
  • Research Support
  • Non-U.S. Gov't
  • Research Support
  • U.S. Gov't
  • P.H.S.

Summary

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The research paper investigates the re-emergence of the Venezuelan equine encephalomyelitis (VEE) outbreak in South America in the 1990s, particularly in Venezuela and Colombia. The VEE virus, which has a history of causing periodic epidemics in Latin America since the 1920s, impacts both humans and equines. The research identifies the characteristics of this outbreak, compares it to previous occurrences and examines its implications.

Methods Used in the Study

  • The researchers isolated the virus in cell culture from various sources such as human serum, swabs from human throats, brain tissue from aborted and stillborn human fetuses, horse brain tissue and collected mosquitoes.
  • Human sera were tested for VEE-specific antibodies.
  • The researchers also identified the serotypes of the VEE isolates through antigen assays.
  • The viruses were characterized genetically by sequencing PCR product generated from their E3 and E2 genes. Phylogenetic analysis was used to determine their evolutionary relations with prior epidemic and enzootic VEE virus isolates.
  • Mosquito collections were used to identify possible vectors.
  • The clinical findings were collected from patient visits to hospitals and clinics in the regions affected, supplemented by patient record inspections. Equine vaccination and vector control were utilized to try curbing the outbreak’s spread.

Key Findings of the Study

  • The majority of the infected people had an acute illness lasting 3-4 days accompanied by a fever. It was also observed that children dealing with the infection often had convulsions, pregnant women experienced fetal deaths, and abortions correlated with the VEE virus infection.
  • The antigenic characterization of 12 virus isolates from the outbreak revealed that all belonged to the VEE serotype IC.
  • Phylogenetic analysis showed that all the virus isolates in 1995 closely related to serotype IC viruses from a large VEE outbreak in Colombia and Venezuela between 1962-1964, along with a 1983 mosquito isolate from Venezuela.

Conclusions Drawn from the Research

  • Comparing the 1995 outbreak to previous ones, the research found considerable similarities in symptoms, mortality rates, preemptive meteorological conditions, and seasonal transmission patterns, particularly with the Colombia and Venezuela outbreak of 1962-1964.
  • The antigens and genetics of the viruses isolated in 1995 were nearly identical to those from the 1962-1964 period, suggesting that the epidemic was due to a re-emergence of the epizootic serotype IC VEE virus.
  • The identification of a similar isolate in Venezuelan mosquitoes in 1983, decades after the epidemic/epizootic VEE activities ceased, introduces the possibility of an enzootic transmission cycle of the serotype IC in the region.

Cite This Article

APA
Weaver SC, Salas R, Rico-Hesse R, Ludwig GV, Oberste MS, Boshell J, Tesh RB. (1996). Re-emergence of epidemic Venezuelan equine encephalomyelitis in South America. VEE Study Group. Lancet, 348(9025), 436-440. https://doi.org/10.1016/s0140-6736(96)02275-1

Publication

ISSN: 0140-6736
NlmUniqueID: 2985213R
Country: England
Language: English
Volume: 348
Issue: 9025
Pages: 436-440

Researcher Affiliations

Weaver, S C
  • Center for Tropical Diseases, University of Texas Medical Branch, Galveston 77555-0605, USA.
Salas, R
    Rico-Hesse, R
      Ludwig, G V
        Oberste, M S
          Boshell, J
            Tesh, R B

              MeSH Terms

              • Adolescent
              • Adult
              • Animals
              • Child
              • Child, Preschool
              • Colombia / epidemiology
              • Disease Outbreaks / veterinary
              • Encephalitis Virus, Venezuelan Equine / classification
              • Encephalitis Virus, Venezuelan Equine / isolation & purification
              • Encephalomyelitis, Venezuelan Equine / epidemiology
              • Encephalomyelitis, Venezuelan Equine / veterinary
              • Encephalomyelitis, Venezuelan Equine / virology
              • Female
              • Horse Diseases / epidemiology
              • Horses
              • Humans
              • Infant
              • Middle Aged
              • Molecular Sequence Data
              • Pregnancy
              • Venezuela / epidemiology

              Grant Funding

              • AI 10894 / NIAID NIH HHS
              • AI 33983 / NIAID NIH HHS
              • AI 39508 / NIAID NIH HHS

              Citations

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