Four Human Cases of Eastern Equine Encephalitis in Connecticut, USA, during a Larger Regional Outbreak, 2019

Abstract

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Clinical Characteristics of the 2019 Eastern Equine Encephalitis Outbreak in Michigan

“…Notably, public health laboratory testing of CSF specimens using microsphere immunoassay appeared to show greater sensitivity with the initial CSF specimen than commercially available assays, which use a cell-based, indirect fluorescent antibody technique. This concern was also identified in a previous report [ 15 ]. Thus, more timely diagnosis of EEE may be achieved by wider use of improved serologic techniques.…”

“…Brain imaging frequently demonstrates abnormalities in the thalamus and basal ganglia. Diagnosis of EEE is typically accomplished via detection of anti-EEEV antibodies in cerebrospinal fluid (CSF) or serum samples, performed at commercial reference and public health laboratories, with molecular detection of viral RNA available only at select public health laboratories; however, poor sensitivity of commercially available CSF serologic tests has been identified as a diagnostic concern [ 15 ]. Treatment is supportive as no specific therapy is available, although intravenous immunoglobulin (IVIG) and corticosteroids have been administered [ 16 ].…”

The emerging scenario for the Eastern equine encephalitis virus and mitigation strategies to counteract this deadly mosquito-borne zoonotic virus, the cause of the most severe arboviral encephalitis in humans—an update

“…Examination revealed pleocytosis in the cerebrospinal fluid (CSF), but initial immunoglobin M (IgM) testing was negative, so the patients were referred to the CDC, where EEE was diagnosed. This unexpected outbreak of EEE in this state shows the importance of public health departments being connected to the CDC and having the ability to administer diagnostic tests that will enable the detection of EEE in an evidence-based manner (26).…”