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Endemic Venezuelan equine encephalitis in the Americas: hidden under the dengue umbrella

    Patricia V Aguilar

    Center for Tropical Diseases, Institute for Human Infections & Immunity, University of Texas Medical Branch, Galveston, TX, USA

    Department of Pathology, University of Texas Medical Branch, Galveston, TX, USA

    ,
    Jose G Estrada-Franco

    Center for Tropical Diseases, Institute for Human Infections & Immunity, University of Texas Medical Branch, Galveston, TX, USA

    Department of Pathology, University of Texas Medical Branch, Galveston, TX, USA

    ,
    Roberto Navarro-Lopez

    Comision Mexico-Estados Unidos para la Prevencion de la Fiebre Aftosa & Otras Enfermedades Exoticas de los Animales, Mexico City, Mexico

    ,
    Cristina Ferro

    Instituto Nacional de Salud, Bogota, Colombia

    ,
    Andrew D Haddow

    Center for Tropical Diseases, Institute for Human Infections & Immunity, University of Texas Medical Branch, Galveston, TX, USA

    Department of Pathology, University of Texas Medical Branch, Galveston, TX, USA

    &
    Published Online:https://doi.org/10.2217/fvl.11.50

    Venezuelan equine encephalitis (VEE) is an emerging infectious disease in Latin America. Outbreaks have been recorded for decades in countries with enzootic circulation, and the recent implementation of surveillance systems has allowed the detection of additional human cases in countries and areas with previously unknown VEE activity. Clinically, VEE is indistinguishable from dengue and other arboviral diseases and confirmatory diagnosis requires the use of specialized laboratory tests that are difficult to afford in resource-limited regions. Thus, the disease burden of endemic VEE in developing countries remains largely unknown, but recent surveillance suggests that it may represent up to 10% of the dengue burden in neotropical cities, or tens-of-thousands of cases per year throughout Latin America. The potential emergence of epizootic viruses from enzootic progenitors further highlights the need to strengthen surveillance activities, identify mosquito vectors and reservoirs and develop effective strategies to control the disease. In this article, we provide an overview of the current status of endemic VEE that results from spillover of the enzootic cycles, and we discuss public health measures for disease control as well as future avenues for VEE research.

    Papers of special note have been highlighted as: ▪ of interest ▪▪ of considerable interest

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