Venezuelan equine encephalitis

Venezuelan equine encephalitis is the most important arboviral etiology of central nervous system disease in the Americas. Human and equine disease results from equine-amplified, mosquito-borne outbreaks that expose hundreds of thousands of people to spillover infections. In addition, an estimated tens of thousands of human cases occur annually from spillover infections near forest habitats where rodent-mosquito enzootic cycles occur continuously. Although the vast majority of human infections result in a nonspecific “flu-like” febrile syndrome, about 4% of infections progress to neurologic disease, which can be fatal and which often results in severe, permanent sequelae in survivors, who are typically children. Here, we review VEEV replication and transmission, immune responses to infection and pathogenesis, as well as vaccine development and other approaches to control disease.