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[Preprint]. 2024 Feb 3:2024.02.02.24302220.
doi: 10.1101/2024.02.02.24302220.

Clinical and epidemiological characteristics of Madariaga and Venezuelan equine encephalitis virus infections

Luis Felipe Rivera  1   2 , Carlos Lezcano-Coba  1   2 , Josefrancisco Galué  1   2 , Xacdiel Rodriguez  1   2 , Yelissa Juarez  1   2 , William M de Souza  3 , Zeuz Capitan-Barrios  2   4 , Anayansi Valderrama  1   2 , Leyda Abrego  1   2   4 , Hector Cedeño  5 , Carmela Jackman  5 , Jesse J Waggoner  6 , Patricia V Aguilar  7 , Hilda Guzman  7 , Scott C Weaver  7 , Robert B Tesh  7 , Sandra López-Vèrges  1 , Christl A Donnelly  8 , Cassia F Estofolete  9 , Mauricio L Nogueira  7   9 , Nuno R Faria  10   11 , Nikos Vasilakis  7 , Amy Y Vittor  12 , Darci R Smith  13 , Jean-Paul Carrera  1   2   8
Affiliations

Clinical and epidemiological characteristics of Madariaga and Venezuelan equine encephalitis virus infections

Luis Felipe Rivera et al. medRxiv. .

Update in

  • Characteristics of Madariaga and Venezuelan Equine Encephalitis Virus Infections, Panama.
    Rivera LF, Lezcano-Coba C, Galué J, Rodriguez X, Juarez Y, de Souza WM, Capitan-Barrios Z, Valderrama A, Abrego L, Cedeño H, Jackman C, Waggoner JJ, Aguilar PV, Guzman H, Weaver SC, Tesh RB, López-Vèrges S, Donnelly CA, Estofolete CF, Nogueira ML, Faria NR, Vasilakis N, Vittor AY, Smith DR, Carrera JP. Rivera LF, et al. Emerg Infect Dis. 2024;30(14):94-104. doi: 10.3201/eid3014.240182. Emerg Infect Dis. 2024. PMID: 39530903 Free PMC article. Review.

Abstract

Madariaga virus (MADV) and Venezuelan equine encephalitis virus (VEEV) are emerging arboviruses affecting rural and remote areas of Latin America. However, there are limited clinical and epidemiological reports available, and outbreaks are occurring at an increasing frequency. We addressed this gap by analyzing all the available clinical and epidemiological data of MADV and VEEV infections recorded since 1961 in Panama. A total of 168 of human alphavirus encephalitis cases were detected in Panama from 1961 to 2023. Here we describe the clinical signs and symptoms and epidemiological characteristics of these cases, and also explored signs and symptoms as potential predictors of encephalitic alphavirus infection when compared to those of other arbovirus infections occurring in the region. Our results highlight the challenges clinical diagnosis of alphavirus disease in endemic regions with overlapping circulation of multiple arboviruses.

Keywords: Madariaga Virus; Venezuelan equine encephalitis; alphaviruses; outbreak investigation.

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Figures

Figure 1.
Figure 1.. Laboratory algorithm for Madariaga and Venezuelan equine encephalitis diagnosis.
Diagnostic algorithm used for two endemic encephalitic alphaviruses based on days since symptom onset.
Figure 2.
Figure 2.. Timeline of recorded a) VEEV and b) MADV important events in Panama.
Timeline showing historical of VEEV and MADV events in, human cases, vectors, and animals in Panama over time from 1961 to 2023.
Figure 3.
Figure 3.. Map of recorded MADV and VEEV cases in Panama.
Map showing the distribution of all MADV (green squares) and VEEV (red circles) cases reported in Panama from 1961–2023. MADV cases were only reported in the eastern Panama region, in the province of Darien. MADV cases detected outside Darien, in Chiriquí, Comarca Näbe Bugle and Herrera were reported in members of the border police working in the Darien Province, but at time of symptom onset these cases were detected in their home region.
Figure 4.
Figure 4.. Sign/symptom frequency heatmap by viral infection.
Gray blocks denote missing data. * Several datasets from alphavirus cases in Panama and DENV, CHIKV and ZIKV infection cases from Brazil were used to provide more complete symptom data. † e.g., seizures, focal sensory and/or motor deficits, and diminished level of consciousness.
Figure 5.
Figure 5.. Sign/symptom frequency heatmap by sex and viral infection.
† e.g., seizures, focal sensory and/or motor deficits, and diminished level of consciousness.
Figure 6.
Figure 6.. Sign/symptom frequency heatmap by age and viral infection.
† e.g., seizures, focal sensory and/or motor deficits, and diminished level of consciousness.
Figure 7.
Figure 7.. Multivariable logistic regression analysis of associated symptoms of A) MADV vs VEEV infection, and combined encephalitic alphavirus infection versus, B) DENV infection, C) ZIKV infection and D) CHIKV infection.
The red vertical line represented number 1, an odds ratio of 1 indicates that the odds of the event are the same in both groups.
See this image and copyright information in PMC

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