page_title: Eastern equine encephalitis
section_title: Treatment and prognosis
hierarchical_section_title: Eastern equine encephalitis / Treatment and prognosis
caption_attribution_description: English: Magnetic resonance images (MRIs) and computed tomography (CT) neuroradiographs showing lesions in brains of 3 children with eastern equine encephalitis. A) Results of noncontrast CT scan of the brain of patient 12 on hospital day 2; the neuroradiograph shows subtle hypoattenuation of the left caudate head (arrow) and diencephalic region. B) Axial fluid attenuated inversion recovery (FLAIR) image from brain MRI scan of patient 14 on hospital day 2; the image shows abnormal T2 hyperintense regions of the bimesial temporal regions (thick arrows) with accompanying abnormal T2 hyperintense regions of the dorsal pontomesencephalic regions (thin arrows). C, D) FLAIR images from brain MRI scan of patient 15 on hospital day 3. C) Abnormal T2 hyperintense caudate and thalamic nuclei, most prominent on the right (arrow). D) Abnormal T2 hyperintense regions are most prominent in the right parietotemporal gray matter (arrow) and subcortical white matter but are also seen scattered throughout.
context_page_description: Eastern equine encephalitis, commonly called Triple E or sleeping sickness, is a disease caused by a zoonotic mosquito vectored Togavirus that is present in North, Central, and South America, and the Caribbean. EEE was first recognized in Massachusetts, United States, in 1831, when 75 horses died mysteriously of viral encephalitis.
  Epizootics in horses have continued to occur regularly in the United States. It can also be identified in donkeys and zebras. Due to the rarity of the disease, its occurrence can cause economic impact beyond the cost of horses and poultry. EEE is found today in the eastern part of the United States and is often associated with coastal plains. It can most commonly be found in East Coast and Gulf Coast states. In Florida, about one to two human cases are reported a year, although over 60 cases of equine encephalitis are reported. In years in which conditions are favorable for the disease, the number of equine cases is over 200. Diagnosing equine encephalitis is challenging because many of the symptoms are shared with other illnesses and patients can be asymptomatic.
context_section_description: No cure for EEE has been found. Treatment consists of corticosteroids, anticonvulsants, and supportive measures (treating symptoms) such as intravenous fluids, tracheal intubation, and antipyretics. About 4% of humans known to be infected develop symptoms, with a total of about six cases per year in the US. A third of these cases die, and many survivors suffer permanent brain damage.
caption: Magnetic resonance images (MRIs) and computed tomography (CT) neuroradiographs showing lesions in brains of three children with eastern equine encephalitis: A) Results of noncontrast CT scan of the brain of patient 12 on hospital day 2; the neuroradiograph shows subtle hypoattenuation of the left caudate head (arrow) and diencephalic region. B) Axial fluid attenuated inversion recovery image from brain MRI scan of patient 14 on hospital day 2; the image shows abnormal T2 hyperintense regions of the bimesial temporal regions (thick arrows) with accompanying abnormal T2 hyperintense regions of the dorsal pontomesencephalic regions (thin arrows). C, D) FLAIR images from brain MRI scan of patient 15 on hospital day 3. C) Abnormal T2 hyperintense caudate and thalamic nuclei, most prominent on the right (arrow). D) Abnormal T2 hyperintense regions are most prominent in the right parietotemporal gray matter (arrow) and subcortical white matter but are also seen scattered throughout.
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