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Rhode Island Hospital Successfully Manages Case of Severe EEE

7/8/2013

mosquito Rhode Island Hospital successfully treated a 21-year-old patient with severe neuroinvasive Eastern Equine Encephalitis (EEE), minimizing neurological deficits and resulting in a very positive outcome. The findings from this treatment are published online in advance of print in the journal Neurocritical Care.

EEE is a rare mosquito-borne virus that can be deadly to humans. While it is mostly asymptomatic in humans, it can cause a neuroinvasive infection with a high rate of mortality. These cases typically present as a generalized illness with fever, headache, chills and vomiting. Only a handful of cases of EEE are reported in the U.S. each year.

"Every summer we hear about cases of EEE, and for the severe cases the outcomes are rarely favorable," said lead author Linda C. Wendell, MD, of the department of neurology and neurosurgery at Rhode Island Hospital. "We were able to diagnose this patient quickly, and through an aggressive approach we were able to manage brain swelling, stop his seizures and significantly minimize brain injury."

Wendell continued, "The patient was in great physical health, which no doubt contributed to his recovery. It was a scary time for a few weeks, but he continues to make progress and we could not have hoped for a better outcome."

According to the Centers for Disease Control and Prevention, EEE is one of the most severe mosquito-transmitted diseases in the U.S. It has a mortality rate of approximately 33 percent, and those who survive are likely to suffer significant brain damage. No specific treatment for EEE has been identified, rather care is based on the patient's symptoms.

"There is no protocol for avoiding EEE, other than to be careful," Wendell said. "Unfortunately in many areas of the country, mosquitoes are simply a fact of life - we can get bitten by them at any time during the warm weather months. But by protecting yourself with appropriate clothing, mosquito repellent and staying indoors during peak mosquito hours (dusk), you can minimize risk."

There was no outside funding for this study. Wendell's principal affiliation is Rhode Island Hospital, a member hospital of the Lifespan health system in Rhode Island. She also has an academic appointment at The Warren Alpert Medical School of Brown University, departments of neurology and neurosurgery. Other researchers involved in the study are N. Stevenson Potter, MD, PhD, and Bradford B. Thompson, MD, also of the departments of neurology and neurosurgery; July L. Roth, MD department of neurology at Rhode Island Hospital and the Alpert Medical School; and Stephen P. Salloway, MD, MS, department of neurology at Butler Hospital and the Alpert Medical School.