Definition

Western equine encephalitis (WEE) is a virus spread by a bite from an infected mosquito. While WEE is rare, an infected person can become seriously ill and even die from the virus.

Causes

WEE is caused by being bitten by a mosquito that is infected with the virus.

Risk Factors

Factors that may increase your chance of WEE include:

• Living in or visiting the plains regions of western and central United States
• Doing activities outdoors and not using insect repellent

Symptoms

Most people with WEE do not have any symptoms.

If symptoms do occur, they appear within 5-10 days after infection and include:

• Headache
• Fever
• Neck stiffness
• Chills
• Fatigue
• Joint and muscle pain
• Vomiting

WEE can lead to more serious, life-threatening symptoms like inflammation of the brain (encephalitis), seizures, and coma. These serious symptoms are more common in infants and older adults.

Diagnosis

In addition to taking your medical history and doing a physical exam, your doctor will ask you:

• What kind of symptoms you are experiencing
• Where you have been living or traveling
• Whether you have been exposed to mosquitoes

Your doctor may need to test your bodily fluids. This can be done with:

• Blood tests
• Cerebrospinal fluid tests to evaluate the fluid that surrounds the brain and spinal cord

Imaging tests to evaluate the brain can be done with:

• MRI scan
• CT scan

Treatment

Because the infection is viral, there is no specific treatment for WEE. Treatment will focus on managing your symptoms and related complications through:

• IV fluids
• Antiseizure medications
• Medications to decrease brain swelling
• Breathing support— mechanical ventilation

Prevention

There is no vaccine for humans. There is a vaccine for horses. Prevention of WEE focuses on controlling mosquitoes and avoiding mosquito bites. Steps you can take to avoid mosquito bites include:

• Stay inside between dusk and dark, when mosquitoes are most active.
• Wear long pants and long-sleeved shirts when outside.
• Use an insect repellent with DEET.
• Repair screens to prevent mosquitoes from entering the house.
• Use proper mosquito netting at night. Look for netting treated with insecticide.
• Remove standing water (such as birdbaths, clogged gutters) to prevent mosquito breeding.

National Institute of Allergy and Infectious Diseases http://www.niaid.nih.gov

Healthy Alberta http://www.healthyalberta.com/

Meningitis and encephalitis fact sheet. National Institutes of Neurological Disorders and Stroke website. Available at:
http://www.ninds.nih.gov/disorders/encephalitis_meningitis/detail_encephalitis_meningitis.htm
Updated February 16, 2011. Accessed January 4, 2013.

Reimann CA, Hayes EB, et al. Epidemiology of neuroinvasive arboviral disease in the United States, 1999-2007. Am J Trop Med Hyg. 2008;79(6):974-979.

Western equine encephalitis fact sheet. Minnesota Department of Public Health website. Available at:
http://www.health.state.mn.us/divs/idepc/diseases/weencephalitis/wee.html
Accessed January 4, 2013.

10/1/2013 DynaMed Systematic Literature Surveillance
http://www.ebscohost.com/dynamed:
Reimer LJ, Thomsen EK, Tisch DJ, et al. Insecticidal bed nets and filariasis transmission in Papua New Guinea. N Eng J Med. 2013;369(8):745-753.