Equine amplification and virulence of subtype IE Venezuelan equine encephalitis viruses isolated during the 1993 and 1996 Mexican epizootics. (Research).To assess the role of horses as amplification hosts during the 1993 and 1996 Mexican Venezuelan equine encephalitis Venezuelan equine encephalitis An alphavirus infection first identified in a sick horse in Venezuela in 1938, which occurs as an epizootic infection in central and northern South America; most exposed humans develop flu-like Sx; ±4%, especially adolescents, (VEE) epizootics, we subcutaneously infected 10 horses by using four different equine isolates. Most horses showed little or no disease and low or nonexistent non·ex·is·tence n. 1. The condition of not existing. 2. Something that does not exist. non viremia viremia /vi·re·mia/ (vi-re´me-ah) the presence of viruses in the blood. vi·re·mi·a n. The presence of viruses in the bloodstream. . Neurologic disease developed in only 1 horse, and brain histopathologic examination showed meningeal me·nin·ge·al adj. Of, relating to, or affecting the meninges. meningeal pertaining to the meninges. meningeal hemorrhage lymphocytic infiltration, perivascular perivascular /peri·vas·cu·lar/ (-vas´ku-lar) near or around a vessel. perivascular around a vessel. perivascular cellulitis cuffing, and focal encephalitis. Three animals showed mild meningoencephalitis meningoencephalitis /me·nin·go·en·ceph·a·li·tis/ (me-ning?go-en-sef?ah-li´tis) inflammation of the brain and meninges. toxoplasmic meningoencephalitis without clinical disease. Viral RNA RNA: see nucleic acid. RNA in full ribonucleic acid One of the two main types of nucleic acid (the other being DNA), which functions in cellular protein synthesis in all living cells and replaces DNA as the carrier of genetic was detected in the brain of several animals 12-14 days after infection. These data suggest that the duration and scope of the recent Mexican epizootics were limited by lack of equine amplification characteristic of previous, more extensive VEE outbreaks. The Mexican epizootics may have resulted from the circulation of a more equine-neurotropic, subtype IE virus strain or from increased transmission to homes due to amplification by other vertebrate hosts or transmission by more competent mosquito vectors. ********** Venezuelan equine encephalitis virus Venezuelan equine encephalitis virus is a mosquito-borne viral pathogen that causes Venezuelan equine encephalitis or encephalomyelitis (VEE). VEE can affect all equine species, such as horses, asses, and zebras. (VEEV; Togaviridae: Alphavirus) is an emerging pathogen of humans and equines in many parts of the New World (1-3). Sporadic outbreaks date to the 1930s or earlier in South America and have affected hundreds of thousands of people, horses, donkeys, and mules, causing high mortality rates in equines and severe illness in humans. Most outbreaks have been confined to northern South America Northern South America is a region in the continent South America. This region has a rich range of natural resources exploited to European explorers over the past couple of centuries. Most of the most populous cities, such as Bogotá, are located temperate conditions of the Andes. , but one that began in Guatemala and El Salvador in 1969 spread northward through Mexico and reached Texas in 1971 (2,4,5). The etiologic agents during all of the major VEE outbreaks were subtype IAB (1) See Internet Architecture Board. (2) (Interactive Advertising Bureau, New York, www.iab.net) An industry association founded in 1996 to set standards and guidelines for interactive advertising and marketing. or IC VEEV. Other subtypes of VEEV, including subtype IE strains that circulate in sylvatic sylvatic /syl·vat·ic/ (sil-vat´ik) sylvan; pertaining to, located in, or living in the woods. sylvatic found in the woods; occurring in animals of the forest. and swamp habitats of Central America and Mexico, are traditionally considered enzootic en·zo·ot·ic adj. Prevalent among or restricted to animals of a specific geographic area. Used of a disease. n. An enzootic disease. enzootic peculiar to or present constantly in a location. See also endemic. , equine-avirulent, and incapable of exploiting horses as amplification hosts to cause widespread disease (6-9). Before 1993, the only VEE outbreak confirmed by virus isolation in Mexico was the 1969-1971 epizootic/epidemic (5). The etiologic agent was a subtype IAB VEEV strain that likely originated from an inadequately inactivated inactivated rendered inactive; the activity is destroyed. inactivated viruses treated so that they are no longer able to produce evidence of growth or damaging effect on tissue. equine vaccine preparation (10,11). Another VEE outbreak in Tamaulipas, Mexico, was detected serologically in 1965-1966, but no virus strains were isolated (12,13). During 1993 and 1996, small outbreaks of equine encephalitis occurred near the Pacific Coast in the Mexican States of Chiapas and Oaxaca, respectively. These outbreaks involved 125 and 32 equine cases, respectively, with case-fatality rates of 50% and 38%; human VEE was not confirmed, although human seroprevalence seroprevalence Immunology The proportion of a population that is seropositive–ie, has been exposed to a particular pathogen or immunogen; the seropositivity of a population is calculated as the number of individuals who produce a particular antibody divided in the region is high (J.G.E.-F., S.C.W., unpub, data). Antigenic, sequencing and phylogenetic studies indicated that the VEEV strains isolated from horses belong to subtype IE and are closely related to enzootic strains isolated nearby in sylvatic habitats on the Pacific Coast of Guatemala from 1968-1980 (14-16). These Mexican outbreaks represented the first confirmed equine cases attributed to VEEV subtype IE infection. Although the 1966 Tamaulipas epizootic ep·i·zo·ot·ic adj. Affecting a large number of animals at the same time within a particular region or geographic area. Used of a disease. ep may have been caused by subtype IE viruses that circulate nearby on the Gulf Coast of Mexico The Gulf Coast of Mexico stretches along the Gulf of Mexico from the border with the United states at Matamoros all the way to the tip of the Yucatán Peninsula at Cancún. It includes the coastal regions along the Bay of Campeche. Major cities include Veracruz, Tampico, and Coatzacoalcos. (12), the IE subtype was not known to be equine virulent (8) and had never been shown to be capable of equine amplification or of producing equine epizootics. The 1993 and 1996 Mexican epizootics placed these assumptions into doubt. Partial sequence analysis of the PE2 envelope glycoprotein precursor gene of four isolates made during the 1993 and 1996 Mexican outbreaks showed that they are strongly linked to enzootic subtype IE VEEV isolates made in 1968 and 1980 along the Guatemalan Pacific Coast (14,15). Complete structural gene nucleotide sequence comparison of a Guatemalan 1968 isolate with a 1993 Mexican isolate showed that they differ by only 3% at the nucleotide level (14), and more recent genomic sequencing of four strains has shown an overall nucleotide sequence divergence of <2%. Only eight amino acid changes are predicted to have accompanied the emergence of the epizootic strains (16). This genetic similarity suggests that small numbers of mutations in enzootic progenitors may have resulted in acquisition of the equine-virulent phenotype, as indicated by previous studies of subtype IC VEEV emergence in Venezuela (17). To determine the virulence and viremia characteristics of VEEV strains isolated during these Mexican outbreaks, and to assess retrospectively the role of equines as amplification hosts during epizootic transmission, we conducted experimental infections of horses with four different Mexican strains isolated from horses in 1993 and 1996. Although severe clinical neurologic disease occurred in one animal, low levels of viremia or none was detected after subcutaneous inoculation of any of the horses, which suggests that equines were not the principal amplification hosts in Mexico during the 1993 and 1996 epizootics. Methods Virus Preparation The VEEV strains used for experimental infections are described in Table 1. These viruses (without further passage) were diluted in Eagle minimal essential medium (MEM) containing antibiotics and 10% antibody-negative normal horse serum before being used. Horse Infections Ten antibody-negative horses were identified, ranging in estimated age from 24 to 36 months. Only horses with no evidence of preexisting pre·ex·ist or pre-ex·ist v. pre·ex·ist·ed, pre·ex·ist·ing, pre·ex·ists v.tr. To exist before (something); precede: Dinosaurs preexisted humans. v.intr. alphavirus immunity were used in this study of experimental infections. One week before the VEEV inoculations, all horses were treated with insecticide to eliminate external parasites, and their temperature and blood counts were recorded 3 days before the viral inoculations. The horses were selected at random for inclusion in two experimental groups of six and four animals, respectively. Horses were inoculated with four different Mexican subtype IE VEE epizootic isolates (Table 1). Two strains were obtained from the 1993 Chiapas outbreak and two others from the 1996 Oaxaca outbreak. The first set of six horses was inoculated (three each) with strain CPA (Computer Press Association, Landing, NJ) An earlier membership organization founded in 1983 that promoted excellence in computer journalism. Its annual awards honored outstanding examples in print, broadcast and electronic media. The CPA disbanded in 2000. 201, isolated from the brain of an encephalitic horse during the 1993 Chiapas outbreak, and strain OAX OAX Oaxaca OAX Oaxaca, Oaxaca, Mexico - Xoxocotlan (Airport Code) OAX Object Oriented Api for Xml 131, isolated from the brain of a diseased horse from the 1996 Oaxaca outbreak. The last group of four horses (two each) was inoculated with OAX 142, isolated from the brain of a moribund horse from Oaxaca in 1996, and the I-290-93 strain, from the serum of a diseased horse from the 1993 Chiapas outbreak. All horses were infected by subcutaneous inoculation in the shoulder region of 0.6-1.0 mL of MEM containing 10% antibody-negative normal horse serum and 2,000 Vero cell PFU PFU plaque-forming unit; in virology, areas of cell lysis (CPE) in monolayer cell culture, under overlay conditions, initiated by infection with a single virus particle. of VEEV, a dose comparable to that inoculated by alphavirus-infected mosquitoes (18). Although infection by the bite of an infected mosquito may potentiate po·ten·ti·ate v. 1. To make potent or powerful. 2. To enhance or increase the effect of a drug. 3. To promote or strengthen a biochemical or physiological action or effect. viremia levels generated by some bunyaviruses (19,20), we used needle inoculation for two reasons: 1) almost all past experimental equine infections with other epizootic VEEV have been conducted with needle infections, and we wanted to generate data that could be compared directly to the literature; and 2) lack of a high containment insectary in·sec·tar·y or in·sec·tar·i·um n. pl. in·sec·tar·ies or in·sec·tar·i·a A place for keeping, breeding, or observing living insects. near the large animal biocontainment facility precluded the use of infected mosquitoes. Each pair or trio of horses inoculated with a given virus strain was housed together in an isolation room within a large animal biocontainment building. Each horse was placed in a single stall and fed daily with fresh hay and water, and the horse's clinical signs were monitored at least twice daily. Rectal temperature was recorded twice daily until day 14 postinoculation, beginning on the day before inoculation. Blood was collected twice daily by venipuncture venipuncture /veni·punc·ture/ (ven?i-pungk´chur) surgical puncture of a vein. ve·ni·punc·ture or ve·ne·punc·ture n. until day 9 and serum samples were stored at -70[degrees]C for virus titration. Additional blood was also collected into EDTA-containing tubes every morning for up to 9 days, beginning the day before inoculation, and analyzed for hematocrit Hematocrit Definition The hematocrit measures how much space in the blood is occupied by red blood cells. It is useful when evaluating a person for anemia. Purpose Blood is made up of red and white blood cells, and plasma. , hemoglobin determination, and platelet and leukocyte counts (also counts of basophils, eosinophils Eosinophils A leukocyte with coarse, round granules present. Mentioned in: Histiocytosis X eosinophils , and monocytes monocytes, n.pl the largest of the white blood cells. They have one nucleus and a large amount of grayish-blue cytoplasm. Develop into macrophages and both consume foreign material and alert T cells to its presence. ). The maintenance and care of animals complied with the guidelines of the Centro Nacional de Investigaciones en Microbiologia, Instituto Nacional de Investigaciones Forestales, Agricolas y Pecuarias. Histopathologic Studies All of the horses, except one (no. 4) that died on day 12, were killed 15 days after inoculation. Necropsies were carried out to extract tissues of interest. For histopathologic studies, samples were taken of white and gray matter from the anterior, median, and posterior brain. The medula oblongata and a portion of the spinal chord were taken at random. Tissue samples <5 mm in thickness were fixed in 10% neutral buffered formalin formalin /for·ma·lin/ (for´mah-lin) formaldehyde solution. for·ma·lin n. An aqueous solution of formaldehyde that is 37 percent by weight. and processed by routine methods for paraffin embedding. Sections were stained with hematoxylin hematoxylin /he·ma·tox·y·lin/ (he?mah-tok´si-lin) an acid coloring matter from the heartwood of Haematoxylon campechianum; used as a histologic stain and also as an indicator. and eosin eosin /eo·sin/ (e´o-sin) any of a class of rose-colored stains or dyes, all being bromine derivatives of fluorescein; eosin Y, the sodium salt of tetrabromofluorescein, is much used in histologic and laboratory procedures. . Virus and Viral RNA Assays Serum viremia levels were assayed by the inoculation of serial dilutions onto monolayers of Vero cells to assess plaque formation. Serial dilutions were also injected intracerebrally into 1- to 2-day-old mice, and titers were calculated as 50% lethal dose (L[D.sub.50]) values. Attempts to isolate VEEV from brain samples included the inoculation of Vero cell monolayers and inoculation of 1- to 2-day-old mice. Reverse transcription-polymerase chain reactions (RT-PCR RT-PCR reverse transcriptase-polymerase chain reaction. See PCR1. ) were also carried out on RNA extracted from paraffin-embedded brain tissue from horses 1, 2, 3, 4, and 10 (insufficient brain tissue was left after histologic analyses on the remaining horses) to detect VEEV RNA. RNA was extracted from tissues by using the QIAGEN (Valencia, CA) RNeasy kit according to the manufacturer's protocol. Approximately 20 mg of each sample was placed in a microfuge tube with 1,200 [micro]L of 100% xylene xylene (zī`lēn) or dimethylbenzene (dī'mĕthəlbĕn`zēn), C6H4(CH3)2 and vortexed to dissolve the paraffin. The tissue was washed twice with an equal volume of 100% ethanol, then dried and resuspended in 350 [micro]L of the QIAGEN RTL (Register Transfer Level) A high-level hardware description language (HDL) for defining digital circuits. The circuits are described as a collection of registers, Boolean equations, control logic such as "if-then-else" statements as well as complex event sequences; buffer before being ground with a pestle pestle /pes·tle/ (pes´'l) an implement for pounding drugs in a mortar. pes·tle n. A club-shaped, hand-held tool for grinding or mashing substances in a mortar. and 0.5 mm zirconia/silica beads (BioSpec Products, Bartlesville, OK). The RNA was eluted in 30 [micro]L of Rnase-free water and 3 [micro]L of RNasin (Promega, Madison, WI) and used for RT-PCR. RT-PCR was performed with the OneStep RT-PCR kit (QIAGEN). The primers were designed to amplify genome positions 8505-8882, yielding an expected 377-bp product: sense primer: 5'-CATAGACAATCCTGGTTACGACGAG-3' reverse primer: 5'-CACCTGGCAAGCAGAAAGTATCC-3'. The 50-[micro]L reaction mix was comprised of QIAGEN OneStep RT-PCR buffer, 400 [micro]M of each dNTP, 600 nM of each primer, and 10 [micro]L of RNA sample. The samples, along with negative control (water alone) and positive control (viral RNA) samples, were placed in a thermocycler for: 30 min at 50[degrees]C, 15 min at 95[degrees]C, followed by 40 cycles at 94[degrees]C for 1 min, 56[degrees]C for 1 min, 72[degrees]C for 1 min, and a final extension of 10 min at 72[degrees]C. A seminested reaction followed with the same sense primer and a nested reverse primer 5'-GCACACCTGATGCACCTG-3' to amplify genome positions 8505-8642, for an expected 137-bp product. For the seminested PCR PCR polymerase chain reaction. PCR abbr. polymerase chain reaction Polymerase chain reaction (PCR) , all initial PCR samples, including the controls, were diluted 1/50. The seminested PCR was performed by using Taq polymerase (Promega) for 30 cycles at 95[degrees]C for 30 sec, 56[degrees]C for 30 sec, 72[degrees]C for 2 min, and a final 72[degrees]C extension for 10 min. PCR samples were analyzed on a 1% agarose gel, and visible DNA DNA: see nucleic acid. DNA or deoxyribonucleic acid One of two types of nucleic acid (the other is RNA); a complex organic compound found in all living cells and many viruses. It is the chemical substance of genes. products were purified by using a QIAquick PCR purification kit (QIAGEN) and sequenced by using the sense primer and the ABI Abi (ā`bī) [short for Abijah], in the Bible, King Hezekiah's mother. (Application Binary Interface) A specification for a specific hardware platform combined with the operating system. PRISM Big Dye Terminator v3.0 kit (Applied Biosystems, Foster City, CA). Results were compared to the genomic viral sequences for the Mexican viruses used (GenBank Accession nos. AF448536, AF448537, and AF448538). Serologic Tests Before the virus inoculation, serum samples from all horses were tested for preexisting antibodies to VEE, eastern (EEE EEE eastern equine encephalomyelitis. EEE eastern equine encephalomyelitis. ), and western equine encephalitis western equine encephalitis see equine viral encephalomyelitis; abbreviated WEE. (WEE) viruses by using an enzyme-linked immunosorbent assay enzyme-linked immunosorbent assay n. ELISA. Enzyme-linked immunosorbent assay (ELISA) A diagnostic blood test used to screen patients for AIDS or other viruses. (ELISA ELISA (e-li´sah) Enzyme-Linked Immuno-Sorbent Assay; any enzyme immunoassay using an enzyme-labeled immunoreactant and an immunosorbent. ELISA n. ) with cell lysates prepared from BHK-21 cells infected with VEEV strain Trinidad donkey (21,22), EEE virus strain 82V2137 (23), and WEE virus strain Fleming (24). After the horses were injected, seroconversion seroconversion /se·ro·con·ver·sion/ (-con-ver´zhun) the change of a seronegative test from negative to positive, indicating the development of antibodies in response to immunization or infection. was detected by using Vero cell plaque reduction ([greater than or equal to] 80%) neutralization tests (PRNT) with the CPA201 strain. Results Clinical Signs and Symptoms All animals became infected by VEEV as indicated by seroconversion detected by PRNT (titers [greater than or equal to] 1:40) on day 12 or 15 after inoculation. Symptoms of VEEV infection were absent in the infected horses, and only clinical signs were observed. In 9 of the 10 horses, the only clinical sign consistent with VEE was intermittent fever. Horses nos. 1-5 and 10 showed a moderate temperature elevation of approximately 1[degree]-2[degrees]C, whereas horses 6-8 and 9 showed only a small elevation of approximately 0.5[degree]-1.0[degree]C. Horse 6 did not display any febrile febrile /feb·rile/ (feb´ril) pertaining to or characterized by fever. feb·rile adj. Of, relating to, or characterized by fever; feverish. response, only normal variation in its temperature (Table 2). All animals had normal temperatures when they were killed on day 12 or 15. When it occurred, fever peaked 27 days after inoculation (Figure 1). Most horses displayed a slight anorexia, but none completely ceased eating during the study, except for horse no. 4 (described below). Diminished eating tended to coincide with fever, and appetence coincided with a return to normal temperature. [FIGURE 1 OMITTED] Platelet counts increased slightly after day 5 in horses infected with strain CPA201 (Figure 2). A modest leukopenia leukopenia /leu·ko·pe·nia/ (-pe´ne-ah) reduction of the number of leukocytes in the blood below about 5000 per cubic mm.leukope´nic basophilic leukopenia basophilopenia. occurred from day 2 to day 6 in two of three animals infected with strain CPA201. Horse no. 4, infected with strain CPA201, developed severe neurologic disease and showed the greatest reduction in leukocyte counts (Figure 3). A slight leukocytosis Leukocytosis Definition Leukocytosis is a condition characterized by an elevated number of white cells in the blood. Description Leukocytosis is a condition that affects all types of white blood cells. was seen in animals infected with OAX131 from day 3 to day 5. Otherwise, most animals showed little evidence of changes in leukocyte counts. Hematocrit values did not drop (data not shown) as in most previous studies of equines infected with epizootic VEEV (6,9). Strains I-290-93 and OAX142 produced no apparent reduction in platelet counts (data not shown). [FIGURE 2-3 OMITTED] Horse no. 4 was the only animal that exhibited clinical signs of encephalitis. On day 6 postinoculation, this male appeared weak, and on day 8 it exhibited nervousness, anorexia, pendular pendular /pen·du·lar/ (pen´du-lar) having a pendulum-like movement. head movements, marked incoordination incoordination /in·co·or·di·na·tion/ (in?ko-or?di-na´shun) ataxia. in·co·or·di·na·tion n. See ataxia. of the extremities, penile penile /pe·nile/ (pe´nil) of or pertaining to the penis. pe·nile adj. Of or relating to the penis. penile of or pertaining to the penis. relaxation, teeth grinding, muscular tremors, restlessness, dyspnea, head shaking, excessive sweating, movement of the ears in all directions, circular walking, and blindness. On day 9 this animal was more tranquil, with less sweating. It assumed an abnormal posture with its head resting on the wall, and blindness was evident because the horse began walking into various objects. On day 10, horse no. 4 showed incoordination, nervous ticks of the head, and complete blindness. By day 11 a weight loss was evident; on day 12 the horse was prostrate and was therefore killed. Viremia Levels Of 10 horses infected with VEEV strains from the two Mexican epizootics, none showed detectable viremia levels when serum specimens were assayed for plaques on Vero cells. When inoculation of newborn mice with serial dilutions was used, two of three horses infected with strain CPA201 and three horses infected with strain OAX131 demonstrated viremia with low titers on days 1-3 and 2-4, respectively (Figure 4). The other two VEEV strains (I-290-93 and OAX142) did not produce detectable viremia levels. [FIGURE 4 OMITTED] Virus Isolation and Viral RNA Detection Virus could not be isolated from brain tissues of any of the horses by inoculation of either Vero cells or baby mice. This was not unexpected because the animals were killed 12-15 days after infection, when the virus was presumably pre·sum·a·ble adj. That can be presumed or taken for granted; reasonable as a supposition: presumable causes of the disaster. cleared by the immune response (neutralizing antibodies detected in all animals). Of the brain samples from horses 1-4 and 10 which were available for viral RNA detection by RT-PCR, all were positive (Figure 5). Sequences of the PCR amplicons were all identical to the parent strains, except for horse no. 4 infected with strain CPA201, which had a thymine thymine (thī`mēn), organic base of the pyrimidine family. Thymine was the first pyrimidine to be purified from a natural source, having been isolated from calf thymus and beef spleen in 1893–4. to cytosine cytosine (sī`tōsēn'), organic base of the pyrimidine family. It was isolated from the nucleic acid of calf thymus tissue in 1894. synonymous transition at nucleotide position 8562. Strain I-290-93 used to infect horse 10 had not been sequenced previously, but the sequence of the amplicon derived from horse 10 was identical to that of strain OAX131. [FIGURE 5 OMITTED] Necropsy necropsy /nec·rop·sy/ (nek´rop-se) examination of a body after death; autopsy. nec·rop·sy n. See autopsy. necropsy examination of a body after death. See also autopsy. and Histopathologic Findings Gross pathologic lesions attributable to VEEV infection were not observed upon necropsy in any of the horses. Sections of brain from all 10 horses were examined. The fatally infected horse, no. 4, showed multifocal multifocal /mul·ti·fo·cal/ (mul?te-fo´k'l) arising from or pertaining to many foci. mul·ti·fo·cal adj. Relating to or arising from many foci. perivascular cuffing, lymphocytic meningitis, and focal encephalitis, characterized by focal neuronal necrosis and neuronophagia with associated microglial nodules Nodules A small mass of tissue in the form of a protuberance or a knot that is solid and can be detected by touch. Mentioned in: Leprosy (Figure 6B). Lesions were seen in gray and white matter of the cerebrum cerebrum: see brain. cerebrum Largest part of the brain. The two cerebral hemispheres consist of an inner core of myelinated nerve fibres, the white matter, and a heavily convoluted outer cortex of gray matter (see cerebral cortex). and cerebellum cerebellum (sĕr'əbĕl`əm), portion of the brain that coordinates movements of voluntary (skeletal) muscles. It contains about half of the brain's neurons, but these particular nerve cells are so small that the cerebellum accounts for , but were not present in available sections of hippocampus or spinal cord. Samples of skeletal muscle and kidney from horse no. 10 showed no pathologic changes. Lymphoid tissue was not examined for any of the animals. All three horses infected with isolate OAX131 also showed evidence of meningitis with perivascular cuffing, and minimal encephalitis (Figure 6A). Animal no. 2 displayed more intense lesions, with numerous admixed eosinophils within leptomeningeal and perivascular infiltrates (Figures 6C and 6D). [FIGURE 6 OMITTED] Discussion Equine Amplification and VEE Emergence Previously described experimental infections of equines with epizootic subtype IAB and IC VEEV generally resulted in high rates of overt disease with high-titered viremia levels, often reaching [10.sup.5-8] suckling suckling In mammals, the drawing of milk into the mouth from the nipple of a mammary gland. In human beings, it is referred to as nursing or breast-feeding. The word also denotes an animal that has not yet been weaned—that is, whose access to milk has not yet been mouse intracerebral in·tra·cer·e·bral adj. Existing within the cerebrum. lethal dose 50% units (SMICL[D.sub.50]/mL serum) (4,6,7,9,25-28). This high-titered viremia, combined with the attractiveness of equines to many potential mosquito vectors and poor anti-mosquito defensive behavior, results in their high efficiency as amplification hosts for epizootic virus transmission. Equine case-fatality rates in these previous studies were generally approximately 50%, similar to those measured during natural epizootics. In contrast, enzootic VEEV belonging to subtypes ID (6,9), IE (8,9), II (Everglades virus) (25), III (Mucambo virus), and IV (Pixuna virus) (29) generally produces little or no clinical illness and viremia less than [10.sup.5] SMICL[D.sub.50]/mL serum after experimental equine infection. These enzootic viruses, including a subtype IE virus strain isolated near Veracruz near the Gulf Coast of Mexico, also have not generally been associated with equine disease in nature (3,8). During 1969-1971, a VEE epizootic involving a subtype IAB strain spread northward from Guatemala along the Pacific Coast of Chiapas and Oaxaca States and then crossed into Veracruz State on the Gulf Coast before moving north to Texas (5). The reasons why the 1993 and 1996 Mexican outbreaks did not spread northward along the same route are unknown, but our studies suggest that the recent Mexican outbreaks were fundamentally different than those caused by subtype IAB and IC VEEV. The maximum viremia levels we measured in experimentally infected horses were approximately 1,000-fold lower than titers measured in previous studies using subtype IAB and IC VEEV strains from more extensive outbreaks (4,6,7,9,25-28,30). The titers we measured with the Mexican equine strains were also much lower than the infection thresholds for mosquitoes, as predicted by most experimental infections with VEEV (31-34). This finding indicates that equines probably did not serve as amplification hosts to support epizootic transmission cycles in Mexico during 1993 and 1996. This lack of equine amplification, which is believed to be a critical factor in VEE spread, probably limited the duration and scope of the 1993 and 1996 Mexican epizootics. The low-titered viremia level, even in the horse in which fatal encephalitis developed, also indicates that the Mexican subtype IE epizootic viruses may be more neurotropic neurotropic pertaining to or emanating from neurotrophy, e.g. neurotropic osteopathy. than other VEEV strains that apparently reach the central nervous system only after exceeding higher viremia titer thresholds (4,6,9). Other possible explanations for sudden appearance of equine disease during the 1993 and 1996 outbreaks include increased transmission to horses by efficient amplification in other vertebrate hosts, or enhanced transmission by adaptation of local VEEV strains to equiphilic mosquito vectors. Although robust vector surveillance was not conducted during the 1993 and 1996 Mexican epizootics, rainfall patterns and anecdotal reports do not indicate unusually large mosquito populations. Vector incrimination and susceptibility testing are needed to assess the hypothesis that the Mexican epizootic strains are more infectious for mosquitoes and more readily transmitted than putative enzootic IE progenitors identified in phylogenetic studies (15,16). Equine Virulence of the Mexican VEEV Strains In some respects, our results agreed with those of previous experimental studies of VEEV in equines. Infection with the Mexican VEEV strains resulted in mild leukopenia as has been reported (9). However, the mild hematologic hematological, hematologic pertaining to or emanating from blood cells. hematological tests total and differential white cell counts, hematocrit estimation, erythrocyte count. abnormalities were more like those caused by enzootic VEEV strains than epizootic, subtype IAB and IC variants (9). In contrast to many VEE outbreaks attributed to subtype IAB and IC strains (3), the four Mexican epizootic virus strains we tested in horses produced an overall mortality rate of 10% but a case-fatality rate of 100%. These results also contrast with the reported case-fatality rates during the 1993 and 1996 Mexican outbreaks of 50% and 37%, respectively, and with the 1993 attack rate of 30% (14). The case-fatality rate differences probably reflect sampling error because our experimental infections produced disease in only one horse. Possible explanations for the discrepancy in apparent:inapparent inapparent not clearly seen. inapparent infection infection without clinical signs. ratios in our study versus data collected during the outbreaks include an underreporting of true inapparent infections during the 1993 epizootic, or phenotypic differences between the virus populations we inoculated into horses versus those circulating naturally during the epizootics. The latter possibility is discussed below. Detection of VEEV RNA in the brain of five horses killed 12-14 days after infection, despite the absence of detectable infectious virus, was somewhat surprising. This result indicates that VEEV replicated in the brain of all horses, consistent with some pathologic lesions in the asymptomatic animals infected with strain OAX131 (Table 1). Persistence of viral RNA in the brain after the disappearance of infectious virus has also been reported for other alphaviruses (35). Previous sequencing, rodent infection, and in vitro studies with these Mexican VEEV strains suggested that mixed populations of viruses may circulate in nature, represented by differences in amino acid composition and charge on the surface of the E2 envelope spike glycoprotein (16). Genomic sequencing studies of the four Mexican VEEV strains we studied revealed one amino acid difference: strain OAX142 has a Glu residue at position 117 of the E2 envelope glycoprotein, whereas the other three strains have Lys (16). The possibility that the Lys residue does not represent the wild-type sequence was considered previously because alphaviruses including VEEV are known to accumulate artifactual, positive charge amino acid changes in the E2 protein as the result of selection for binding to heparan sulfate on the surface of cells in culture (36). Because these changes reduce the virulence of alphaviruses in laboratory rodents, they can place into question the wild-type phenotype of VEEV strains. However, our results further support the previous conclusion that the E2-117 Lys residue was present in natural VEEV isolates during the Mexican outbreaks as the consensus amino acid, but possibly in a mixed quasispecies population (16). The only strain that produced neurologic disease in our study was CPA201, which has a consensus Lys at E2-117. Strain OAX142, which has Glu-117, produced no detectable disease, viremia, or hematologic alterations. These results are not consistent with the hypothesis that the Lys at E2-117 resulted from heparan sulfate adaptation during RK cell passage, which would be expected to result in artificial attenuation Loss of signal power in a transmission. Attenuation The reduction in level of a transmitted quantity as a function of a parameter, usually distance. It is applied mainly to acoustic or electromagnetic waves and is expressed as the ratio of power densities. (36). Because the Lys-117 mutation produces the small plaque phenotype characteristic of most epizootic, equine-virulent VEEV strains, it remains a potential virulence determinant worthy of further characterization by using cDNA clones and reverse genetics. Acknowledgments We thank Amelia Travassos da Rosa and Robert Tesh for assistance with serology Serology The division of biological science concerned with antigen-antibody reactions in serum. It properly encompasses any of these reactions, but is often used in a limited sense to denote laboratory diagnostic tests, especially for syphilis. , and Wenli Kang for fine technical assistance. We also thank Isidro Angel Nunez for his valuable assistance with the handling of the horses, Alejandro Hernandez Magdaleno for his participation in the horse inoculations, and Juan Garcia Garcia for providing the facilities for completing these experiments. This research was supported by grants AI39800 and AI48807 from the National Institutes of Health. The opinions expressed by authors contributing to this journal do not necessarily reflect the opinions of the Centers for Disease Control and Prevention Centers for Disease Control and Prevention (CDC), agency of the U.S. Public Health Service since 1973, with headquarters in Atlanta; it was established in 1946 as the Communicable Disease Center. or the institutions with which the authors are affiliated.
Table 1. Mexican equine isolates of Venezuelan equine encephalitis
virus used for experimental infections
Strain Date of Place of isolation
isolation
OAX 131 25 June 1996 Chahuites, Oaxaca State
CPA201 29 June 1993 Rancho E1 Recuerdo, Mapastepec,
Chiapas State; 15[degrees], 25' N
93[degrees] 01' W
OAX 142 5 July 1996 Tapanatepec, Oaxaca State
1-290-93 12 July 1993 Rancho La Guadalupe, Mapastepec,
Chiapas State 15[degrees], 25' N
93[degrees] 00' W
Strain Tissue Passage history (a)
OAX 131 Cerebrum sm1, RK1
CPA201 Brain sm1, RK1
OAX 142 Cerebrum sm1, RK1
1-290-93 Serum sm1, RK1
(a) RK, rabbit kidney; sm, suckling mouse.
Table 2. Outcome for homes experimentally infected with
Venezuelan equine encephalitis virus strains
Maximum
temperature Maximum
Horse no. Gender Virus strain ([degrees]C) viremia level (a)
1 Male OAX131 40.3 2.8
2 Male OAX131 40.2 1.4
3 Male OAX131 39.1 1.4
4 Male CPA201 40.8 2.4
5 Male CPA201 38.4 1.4
6 Female CPA201 37.7 <0.6
7 Male OAX142 38.2 <0.6
8 Female OAX142 38.9 <0.6
9 Male 1-290-93 38.6 <0.6
10 Male 1-290-93 39.8 <0.6
Horse no. Clinical outcome Histopathologic findings
1 No disease Perivascular cuffing, minimal encephalitis
2 No disease Perivascular cuffing, minimal encephalitis
3 No disease Perivascular cuffing, minimal encephalitis
4 Fatal Perivascular cuffing, lymphocytic
encephalitis meningitis, focal encephalitis
5 No disease Normal
6 No disease Normal
7 No disease Normal
8 No disease Normal
9 No disease Normal
10 No disease Normal
(a) Titers expressed as [log.sub.10] suckling mouse intracerebral
lethal [dose.sub.50]/mL serum.
References (1.) Weaver SC. Recurrent emergence of Venezuelan euine encephalomyelitis encephalomyelitis /en·ceph·a·lo·my·eli·tis/ (en-sef?ah-lo-mi?e-li´tis) inflammation of the brain and spinal cord. acute disseminated encephalomyelitis . In: Scheld WM, Hughes J, editors. Emerging infections I. Washington: ASM (1) (Association for Systems Management) An international membership organization based in Cleveland, Ohio. Founded in 1947 and disbanded in 1996, it sponsored conferences in all phases of administrative systems and management. Press; 1998. p. 27-42. (2.) Weaver SC. Venezuelan equine encephalitis. In: Service MW. The encyclopedia of arthropod-transmitted infections. Wallingford, UK: CAB International; 2001. p. 539-48. (3.) Walton TE, Grayson MA. Venezuelan equine encephalomyelitis Venezuelan equine encephalomyelitis an encephalomyelitis with clinical signs similar to those of western and eastern encephalomyelitis; abbreviated VEE. See also equine viral encephalomyelitis. . In: Monath TP. The arboviruses arboviruses (ar´bōvī´r n. : epidemiology and ecology, vol. IV. Boca Raton (FL): CRC (Cyclical Redundancy Checking) An error checking technique used to ensure the accuracy of transmitting digital data. The transmitted messages are divided into predetermined lengths which, used as dividends, are divided by a fixed divisor. Press; 1988. p. 203-31. (4.) Johnson KM, Martin DH. Venezuelan equine encephalitis. Adv Vet Sci Comp Med 1974;18:79-116. (5.) Lord RD. History and geographic distribution of Venezuelan equine encephalitis. Bulletin of the Pan American Health Organization The Pan American Health Organization (PAHO) is an international public health agency with 100 years of experience in working to improve health and living standards of the countries of the Americas. It serves as the specialized organization for health of the Inter-American System. 1974;8:100-10. (6.) Wang E, Bowen RA, Medina G, Powers AM, Kang W, Chandler LM, et al. Virulence and viremia characteristics of 1992 epizootic subtype IC Venezuelan equine encephalitis viruses and closely related enzootic sub-type ID strains. Am J Trop Med Hyg 2001;65:64-9. (7.) Martin DH, Dietz WH, Alvaerez O, Jr., Johnson KM. Epidemiological significance of Venezuelan equine encephalomyelitis virus in vitro markers. Am J Trop Med Hyg 1982;31:561- (8.) Garman JL, Scherer WF, Dickerman RW. A study of equine virulence of naturally occurring Venezuelan encephalitis virus in Veracruz with description of antibody responses. Bulletin of the Pan American Health Organization 1968;65:238-52. (9.) Walton TE, Alvarez O, Buckwalter RM, Johnson KM. Experimental infection of horses with enzootic and epizootic strains of Venezuelan equine encephalomyelitis virus. J Infect Dis 1973; 128:271-82. (10.) Weaver SC, Pfeffer M, Marriott K, Kang W, Kinney RM. Genetic evidence for the origins of Venezuelan equine encephalitis virus subtype IAB outbreaks. Am J Trop Med Hyg 1999;60:441-8. (11.) Franck PT, Johnson KM. An outbreak of Venezuelan equine encephalomeylitis in Central America. Evidence for exogenous source of a virulent virus subtype. Am J Epidemiol 1971;94:487-95. (12.) de Mucha-Macias J. Encefalitis equina de Venezuela en Tamaulipas, Mexico. Rev Invest Salud Publica (Mexico) 1966;26:277-9. (13.) Zarate ML, Scherer WF, Dickerman RW. A probable case of Venezuelan equine encephalitis occurring in Jaltipan, Veracruz, Mexico, 1965. Salud Publica de Mexico 1971; 13:97-9. (14.) Oberste MS, Fraire M, Navarro R, Zepeda C, Zarate ML, Ludwig GV, et al. Association of Venezuelan equine encephalitis virus subtype IE with two equine epizootics in Mexico. Am J Trop Med Hyg 1998;59:100-7. (15.) Oberste MS, Schmura SM, Weaver SC, Smith JF. Geographic distribution of Venezuelan equine encephalitis virus subtype IE genotypes in Central America and Mexico. Am J Trop Med Hyg 1999;60:630-4. (16.) Brault AC, Powers AM, Holmes EC, Woelk CH, Weaver SC. Positively charged amino acid substitutions in the E2 envelope glycoprotein are associated with the emergence of Venezuelan equine encephalitis virus. J Virol 2002;76:1718-30. (17.) Wang E, Barrera R, Boshell J, Ferro C, Freier JE, Navarro JC, et al. Genetic and phenotypic changes accompanying the emergence of epizootic subtype IC Venezuelan equine encephalitis viruses from an enzootic subtype ID progenitor. J Virol 1999;73:4266-71. (18.) Weaver SC, Scott TW, Lorenz LH. Patterns of eastern equine encephalomyelitis Eastern equine encephalomyelitis see encephalomyelitis. virus infection in Culiseta melanura. J Med Entomol 1990;27:878-91. (19.) Edwards JF, Higgs S, Beaty BJ. Mosquito feeding-induced enhancement of Cache Valley virus Cache Valley virus one of the California serotype bunyaviruses associated with equine viral encephalomyelitis. Cache Valley virus Virology A common Bunyamwera virus, isolated in Utah in 1956 and recovered primarily from mosquitos–genera (Bunyaviridae) infection in mice. J Med Entomol 1998;35:261-5. (20.) Osorio JE, Godsey MS, Defoliart GR, Yuill TM. La Crosse viremias in white-tailed deer and chipmunks exposed by injection or mosquito bite. Am J Trop Med Hyg 1996;54:338-42. (21.) Kinney RM, Johnson B J, Welch JB, Tsuchiya KR, Trent DW. The full-length nucleotide sequences of the virulent Trinidad donkey strain of Venezuelan equine encephalitis virus and its attenuated Attenuated Alive but weakened; an attenuated microorganism can no longer produce disease. Mentioned in: Tuberculin Skin Test attenuated having undergone a process of attenuation. vaccine derivative, strain TC-83. Virology virology, study of viruses and their role in disease. Many viruses, such as animal RNA viruses and viruses that infect bacteria, or bacteriophages, have become useful laboratory tools in genetic studies and in work on the cellular metabolic control of gene expression 1989; 170:19-30. (22.) Berge TO, Banks IS, Tigertt WD. Attenuation of Venezuelan equine encephalomyelitis virus by in vitro cultivation in guinea pig heart cells. Am J Hyg 1961;73:209-18. (23.) Weaver SC, Hagenbaugh A, Bellew LA, Netesov SV, Voichkov VE, Chang G-JJ, et al. A comparison of the nucleotide sequences of eastern and western equine encephalomyelitis viruses with those of other alphaviruses and related RNA viruses. Virology 1993; 197:375-90. (24.) Calisher CH, Karabatsos N, Lazuick JS, Monath TP, Wolff KL. Reevaluation of the western equine encephalitis antigenic complex of alphaviruses (family Togaviridae) as determined by neutralization tests. Am J Trop Med Hyg 1988;38:447-52. (25.) Henderson BE, Chappell WA, Johnston JG, Jr, Sudia WD. Experimental infection of horses with three strains of Venezuelan equine encephalomyelitis virus. I. Clinical and virological virological pertaining to viruses. studies. Am J Epidemiol 1971;93:194-205. (26.) Dietz WH, Jr., Alvarez O Jr, Martin DH, Walton TE, Ackerman L J, Johnson KM. Enzootic and epizootic Venezuelan equine encephalomyelitis virus in horses infected by peripheral and intrathecal intrathecal /in·tra·the·cal/ (-the´k'l) within a sheath; through the theca of the spinal cord into the subarachnoid space. Intrathecal routes. J Infect Dis 1978;137:227-37. (27.) Mackenzie RM, de Siger J, Parra D. Venezuelan equine encephalitis virus: comparison of infectivity and virulence of strains V-38 and P676 in donkeys. Am J Trop Med Hyg 1976;25:494-9. (28.) Kissling RE, Chamberlain RW, Nelson DB, Stamm DD. Venezuelan equine encephalomyelitis in horses. Am J Hyg 1956;63:274-82. (29.) Shope RE, Causey Causey is a village in County Durham, in England. It is situated a short distance to the north of Stanley. OR, Homobono Paes de Andrade A, Theiler M. The Venezuelan equine encephalomyelitis complex of group A arthropod-borne viruses, including Mucambo and Pixuna from the Amazon region of Brazil. Am J Trop Med Hyg 1964;13:723-7. (30.) Kissling RE, Chamberlain RW. Venezuelan equine encephalitis. Adv Vet Sci 1967;11:65-84. (31.) Sudia WD, Newhouse VF, Henderson BE. Experimental infection of horses with three strains of Venezuelan equine encephalomyelitis virus. II. Experimental vector studies. Am J Epidemiol 1971;93:206-11. (32.) Sudia WD, Lord RD, Newhouse VF, Miller DL, Kissling RE. Vector-host studies of an epizootic of Venezuelan equine encephalomyelitis in Guatemala, 1969. Am J Epidemiol 1971;93:137-43. (33.) Turell MJ, Barth J, Coleman RE. Potential for Central American mosquitoes to transmit epizootic and enzootic strains of Venezuelan equine encephalitis virus. J Am Mosq Control Assoc 1999; 15:295-8. (34.) Kramer LD, Scherer WF. Vector competence of mosquitoes as a marker to distinguish Central American and Mexican epizootic from enzootic strains of Venezuelan encephalitis virus. Am J Trop Med Hyg 1976;25:336-46. (35.) Levine B, Hardwick JM, Griffin DE. Persistence of alphaviruses in vertebrate hosts. Trends Microbiol 1994;2:25-8. (36.) Bernard KA, Klimstra WB, Johnston RE. Mutations in the E2 glycoprotein of Venezuelan equine encephalitis virus confer heparan sulfate interaction, low morbidity, and rapid clearance from blood of mice. Virology 2000;276:93-103. Address for correspondence: Scott Weaver, Keiller 4.128, Department of Pathology, University of Texas Medical Branch "UTMB" redirects here. For other system schools, see University of Texas System. The University of Texas Medical Branch (UTMB) is a component of the University of Texas System located in Galveston, Texas, about 50 miles (80 km) southeast of downtown Houston. , Galveston, Texas 77555-0609, USA; fax: 409-747-2415; e-mail: sweaver@utmb.edu Dante Gonzalez-Salazar, * Jose G. Estrada-Franco, ([dagger]) Anne-Sophie Carrara, ([dagger]) Judith F. Aronson, ([dagger]) and Scott C. Weaver ([dagger]) * Instituto Nacional de Investigaciones Forestales, Agricolas y Pecuarlas, Mexico City, Mexico; and ([dagger]) University of Texas Medical Branch, Galveston, Texas, USA Dr. Gonzalez-Salazar is chief of the animal diagnostics laboratory at the National Institute for Research on Agriculture, Livestock and Forestry of the Mexican Agricultural Ministry in Mexico City, where he directs the animal disease pathology and histology research section. His research interests include veterinary viral diseases such as encephalitides, rabies, swine fever, and avian influenza. |
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