{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T06:17:56Z","timestamp":1791353876561,"version":"4.3.1"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T00:00:00Z","timestamp":1778716800000},"content-version":"vor","delay-in-days":13,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Eastern equine encephalitis (EEE) is a highly fatal neurologic disease of horses, but data describing clinical presentation, epidemiology, and prognostic factors are limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Describe the clinicopathologic and epidemiologic features of horses with EEE and identify factors associated with survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Animals<\/jats:title>\n                    <jats:p>One hundred four horses diagnosed with EEE presented with signs of diffuse brain disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective case series of horses evaluated at a Veterinary Teaching Hospital (1979-2017). Medical records were reviewed for clinical findings, diagnostic results, and outcomes. Logistic regression assessed associations between demographic, epidemiologic, and clinicopathologic variables and survival. Generalized linear models evaluated associations between climatic variables and annual case count.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Median age was 1.4\u00a0years (0.1-13.4), predominantly Thoroughbreds and Quarter Horses. Most horses (66\/104) presented during summer. In negative binomial regression adjusted for temperature and year, each 100-mm increase in annual precipitation was associated with a 43% increase in cases (IRR 1.43; 95% CI, 1.22-1.82; P\u00a0&amp;lt;\u00a0.001). Common findings included abnormal behavior (96%), hyperthermia (99%), recumbency (51%), and seizure-like activity (46%). Cerebrospinal fluid (CSF) abnormalities included discoloration (65%), high protein concentration\u00a0&amp;gt;\u00a080\u00a0mg\/dL (80%), and neutrophilic pleocytosis (62%). Case fatality rate was 90% (94\/104). Recumbency, seizure activity during hospitalization, band neutrophilia, monocytosis, and high CSF protein concentration and neutrophils were associated with death.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions and clinical importance<\/jats:title>\n                    <jats:p>Eastern equine encephalitis is a rapidly progressive, highly fatal neurologic disease of horses, with increased case numbers during periods of higher precipitation. Clinicopathologic findings, particularly recumbency, seizure-like activity, leukogram changes and CSF abnormalities, provide prognostic indicators to guide clinical decision-making and client communication.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jvimsj\/aalag087","type":"journal-article","created":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T11:31:50Z","timestamp":1778758310000},"source":"Crossref","is-referenced-by-count":1,"title":["Eastern equine encephalitis\u2014104 horses (1979-2017)"],"prefix":"10.1093","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7495-4868","authenticated-orcid":false,"given":"Diego E","family":"Gomez","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Abu Dhabi Equine and Camel Hospital (ADECH) , Abu Dhabi, AD 00000 ,","place":["UAE"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriela","family":"Suarez","sequence":"additional","affiliation":[{"name":"Department of Large Animal Clinical Sciences, University of Florida, College of Veterinary Medicine , Gainesville, FL 32611 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7104-7920","authenticated-orcid":false,"given":"Demia J","family":"de Tonnerre","sequence":"additional","affiliation":[{"name":"Northside Emergency Veterinary Service, Terrey Hills , NSW 2084, \u00a0","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4450-9859","authenticated-orcid":false,"given":"Martha F","family":"Mallicote","sequence":"additional","affiliation":[{"name":"Department of Large Animal Clinical Sciences, University of Florida, College of Veterinary Medicine , Gainesville, FL 32611 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3096-4762","authenticated-orcid":false,"given":"Jorge A","family":"Hernadez","sequence":"additional","affiliation":[{"name":"Department of Large Animal Clinical Sciences, University of Florida, College of Veterinary Medicine , Gainesville, FL 32611 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7362-5325","authenticated-orcid":false,"given":"L Chris","family":"Sanchez","sequence":"additional","affiliation":[{"name":"Department of Large Animal Clinical Sciences, University of Florida, College of Veterinary Medicine , Gainesville, FL 32611 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8737-3018","authenticated-orcid":false,"given":"Robert J","family":"Mackay","sequence":"additional","affiliation":[{"name":"Department of Large Animal Clinical Sciences, University of Florida, College of Veterinary Medicine , Gainesville, FL 32611 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,5,14]]},"reference":[{"key":"2026051407253730300_ref1","first-page":"170","article-title":"Eastern equine encephalitis in a horse from southwestern Ontario","volume":"36","author":"Carman","year":"1995","journal-title":"Can Vet J"},{"key":"2026051407253730300_ref2","doi-asserted-by":"publisher","first-page":"846","DOI":"10.1111\/j.1939-1676.2007.tb03030.x","article-title":"Eastern equine encephalitis in 9 south American camelids","volume":"21","author":"Nolen-Walston","year":"2007","journal-title":"J Vet Intern Med"},{"key":"2026051407253730300_ref3","doi-asserted-by":"publisher","first-page":"133","DOI":"10.4269\/ajtmh.1980.29.133","article-title":"Eastern equine encephalomyelitis in Panama: the epidemiology of the 1973 epizootic","volume":"29","author":"Dietz","year":"1980","journal-title":"Am J Trop Med Hyg"},{"key":"2026051407253730300_ref4","first-page":"1011","article-title":"An eastern equine encephalomyelitis (EEE) outbreak in Quebec in the fall of 2008","volume":"51","author":"Ch\u00e9nier","year":"2010","journal-title":"Can Vet J"},{"key":"2026051407253730300_ref5","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1016\/0167-5877(86)90028-0","article-title":"A survey of eastern equine encephalomyelitis in Florida horses: prevalence, economic impact","volume":"4","author":"Wilson","year":"1986","journal-title":"Prev Vet Med"},{"key":"2026051407253730300_ref6","doi-asserted-by":"publisher","first-page":"1869","DOI":"10.3201\/eid1612.100640","article-title":"Eastern equine encephalitis virus in mosquitoes and their role as bridge vectors","volume":"16","author":"Armstrong","year":"2010","journal-title":"Emerg Infect Dis"},{"key":"2026051407253730300_ref7","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1111\/j.2042-3306.1976.tb03293.x","article-title":"Equine viral encephalitis","volume":"8","author":"Gibbs","year":"1976","journal-title":"Equine Vet J"},{"key":"2026051407253730300_ref8","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1016\/j.cveq.2022.04.004","article-title":"Arboviral equine encephalitides","volume":"38","author":"Toribio","year":"2022","journal-title":"Vet Clin North Am Equine Pract"},{"key":"2026051407253730300_ref9","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1016\/0167-5877(95)00479-G","article-title":"A case-control study of an outbreak of eastern equine encephalomyelitis in Michigan (USA) equine herds in 1991","volume":"24","author":"Ross","year":"1995","journal-title":"Prev Vet Med"},{"key":"2026051407253730300_ref10","doi-asserted-by":"publisher","first-page":"1143","DOI":"10.1093\/jme\/tjy067","article-title":"Validation of a risk index model for predicting eastern equine encephalitis virus transmission to horses in Florida","volume":"55","author":"Downs","year":"2018","journal-title":"J Med Entomol"},{"key":"2026051407253730300_ref11","doi-asserted-by":"publisher","first-page":"1014","DOI":"10.1128\/JVI.01586-09","article-title":"Evolutionary patterns of eastern equine encephalitis virus in north versus South America suggest ecological differences and taxonomic revision","volume":"84","author":"Arrigo","year":"2010","journal-title":"J Virol"},{"key":"2026051407253730300_ref12","author":"Centers for Disease Control and Prevention (CDC)"},{"key":"2026051407253730300_ref13","doi-asserted-by":"publisher","first-page":"858","DOI":"10.4269\/ajtmh.1957.6.858","article-title":"An epizootic of equine encephalomyelitis that occurred in Massachusetts in 1831","volume":"6","author":"Hanson","year":"1957","journal-title":"Am J Trop Med Hyg"},{"key":"2026051407253730300_ref14","doi-asserted-by":"publisher","first-page":"451","DOI":"10.1354\/vp.38-4-451","article-title":"Clinical, pathologic, immunohistochemical, and virologic findings of eastern equine encephalomyelitis in two horses","volume":"38","author":"Del Piero","year":"2001","journal-title":"Vet Pathol"},{"key":"2026051407253730300_ref15","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1177\/104063879600800203","article-title":"Immunohistochemical diagnosis of eastern equine encephalomyelitis","volume":"8","author":"Patterson","year":"1996","journal-title":"J Vet Diagn Invest"},{"key":"2026051407253730300_ref16","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1177\/1040638711435230","article-title":"Diagnostic sensitivity and specificity of in situ hybridization and immunohistochemistry for eastern equine encephalitis virus and West Nile virus in formalin-fixed, paraffin-embedded brain tissue of horses","volume":"24","author":"Pennick","year":"2012","journal-title":"J Vet Diagn Invest"},{"key":"2026051407253730300_ref17","volume-title":"Statewide Averages: Precipitation","author":"Florida Climate Center"},{"key":"2026051407253730300_ref18","volume-title":"Statewide Averages: Temperature","author":"Florida Climate Center"},{"key":"2026051407253730300_ref19","doi-asserted-by":"publisher","first-page":"b2393","DOI":"10.1136\/bmj.b2393","article-title":"Multiple imputation for missing data in epidemiological and clinical research: potential and pitfalls","volume":"338","author":"Sterne","year":"2009","journal-title":"BMJ."},{"key":"2026051407253730300_ref20","doi-asserted-by":"publisher","first-page":"305","DOI":"10.1089\/vbz.2020.2671","article-title":"Eastern equine encephalitis virus: a scoping review of the global evidence","volume":"21","author":"Corrin","year":"2021","journal-title":"Vector Borne Zoonotic Dis"},{"key":"2026051407253730300_ref21","doi-asserted-by":"publisher","first-page":"425","DOI":"10.1016\/j.ecolmodel.2005.07.011","article-title":"A dynamic transmission model of eastern equine encephalitis virus","volume":"192","author":"Unnasch","year":"2006","journal-title":"Ecol Model"},{"key":"2026051407253730300_ref22","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1126\/science.74.1913.227","article-title":"The etiology of epizootic encephalomyelitis of horses in the San Joaquin Valley, 1930","volume":"74","author":"Meyer","year":"1931","journal-title":"Science."},{"key":"2026051407253730300_ref23","doi-asserted-by":"publisher","first-page":"283","DOI":"10.3201\/eid0803.010199","article-title":"Eastern equine encephalomyelitis virus infection in a horse from California","volume":"8","author":"Franklin","year":"2002","journal-title":"Emerg Infect Dis"},{"key":"2026051407253730300_ref24","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1177\/104063879600800202","article-title":"Detection of eastern equine encephalomyelitis virus RNA in formalin-fixed, paraffin-embedded tissues using DNA in situ hybridization","volume":"8","author":"Gregory","year":"1996","journal-title":"J Vet Diagn Invest"},{"key":"2026051407253730300_ref25","volume-title":"Equine Infectious Diseases","author":"Sellon","year":"2014","edition":"2nd"},{"key":"2026051407253730300_ref26","first-page":"469","article-title":"West Nile virus encephalomyelitis in horses in Ontario: 28 cases","volume":"44","author":"Weese","year":"2003","journal-title":"Can Vet J"},{"key":"2026051407253730300_ref27","doi-asserted-by":"publisher","first-page":"601","DOI":"10.1111\/j.1939-1676.2006.tb02903.x","article-title":"Equine herpesvirus type 1-associated myeloencephalopathy in the Netherlands: a four-year retrospective study (1999\u20132003)","volume":"20","author":"Goehring","year":"2006","journal-title":"J Vet Intern Med"},{"key":"2026051407253730300_ref28","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1016\/j.cveq.2022.04.007","article-title":"Nonarboviral equine encephalitides","volume":"38","author":"Toribio","year":"2022","journal-title":"Vet Clin North Am Equine Pract"},{"key":"2026051407253730300_ref29","doi-asserted-by":"publisher","first-page":"535","DOI":"10.1177\/030098589803500608","article-title":"Intestinal lesions in a horse associated with eastern equine encephalomyelitis virus infection","volume":"35","author":"Poonacha","year":"1998","journal-title":"Vet Pathol"},{"key":"2026051407253730300_ref30","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1111\/j.2042-3306.2010.00128.x","article-title":"Putative intestinal hyperammonaemia in horses: 36 cases","volume":"43","author":"Dunkel","year":"2011","journal-title":"Equine Vet J"},{"key":"2026051407253730300_ref31","doi-asserted-by":"publisher","first-page":"530","DOI":"10.1001\/jama.2025.9073","article-title":"Eastern equine encephalitis in the US","volume":"334","author":"Staples","year":"2025","journal-title":"JAMA."},{"key":"2026051407253730300_ref32","doi-asserted-by":"publisher","first-page":"ofad206","DOI":"10.1093\/ofid\/ofad206","article-title":"Clinical characteristics of the 2019 eastern equine encephalitis outbreak in Michigan","volume":"10","author":"Ladzinski","year":"2023","journal-title":"Open Forum Infect Dis"}],"container-title":["Journal of Veterinary Internal Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jvim\/article-pdf\/40\/3\/aalag087\/68283784\/aalag087.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jvim\/article-pdf\/40\/3\/aalag087\/68283784\/aalag087.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T11:31:52Z","timestamp":1778758312000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jvim\/article\/doi\/10.1093\/jvimsj\/aalag087\/8677941"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":32,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,5,4]]}},"URL":"https:\/\/doi.org\/10.1093\/jvimsj\/aalag087","relation":{},"ISSN":["1939-1676"],"issn-type":[{"value":"1939-1676","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,5]]},"published":{"date-parts":[[2026,5]]},"article-number":"aalag087"}}