Primary prevention
Natural setting
Avoidance of mosquito bites while in endemic areas is the primary means of prevention. Wearing appropriate clothing (e.g., long-sleeved shirts and long trousers), using insect repellent (e.g., containing DEET [N,N-diethyl-3-methylbenzamide], picaridin, IR3535, 2-undecanone, or oil of lemon eucalyptus), and using mosquito nets can help reduce the risk of mosquito bites. Staying indoors (ideally with air conditioning) during periods of the day when mosquitoes are most active can also minimise the risk of mosquito bites.[28]
Laboratory setting
Aerosolised transmission of VEEV has been documented in the laboratory setting. Handling high virus concentrations, mouth pipetting, and engaging in activities that generate aerosols (e.g., tissue homogenisation, centrifugation) are risk factors for occupational infection.[1] To prevent transmission via the aerosol route, materials infected with VEEV should be handled in a biosafety level 3 laboratory with appropriate use of respirators by laboratory personnel.[1][29]
There is currently no licensed vaccine available; however, the investigational TC-83 vaccine is a live-attenuated vaccine which can be used for those at risk of laboratory infections (e.g., researchers, laboratory technicians) and for certain military personnel.[30] There are ongoing clinical trials of an investigational trivalent virus-like particle (VLP) vaccine against western, eastern, and VEEV.[31]
Secondary prevention
VEEV is a reportable disease in some countries. VEEV infection is not transmitted through direct contact with infected equines or humans. No post-exposure prophylaxis is available.
In suspected cases of meningitis or meningoencephalitis, droplet precautions may be necessary in hospitalised patients until bacterial infections are excluded.
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