Prognosis

VEEV infection in the absence of neurological complications is self-limiting and a good prognosis can be expected. Typically, symptoms last up to one week. In outbreak settings, overall mortality rarely exceeds 1%.[1]​ Mortality occurs mainly in children, and is generally attributable to consequences of neurological involvement.[2] Immunity likely lasts for decades.

Long-term sequelae

Neurological involvement may result in long-term sequelae consisting of recurrent headaches, fatigue, depression, weakness, myalgia, and reduction in hearing, taste, or smell.[44] Diplopia, cranial nerve paresis, and personality changes may also persist.[11] Children are at higher risk of developing long-term neurological sequelae as a result of VEEV infection, compared with adults.[9][11][14] Furthermore, neurological complications tend to be more prevalent with the epizootic strains (IAB and IC) of VEEV.[4]

Neither the prognosis nor the long-term sequelae are well understood in patients who develop gastrointestinal (GI) bleeding. However, case reports of patients with GI bleeding report death in one third of cases.[3][4]

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