Eastern equine encephalitis (EEE): a description of the 1989 outbreak, recent epidemiologic trends, and the association of rainfall with EEE occurrence.

An Eastern equine encephalitis (EEE) outbreak in 1989 led to nine human and 196 equine cases, chiefly in coastal Atlantic and Gulf Coast counties. In the past two decades, EEE age-specific incidence and mortality rates have declined compared with earlier years. Analysis of rainfall patterns in areas where human EEE cases occurred between 1983 and 1989 revealed an association between occurrence of human cases and excess rainfall. The association was stronger with data from local weather stations than from statewide rainfall averages and the predictive models were best when applied to northern states. The sensitivity and specificity of these measures varied, depending on the model used, but the positive predictive value was no better than 50%, regardless of the rainfall model applied.