**2.4 Madariaga (MADV)**

Recent ecologic and genetic studies of eastern equine encephalitis virus (EEEV; togaviridae: alphavirus) have demonstrated clear separation between North and South American EEEV strains: North American EEEV cluster in a single genetic lineage—lineage I, in the system proposed by Arrigo et al. [84]—with South American EEEV strains (now known as Madariaga virus [MADV]) clustering in EEEV lineages II, III, and IV. Although there is a reasonable understanding of North American EEE's clinical and epidemiologic features, much less is known about MADV infections. MADV is neglected in multiple ways [85]. Contrasting with other neglected arboviruses, MADV has no previous bibliometric assessments nor for EEE. As shown before, there is a significant lack of studies about it [85–94]. Recent studies in Panama have clinically characterized this emerging encephalitis (**Table 2**) [90]. Studies from that central American countries suggest that the lack of additional neurological cases may indicate that severe MADV infections occur only rarely. Field studies suggest that over the past five decades, alphavirus infections, such as MADV and VEEV, have occurred at low levels in eastern Panama, but that MADV and VEEV infections have recently increased-potentially during the past decade. In some of eastern Panama, the endemic diseases and outbreaks of MADV and VEEV appear to differ spatially [95].

These neglected arboviruses are usually neglected; in the past, the ChikDenMaZika syndrome helped to decrease the neglect of thinking on Mayaro. Nevertheless, still, that alphavirus, as well as others, and the rest of discussed arboviruses, should be considered for an additional mnemotechnic, as **MAMA-ROS** syndrome (**MA**yaro, **MA**dariaga, **R**ocio, **O**ropouche and **S**t. Louis encephalitis) (**Table 2**) to think in them as differential diagnoses, as also to assess their clinical presentations.
