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Inter- and intra-virion crosslinking effects may contribute to the neutralization potency of C34 and C37 Previous research on EEEV antibodies has demonstrated that the intravirion and intervirion crosslinking capacity of IgG, determined by the spatial distribution of cysteine residues at the end of each CH1 domain of the corresponding Fab and the binding orientation of Fab molecules on the virus surface, plays a critical role in neutralizing potency 49

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Patients will be randomised (1:1) by minimisation on age, mRS, NIHSS, type of centre and time from onset, to receive 10mg of MCL/placebo (normal saline 2ml) tds via injection or nasogastric tube for 14 days