The Margin: Everything you need to know about the mosquito-borne EEE virus

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Turns out, murder hornets aren’t the killer insects to worry about this summer.

Mosquitoes are actually the deadliest animal in the world, spreading diseases such as malaria, dengue, West Nile, yellow fever and Zika that kill more than 700,000 people a year. And entomologists in the Northeast and Gulf states are worried about the increasing number of Eastern equine encephalitis outbreaks over the past few years, according to a new report by One Zero on Medium, which warns that the EEE virus has a mortality rate as high as 33% if the infection spreads to the brain.

This report, “A Deadly Mosquito-Borne Illness Is Brewing in the Northeast,” went viral on TWTR, -5.57% and Google GOOG, -2.99% on Wednesday and Thursday as readers already jittery about going outside again this summer amid the coronavirus pandemic realized they also have to reckon with mosquitoes. “Can’t we just get a f—ing break this year,” reads the top comment on the One Zero tweet, which has been liked more than 230 times.

While the EEE virus is serious and can be deadly, transmission is rare: the CDC only estimates about seven cases a year on average (sometimes ranging between three and 15) — although it reported 38 confirmed cases in 10 states last year. The infection only spreads via mosquito bites — not person-to-person, the way COVID-19 does. “We try our best to make people aware of the risks without sensationalizing,” Dr. Catherine Brown, Massachusetts state epidemiologist and state public health veterinarian, told One Zero.

Still, here’s what you should know about EEE, its symptoms and ways to prevent it, according to the CDC, to help keep you safer this summer. Keep in mind that this information is subject to change as we learn more about EEE, so refer to the CDC for the latest information.

What is EEE?

The Eastern equine encephalitis virus is a rare disease spread by infected mosquitoes. It can cause inflammation of the brain (aka encephalitis.) The first recorded infection was in Massachusetts horses in 1831, and horses remain susceptible to it, which is where the “equine” part of the name comes in.

How is it transmitted?

EEE is spread when an infected mosquito bites a person — but even then, transmission is rare. About 95% of people bitten by an EEE-infected mosquito won’t get sick. What’s more, the disease is not spread directly from person to person. And it’s believed that once someone recovers from EEE, they have life-long immunity against reinfection. But the consequences for the 4% to 5% of people who do get sick from a bite are severe. They can suffer lifelong brain damage or even death if the infection impacts their brain or spinal cord.

What are the symptoms?

The symptoms of mild cases are flu-like, including fever and joint or muscle pain. More severe infections can develop into encephalitis (the swelling of the brain) or meningitis (swelling of the membranes surrounding the brain and spinal cord), and the symptoms include:

  • Sudden fever
  • Chills
  • Headache
  • Vomiting
  • Disorientation
  • Seizures
  • Coma

The incubation period between getting bitten and developing symptoms ranges from four to 10 days, and the illness lasts one to two weeks. Most people recover completely if the infection does not reach the central nervous system, including the brain and spinal cord.

What if I think that I or a member of my family has this?

Consult your health care provider or local health department.

How deadly is it?

The CDC reports that approximately one-third of the patients who develop encephalitis from EEE die, and many of those who survive have mild to severe brain damage and can face months or years of rehabilitation.

How is it treated?

There is unfortunately no approved human vaccine or specific antiviral treatment. Antibiotics are not effective against viruses. So severe illnesses are treated by hospitalization, respiratory support, IV fluids and medications to prevent against other infections. The virus is diagnosed based on blood and spinal fluid tests, which look for EEE antibodies.

There is, however, a vaccine for horses.

Who’s most at risk?

The CDC reported 38 confirmed cases of EEE in 2019, including 15 deaths in 10 states: Alabama, Connecticut, Georgia, Indiana, Massachusetts, Michigan, New Jersey, North Carolina, Rhode Island and Tennessee. So as you can see, infections were reported primarily in eastern and Gulf Coast states, particularly in and around cedar or hardwood swamp areas near the Atlantic Ocean, the Gulf of Mexico and the Great Lakes. People who live and visit these areas of high EEE activity are at higher risk of infection, as are people who work outdoors or engage in outdoor recreational activities in these areas. People over 50 and under 15 seem to be at greatest risk for developing the most severe cases of EEE.

How can I prevent it?

The best way to avoid getting EEE — or any other mosquito-borne illness — is to avoid getting bitten by mosquitoes. The CDC recommends using insect repellent containing DEET, picaridin, IR3535 or oil of lemon eucalyptus on exposed skin and/or clothing. The repellent/insecticide permethrin can be used on clothing to protect it through several washes; just be sure to follow the directions on the package. Cover strollers and baby carriers with mosquito netting. Wear long sleeves and pants outdoors, weather permitting, and make sure all door and window screens are intact to prevent mosquitoes from entering your home. You can also help control the mosquito population by eliminating breeding sites around your home, such as emptying standing water from planters, buckets, barrels and other containers, emptying the water from tire swings, or emptying children’s wading pools when they aren’t being used.

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