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| EASTERN EQUINE ENCEPHALITIS (cont.) | |
| Division of Public Health Services Disease Handbook for Childcare Providers | |
| Bureau of Infectious Disease Control REVISED –January 2018 | |
| EASTERN EQUINE ENCEPHALITIS | |
| What is eastern equine encephalitis? | |
| Eastern equine encephalitis (EEE) is an uncommon | |
| but serious disease caused by EEE virus. EEE is an | |
| arbovirus (short for ar thropod-borne, meaning | |
| spread by insects). The virus can be transmitted to | |
| horses, other animals, and in rare cases, people. | |
| How do people get eastern equine | |
| encephalitis? | |
| The EEE virus grows in birds that live in freshwater | |
| swamps. The virus has a complex life cycle | |
| involving birds and a specific type of mosquito, | |
| called Culiseta melanura. This particular mosquito | |
| does not bite people. Sometimes though, the virus | |
| can escape from its marsh habitat by means of other | |
| mosquitoes that feed on both birds and mammals. | |
| These mosquitoes can transmit the virus to animals | |
| and people. | |
| What are the symptoms of EEE? | |
| Infection can cause a range of illnesses. Most | |
| people have no symptoms; others get only a mild | |
| flu-like illness with fever, headache, and sore throat. | |
| For people with infection of the central nervous | |
| system, a su dden high fever (103 to 106 ), severe | |
| headache, and stiff neck can be followed quickly by | |
| seizures and coma. About one third of these | |
| patients die from the disease. Of those that survive, | |
| many suffer permanent brain damage and require | |
| lifetime institutional care. | |
| How soon after exposure do symptoms | |
| appear? | |
| Symptoms of EEE usually appear 4 to 10 days after | |
| the bite of an infected mosquito. | |
| How is eastern equine encephalitis | |
| diagnosed? | |
| Diagnosis is based on tests of blood or spinal fluid. | |
| Who is at risk for eastern equine | |
| encephalitis? | |
| Anyone can get EEE, but some people are at | |
| increased risk, such as people living in or visiting | |
| areas where the disease is common and people who | |
| work outside or participate in outdoor recreational | |
| activities in areas where the disease is common. | |
| Children and those over age 50 are more susceptible | |
| to the disease. The risk of getting EEE is highest | |
| from late July through September. | |
| What is the treatment for eastern equine | |
| encephalitis? | |
| There is no specific treatment for east ern equine | |
| encephalitis. Antibiotics are not effective against | |
| viruses, and no effective anti -viral drugs have yet | |
| been discovered. Care of the patient centers around | |
| treatment of symptoms and complications. | |
| How common is eastern equine | |
| encephalitis? | |
| EEE is a rare disease. An average of 6 cases are | |
| reported in the United States in most years. There | |
| is concern, however, that EEE is re -emerging. In | |
| NH, EEE has been found in horses, mosquitoes and | |
| several species of birds. In 2014, 3 cases of EEE | |
| were reported in humans in NH. | |
| How can eastern equine encephalitis be | |
| prevented? | |
| A vaccine is available for horses, but not for | |
| humans. Prevention of the disease centers around | |
| controlling mosquitoes and on individual action to | |
| avoid mosquito bites. To avoi d being bitten by the | |
| mosquitoes that transmits EEE: | |
| • If possible, stay inside between dusk and dawn, | |
| when mosquitoes are most active | |
| • When outside between dusk and dawn, wear | |
| long pants and long-sleeved shirts | |
| EASTERN EQUINE ENCEPHALITIS (cont.) | |
| Division of Public Health Services Disease Handbook for Childcare Providers | |
| Bureau of Infectious Disease Control REVISED –January 2018 | |
| • Use an insect repellent with DEET or Picaridi n | |
| according to the manufacturer’s directions | |
| when outside. Oil of lemon eucalyptus and | |
| IR3535 have been found to provide protection | |
| similar to repellents with low concentrations of | |
| DEET | |
| • Clothing can be treated with permethrin | |
| according to the manufacturer’s directions | |
| • When possible wearing long sleeves and pants | |
| while outside | |
| • Put screens on windows and make sure they do | |
| not have holes | |
| • Eliminate standing water and other mosquito | |
| breeding locations from your property. Do not | |
| alter natural water bodies. The management of | |
| ponds and wetlands is regulated by the | |
| Department of Environmental Services and any | |
| alterations require a permit before work may | |
| begin | |
| For more information about eastern equine | |
| encephalitis, call the New Hampshire Department | |
| of Health & Hum an Services, Bureau of Infectious | |
| Disease Control at (603) 271- 4496 or visit our | |
| website at www.dhhs.nh.gov | |
| or the Centers for | |
| Disease Control and Prevention at www.cdc.gov. | |