HANCOCK — Eastern equine encephalitis (EEE) is a rare – but serious disease that is caused by a virus spread by infected mosquitoes. In late summer and autumn of 2020, Michigan experienced an outbreak of EEE. Michigan saw three human cases and 41 animal cases across 18 counties, including Baraga and Marquette counties in the Upper Peninsula.

Michigan has had outbreaks of EEE about every 10 years since 1980 when the first human case was reported. Eastern equine encephalitis is one of the most dangerous mosquito- borne diseases in the US with a fatality rate of 33% among infected humans and 90% fatality rate among infected horses.

People can be infected with EEE from the bite of a mosquito carrying the virus. Most (95-96%) cases of human EEE do not cause any symptoms, and less than 1% develop serious illness. In humans, signs and symptoms of EEE develop four to 10 days after the bite include: sudden onset of fever and chills along with body and joint aches. The infection can develop into severe encephalitis, resulting in headaches, disorientation, tremors, seizures, and paralysis. Permanent brain damage, coma, and death are also possible in some cases.

The risk for infection of EEE is highest for people who live in or visit woodland habitats, hunters, and people who work outside, although anyone in an area where the virus is circulating in mosquitoes can get infected. Hunters face a risk from EEE due to exposure to mosquitos, not from handling or consuming normal-appearing game from affected counties. Use the following list to reduce your chances of getting infected with EEE:

— Use Environmental Protection Agency (EPA) -registered insect repellants (https://www.epa.gov/insect-repellents) containing DEET, picaridin, IR3535, oil of eucalyptus (OLE), paramenthane-idol (PMD), or 2-undecanone. Always follow product instructions. Do not use insect repellent on babies younger than two months old. Do not use products containing OLE or PMD on children under three years old.

— Wear long sleeved shirts and long pants when outdoors. Spray outer clothing with insect repellants.

— Maintain window and door screening to help keep mosquitos outside.

— Eliminate possible mosquito breeding areas. Empty water from mosquito breeding sites around the home such as buckets, unused kiddie pools, old tires, or similar sites where mosquitoes may lay eggs.

— Use nets and/or fans over outdoor eating areas.

— Don’t handle or consume wild animals that appear sick or act abnormal. Be sure to wear gloves and safety glasses when handling, field-dressing, and processing game. Care should be used when processing game to avoid cuts that could cause infection.

People who have been bitten by mosquitoes can monitor their health and talk with their healthcare provider if they develop symptoms such as fever, malaise, headache and confusion. Testing for EEE is not indicated in a person who is not showing symptoms of EEE illness.

For more information, visit the Michigan Emerging Disease Issues webpage at www.michigan.gov/emergingdiseases/ or the Centers of Disease Control and Prevention Eastern Equine Encephalitis webpage at www.cdc.gov/easternequineencephalitis/index.html