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Eastern Equine Encephalitis
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brain (encephalitis). The disease is rare in
humans, but can occur when an infected
mosquito bites a person. EEE disease occurs
primarily in areas close to swamps and
marshes with high mosquito populations.
The last confirmed human case in Maryland
was in 1989, and prior to that there were two
cases in 1982. The last confirmed case in a
horse in Maryland was in 2009 in Wicomico
County.
Although EEE occurs in humans less
frequently than West Nile virus (WNV), it
can be more serious. Only a subset of people
infected with either virus develop neurological
illness, however of those who develop
neurological illness, approximately onethird
of all EEE-infected persons may die
compared to fewer than 10 percent who die
following WNV neurological illness. EEE
survivors can have long-term damage to the
nervous system.
Typical symptoms of EEE in humans
include fever, headache, mental confusion,
nausea, vomiting, muscle aches, joint pain,
and sometimes seizures and coma. Individuals
reporting these symptoms should be referred
to their health care provider.
Symptoms usually occur four to 10 days
after exposure to a mosquito carrying the
virus. There is neither a specific treatment
nor a vaccine available for use in humans infected
with EEE virus.
In horses, EEE is a serious disease that
can be fatal; however, well vaccinated
horses are generally safe from the disease.
The Maryland Department of Agriculture
(MDA) encourages all horse owners to consult
with their veterinarian to discuss the
best vaccination program for their horse and
its circumstances. The horse in Worcester
County had not been vaccinated. Infected
horses show a range of clinical signs that
often progress over two to three days, including
depression, altered mental status,
circling, problems with balance, weakness,
aimless wandering, impaired vision, walking
(gait) abnormalities, head pressing,
paralysis, convulsions and death. Horses that
survive serious disease often have permanent
nervous system deficits.
Measures people can take to protect
themselves from diseases spread by mosquitoes
include:
• Avoid areas of high mosquito activity
• Avoid unnecessary outdoor activities at
dawn and dusk when mosquitoes are most
active
• Wear long pants, long-sleeved shirts and
hats to reduce mosquito exposure
• Use an EPA-registered insect repellent according
to package directions
For additional information on West
Nile virus and other mosquito-borne viruses,
visit:
• Maryland Department of Health and
Mental Hygiene: http://phpa.dhmh.maryland.gov/OIDEOR/CZVBD/SitePages/west
-nile.aspx
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• Maryland Department of Agriculture:
http://mda.maryland.gov/plantspests/Pages/mosquito_control.aspx
• Centers for Disease Control and
P r e v e n t i o n :
http://www.cdc.gov/westnile/index.htmland
http://www.cdc.gov/easternequineencephalitis/