Missouri Department of Health and Senior Services Reports

Suspected Eastern Equine Encephalitis Case

The Missouri Department of Health and Senior Services (DHSS) announced today that Missouri has a suspected case of eastern equine encephalitis (EEE) in a 54-year-old woman from Butler County. This virus, like West Nile virus, is sometimes found in wild birds and is occasionally transmitted from them to humans by the bite of infected mosquitoes. Symptoms typically include a sudden onset of fever, stiff neck, headache, mental confusion, and vomiting (especially in children). The individual is recovering.

Disease from the EEE virus is relatively rare in the United States, with only 182 cases being confirmed from 1964-2000. No cases were detected in Missouri during that period. So far in 2003, Illinois has reported one human case of EEE virus infection, while Georgia and Florida are reporting two human cases each.

The EEE virus can seriously affect all age groups, but tends to be more common in children under 15 years of age. The virus can also be especially serious in adults older than 55. A significant difference between West Nile virus and EEE is that EEE causes death in one third of the cases and serious neurological complications in another third.

“We have been expecting to have West Nile virus cases again this year throughout the state, and the prospect of a second mosquito-borne disease is something we are going to keep a very close eye on,” said Dr. Howard Pue, State Public Health Veterinarian. “However, our message is still the same regardless of whether we are talking about West Nile virus or EEE: this is not something to panic about, it still is very rare for people to get these viruses, and there are some very simple, effective actions people can take to greatly reduce their already extremely low risk of getting the disease.”

“Public health authorities believe that two of the most effective ways to prevent mosquito-borne infection are using effective insect repellent containing DEET if going outside in the morning and evening (mosquitoes’ most active feeding times), and making sure windows and doors are screened,” Pue said.

He said insect repellent should be applied to clothing and exposed skin, and outside activity minimized during dusk and dawn. It also helps to wear long sleeve shirts and pants when outdoors to cover the skin. He added that homes should be mosquito-proofed by ensuring doors and windows have screens, and standing water that can serve as mosquito breeding habitat should be eliminated.

Hunters should follow the usual precautions when handling wild animals. They should wear gloves when handling and cleaning animals to prevent blood exposure to bare hands and meat should be thoroughly cooked.

Pue said that both West Nile virus and EEE can infect and kill wild birds. People who observe an unusual number of dead birds, especially crows and blue jays, are encouraged to report the incident to their city or county health department. Health officials will determine whether the event should be investigated and whether bird specimens should be submitted to a laboratory for testing.

Procedures for New West Nile Virus Case Reporting

The Missouri Department of Health and Senior Services this year will list all new cases of West Nile virus on its web site (www.dhss.state.mo.us/WestNileVirus/index.html) in a listing that gives the gender, age, and county of residence of each case; other personal identifying information will be kept strictly confidential. The department is encouraging news reporters and citizens to use the web site to follow the progression of the disease in the state. Any major developments in Missouri’s West Nile virus situation, including any deaths, will be announced through news releases. Human case information posted on the web site represent cases that are under investigation, are therefore provisional, and subject to change.

Further, DHSS urges that physicians request analysis of specimens for evidence of arboviral activity only for those patients who currently show symptoms of possible West Nile virus infection. Because evidence of West Nile virus can be found in blood specimens more than a year following initial infection, a person’s symptoms play an important role in differentiating current infections from those acquired the preceding year. All human cases listed on the DHSS web site will have been screened to eliminate the reporting of individuals who were infected in 2002.

For more information about Eastern Equine Encephalitis and other mosquito-borne diseases, visit the Center for Disease Control and Prevention web site at http://www.cdc.gov/ncidod/dvbid/arbor/.

For more information on the West Nile virus, contact your local health department or the Department of Health and Senior Services at 1-866/628-9891 or 573/751-6113, or visit the DHSS web site at www.dhss.state.mo.us/WestNileVirus.

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