Sophia Garabedian had been dealing with a persistent fever and painful headache when her parents found her unresponsive in her bed one morning last fall.
Doctors ultimately diagnosed the then-five-year-old Sudbury, Massachusetts, resident with eastern equine encephalitis (EEE), a rare, but severe mosquito-borne virus that causes brain swelling.
Garabedian survived the potentially fatal virus after about a month in Boston hospitals, but her parents say her ordeal and ongoing recovery should be a warning as people take advantage of the outdoors this summer.
Photo: AP
“It’s been a rough year,” her father, David Garabedian, said. “With any brain injury, it’s hard to tell. The damage is there. How she works through it is anyone’s guess.”
As the COVID-19 pandemic subsides for now in the hard-hit northeast US, public health officials in the region are warning about another potentially bad summer for EEE and other insect-borne illnesses.
EEE saw an unexpected resurgence last summer across 10 US states: Alabama, Connecticut, Georgia, Indiana, Massachusetts, Michigan, New Jersey, North Carolina, Rhode Island and Tennessee.
There were 38 human cases and 15 deaths from the virus, with many of the cases in Massachusetts and Michigan, the US Centers for Disease Control and Prevention.
Most years, the country sees just half a dozen cases of the virus in humans, it said.
In Massachusetts and New Jersey, officials have already detected EEE in mosquitoes this year, the earliest on record in those states.
“It’s unnerving,” said Scott Crans, who heads up mosquito control efforts for the New Jersey Department of Environmental Protection. “It could signal a busy year.”
Crans and other state health officials say EEE, which has no cure in humans, tends to come in two to three-year cycles, but they also stress that mosquito-borne diseases are notoriously tricky to predict.
Local health officials are also warning about the risk of contracting other insect-borne illnesses.
In Michigan, an invasive mosquito known to transmit dengue, Zika and other tropical viruses has already been detected for the first time this season, said Mary Grace Stobierski, the state’s public health veterinarian.
The state also had its first case of West Nile virus this season.
Ticks are also expected to be out earlier and in larger numbers this season because of the relatively mild winter, said Aaron Bernstein, a pediatrician at Boston Children’s Hospital and a director at Harvard’s School of Public Health.
That could mean more cases of debilitating Lyme disease and other tick-related illnesses, he said.
“Some of the people going into the woods more now might not be experienced with how to protect themselves in the forest, and that’s a concern,” he said.
The CDC has offered states additional help with mosquito testing this season as the pandemic has overwhelmed state public health offices, spokeswoman Candice Hoffmann said.
Officials in eight states and Washington have taken up the offer.
In Michigan, where six of that state’s 10 cases of EEE last year proved fatal, officials this summer have launched a pilot program to improve the state’s response to mosquito-borne illnesses.
Ned Walker, a medical entomologist at Michigan State University heading up the effort, said the goal is to create the kind of regular mosquito surveillance system already in place in Massachusetts and elsewhere to better predict and prepare for disease outbreaks.
In Massachusetts, , officials have been testing earlier, more often and in a wider range of locations this year in order to quickly identify infection clusters, State Epidemiologist Catherine Brown said.
A pilot effort is also testing the efficacy of different larvicides to help cull the mosquito population at its earliest stages, she said.
One troubling development: the two earliest cases of EEE in mosquitoes this year were found in a northern part of the state close to New Hampshire, rather than the virus’ typical hotspots near Cape Cod, where officials also detected the virus in a mosquito sample last week.
That, along with last year’s widespread cases, strongly suggests the territory of EEE-carrying mosquitoes is expanding, Brown said.
Climate changes that are causing warmer summers and altering bird migration patterns and local mosquito populations could be among the drivers, she said.
Meanwhile, an environmental group is calling on Massachusetts to avoid resorting to widespread aerial spraying of insecticide, which took place six times last year.
Maryland-based Public Employees for Environmental Responsibility filed a complaint with the Massachusetts Inspector General’s office this month, arguing that last year’s aerial spraying cost more than US$2 million but was not effective in reducing EEE-carrying mosquitoes.
“Last year was unprecedented,” she said. “No one wants to do that again.”
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