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Eastern Equine encephalitis, also known as EEE or Triple E, is a virus that causes inflammation of the brain and is spread through mosquito bites. 

EEE has been in the news lately because this is a particularly active year for the virus, though it's not clear why. There's a lot of information out there about EEE, but here are a few facts that you — and your patients — may know know. 

1. Only 4-5% of human EEEV infections result in EEE

According to the Centers for Disease Control, EEE is rare. In fact, since the disease was identified in 1938, there have been fewer than 100 cases reported in Massachusetts. Generally, there are 5-10 cases reported nationally per year. 

Despite it's infrequency, EEE is still alarming because it's fatal 30% of cases. In addition, many survivors experience long-term neurological issues. 

However, while it's smart to take precautions, you can reassure your patients that their chances of getting EEE from a mosquito bite are low. 

2. Lemon eucalyptus can be an alternative to DEET (but don't use either on  children under three)

The Boston Public Health Commission recommends an insect repellent with no more than a 30% concentration of DEET. You can also try lemon eucalyptus (from the corymbia citriodora tree), which has been found to be as effective as DEET in repelling mosquitoes. However, let your patients know not to use either product on children under the age of three. For older children, advise adults to apply repellent to their hands and rub it on children, rather than spraying it directly onto their skin. To prevent exposure in young children, avoid being outside from dusk to dark. If you do go out, children (and adults) should wear pants, long sleeved shirts, and shoes with socks. 

Mosquito activity drops off after the first hard frost, which is typically in early November in Massachusetts. 

EEE symptoms appear 4-10 days after a bite

The symptoms of EEE take up to ten days to manifest. The New Hampshire Department of Health and Human Services lists fever, headache, and sore throat as mild symptoms while a sudden high fever, severe headache, and stiff neck are symptoms of a more serious infection of the central nervous system. Let your patients know that they should contact you or another provider right away if they or a family member have symptoms of EEE.

For more information, you or your patients can visit the information center on the CDC website

 

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