Equine encephalitis illness on the upswing in US: 6 things to know

Eastern equine encephalitis, a mosquito-borne illness, is an emerging disease threat, National Institutes of Health officials wrote in a commentary in The New England Journal of Medicine.

Although the disease has been known for centuries, 2019 saw a significant uptick in confirmed cases in the U.S.

As of Nov. 19, there have been 36 cases of EEE in the country for this year, and 14 people have died from it, according to CDC data. Cases have been reported from the following eight states: Connecticut, Indiana, Massachusetts, Michigan, North Carolina, New Jersey, Rhode Island and Tennessee.

Officials from the National Institute of Allergy and Infectious Diseases, part of the NIH, detailed the symptoms of EEE as well as current research efforts. Here are six things to know:

1. There have been 12 documented EEE epidemics in the U.S., occurring between 1831 and 1959.

2. People infected with EEE take around three to 10 days to show symptoms, such as fever, muscle aches, nausea and intense headaches.

3. Most people who are infected with the EEE virus do not develop symptoms, but one-third or more of those who do show symptoms die ,and others may suffer from permanent and severe neurologic damage.

4. It is difficult to use diagnostic testing to identify EEE, as it is hard to isolate the virus from clinical samples, and testing for EEE virus antibodies may be negative.

5. No antiviral drug has proved to be a safe and effective treatment for EEE.

6. EEE vaccines are being developed, but they may have trouble advancing and reaching the licensure phase. Since EEE outbreaks are rare, brief and often occur in unpredictable locations, it is hard to pinpoint a target population for vaccination.

"Although EEE is not yet a disease of major national importance, this year's spike in cases exposed our inadequate preparation for emergent disease threats," the authors concluded. "Though the best way to respond to these threats is not entirely clear, to ignore them completely and do nothing would be irresponsible."

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