Sophia Garabedian had been dealing with a persistent fever and a painful headache when her parents found her numb in her bed one morning last fall.
Doctors finally diagnosed Sudbury, Massachusetts, 5, a resident with eastern equine encephalitis, a rare but severe mosquito-borne virus that causes brain inflammation.
Garabedian survived the potentially fatal virus after about a month in Boston hospitals, but his parents say his ordeal and his ongoing recovery should be a warning, as people take advantage of the outdoors this summer.
“It has been a tough year,” said David Garabedian, his father. “With any brain injury, it’s hard to tell. The damage is there. The way it works is something no one knows.
As the coronavirus pandemic declines for now in the northeast of the country, public health officials in the region warn of another potentially bad summer for the EEA and other insect-borne diseases.
EEE saw an unexpected resurgence last summer in 10 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, according to the Centers for Disease Control and Prevention. Most of the year, the country sees only half a dozen cases of the virus in humans, the agency said.
In Massachusetts and New Jersey, authorities have already detected EEE in mosquitoes this year, the first recorded in those states. There have been no human or animal cases yet.
“It is puzzling,” said Scott Crans, who heads mosquito control efforts for the New Jersey Department of Environmental Protection. “It could indicate a busy year.”
Crans and other state health officials say that the EEE, which has no cure in humans, tends to occur in two to three year cycles, but they also emphasize that mosquito-borne diseases are notoriously difficult to predict.
A relatively mild winter may have benefited mosquito populations, but below-average rain could also have provided a welcome counterweight, he said.
Local health officials are also warning of the risk of contracting other insect-borne diseases as more people spend more time outdoors amid the coronavirus pandemic.
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. A more common but less severe mosquito-borne illness than EEE, can cause fever, headaches, body pain, and other symptoms. The infection was found in a captive falcon in early June.
Ticks are also expected to come out earlier and in greater numbers this season due to the relatively mild winter, said Aaron Bernstein, a pediatrician at Boston Children’s Hospital and director of the Harvard School of Public Health.
That could mean more cases of debilitating Lyme disease and other tick-related illnesses for local health care systems already feeling the pressure to respond to the coronavirus, he said.
“Some of the people who go into the forest more now may not have experience of how to protect themselves in the forest, and that’s a concern,” he said.
Authorities say people should avoid the early afternoon and early morning when mosquitoes are most active, wear insect repellent, and wear long clothing when possible outdoors.
CDC has offered states additional help with mosquito testing this season as the coronavirus pandemic has overwhelmed state public health offices.said Candice Hoffmann, an agency spokeswoman.
So far, officials from eight states and the District of Columbia have accepted the offer: Maryland, Ohio, North Carolina, South Carolina, Vermont, Maine, Florida and Arizona.
During last year’s EEE outbreak, CDC provided about $ 700,000 in emergency funding and technical assistance to Rhode Island, Indiana, Michigan and Massachusetts, in addition to approximately $ 18 million that they provided to states for annual disease surveillance vector-borne, Hoffmann said.
In Michigan, where six of the state’s 10 EEE cases last year were fatal, officials this summer launched a pilot program to improve the state’s response to mosquito-borne diseases.
Ned Walker, a Michigan State University medical entomologist who is leading the effort, said the goal is to create the kind of regular mosquito surveillance system that already exists in Massachusetts and elsewhere to better predict and prepare for outbreaks of diseases.
In Connecticut, officials have increased the number of mosquito test sites in its high-risk eastern portion, according to Philip Armstrong, a virologist with the state Department of Environmental Sciences.
In Massachusetts, which was hit hardest by the EEA last year, with 12 cases and 6 deaths, officials have been testing earlier, more frequently and in a wider range of locations this year to quickly identify clusters of infections. , said state epidemiologist Catherine Brown. . A pilot effort is also testing the efficacy of different larvicides to help eliminate the mosquito population in its early stages, she said.
A worrying development: The first two cases of EEE in mosquitoes this year were found in a northern part of the state near New Hampshire, rather than typical virus hotspots near Cape Cod, where officials also detected the virus in a Mosquito shows last week.
That, along with widespread cases from last year, strongly suggests that the territory of EEE-carrying mosquitoes is expanding, according to Brown. Climate changes that are causing warmer summers and altering bird migration patterns and local mosquito populations could be among the drivers, he said.
Meanwhile, an environmental group calls on Massachusetts to avoid resorting to widespread aerial spraying of insecticides, which took place six times last year as cases increased.
The Maryland-based Public Employees for Environmental Responsibility filed a complaint with the Massachusetts Inspector General’s office this month, arguing that the 2019 aerial spraying cost more than $ 2 million but was not effective in reducing mosquitoes transporting EEA.
Brown denies the group’s claim, but acknowledges that insecticides may be toxic to bees and other species, another concern raised by the group. “Last year was unprecedented,” he said. “No one wants to do that again.”
Back in Sudbury, David and Kirstin Garabedian say they are optimistic that their daughter can continue to heal from EEE.
Now 6 years old, she was able to return to kindergarten in January before the coronavirus pandemic closed schools weeks later. But her parents say she still regularly attends speech and occupational therapy to deal with persistent speech and memory problems.
Kirstin Garabedian says he understands that people want to take advantage of the outdoors this summer.
“Go out and have fun, but take the proper precautions,” he said. “Just stay alert. Use common sense. “
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