Delaware Health Alert Network #80
August 5, 2004 1:10 pm
Health
Advisory
LABORATORY CONFIRMED EASTERN EQUINE ENCEPHALITIS
The Delaware Division of Public Health (DPH) wishes to alert the Delaware medical community about a sentinel chicken that tested positive
for Eastern Equine Encephalitis (EEE) in New Castle County Delaware earlier this week.
Background:
Surveillance for EEE in Delaware is accomplished through periodic testing of sentinel chicken flocks. An EEE positive bird was detected
recently in the Blackbird area of New Castle County. There have been no confirmed human cases of EEE in Delaware since 1979.
Clinical Description:
Eastern Equine Encephalitis (EEE) is a mosquito-transmitted virus causing acute febrile illness. Symptoms range from a headache and mild
flu-like illness to encephalitis (inflammation of the brain), coma and death. The EEE case fatality rate (the percentage of persons who
develop the disease who will die) is 35%, making it one of the most pathogenic mosquito-borne diseases in the United States. There is no
specific treatment for EEE.
Risk Groups:
Those at increased risk for developing EEE are residents of and visitors to endemic areas and people who engage in outdoor work and
recreational activities. Persons over age 50 and younger than age 15 seem to be at greatest risk for developing severe disease.
Incubation Period:
Incubation period is usually 5-15 days.
Period of Communicability:
There is no direct person-to-person transmission. Viremia in horses is short-lived and horses are not implicated as a reservoir for human
infection.
Laboratory Criteria for Diagnosis:
Detection of the presence of EEE is made by demonstrating specific IgM in acute phase serum or CSF, or antibody rises between early and
late serum specimens by serological testing methods.
Prevention:
People should avoid mosquito bites by employing personal and household protection measures, such as using insect repellent containing
DEET, wearing protective clothing, taking precautions from dusk to dawn when mosquitoes are most likely to bite and controlling standing
water that can provide mosquito-breeding sites. There is an available vaccine to protect horses.
Reporting of Suspect Cases:
To aid in surveillance, the Delaware Division of Public Health (DPH) requests that health care providers be suspicious of patients
presenting with clinically compatible illness and report suspicious cases and laboratory confirmed EEE infections to DPH, Bureau of
Epidemiology at 1-888-295-5156. The number is available during normal business hours and during non-business hours for emergencies.
For Further Information:
DPH, Bureau of Epidemiology at 1-888-295-5156. The number is available during normal business hours and during non-business hours for
emergencies.
Categories of Health Alert messages:
- Health Alert: Conveys the highest level of importance; warrants immediate action or attention.
- Health Advisory: Provides important information for a specific incident or situation; may not require immediate action.
- Health Update: Provides updated information regarding an incident or situation; unlikely to require immediate action.



