When I left RI for the Far East in the last week of September, they had just sprayed for mosquitoes in East Providence. There was a great concern over Eastern Equine Encephalitis (EEE), as states throughout the Northeast were having an unusually active season, and it a problem worthy of concern. EEE is a disease that kills one-third of the people who contract it, usually within 2 to 8 days. Those who survive seldom fully recover — they are often left physically or mentally disabled, with problems ranging from brain dysfunction to severe intellectual impairment, personality disorders, seizures, paralysis and cranial nerve dysfunction. Many of the patients with severe complications die within a few years. No one knows exactly why the disease is accelerating right now.
I began reading up on the statistics for patients on my flight and noted the timeline and maps. According to the CDC, the Northeast region of the US was hardest hit, although EEE has been found across the country. By the week of September 20, Connecticut, Massachusetts, Rhode Island and Michigan were the states with the most cases nationally so far. There had been a total of 8 deaths, 3 of them in Michigan, 3 in Massachusetts, 1 in RI and 1 in CT. By the time I reached Taoyüan on September 25, the total number of deaths in MA rose to 4. Now, this may not seem like a large number when compared to the number of people who have died in the opioid crisis, but when you consider that EEE is an extremely rare disease and the total number of deaths from 2009 to 2018 was only 30, it changes the picture a bit. There have already been that many confirmed cases this year, and I do not use the term “confirmed” lightly. EEE is not the easiest condition to diagnose.
Many different microbes can cause encephalitis, including the herpes simplex virus, Epstein-Barr, West Nile Virus, and the measles and mumps. In order to diagnose EEE, specific antibodies (CSF) must be found in your blood or spinal fluid, and not all clinics and hospitals have this test. In addition, doctors may not be looking for EEE since it is typically so rare. Because of this, and because of the sheer amount of time it can take for clinics and hospitals to report a case of EEE to public health officials, and then for public health officials to then report these cases to the CDC, the information coming in on total cases may be both incomplete and lapse far behind public awareness. In many parts of our country there is a regrettable dearth of well-established, efficient disease surveillance and reporting systems. It is best to install your own personal preventative alarm system. First, learn to recognize the symptoms: The illness is characterized by chills, fever, malaise and pains and aches in the muscles and joints. It can come on pretty quickly. While these are also symptoms of the common cold, I am guessing that one coming down with EEE would feel far worse than with the average cold. Don’t be an alarmist, but if you feel like crap in a particularly soul-sucking way, get to a doctor. If you have children, get them to the doctor. Better safe and foolish than dead in 10 days. With no vaccine or antiviral treatment available, the CDC emphasizes prevention through stopping mosquito bites. Here’s some recommendations that just make sense: cdc.gov/easternequineencephalitis/gen/pre.html And for some good basic info on EEE, visit cdc.gov/easternequineencephalitis/tech/symptoms.html
Here in Taoyüan, there may be no threat of EEE, but Japanese Encephalitis is always a possibility and in schools, a wide variety of bugs and viruses are easily spread. I asked several people if there is ever aerial spraying to control mosquitoes. No one has ever seen it here; that may be why the Taiwanese are very conscientious about preventing the spread of germs — the use of masks is very widespread. At the Chinese preschool my granddaughter Oona attends, you will see many of the students, and teachers as well, wearing surgical masks if there is any chance they might expose others to illness. When my son and I walked Oona to school yesterday morning, there was a line and checkpoint before students could enter. A school nurse took every child’s temperature and looked at their tongue. An elevated temperature and suspicious looking tongue meant a stay-at-home day for the student. It is one way they protect the youngest children here, and it has saved a great number of viruses from spreading in recent years. The check point and temperature taking may be a bit too time consuming for our large schools, but the masks might be something for those of us in the West to consider. Too fashion conscious to wear basic hospital white? Stylish women here wear masks in colors and designs to match their beautiful clothes.