The Michigan Department of Health and Human Services reported Tuesday that there have been fatal cases of Eastern equine encephalitis in Van Buren and Cass counties.

The report came with the announcement of four additional confirmed cases of the disease, expanding the geographic area affected by human EEE cases to include Barry, Cass and Van Buren counties, along with previously identified cases in Kalamazoo and Berrien counties.

The Van Buren/Cass District Health Department has information about EEE on its website, vbcassdhd.org.

The mosquito-borne disease has now resulted in seven confirmed human cases of EEE in Michigan with onset dates in July. There have now been three fatal cases – the earliest from Kalamazoo County.

“Michigan is currently experiencing its worst Eastern Equine Encephalitis outbreak in more than a decade,” Dr. Joneigh Khaldun, MDHHS chief medical executive and chief deputy for health, said in a news release. “The ongoing cases reported in humans and animals and the severity of this disease illustrate the importance of taking precautions against mosquito bites.”

The MDHHS is encouraging officials in the five counties that have been affected by human EEE cases, plus the three counties that have had animal EEE cases – St. Joseph, Genesee and Lapeer counties – to consider postponing, rescheduling or cancelling outdoor activities occurring at or after dusk, particularly activities that involve children.

This would include events such as late evening sports practices or games or outdoor music practices. The MDHHS reports that its recommendation is being made out of an abundance of caution to protect the public health and applies until the first hard frost of the year.

EEE is one of the most dangerous mosquito-borne diseases in the United States, with a 33 percent fatality rate in people who become ill. People can be infected with EEE from the bite of a mosquito carrying the viruses. People younger than age 15 and over age 50 are at greatest risk of severe disease following infection.

Signs of EEE include the sudden onset of fever, chills, body and joint aches that can progress to a severe encephalitis, resulting in headache, disorientation, tremors, seizures and paralysis. Permanent brain damage, coma and death may also occur. Anyone experiencing these symptoms seek immediate medical attention.

The MDHHS recommends the public follows these steps to avoid mosquito bites:

• Apply insect repellents that contain the active ingredient DEET, or other U.S. Environmental Protection Agency-registered product to exposed skin or clothing, and always follow the manufacturer’s directions for use.

• Wear long-sleeved shirts and long pants when outdoors. Apply insect repellent to clothing to help prevent bites.

• Maintain window and door screening to help keep mosquitoes outside.

• Empty water from mosquito breeding sites around the home, such as buckets, unused kiddie pools, old tires or similar sites where mosquitoes may lay eggs.

• Use nets and/or fans over outdoor eating areas.

In addition to the human cases, as of Sept. 16, nine cases of EEE in horses had been confirmed in Barry, Kalamazoo, Lapeer and St. Joseph counties. None of the horses were vaccinated against EEE and all animals have died. There is an EEE vaccine available for horses, but not for people.

Also, five deer, in Barry, Cass, Genesee, Kalamazoo, and Van Buren counties, have been confirmed with EEE infection and were euthanized due to the severity of their disease symptoms.

Contact: anewman@TheHP.com, 932-0357, Twitter: @HPANewman