So, in all, Missouri’s case count in the H5N1 outbreak will stay at one for now, and there remains no evidence of human-to-human transmission. Though both the household contact and the index case had evidence of an exposure, their identical blood test results and simultaneous symptom development suggest that they were exposed at the same time by a single source—what that source was, we may never know.
California and Washington
While the virus seems to have hit a dead end in Missouri, it’s still running rampant in California. Since state officials announced the first dairy herd infections at the end of August, the state has now tallied 137 infected herds and at least 13 infected dairy farm workers. California, the country’s largest dairy producer, now has the most herd infections and human cases in the outbreak, which was first confirmed in March.
In the briefing Thursday, officials announced another front in the bird flu fight. A chicken farm in Washington state with about 800,000 birds became infected with a different strain of H5 bird flu than the one circulating among dairy farms. This strain likely came from wild birds. While the chickens on the infected farms were being culled, the virus spread to farmworkers. So far, two workers have been confirmed to be infected, and five others are presumed to be positive.
As of publication time, at least 31 humans have been confirmed infected with H5 bird flu this year.
With the spread of bird flu in dairies and the fall bird migration underway, the virus will continue to have opportunities to jump to mammals and gain access to people. Officials have also expressed anxiety as seasonal flu ramps up, given influenza’s penchant for swapping genetic fragments to generate new viral combinations. The reassortment and exposure to humans increases the risk of the virus adapting to spread from human to human and spark an outbreak.
Measles, whopping cough, polio, tetanus—devastating and sometimes deadly diseases await comebacks in the US as more and more parents are declining routine childhood vaccines that have proved safe and effective.
The vaccination rates among kindergartners have fallen once again, dipping into the range of 92 percent in the 2023–2024 school year, down from about 93 percent the previous school year and 95 percent in 2019–2020. That’s according to an analysis of the latest vaccination data published today by the Centers for Disease Control and Prevention.
The analysis also found that vaccination exemptions rose to an all-time high of 3.3 percent, up from 3 percent in the previous school year. The rise in exemptions is nearly entirely driven by non-medical exemptions—in other words, religious or philosophical exemptions. Only 0.2 percent of all vaccination exemptions are medically justified.
The new stats mean that more parents are choosing to decline lifesaving vaccines and, for the fourth consecutive year, the US has remained below the 95 percent vaccination target that would keep vaccine-preventable diseases from spreading within communities. In fact, the country continues to slip further away from that target.
Based on data from 49 states plus the District of Columbia (Montana did not report data), 80 percent of jurisdictions saw declines in vaccinations of all four key vaccines assessed: MMR, against measles, mumps, and rubella; DTaP, against diphtheria, tetanus, and pertussis (whooping cough); VAR, against chickenpox; and polio.
Vulnerable kids
Coverage for MMR fell to 92.7 percent in 2023–2024, down from 93.1 percent in the previous school year. That means that about 280,000 (7.3 percent) kindergartners in the US are at risk of measles, mumps, and rubella infections. Likewise, DTaP coverage fell to 92.3 percent, down from 92.7 percent. Polio vaccination fell to 92.6 percent from 93.1 percent, and VAR was down to 92.4 percent from 92.9 percent.
If you’re going to eat a bear, make sure it’s not rare.
You’d be forgiven for thinking that once the beast has been subdued, all danger has passed. But you might still be in for a scare. The animal’s flesh can be riddled with encased worm larvae, which, upon being eaten, will gladly reproduce in your innards and let their offspring roam the rest of your person, including invading your brain and heart. To defeat these savage squirmers, all one must do is cook the meat to at least 165° Fahrenheit.
But that simple solution continues to be ignored, according to a report today in the Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report. In this week’s issue, health officials in North Carolina report that rare bear meat was served at a November 23 gathering, where at least 22 people ate the meat and at least 10 developed symptoms of a worm infection. Of the 10, six were kids and teens between the ages of 10 and 18.
The infection is from the roundworm Trichinella, which causes trichinellosis. While the infection is rarely fatal, the nematodes tend to burrow out of the bowels and meander through the body, embedding in whatever muscle tissue they come across. A telltale sign of an infection in people is facial swelling, caused when the larvae take harbor in the muscles of the face and around the eyes. Of the 10 ill people in North Carolina, nine had facial swelling.
Local health officials were onto the outbreak when one person developed flu-like symptoms and puzzling facial swelling. They then traced it back to the gathering. The report doesn’t specify what kind of gathering it was but noted that 34 attendees in total were surveyed, from which they found the 22 people who ate the rare meat. The 10 people found with symptoms are technically considered only “probable” cases because the infections were never diagnostically confirmed. To confirm a trichinellosis infection, researchers need blood samples taken after the person recovers to look for antibodies against the parasite. None of the 10 people returned for blood draws.
California’s infections bring the country’s total number of affected herds to 255 in 14 states, according to the USDA.
In a new release Thursday, California health officials worked to ease alarm about the human case, emphasizing that the risk to the general public remains low.
“Ongoing health checks of individuals who interact with potentially infected animals helped us quickly detect and respond to this possible human case. Fortunately, as we’ve seen in other states with human infections, the individual has experienced mild symptoms,” Tomás Aragón, director of California’s Department of Public Health, said. “We want to emphasize that the risk to the general public is low, and people who interact with potentially infected animals should take prevention measures.”
The release noted that in the past four months, the health department has distributed more than 340,000 respirators, 1.3 million gloves, 160,000 goggles and face shields, and 168,000 bouffant caps to farm workers. The state has also received 5,000 doses of seasonal flu vaccine earmarked for farm workers and is working to distribute those vaccines to local health departments.
Still, herd infections and human cases continue to tick up. Influenza researchers and other health experts are anxiously following the unusual dairy outbreak—the first time an avian influenza is known to have spilled over to and caused an outbreak in cattle. The more opportunities the virus has to spread and adapt to mammals, the more chances it could begin spreading among humans, potentially sparking an outbreak or even a pandemic.
Enlarge/ A warning sign outside a laboratory testing the H5N1 bird flu virus at The Pirbright Institute in Woking, UK, on Monday, March 13, 2023.
More than a month after a person in Missouri mysteriously fell ill with H5-type bird flu, investigators in the state are still identifying people who became ill after contact with the patient, raising questions about the diligence of the ongoing health investigation.
On September 6, Missouri’s health department reported the state’s first human case of H5-type bird flu, one that appears closely related to the H5N1 bird flu currently causing a nationwide outbreak among dairy cows. But the infected person had no known contact with infected animals—unlike all of the other 13 human cases identified amid the dairy outbreak this year. Those previous cases have all occurred in dairy- or poultry-farm workers. In fact, Missouri has not reported bird flu in its dairy herds nor recent poultry outbreaks.
Given the unexplained source of infection, health investigators in the state have been working to track the virus both backward in time—to try to identify the source—and forward—to identify any potential onward spread. The bird flu patient was initially hospitalized on August 22 but recovered and had been released by the time the state publicly reported the case.
In an update Friday, September 27, the Centers for Disease Control and Prevention relayed that Missouri officials have now identified four more health care workers who experienced mild respiratory illnesses after caring for the person with bird flu. None of the four workers were tested for flu at the time of their illnesses and all have since recovered.
Testing new cases for antibodies to H5N1
The four newly identified cases bring the total number of health care workers who fell ill after contact to six. Missouri investigators had previously identified two other health care workers who developed mild respiratory symptoms. One of those workers was tested for flu around the time of their illness—and tested negative. But the other, like the four newly identified cases, was not tested. That person has since submitted a blood sample to test for bird flu antibodies, which would indicate a previous infection.
In addition, a household contact of the bird flu patient also fell ill at the same time as the patient, suggesting a possible common source of the infection.
The illnesses are concerning, given the fear that H5N1 bird flu could begin spreading from human to human and spark a widespread outbreak or even a pandemic. However, it can’t be overlooked that a plethora of other respiratory viruses are around—and SARS-CoV-2 transmission was relatively high in Missouri at the time—it’s impossible to draw any conclusions at this point about whether the illnesses were bird flu infections.
But, the illnesses do clearly raise concern about the health investigation, which is being conducted by Missouri officials. “The slow trickle of info is the most concerning part,” infectious disease expert Krutika Kuppalli wrote on social media Friday. The CDC can get involved at the request of a state, but such a request has not been made. For now, the CDC is only providing technical assistance from Atlanta.
In its update today, the CDC emphasized that “to date, only one case of influenza A(H5N1) has been detected in Missouri. No contacts of that case have tested positive for influenza A(H5N1).” The agency added that blood testing results for H5 antibodies are pending.
Enlarge/ An entomologist for the Louisville Metro Department of Public Health and Wellness in a swampland area on August 25, 2021 in Louisville, Kentucky collecting various mosquito species, and testing the samples for mosquito-borne diseases, such as EEE.
New York is facing an unusual boom in mosquitoes toting the deadly eastern equine encephalitis (EEE) virus, which has already led to one rare death in the state and a declaration of an “imminent threat” by officials.
While the state’s surveillance system typically picks up EEE-positive mosquitoes in two or three counties each year, this year there have been 15 affected counties, which are scattered all across New York, State Health Commissioner James McDonald said this week.
“Eastern equine encephalitis is different this year,” McDonald said, noting the deadly nature of the infection, which has a mortality rate of between 30 and 50 percent. “Mosquitoes, once a nuisance, are now a threat,” McDonald added. “I urge all New Yorkers to prevent mosquito bites by using insect repellents, wearing long-sleeved clothing, and removing free-standing water near their homes. Fall is officially here, but mosquitoes will be around until we see multiple nights of below-freezing temperatures.”
On Monday, McDonald issued a Declaration of an Imminent Threat to Public Health for EEE, and Governor Kathy Hochul announced statewide actions to prevent infections. At the same time as the declaration, the officials reported the death of a New Yorker who developed EEE. The case, which was confirmed in Ulster County on September 20, is the state’s first EEE case since 2015.
The disease is very rare in New York. Between 1971 and 2024, there were only 12 cases of EEE reported in the state; seven cases were fatal.
Rare but deadly
EEE is generally rare in the US, with an average of only 11 cases reported per year, according to the Centers for Disease Control and Prevention. The virus lurks in wild birds and spreads to people and other animals via mosquitoes. The virus is particularly deadly in horses—as its name suggests—with mortality rates up to 90 percent. In people, most bites from a mosquito carrying the EEE virus do not lead to EEE. In fact, the CDC estimates that only about 4–5 percent of infected people develop the disease; most remain asymptomatic.
Fo those who develop EEE, the virus travels from the mosquito bite into the lymph system and spreads from there to cause a systemic infection. Initial symptoms are unspecific, including fever, headache, malaise, chills, joint pain, nausea, and vomiting. This can progress to inflammation of the brain and neurological symptoms, including altered mental state and seizures. Children under the age of 15 and adults over the age of 50 are most at risk.
The CDC estimates that about 30 percent of people who develop severe EEE die of the disease. But, with small numbers of cases over time, the reported mortality rates can vary. In Massachusetts, for instance, about 50 percent of the cases have been fatal. Among those who survive neuro-invasive disease, many are left severely disabled, and some die within a few years due to complications. There is no vaccine for EEE and no specific treatments.
Overall numbers
While New York seems to be experiencing an unusual surge of EEE-positive mosquitoes, the country as a whole is not necessarily seeing an uptick in cases. Only 10 cases from six states have been reported to the CDC this year. That count does not include the New York case, which would bring the total to 11, around the country’s average number of cases per year.
In addition to New York, the states that have reported cases are Massachusetts, Vermont, New Jersey, Rhode Island, Wisconsin, and New Hampshire. Most cases have been in the Northeast, where cases are typically reported between mid-June and early October before freezing temperatures kill off mosquito populations.
EEE gained attention last month when a small town in Massachusetts urged residents to follow an evening curfew to avoid mosquito bites. The move came after the state announced its first EEE case this year (the state’s case count is now at four) and declared a “critical risk level” in four communities.
Between 2003 and 2023, the highest tally of cases in a year was in 2019, when states reported 38 EEE cases.
Enlarge/ A recall notice is posted next to Boar’s Head meats that are displayed at a Safeway store on July 31, 2024, in San Rafael, California.
The Boar’s Head deli-meat plant at the epicenter of a nationwide Listeria outbreak that killed nine people so far harbored the deadly germ in a common area of the facility deemed “low risk” for Listeria. Further, it had no written plans to prevent cross-contamination of the dangerous bacteria to other products and areas. That’s according to a federal document newly released by Boar’s Head.
On Friday, the company announced that it is indefinitely closing that Jarratt, Virginia-based plant and will never again produce liverwurst—the product that Maryland health investigators first identified as the source of the outbreak strain of Listeria monocytogenes. The finding led to the recall of more than 7 million pounds of Boar’s Head meat. The Jarratt plant, where the company’s liverwurst is made, has been shuttered since late July amid the investigation into how the outbreak occurred.
In the September 13 update, Boar’s Head explained that:
[O]ur investigation has identified the root cause of the contamination as a specific production process that only existed at the Jarratt facility and was used only for liverwurst. With this discovery, we have decided to permanently discontinue liverwurst.
While the statement seems to offer some closure on the outbreak’s source, previously released inspection reports described a facility riddled with sanitation failures. Between August 1, 2023, and August 2, 2024, the facility was cited for 69 violations, which included water leaks, mold in numerous places, algal growth, “meat buildup” caking equipment, and walls that were also crawling with flies and gnats, sightings of other insects, rancid smells, trash and debris on the floors, and even “ample amounts of blood in puddles.”
The New York Times also reported that a 2022 inspection found that the plant posed an “imminent threat” to public health and that inspectors cited “extensive rust, deli meats exposed to wet ceilings, green mold and holes in the walls.”
Cross-contamination
The document newly released by Boar’s Head is a letter dated July 31 from the US Department of Agriculture’s Food Safety and Inspection Service notifying the company that the Jarratt facility was suspended. The basis of the suspension was an inspection finding from July 24 and 25 of L. monocytogenes contaminating a pallet jack in a large room where ready-to-eat meats were processed. The room was a common area not specific to liverwurst processing and was deemed by Boar’s Head to be “low risk” for Listeria.
Meats from eight processing lines were in the room, with lines 1 through 4 on the left side and 5 through 8 on the right, handling hot dogs and other small sausages. The contaminated pallet jack was designated for production line 2, which was handling Beechwood Hams, and was used to move racks of hams from blast coolers to production lines in the processing room.
However, inspectors noted that the pallet jacks and product racks in the room weren’t kept to designated production lines, and instead, employees moved them between all of the lines and all of the blast coolers, enabling cross-contamination. And, while the equipment was moved around, people did, too. Although employees typically stuck to one production line, they would sometimes move between lines, and there were no procedures for employees to change personal protective equipment (PPE)—gloves, disposable aprons, and arm covers—when they switched. Inspectors saw them switching without changing their PPE.
“They also observed employees who freely move between all lines without directly interacting with product such as those removing garbage, removing product debris from the floors, removing condensation from overhead structures, or performing maintenance,” the USDA officials wrote.
Outbreak spread
Given that this was in a room full of meats that were supposedly ready to eat, the USDA concluded that Boar’s Head “failed to maintain sanitary conditions” and that its Listeria control program was “ineffective.”
To date, 57 people from 18 states have been sickened. All 57 were hospitalized, and nine people died. The Centers for Disease Control and Prevention reported that health officials have interviewed 44 people sickened during the outbreak, who said they ate various deli-sliced meats. Only 25 reported eating deli-sliced liverwurst.
In light of the outbreak, Boar’s Head said it is revamping its safety and quality assurances at its other facilities and hiring experienced food safety experts. “You have our promise that we will work tirelessly to regain your trust and ensure that all Boar’s Head products consistently meet the high standards that you deserve and expect. We are determined to learn from this experience and emerge stronger.”
MDHSS reported that the person, who has underlying medical conditions, was hospitalized on August 22 and tested positive for an influenza A virus. Further testing at the state’s public health laboratory indicated that the influenza A virus was an H5-type bird flu. The Centers for Disease Control and Prevention has now confirmed that finding and is carrying out further testing to determine if it is the H5N1 strain currently causing a widespread outbreak among US dairy cows.
It remains unclear if the person’s bird flu infection was the cause of the hospitalization or if the infection was discovered incidentally. The person has since recovered and was discharged from the hospital. In its announcement, MDHSS said no other information about the patient will be released to protect the person’s privacy.
The report marks the 15th human case of an H5-type bird flu infection in the country since 2022. But, the case stands out—and is quickly generating alarm online—because the man reported no contact with animals. All 14 of the previous cases occurred in farmworkers who had contact with either dairy cows or poultry that were known to be infected with H5N1.
The finding in a person without such an exposure raises the possibility that the H5N1 virus is spreading from person to person, undetected, or is spreading via an undetected animal source.
But, while the case raises concern, some infectious disease experts are cautious not to sound the alarm without more data on the case and potential exposures.
“[U]ntil such data is collected and analyzed, my level of alarm is only mildly heightened,” Caitlin Rivers, a senior scholar at the Johns Hopkins Center for Health Security and founding associate director of the Center for Forecasting and Outbreak Analytics at the CDC, said online.
“I am encouraged that this case was detected through existing surveillance systems, which bodes well for our ability to identify any additional cases in the future,” she added. “Federal, state, and local health officials maintained flu surveillance through the summer months in response to the H5 situation, and that was definitely the right move.”
But Rivers, like many of her colleagues, has long worried about H5N1’s potential to jump to humans and spark a pandemic.
Enlarge/ A US child infected with measles during a 2024 outbreak. The child’s cheek shows the characteristic rash associated with this viral infection.
With one of the highest vaccine exemption rates in the country, Oregon is experiencing its largest measles outbreak in decades. This year’s count is now higher than anything seen since 2000, when the Centers for Disease Control and Prevention declared the highly contagious virus eliminated from the US.
Last month, when the outbreak tally was still in the 20s, health officials noted that it was nearing a state record set in 2019. There were 28 cases that year, which were linked to a large outbreak across the border in Washington state. But, with that record now surpassed, the state is in pre-elimination territory.
“Before 2019, you have to go all the way back to the early 1990s to see case counts this high,” Paul Cieslak, medical director for communicable diseases and immunization at Oregon Health Authority, said in a statement. “The reason is, we maintained very high vaccination rates and very high population levels of immunity. Unfortunately, we’ve seen an erosion in the percentage of people who are getting vaccinated against measles.”
Vaccination decline
In 2000, when measles was declared officially eliminated, only about 1 percent of kindergarteners in the state had exemptions from childhood vaccines, such as measles. But in the years since, Oregon has become one of the states with the highest exemption rates in the country. In the 2022–2023 school year, 8.2 percent of Oregon kindergarteners had exemptions from vaccinations, according to a CDC analysis published in November. Only Idaho had a higher rate, with 12.1 percent of kindergarteners exempt. Utah was a close third, with 8.1 percent, followed by Arizona (7.4 percent) and Wisconsin (7.2 percent).
Oregon’s exemption rate has risen since then, with the exemption rate now at 8.8 percent, according to the Oregon Health Authority. Any exemption rate above 5 percent is concerning. At that threshold, even if every non-exempt child is vaccinated, a state will not be able to achieve the target of 95 percent vaccine coverage expected to prevent sustained transmission of infectious diseases.
Health officials are directly linking the rise of non-medical exemptions to the current measles outbreak, which is centered in Clackamas, Marion, and Multnomah counties. All three are in the northwestern corner of the state, with Clackamas and Multnomah in the Portland area.
“In Clackamas County, as in other Oregon counties, pockets of unvaccinated people raise risk of infection in communities where they live,” Clackamas County Health Officer Sarah Present said. “That’s why the counties reach out to every case that’s been identified and try to determine exactly where they’ve been while infectious.”
Notorious virus
Measles is among the most infectious viruses known. It is notorious for its ability to stay aloft in indoor air for up to two hours after an infected person has been present. For unvaccinated people who are exposed, up to 9 out of 10 will end up falling ill. Those who become infected are contagious from about four days before developing the tell-tale rash and four days after it erupts. Other common symptoms of the infection include high fever, runny nose, cough, and conjunctivitis (pink eye). Many children become severely ill, requiring hospitalization.
In a small percentage of cases, measles can lead to severe complications, including pneumonia, encephalitis, and a progressive neurological disorder (subacute sclerosing panencephalitis), which develops five to 10 years after an initial infection. Additionally, measles is known to cause “immune amnesia.” That is, being infected with measles virus wipes out existing antibodies and immune responses to other germs, leaving people more vulnerable to other diseases.
So far this year, the US has logged 236 measles cases. Of those, 40 percent were in children under the age of 5, while 30 percent were in children and teens between the ages 5 and 19. Eighty-seven percent were either unvaccinated or had an unknown vaccination status. Forty-four percent (103 of 236) were hospitalized.
This year’s tally is already well ahead of the total for 2023, which reached just 59 cases. It is still significantly lower than the 1,274 cases seen in 2019, when the US nearly lost its elimination status.
To date, 57 people across 18 states have been sickened, all of whom required hospitalization. A total of eight have died. The latest tally makes this the largest listeriosis outbreak in the US since 2011, when cantaloupe processed in an unsanitary facility led to 147 Listeria infections in 28 states, causing 33 deaths, the CDC notes.
The new cases and deaths come after a massive recall of more than 7 million pounds of Boar’s Head meat products, which encompassed 71 of the company’s products. That recall was announced on July 30, which itself was an expansion of a July 26 recall of an additional 207,528 pounds of Boar’s Head products. By August 8, when the CDC last provided an update on the outbreak, the number of cases had hit 43, with 43 hospitalizations and three deaths.
In a media statement Wednesday, the CDC says the updated toll of cases and deaths is a “reminder to avoid recalled products.” The agency noted that the outbreak bacteria, Listeria monocytogenes, is a “hardy germ that can remain on surfaces, like meat slicers, and foods, even at refrigerated temperatures. It can also take up to 10 weeks for some people to have symptoms of listeriosis.” The agency recommends that people look through their fridges for any recalled Boar’s Head products, which have sell-by dates into October.
If you find any recalled meats, do not eat them, the agency warns. Throw them away or return them to the store where they were purchased for a refund. The CDC and the US Department of Agriculture also recommend that you disinfect your fridge, given the germs’ ability to linger.
L. monocytogenes is most dangerous to people who are pregnant, people age 65 years or older, and people who have weakened immune systems. In these groups, the bacteria are more likely to move beyond the gastrointestinal system to cause an invasive listeriosis infection. In older and immunocompromised people, listeriosis usually causes fever, muscle aches, and tiredness but may also cause headache, stiff neck, confusion, loss of balance, or seizures. These cases almost always require hospitalization, and 1 in 6 die. In pregnant people, listeriosis also causes fever, muscle aches, and tiredness but can also lead to miscarriage, stillbirth, premature delivery, or a life-threatening infection in their newborns.
Enlarge/ A 13-year-old celebrates getting the Pfizer-BioNTech COVID-19 vaccine in Hartford, Connecticut, on May 13, 2021.
With the impending arrival of the 2024–2025 COVID-19 vaccines approved yesterday, some Americans are now gaming out when to get their dose—right away while the summer wave is peaking, a bit later in the fall to maximize protection for the coming winter wave, or maybe a few weeks before a big family event at the end of the year? Of course, the group pondering such a question is just a small portion of the US.
In a press briefing Friday, federal health officials were quick to redirect focus when reporters raised questions about the timing of COVID-19 vaccination in the coming months and the possibility of updating the vaccines twice a year, instead of just once, to keep up with an evolving virus that has been producing both summer and winter waves.
“The current problem is not that the virus is evolving so much, at least in terms of my estimation,” Peter Marks, the top vaccine regulator at the Food and Drug Administration, told journalists. “It’s that we don’t have the benefits of the vaccine, which is [to say] that it’s not vaccines that prevent disease, it’s vaccination. It’s getting vaccines in arms.” When exactly to get the vaccine is a matter of personal choice, Marks went on, but the most important choice is to get vaccinated.
Estimates for this winter
The press briefing, which featured several federal health officials, was intended to highlight the government’s preparations and hopes for the upcoming respiratory virus season. The FDA, the Centers for Disease Control and Prevention, and the Department of Health and Human Services (HHS) are urging all Americans to get their respiratory virus vaccines—flu, COVID-19, and RSV.
CDC Director Mandy Cohen introduced an updated data site that provides snapshots of local respiratory virus activity, national trends, data visualizations, and the latest guidance in one place. HHS, meanwhile, highlighted a new outreach campaign titled “Risk Less. Do More.” to raise awareness of COVID-19 and encourage vaccination, particularly among high-risk populations. For those not at high risk, health officials still emphasize the importance of vaccination to lower transmission and prevent serious outcomes, including long COVID. “There is no group without risk,” Cohen said, noting that the group with the highest rates of emergency department visits for COVID-19 were children under the age of 5, who are not typically considered high risk.
So far, CDC models are estimating that this year’s winter wave of COVID-19 will be similar, if not slightly weaker on some metrics, than last year’s winter wave, Cohen said. But she emphasized that many assumptions go into the modeling, including how the virus will evolve in the near future and the amount of vaccine uptake. The modeling assumes the current omicron variants stay on their evolutionary path and that US vaccination coverage is about the same as last year. Of course, beating last year’s vaccine coverage could blunt transmission.
Enlarge/ A mosquito collected to test for mosquito-borne diseases.
A small town in Massachusetts is urging residents to stay indoors in the evenings after the spread of a dangerous mosquito-spread virus reached “critical risk level.”
The virus causes Eastern equine encephalitis (EEE), which kills between 30 and 50 percent of people who are stricken—who are often children under the age of 15 and the elderly. Around half who survive are left permanently disabled, and some die within a few years due to complications. There is no treatment for EEE. So far, one person in the town—an elderly resident of Oxford—has already become seriously ill with neuroinvasive EEE.
EEE virus is spread by mosquitoes in certain swampy areas of the country, particularly in Atlantic and Gulf Coast states and the Great Lakes region. Mosquitoes shuttle the virus between wild birds and animals, including horses and humans. In humans, the virus causes very few cases in the US each year—an average of 11, according to the Centers for Disease Control and Prevention. But given the extreme risk of EEE, health officials take any spread seriously.
On August 16, the Massachusetts Department of Public Health announced the state’s first case and declared a “critical risk level” in the four communities of Douglas, Oxford, Sutton, and Webster. These all cluster in Worcester county near the state’s borders with Rhode Island and Connecticut.
Curfew
While the state health department did not identify the man as a resident of Oxford, the town’s manager confirmed his residence in a memorandum Wednesday. The manager, Jennifer Callahan, reported that the man remains hospitalized. She also reported that a horse across the border in Connecticut had recently died of EEE.
Also on Wednesday, the four towns—Douglas, Oxford, Sutton, and Webster—issued a joint health advisory, which included a recommended curfew.
Last night, The Oxford Board of Health voted to adopt the advisory, according to the Boston Globe. The recommendation is for residents to avoid mosquito’s peak activity time. They should “finish outdoor activities before 6: 00 PM through September 30th, 2024 and before 5: 00 PM October 1st, 2024 until the first hard frost.” The advisory also recommends residents wear insect repellent, wear protective clothing, and mosquito-proof their homes.
Officials emphasized that the curfew is a recommendation, not mandatory. However, to use town properties—such as recreation fields—people will first need to file an indemnification form and provide proof of adequate insurance coverage to the town.
To date, there have been only three cases of EEE in the US this year. One in Massachusetts, one in Vermont, and the last in New Jersey. All three are neuroinvasive. The CDC says that about 30 percent of cases are fatal, while Massachusetts health officials report that about half of people who develop EEE in the state have died.
