What are the preventive measures and treatments for mosquito-borne illnesses, such as Eastern Equine Encephalitis (EEE) and West Nile Virus (WNV), in New England?

Prevention and Treatment of Mosquito-Borne Illnesses in New England

The most effective prevention of mosquito-borne illnesses in New England, such as Eastern Equine Encephalitis (EEE) and West Nile Virus (WNV), requires consistent use of personal protective measures including DEET-based repellents, protective clothing, and avoiding outdoor activities during peak mosquito feeding times. 1

Common Mosquito-Borne Diseases in New England

New England experiences several mosquito-borne illnesses, with the primary concerns being:

• Eastern Equine Encephalitis (EEE)
• West Nile Virus (WNV)

These diseases can cause severe neurological symptoms and have significant mortality rates, particularly EEE, which makes prevention critical.

Prevention Strategies

Personal Protective Measures

1. Insect Repellents:

   • Use EPA-registered repellents containing DEET (concentration <50%) 1
   • Apply repellent sparingly to exposed skin and clothing 1
   • Avoid applying high-concentration products to children's skin 1
   • Do not inhale, ingest, or get repellents in eyes 1

2. Protective Clothing:

   • Wear long-sleeved shirts and long pants when outdoors 1
   • Consider permethrin-treated clothing for additional protection 1
   • Light-colored clothing may be less attractive to some mosquito species

3. Timing of Outdoor Activities:

   • Avoid outdoor activities during peak mosquito feeding times 1
   • For most mosquito species, peak biting times are from dusk to dawn 1

4. Home Protection:

   • Use screened windows and doors 1
   • Use air conditioning when available 1
   • Consider bed nets in accommodations without screens or air conditioning 1
   • Use pyrethrum-containing flying-insect spray in living and sleeping areas during evening and nighttime hours 1

Environmental Control Measures

1. Eliminate Breeding Sites:

   • Remove standing water from flower pots, buckets, barrels, and other containers
   • Clean bird baths and pet water dishes regularly
   • Drill holes in tire swings to allow water drainage
   • Keep swimming pools treated and circulating

2. Community-Level Interventions:

   • Mosquito surveillance and control programs
   • Larvicide application in breeding areas
   • Targeted adult mosquito spraying during outbreaks

Special Considerations for High-Risk Groups

Pregnant Women

Pregnant women should be particularly vigilant about preventing mosquito bites due to potential risks to the fetus, especially from WNV:

• Follow all personal protective measures rigorously 1
• Consider limiting outdoor exposure during peak transmission seasons

Laboratory Workers

Laboratory personnel working with mosquito-borne viruses require special precautions:

• Vaccination is recommended for those working with certain viruses (e.g., Japanese Encephalitis, Yellow Fever) 1
• Follow appropriate biosafety protocols based on the specific virus being handled 1

Treatment Approaches

There are no specific antiviral treatments for most mosquito-borne illnesses found in New England. Management is primarily supportive:

1. For mild symptoms:

   • Rest and hydration
   • Over-the-counter pain relievers for fever and discomfort
   • Antihistamines for itching from mosquito bites 2

2. For severe symptoms:

   • Hospitalization may be required
   • Supportive care including IV fluids
   • Respiratory support if needed
   • Management of increased intracranial pressure
   • Prevention of secondary infections

Common Pitfalls in Prevention and Management

1. Inadequate repellent use:

   • Many people don't apply repellents correctly or frequently enough
   • Studies show only 44% of people use mosquito repellent consistently even in areas with known disease activity 3

2. Delayed medical attention:

   • Symptoms of mosquito-borne illnesses can be initially mild and nonspecific
   • Delay in seeking medical care can worsen outcomes, particularly for EEE

3. Misconceptions about repellent safety:

   • Some people avoid DEET due to safety concerns, despite its established safety profile when used as directed 4
   • Education about the safety and efficacy of DEET-containing repellents is warranted 4

4. Inadequate protection for high-risk groups:

   • People over 50 years of age are at higher risk for severe disease but may be less likely to take preventive measures 3
   • Language barriers may prevent some populations from receiving and acting on prevention information 3

When to Seek Medical Attention

Individuals should seek immediate medical evaluation if they develop any of the following symptoms after potential mosquito exposure:

• Fever
• Headache
• Stiff neck
• Confusion or disorientation
• Seizures
• Muscle weakness or paralysis

Early diagnosis through appropriate laboratory testing is crucial for optimal management.

Remember that prevention is the most effective strategy against mosquito-borne illnesses, as there are no specific treatments for most of these infections.