Medicine: EEE on the Loose?

“I’ve got an awful headache,” four-year-old Barbara Mathis wailed to her mother. “I don’t want any breakfast.” All day, Barbara rested on the living-room sofa. That night, when her temperature rose to 102, her parents took Barbara to a doctor, who looked at the child’s inflamed throat, gave her a shot of penicillin. It was no help. Next day, Mrs. Lorraine Mathis returned from market in Forked River, N.J., and found Barbara unconscious, in convulsions, her temperature raging above 110°. Last week, in an ambulance bound for a Manhattan hospital, Barbara Mathis died.

From scattered points in Atlantic, Cape May and Ocean counties in southern New Jersey, other bulletins poured in to the state department of health. By week’s end, the department reported that a strange and deadly malady was reaching alarming proportions: 19 people had been hospitalized, nine had died. The symptoms were the same: headache, nausea, delirium, then coma and convulsions. Some doctors thought it was bulbar polio; others considered it meningitis. But though New Jersey’s health department had not yet issued a blanket diagnosis, most doctors thought they knew what it was: Eastern equine encephalitis, one of the most feared forms (a 75% death rate) of a disease for which medical science has no cure, or even an effective method of control.

Vectors & Variety. Researchers have long known that encephalitis (inflammation of the brain) is caused by viruses transmitted to men and farm animals from infected birds by insect vectors (i.e., carriers), usually mosquitoes or ticks. The viruses have been divided into distinct families labeled “A” and “B”; they crop up around the world in a variety of guises, e.g., Japanese “B” in eastern Asia; Murray Valley Fever in Australia; Mayaro and Ilheus in South and Central America; dengue in India and the West Indies; Chikungunya in Africa; Omsk hemorrhagic fever in Russia. Only a few of the forms circulate widely, even fewer represent great danger to human life. The virulent Japanese “B” variety has been spread across Asia by migrating herons, sometimes affects thousands in a summer. Some 2,800 died in Japan and Korea last year; another epidemic this summer has killed 500 in Korea alone.

There is very little doctors can do about it. One promising vaccine against “B”-type viruses developed at Johns Hopkins University (TIME, March 4, 1957) has not yet proved its worth; the few vaccines against “A” encephalitis forms are still laboratory curiosities. Nor have health authorities often had success in wiping out the mosquito vectors. In some cases where encephalitis-carrying insects in a given area were wiped out, it is suspected that the virus simply sought out new vectors.

Forms & Fever. Fortunately, the U.S. is not often hurt by big, Asian-style outbreaks. The principal domestic forms—Western equine and St. Louis encephalitis —are usually more benign than their Oriental cousins. During an epidemic of Western equine in Utah last year, 47 cases were reported, but only one victim died. Eastern equine is more virulent: those who survive the brain congestion and the raging temperatures (up to 110° before death) often suffer some mental impairment or partial paralysis. The one mitigating factor is that the disease, though common among animals in the eastern U.S., Canada and South America, rarely attacks man. New Jersey had never reported a case of encephalitis before.

For the state’s victims (mostly children under ten and the aged) last week, there was little that doctors could do but keep down body temperatures. Work crews were spraying swamps with oil and DDT. To everyone in the affected areas. Health Commissioner Roscoe Kandle issued a sharp warning: stay clear of swamps and farmyards where mosquitoes or infected animals abound.