Like many contagious and deadly diseases, Eastern equine encephalitis, also called EEE, has links to Fort Detrick.
There have been 12 cases diagnosed in Massachusetts, three in Rhode Island and two in Connecticut, according to the Boston Globe. Michigan is planning to aerial spray for mosquitoes in an effort to prevent EEE, according to the Detroit Free Press.
The U.S. Army Medical Research Institute of Infectious Diseases at Fort Detrick was responsible for one of the unlicensed vaccinations against the disease created around 1967, said Dr. Lesley Dupuy, principal investigator in the Virology Division. The medical laboratory had been working on two new vaccines for the disease before a cease and desist order from the Centers for Disease Control and Prevention.
The cease and desist order essentially shut down all research in biosafety level 3 and 4 laboratories while USAMRIID fixes safety concerns, mostly focused on decontamination. While USAMRIID is working with the CDC to address any concerns, the laboratory has not yet resumed research, Dupuy said.
The vaccine that is available is unlicensed, which means it did not go through the FDA approval for licensure and is not available to the public, said Dr. Connie Schmaljohn, senior research scientist for Medical Defense Against Infectious Disease Threats.
The vaccine has its flaws, with Dr. Pamela Glass, chief of the Viral Pathogenesis Department, calling it “suboptimal.” The lot used at USAMRIID on military members has about a 50 percent rate of causing a good immune response, she said.
The rate does increase after two or three vaccinations, Dupuy said, but the vaccine’s effectiveness does wear off. About 40 percent of people have a reaction, he said.
EEE is closely related to Western equine encephalitis and Venezuelan equine encephalitis. All three are studied at USAMRIID.
Virologists at USAMRIID are working on DNA vaccines for EEE, WEE and VEE, as well as a combination vaccine.
The DNA vaccine, which involves injecting genetically engineered cells, for Venezuelan equine encephalitis showed positive results in phase one testing, which is a beginning phase of testing in humans, Dupuy said.
The virologists have published results showing that the DNA vaccine for EEE and the combination vaccine had good results. They are also seeing immunological protection from primate studies, although the research is not published, Dupuy said.
There is also a partnership with the National Institute of Allergy and Infectious Diseases to work on a virus-like particle vaccine for the viruses. Virus-like particle vaccines use proteins from the virus but not genetic material preventing the virus from replicating.
Those vaccines have been tested in mice and non-human primates, with a current phase one study underway, Glass said.
The continuance of the research depends on funding, which is out of USAMRIID’s control. But the recent attention to EEE might help with grants, Dupuy said.
A group at the University of Texas at Galveston is also working on a vaccine that will use a live virus. The vaccine is used only for prevention, Dupuy said.
There is a higher incidence of exposure rather than infection. Of those who get infected, a small percentage will have symptoms, with a smaller group getting encephalitis.
The symptoms of EEE start out like those for the flu, Dupuy said. Once the disease affects the brain, the symptoms will be seizures or delusions. The flu-like symptoms can cause the disease to go undiagnosed because it is mistaken for the flu, Dupuy said.
Tests can be done to differentiate the disease from the flu, Dupuy said.
The disease is rare but severe. According to the CDC, about 30 percent of those who have EEE will die, with lasting neurological effects for survivors.
There are no treatments for the virus, Dupuy said. Most of the care is fluids and other basic care at hospitals.