Three Michiganders have died from the rare and dangerous mosquito-borne virus Eastern equine encephalitis and four others have been sickened by the disease, state health officials said Tuesday, amid the biggest outbreak in more than a decade.

Those who live in all eight of the affected counties — Kalamazoo, Cass, Van Buren, Berrien, Barry, St. Joseph, Genesee and Lapeer counties — are urged to consider canceling, postponing or rescheduling outdoor events that occur at or after dusk, especially those that involve children, according to the Michigan Department of Health and Human Services.

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This would include events such as late-evening sports practices or games or outdoor music practices "out of an abundance of caution to protect the public health and applies until the first hard frost of the year," according to an MDHHS news release.

The three people who died were all adults, and lived in Kalamazoo, Cass and Van Buren counties, said Bob Wheaton, a spokesman for the Michigan Department of Health and Human Services. The four other confirmed cases are in Kalamazoo, Berrien, and Barry counties.

Animals have also been confirmed to have the virus in St. Joseph, Genesee and Lapeer counties.

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The Kalamazoo County Health and Community Services Department also issued a recommendation to local communities and school districts to consider canceling outdoor events at dusk or after dark, when mosquitoes are most active, or move them indoors.

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

EEE is one of the most deadly mosquito-borne viruses in the U.S. One in three people who develop symptoms of the virus will die, according to the U.S. Centers for Disease Control and Prevention. The only way to prevent it is to avoid mosquito bites.

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The MDHHS says residents should:

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.

Symptoms of EEE include:

Sudden onset of fever, chills

Body and joint aches which can progress to a severe encephalitis

Headache

Disorientation

Tremors

Seizures

Paralysis

Coma

Anyone experiencing these symptoms should visit their doctor.

Contact Kristen Jordan Shamus: 313-222-5997 or kshamus@freepress.com. Follow her on Twitter @kristenshamus.

Editor's note: This story has been edited to make clear that of those who develop symptoms of Eastern equine encephalitis, one in three will die.