(WWJ) Michigan residents are strongly advised to protect themselves from mosquito bites as four additional cases of Eastern Equine Encephalitis (EEE) have been confirmed in Southwest Michigan – including two that were fatal.

Reporting the two deaths on Tuesday, the Michigan Department of Health and Human Services (MDHHS) sais it's taking further action to protect the public health as the mosquito-borne disease remains a threat that has now resulted in seven confirmed human cases of EEE in Michigan with onset dates in July.

“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.”

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Health officials say of these additional cases -- in Cass and Van Buren counties -- were fatal, as was an earlier case in Kalamazoo County, bringing the total number of deaths from EEE in Michigan to three.

The new cases expand the geographic area affected by human EEE cases to include Barry, Cass and Van Buren counties, along with previously identified cases in Kalamazoo and Berrien counties.

Infections can occur even when mosquito bite numbers are low, health officials say.

With that in mind, MDHHS is encouraging local officials in the five Southwest Michigan counties that have been impacted by human EEE cases and St. Joseph, Genesee and Lapeer counties – which have had animal EEE cases – to consider postponing, rescheduling or cancelling outdoor activities occurring at or after dusk, particularly activities that involve children. This would include events such as late evening sports practices or games or outdoor music practices. The MDHHS recommendation is being made out of an abundance of caution to protect the public health and applies until the first hard frost of the year.

The Kalamazoo County Health & Community Services Department also issued a recommendation to local municipalities and schools to consider cancelling outdoor events or moving them inside if they are scheduled at or after dusk.

All Michigan residents are urged to follow these steps to avoid mosquito bites:

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, kiddie pools, old tires or similar sites where mosquitoes may lay eggs.

Use nets and/or fans over outdoor eating areas.

EEE is one of the most dangerous mosquito-borne diseases in the U.S., with a 33 percent fatality rate in people who become ill. People can be infected with EEE from the bite of a mosquito carrying the viruses. Those under 15 years old and over 50 are at greatest risk of severe disease following infection.

Signs of EEE include the sudden onset of fever, chills, body and joint aches which can progress to a severe encephalitis, resulting in headache, disorientation, tremors, seizures and paralysis. Permanent brain damage, coma and death may also occur in some cases. Anyone experiencing these symptoms should visit their physician’s office.

Those sickened but not killed by the virus include a 14-year-old Kalamazoo-area girl who suffered severe brain swelling but is making some progress in her therapy at a rehab hospital, according to her mother on Facebook.

Learn more about eastern equine encephalitis from the U.S. Centers for Disease Control (CDC) AT THIS LINK.