An Acton man died of eastern equine encephalitis, or EEE, about a month ago, according to his family and the town. His death is the first publicly linked to the mosquito-borne illness in Massachusetts this year — the state is withholding EEE mortality information until the end of the season, under a policy designed to protect patient confidentiality.
Basil Chigas, 76, was the third of four people confirmed to have EEE in Massachusetts this year, according to his family, which is calling for answers about his death. He was otherwise healthy, but died within a week, his wife and son said in an exclusive interview with NBC10 Boston Wednesday, voicing concerns about a lack of communication from state and local government both before and after his death.
"The loss of someone in that amount of time is just– it's a staggering experience," son Nick Chigas said. "My mom still hasn't gotten a call from the town or the state about where he was — looking at this as an opportunity to get more information about what happened so they could do something."
Chigas' illness started with chills, a fever and vomiting, and quickly progressed to seizures, according to his family. They said they didn't know it was EEE for sure until a week later, the day before they buried him.
"He said, 'I think we should call primary care.' And when I did call, she said, 'Go to the emergency room because these things can go south very quickly.' And they did," wife Dia Chigas said. "It just happened so fast."
The town reported the case publicly the day Chigas was laid to rest, on Sept. 5.
"It was in the news being reported that a man had been confirmed with EEE, but they didn't announce that he had passed away," Nick Chigas said. "Why wasn't it being more publicized from the towns and from the state? Because if it had been, my father could be alive right now."
New Hampshire shared last month that its first EEE case in 10 years resulted in a man's death. Massachusetts used to report deaths as they happened, but the Department of Public Health changed their policy in 2019 to wait to report aggregate statistics to the public and the CDC on deaths until the end of the season, a representative for the department has told NBC10 Boston.
This is the first outbreak since the 2019-20 EEE outbreak that led to seven deaths among 17 cases in people. The Chigas family thinks the department's policy needs to change.
This year, when new cases of EEE were announced, Massachusetts released information on the sex and general age of the person who was infected, as well as what county they were exposed in.
"The Massachusetts Department of Public Health has a primary responsibility to protect the health of individuals in Massachusetts, while also balancing the importance of protecting patient privacy and confidentiality. The decision about disclosing details of an individual exposed to EEE should be left to the families. DPH works hard to prevent cases of EEE and recognize the significant emotional toll that it can take on families," a Department of Public Health spokesperson said in a statement Wednesday.
The state did not confirm any EEE-related deaths as of Wednesday. The Department of Public Health did announce Wednesday that no community in the state remains at high or critical risk of EEE transmission — a change which includes Acton.
Acton Town Manager John Mangiaratti said Wednesday that the town learned that a resident had died from EEE on Sept. 5, with no prior knowledge of a confirmed case, and issued notifications to the community that day and the day after.
The Sept. 5 notification from the town notes, "The Department of Public Health notified the Town of Acton of the positive results on Thursday September 5th. This is the third reported case of EEE in Massachusetts this year."
"The death of our resident from EEE is a tragedy, and our sincerest condolences go out to the family, friends and loved ones," Mangiaratti said in the statement. "We are always evaluating and re-evaluating our public outreach methods to ensure they are modern, timely and appropriate as technology and the needs of our citizens changes over time."
More on EEE in Massachusetts
This year's outbreak has led some communities to advise residents to limit outdoor activities when mosquitoes are most active, at dawn and dusk.
Of those who develop severe symptoms of EEE, 30% die, according to the U.S. Centers for Disease Control and Prevention, and survivors can have long-term neurological issues.
Massachusetts and New Hampshire have reported the most EEE cases of any state this year — each have now reported four of the 13 total human cases nationwide, according to CDC data, last updated Tuesday.
State epidemiologist Dr. Catherine Brown spoke about the policy in an interview with New York Magazine published on Friday, acknowledging both the need to keep the public informed and the need to keep patients' information private.
"So right now, we’re providing information about the sex of the person, their age range, and then the location where we think they were exposed to the virus," Brown told the magazine. "When you start to add additional information, like whether the patient was hospitalized or their current status, including whether they have passed away or not, it makes it easier to identify people. Also, [EEE] is a very significant infection. People don’t always just die or recover in a very short period of time. And so it often takes time to really understand what the outcome is of all of our patients."
Boston University professor and public health and infectious disease expert Dr. David Hamer has previously told NBC10 Boston the state's policy to reporting EEE mortality seems reasonable, which he reiterated in an interview Wednesday, calling the current approach "cautious and reasonable."
"It would be nice to know, but on the other hand, I understand the need for confidentiality," he said.
State health officials have been consistent in urging caution for anyone in an area at high risk for EEE transmission, including on Thursday, when the state announced a third Massachusetts horse was diagnosed with the virus this year.
In Wednesday's announcement, Brown noted that the likeliest mosquitoes to spread EEE are dying off, and their activity is more driven by temperature and humidity, and less time of day.
Dr. Robbie Goldstein, the public health commissioner, said in their statement that the risk of getting the disease is "thankfully" going down: "We know that most EEE infections occur by the end of September and this decision reflects that. Some risk from EEE will continue to exist until the first hard frost and we encourage people to continue to take steps to prevent mosquito bites as they enjoy the fall weather."
The statement also includes information on how to protect against mosquito bites.
