On a Friday last September, James Longworth came home from the gym and didn’t feel well.
It passed, and the next day, he felt normal enough that they participated in Freetown’s annual neighborhood yard sale, said his wife, Diane Balestracci.
“There's lots of food around because friends come, relatives come, because it's the whole neighborhood,” she said.
His appetite was fine.
Sunday morning, he felt off again. He tried going back to bed, and then got up.
“And he said, ‘My legs — I can't move my legs,’” his wife recalled. “Well, you know, he was 78 years old.”
She thought maybe it was normal aches and pains.
“You know — arthritis, and so on and so forth,” she said. “And then, shortly after that, he fell.”
Twice, he fell out of a chair. She was convinced he was having a stroke.
He wasn’t. It was Eastern equine encephalitis -- life-threatening brain inflammation caused by a mosquito-borne virus.
“In less than 24 hours, he was already in a coma,” she said. “It's a horrible, horrible, horrible disease.”
Four days after he went to the hospital, James Longworth died of EEE.
The risk of Eastern equine encephalitis is already critical this summer in parts of Plymouth County, and entomologists are monitoring Cape Cod. Six people died of the mosquito-borne disease in Massachusetts last year, a mortality rate of 50 percent.
The mosquito life cycle relies on standing water.
Blake Dinius, entomologist educator for Plymouth County Extension, took a walk around his own yard looking for anything as small as a bottle cap that could harbor mosquitoes.
“It’s like the old ads from the ’90s, where it's like, ‘I’m not only the president, but I'm also a client.’ … One of the things I was wondering is, like, how much trash or mosquito harborages I could find in my yard, and I found a lot,” he said.
He found plastic party cups, random trash, and what you might call the “love shack” of container-breeding mosquitoes: tires — in this case, left by a previous owner.
People think tires are hard to get rid of, but he said residents can get tires removed for free through their local mosquito control project.
Dinius mentioned another mosquito maternity ward that’s less obvious: downspout extensions. They’re accordion-style plastic tubes that direct rainwater away from the foundation. He said they are definitely a mosquito breeding spot.
Most people know to avoid being outside at dawn and dusk, but here, too, there may be more you don’t know. Dinius said it’s not just about more mosquitoes coming out — it’s about which mosquitoes.
“Not all mosquitoes are equally good at transmitting EEE,” he said. “And the ones that are really good at transmitting it tend to be active during the twilight or dawn.”
He said limiting your activity really does work. Still, it’s not a guarantee — which brings us to repellent.
Ellen Bidlack, entomologist for the Plymouth County Mosquito Control Project, said people should use one registered with the U.S. Environmental Protection Agency.
“When they’re out in the evening in particular, they should be using repellent,” she said. “They should just use it as a matter of habit — if you're going to be out, you know, maybe hanging out on your deck, or that kind of thing.”
There’s a searchable list at EPA.gov. Common active ingredients are DEET, Picaridin, oil of lemon eucalyptus, and a synthetic amino acid called IR3535.
“You'll see on the label an EPA registration number, and then you'll know that they had to prove to the EPA that the product is effective,” she said.
Bidlack said when the weather’s dry, as it has been this year, there may be fewer mosquitoes, but they can still be infected with EEE.
And repellent is no less important.
“Because it only takes that one odd mosquito,” she said.