The sunlight coming through the picture window of Debbie Casey鈥檚 room at a nursing home in Daytona Beach falls on a message board covered with pictures from her life.
In most, she鈥檚 smiling wearing the trademark blonde bob her son Brian has tried to keep up even though she鈥檚 in a coma in a hospital bed. He says just a few months ago his spunky 68 year-old mother was doing fine.
鈥淲orking full-time. She had just built a little home that was going to be her retirement home, Brain Casey said.鈥�
But then Debbie Casey ended up in an emergency room in Gainesville with what doctors thought was a stroke.
鈥淚t took about ten days to finally identify what was causing her problem,鈥� her son said. 鈥淏ecause it鈥檚 just so extremely rare.鈥�
Debbie Casey was one of only five people hospitalized nationwide with Eastern Equine Encephalitis this year.
University of Florida entomologist Dr. Jonathan Day estimates about five times that many got infected with the disease, but they got only mild flu-like symptoms that went away after a few weeks. He says shifting climate patterns make Florida more vulnerable to the disease.
鈥淒uring years where we have an exceptionally wet winter and early spring, that sets the stage for Eastern transmission and that鈥檚 exactly what we had this year,鈥� Day said.
The number of people who got sick in the United States from an infected mosquito, tick, or flea tripled between 2004 and 2016. More than 640,000 cases over that time, according to the Centers For Disease Control and Prevention.
In Florida, changing climate and a lack of good diagnostic tools, make it easier for insect-borne diseases like Eastern Equine Encephalitis to spread. The personal and financial costs of even one case of this disease can be catastrophic.
In Florida, the dry season between mid-November to mid-May is actually getting wetter. The rise in humidity makes it easier for mosquitoes to fly farther outside the swamps where they normally live. From there, they can end up in people鈥檚 backyards.
鈥淎nd that鈥檚 what we saw this year,鈥� Day said. 鈥淰ery wet winter, very wet conditions that allowed those mosquitos that were infected to disperse, carry the virus with them, and infect horses and humans.鈥�
University of Florida鈥檚 Dr. Kartik Cherabuddi said in the case of patients like Casey, where the infection moved to her brain, long-term care costs can be in the hundreds of thousands of dollars.
鈥淚t amounts to a huge monetary burden,鈥� Cherabudi said. 鈥淔rom the initial bill, rehab and therapy and trying to have people who can be around them and help with daily function.鈥�
Most of Casey鈥檚 costs have been picked up by Medicare and Social Security, but her son Brian says he鈥檚 already had to pay $20,000 in out-of-pocket costs. And he might have to sell Debbie鈥檚 home to pay the rest of her bills.
Cherabuddi, who who treats people with Eastern Equine Encephalitis at UF Health Shands Hospital in Gainesville says most people will never even known if they鈥檝e gotten the virus.
鈥淢ost people would have a syndrome that鈥檚 very similar to a flu-like illness,鈥� she said.
Cherabuddi says only five percent of patients land in the hospital with the severest symptoms including one of the worst headaches of their lives, a high fever, slurred speech and blurry vision.
鈥淭his is when it causes infection in the brain lining and the brain itself,鈥� she said. 鈥淎nd when that happens about a third to a half of patients will succumb to the illness.鈥�
And testing for Eastern Equine Encephalitis isn鈥檛 easy. There鈥檚 a spinal fluid test that often comes back with false negatives if it鈥檚 administered too soon and a standard blood test can be slow.
鈥淢ost often people are not thinking of sending the test and two when they do send it it takes a week or so to come back,鈥� Cherabuddi said.
The patient鈥檚 condition can get much worse waiting for results. And that increases the chances of long-term disabilities. The cost of care for speech and memory problems or even paralysis resulting from the illness can be in the hundreds of thousands of dollars. There鈥檚 no medication or vaccine for Eastern Equine Encephalitis and with a lack of research funding, doctors don鈥檛 expect this will change anytime soon.
Debbie Casey鈥檚 doctors won鈥檛 know the extent of her brain damage until she wakes up. And that makes it hard for her son Brian Casey to plan for her care. He鈥檚 been working from home part-time so that he can be at his mom鈥檚 bedside.
鈥淚t gets frustrating after a while because I鈥檓 a thinker and a planner,鈥� he said. 鈥淎nd there鈥檚 not much I can plan beyond a certain amount of time.鈥�
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