After a fourth Massachusetts resident was diagnosed with eastern equine encephalitis, the city of Methuen raised its risk for the rare virus to critical.
Monday's announcement from Methuen comes after a horse there tested positive for EEE. That automatically triggers the risk level to rise, the city said in a statement, and city leaders met Monday afternoon to assess next steps.
There are now 24 communities across the state with critical EEE risk levels, according to the Massachusetts Department of Health. Methuen is the first in Essex County.
The cities of Andover and Lawrence raised their risk levels to high, now among 24 communities at high risk from the virus.
Methuen ordered that outdoor events, including public schools' sporting events and practices, end at 7 p.m. until Sept. 30 and 6 p.m. from Oct. 1 through the first hard frost. Spraying will begin west of Interstate 93 on Wednesday evening, and anyone with questions can call the city health department at 978-983-8661.
City officials are urging residents of Methuen and neighboring communities to take precautions
"We're being extremely cautious with this," Methuen Mayor James Jajuga said Monday. "We don't want anybody to get sick, and obviously, most importantly, we don't want anybody to lose their life."
Aerial spraying is due to begin Monday night for parts of Middlesex and Worcester counties, with it scheduled to continue for several nights. Visit this page for up-to-date spraying information.
On Sunday, the state confirmed that a fourth person was diagnosed with EEE, identifying the patient as a woman over 50 who lives in southern Bristol County.
Laurie Sylvia, a 59-year-old woman in Fairhaven, died this weekend, and her family said she had been diagnosed with EEE — though the state did not say she was the new case.
Sylvia's husband told NBC10 Boston she began to feel sick on Aug. 19 and died on Sunday. However, she had an underlying medical condition and it is unclear if that was a factor in her death.
"She was a sweetheart, you could never find a nicer person in the whole world," neighbor Randy Perry said.
EEE is a mosquito-borne virus that can affect the nervous system and kills about 1 in 3 people who contract it. Sylvia would be the first EEE-related death this year.
As of Monday, public health officials said 334 samples in Massachusetts had tested positive for EEE. State epidemiologist Catherine Brown said that was "quite a lot, even compared to other active EEE years."
Bristol County has already ordered two aerial sprayings, and Fairhaven has shut down all public parks from dusk to dawn, but people who live and work outside there say that's not enough.
"Where I'm at, it's really bad because, at nighttime, mosquitoes own the night," farmer Morris Mendonca said, adding that there should be more sprayings.
To protect against EEE, use bug spray, wear long sleeves and pants outdoors and avoid activities in the evening and early morning, when mosquitoes are most active, health officials say.
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Before this year, the last EEE outbreak in Massachusetts was between 2010 and 2012.