The Michigan Department of Health and Human Services said state residents are being strongly advised to protect themselves from mosquito bites. The advisory comes after four additional cases of Eastern Equine Encephalitis have been confirmed in southwest Michigan, including two more that were fatal.

Three people and nine horses have died from the virus in Michigan, including 64 year old Gregg McChesney of Kalamazoo County. His family said he died in August after being sick with the illness for just nine days.

The MDHHS said the new cases expanded the geographic area affect by human EEE cases to include Barry, Cass and Van Buren counties along with the previously identified cases of Kalamazoo and Berrien counties. Two of the additional cases, in Cass and Van Buren counties, were fatal, along with an earlier case in Kalamazoo County.

At this time, there is one yet to be confirmed case of EEE in Calhoun County. Initial testing showed a positive result for a 79 year man from Calhoun County who is currently hospitalized.

In addition, the MDHHS is encouraging local officials in the five southwest Michigan counties that have been impacted by human EEE and St. Joseph, Genesee and Lapeer counties, which have had animal EEE cases, to consider postponing, rescheduling or canceling outdoor activities happening at or after dusk, specifically activities that involve children.