Existence of tularemia in Summit County sparks medical warnings
August 17, 2016
All of that winter snowmelt and those afternoon rain showers in the summer and fall are often only thought of as beneficial to the mountain environment, but they also produce opportune conditions for a harmful illness.
Tularemia, though still rare, has been on the rise in Colorado the last few years, in part because damp, lush environments can sustain the bacteria found in urine and droppings from sick animals. This disease most often found on rabbits, hares, beavers or coming from tick or fly bites peaked with more than 50 confirmed human cases statewide just last year.
"We know that it exists within Summit County," said Sara Lopez, a nurse with the county Department of Public Health. "The higher amount of moisture that we've seen has increased the amount of foliage, which shades and protects the bacteria. That moist soil also preserves it from weeks to perhaps even going on to months."
In 2014, there were 16 cases in Colorado. While none of those occurred in the county, three dead beavers were discovered in the Upper Blue River south of Breckenridge and reported to Colorado Parks and Wildlife. Testing confirmed the animals positive for tularemia.
Typically, there have been an average of no more than four cases in the state annually, but 52 human infections were confirmed in 2015. Antibiotics can treat this ailment commonly known to hunters because of their exposure to wildlife, but, because the symptoms are so similar to other disease, it can easily go undiagnosed or people just try to overcome the flu-like symptoms on their own without a doctor's visit.
Signs of tularemia usually appear, sometimes abruptly following contact with the disease within three-to-five days, all the way up to three weeks. They routinely surface as fever, chills, headache, diarrhea and general feelings of weakness. Left untreated, it can develop into pneumonia with chest pain that leads to difficulty breathing.
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And, because it can be so difficult to diagnose or is often delayed, medical experts say prevention is the key. Wearing insect repellents, pants and long sleeves to fend off ticks and flies is an easy first step. Cooking food thoroughly and ensuring water is from a safe source are other tips. Finally, report and avoid areas of wildlife die-offs, and, if you must handle a dead or sick animal, wear gloves and wash your hands rigorously afterwards.
"Likelihood is quite low," adds Lopez, "though it can be quite serious, potentially fatal, if left to run its course. Of the cases, many are hospitalized because the disease is allowed to progress to a point where people get quite sick before a diagnosis is made. It is possible for people's bodies to just get over tularemia on their own, though certainly they can have complications associated with the disease so treatment is recommended."
With so much out there in the news at the moment about Zika and reoccurrence of the West Nile Virus with 13 cases reported in the state this year, the attention tends to remain on mosquitos. Given these pests struggle at elevation, this gives residents the perception there is little to worry about in our mountain climate, but local health experts suggest that's a mistake.
"We consider ourselves kind of almost immune to some issues — for example, some of the more insect-born diseases," said Dan Hendershott, Summit County's environmental health manager. "But (tularemia, as well as hantavirus and rabies) are the ones we feel like still need to be on our concern radar up here."
Now for some good news: Tularemia is not communicable person-to-person once someone is infected. What's been bizarre, though, is the state's more recent cases of tularemia — including one in June in Ft. Collins — have come from unorthodox exposures, what medical personnel refer to as "cryptic."
"There weren't typical exposure patterns," said Lopez. "They didn't have a bug bite, there was no disclosure of being in a space where there were animal die-offs or around dead animals. They were gardening, they were mowing, they were camping, they were trail running."
To that end, if you or someone you know has been outside and may have potentially come into contact with contaminated water or food, see your health care provider as soon as possible and mention these activities. And of course, hunters should always use caution when handling, skinning and consuming wild game.
This is the third in a three-part series of public health stories on zoonotic diseases, which can be transmitted from animal to human. Check online at http://www.summitdaily.com for previous articles in the series.