Infectious Disease in Infectious Disease in Mesa CountyMesa County

PlaguePlague West Nile VirusWest Nile Virus Colorado Tick FeverColorado Tick Fever HantavirusHantavirus

PlaguePlague

Bacteria: Bacteria: Yersinia pestisYersinia pestis Flea bite (78%),Direct animal Flea bite (78%),Direct animal

contact (20%), Aerosolized animal contact (20%), Aerosolized animal Urine/Feces (2%)Urine/Feces (2%)

Human casesHuman cases April-November (93%)April-November (93%) Increased activity of fleas and hostsIncreased activity of fleas and hosts

TypesTypes Bubonic Plague= 80-90% of casesBubonic Plague= 80-90% of cases

Signs: Fever, malaise, chills, headache, “Bubos” and possibly vomiting, abdominal pain, nausea, petechiae

Septicemic Plague- Systemic spreadSepticemic Plague- Systemic spread Signs: Similar to bubonic, plus

Prostration, circulatory collapse, septic shock, organ failure, hemorrhage, Necrosis of extremities, Microthrombi blocking capillaries

Pneumonic Plague Pneumonic Plague Incubation: 1-6 days Primary - Y. pestis inhaled Secondary - septicemic form spreads Signs: Fever, chills, headache,

septicemia Respiratory distress, hemoptysis

Person-to-person possible

Treatment Treatment PreventionPrevention

With early treatment – With early treatment – Survival ~100%Survival ~100%

Supportive treatment Supportive treatment Antibiotics treatmentAntibiotics treatment

AminoglycosidesAminoglycosides Streptomycin, Streptomycin,

kanamycinkanamycin Doxycycline, Doxycycline,

tetracycline, tetracycline, chloramphenicolchloramphenicol

Penicillins and Penicillins and cephalosporins are cephalosporins are NOTNOT effective effective

Don’t handle dead Don’t handle dead animalsanimals

Report animal die-offsReport animal die-offs Rodent-proof homeRodent-proof home Use insect repellentUse insect repellent Treat pets for fleasTreat pets for fleas Treat rodent sitesTreat rodent sites Take pet to vet if Take pet to vet if

symptoms developsymptoms develop Redness or swelling Redness or swelling

around moutharound mouth See a health care See a health care

provider if human provider if human symptoms developsymptoms develop

The West Nile Virus FlavivirusFlavivirus--aa virus, NOT a bacteria. Antibiotics are ineffective.virus, NOT a bacteria. Antibiotics are ineffective.

InfectsInfects humans, birds, humans, birds, mosquitoes, horses and other mammalsmosquitoes, horses and other mammals

Ecology & TransmissionEcology & Transmission CulexCulex species(43 species) of mosquito is cause of human species(43 species) of mosquito is cause of human

cases. cases. Isolated number of cases from ticksIsolated number of cases from ticks

Human Disease:Human Disease: Incubation: 3-14 daysIncubation: 3-14 days

80% asymptomatic or mild flu-like illness80% asymptomatic or mild flu-like illness 20% develop sudden fever, weakness, headache, myalgia, 20% develop sudden fever, weakness, headache, myalgia,

nausea, vomitingnausea, vomiting Symptoms last 3-6 days in mild casesSymptoms last 3-6 days in mild cases Severe illness develops in less than 1% (1:150) infected with Severe illness develops in less than 1% (1:150) infected with

the neurological component- Encephalitis the neurological component- Encephalitis (meningoencephalitis)(meningoencephalitis)

Incidental hosts

Vectors

Humans, horses, and other animalsAmplifying hosts

Birds

Culex sp., Aedes sp., Ochlerotatus sp.

Prevention Prevention ProtectionProtection

Eliminating larval Eliminating larval habitatshabitats Tires, bird baths, Tires, bird baths,

containers, rain containers, rain gutters, unused gutters, unused swimming poolsswimming pools

Avoid mosquito Avoid mosquito habitats during dawn habitats during dawn and dusk when they and dusk when they are most activeare most active

Adjust watering times Adjust watering times and sprinkler heads to and sprinkler heads to prevent water poolingprevent water pooling

Reduce time outdoorsReduce time outdoors Especially evening hoursEspecially evening hours

Wear long pants and Wear long pants and sleevessleeves

Use mosquito repellentUse mosquito repellent 30% DEET, Picaridin, or 30% DEET, Picaridin, or

Oil of Lemon EucalyptusOil of Lemon Eucalyptus Do not use DEET on Do not use DEET on

your animals- check with your animals- check with a vet.a vet.

Make sure all window Make sure all window screens are intactscreens are intact

Use yellow “bug” light Use yellow “bug” light bulbs in outdoor light bulbs in outdoor light fixturesfixtures

Mosquito ControlMosquito Control Mesa County Health Mesa County Health

DepartmentDepartment Larviciding outside of Larviciding outside of

district boundariesdistrict boundaries FREE larvicide FREE larvicide

samples for home usesamples for home use Grand River Mosquito Grand River Mosquito

Control DistrictControl District Expanded control areaExpanded control area Increased staff and Increased staff and

budgetbudget City of Grand JunctionCity of Grand Junction

Treating catch basins Treating catch basins Treating ponds and Treating ponds and

drainage areasdrainage areas

Colorado Tick FeverColorado Tick Fever

Most common tick-borne disease Most common tick-borne disease in Coloradoin Colorado

Caused by virus Caused by virus Maintained in rodent-tick cycleMaintained in rodent-tick cycle

Transmitted by bite of infected Transmitted by bite of infected ticktick Attached for several hours to transmit Attached for several hours to transmit

enough virus to cause illnessenough virus to cause illness

Symptoms Symptoms Treatment Treatment

FeverFever HeadacheHeadache Body achesBody aches NauseaNausea Abdominal painAbdominal pain LethargyLethargy

Currently no Currently no treatmenttreatment

Treat symptomsTreat symptoms Recovery will take Recovery will take

2-3 weeks2-3 weeks Not life Not life

threateningthreatening Infection produces Infection produces

life-long immunitylife-long immunity

HantavirusesHantaviruses A “viral hemorrhagic fever”A “viral hemorrhagic fever”

Hantavirus Pulmonary Syndrome (HPS)Hantavirus Pulmonary Syndrome (HPS) Hemorrhagic Fever with Renal Hemorrhagic Fever with Renal

Syndrome (HFRS)Syndrome (HFRS) Recent Cases:Recent Cases:

Four Corners OutbreakFour Corners Outbreak May 2003: Montana, 3 casesMay 2003: Montana, 3 cases

Cotton RatSigmodon hispidus

Deer MousePeromyscus maniculatus

House Mouse Mus musculus

L.L. Masters

Chronically infected rodent

Virus is present in aerosolized excreta,

particularly urine

Horizontal transmission of infection between same

species by contact

Secondary aerosols, mucous membrane contact, and skin

breaches are also a consideration

Transmission of Transmission of HantavirusesHantaviruses

SignsSigns

Incubation periodIncubation period 14-17 days 14-17 days Early stage:Early stage: Fatigue, fever, myalgia, Fatigue, fever, myalgia,

headache and lasts 3-5 daysheadache and lasts 3-5 days Later stageLater stage 4 to 10 days after initial signs: 4 to 10 days after initial signs:

Coughing and shortness of breath Coughing and shortness of breath Rapidly progressive, non-cardiogenic Rapidly progressive, non-cardiogenic

pulmonary edema and severe hypotensionpulmonary edema and severe hypotension Hospitalization and ventilation required Hospitalization and ventilation required

usually within 24 hoursusually within 24 hours Patients can recoverPatients can recover with early with early

supportive caresupportive care

PreventionPrevention

Limit exposureLimit exposure to mouse excrement to mouse excrement ControlControl rodents indoors rodents indoors Control Control rodents outdoorsrodents outdoors Use safety precautionsUse safety precautions when cleaning rodent infested when cleaning rodent infested

areasareas MinimizeMinimize your exposure when enjoying outdoor your exposure when enjoying outdoor

activitiesactivities Prevent accessPrevent access to food sources to food sources

Keep food preparation and cooking areas cleanKeep food preparation and cooking areas clean Cover pet and human food overnightCover pet and human food overnight Store garbage in tightly covered or elevated containerStore garbage in tightly covered or elevated container

Rodent trappingRodent trapping

Internet ResourcesInternet Resources CDC All About HantavirusCDC All About Hantavirus

www.cdc.gov/ncidod/diseases/hanta/hps/noframes/phys/www.cdc.gov/ncidod/diseases/hanta/hps/noframes/phys/clinical.htmclinical.htm

CDC Infectious Disease Pathology CDC Infectious Disease Pathology ActivityActivity www.cdc.gov/ncidod/diseases/hanta/hps/noframes/www.cdc.gov/ncidod/diseases/hanta/hps/noframes/

printgenlsection.htmprintgenlsection.htm CDC - Plague informationCDC - Plague information

www.bt.cdc.gov/agent/plague/index.aspwww.bt.cdc.gov/agent/plague/index.asp CDC - Division of Vector-borne Infectious CDC - Division of Vector-borne Infectious

DiseasesDiseases www.cdc.gov/ncidod/dvbid/index.htmwww.cdc.gov/ncidod/dvbid/index.htm

Mesa County Health Department WebsiteMesa County Health Department Website http://health.mesacounty.us/http://health.mesacounty.us/