Almost everyone knew it was coming and the waiting last summer was like the proverbial "other shoe" falling.
"It" was the West Nile virus late last summer. It was proven that it had arrived in the area when sentinel chickens in Carbon County tested positive for the disease. That, however was last year, this is this year.
"People need to follow the guidelines we are providing them for this summer," said Dave Cunningham, Director of the Southeastern Utah Health Department. "If our record this year turns out to be anything like Colorado's was last year, we could have some real problems."
Colorado had dozens of serious human cases of the disease last summer and in fact some of the worst cases occurred in rural counties, much like Carbon.
The disease, that originated in Africa, started to appear on the East coast of the United States in 1999. Each year it has progressed, a couple of states at a time across the nation. No one knows how it got here, but authorities do know that the first case was recorded in Uganda in 1937 and has spread north, east and west into Asia, Europe and then to the United States. The year before last it appeared in Colorado and last year it showed it's true self. According to state officials, Utah can probably expect a similar experience this year.
Because of that the Southeastern Utah Health Department is advising Carbon County residents to take preventative measures because that is the best way to be safe from the flu like disease that can have much greater results than just a slight headache.
The statistics on the disease, which is called an Arthropod-borne virus and is transmitted to humans mainly through the bite of an infected mosquito, has taken an increasing toll on people since it was first discovered on the continent.
In 1999, 62 cases were reported, mostly in New Jersey and New York. Seven deaths resulted from those cases.
Then in 2000 it spread to 12 total states, but only 21 cases were reported. One reported death resulted from these cases. However, it came back with renewed range and depth of infection in 2001 as it crossed the borders into every state east of the Mississippi and incurred 66 cases with nine people dying.
The disease is not only a human disease, but also infects some types of bird populations as well as horses. Only a few instances of other domestic animals being infected have been detected. However, horses are at high risk.
In 2002, the disease went comparably wild as it spread into every state but four in the lower 48 (Oregon, Nevada, Arizona and Utah). Over 4000 cases in humans were reported nation wide and 277 people died from the disease.
Animal deaths also escalated steeply in that year with 14,901 cases found in horses (with a 30 percent fatality rate) and 15,745 birds were found dead with positive results for the infection.
Last year was another increase. The disease showed up in 45 states with 9306 cases and 240 deaths. In Colorado alone there were 2943 cases with 54 people dying. In Utah, out of 29 counties the disease showed up in one way another in nine counties including Carbon, Emery, Grand, Uintah, Duchesne, Utah, Sanpete and Millard.
In comparison, the disease is minor compared to many other infectious diseases and certainly to many chronic syndromes such as cancer and heart disease. But nonetheless it is a threat to everyone who lives around it.
According to health officials, the disease, which in various forms affects the tissue surrounding the brain, the brain itself and the general neurological system, is not transmitted from person to person, nor can it come from horses or birds; it comes only from the bite of mosquitos.
Most people who get the disease do not even know they have it. In fact one of the ways that health departments across the country have checked for the disease is to look at the antibodies present in human blood.
A minor infection from a bite will cause only slight symptoms, like a headache, but will make antibodies, which means the person will never get that strain of the disease again.
Others may be affected more dramatically. Symptoms include fever, body aches, rashes and swollen lymph glands (this is called west Nile fever).
When the infection is severe a stiff neck, muscle weakness and disorientation result. At this point the infection becomes West Nile meningitis/ encephalitis. According to medical professionals, patients in this condition may have seizures, go into a coma and sometimes die.
"We are learning new things about this disease all the time," says Dr. Robert Rolfs the epidemiologist for the health department. "One of the things we know is that this disease is age sensitive."
Rolfs points out that the risk of the disease becoming severe is much greater for those over 50, in fact statistics show those over 50 are 10 times more likely to get it. For someone over 80 it gets much worse. The risk goes up 43 times over what someone who is 19 faces.
"Some people think mosquitos don't bite them, especially older people," says Cunningham. "But as we get older our skin gets tougher, particularly on our arms. When you're a kid you get a bump when you get bit, but with that tougher skin it doesn't show. People get bit all the time and don't even know it."
While the vast majority of people who have contacted the disease hardly know they have it, it still poses a substantial risk to the health of citizens.
"The main thing we want to stress is prevention," says Terri Wright, also of the Southeastern Utah Health Department. "There are a lot of things people can do to reduce the chances of anyone getting the disease."
First comes the things people can do to cut down mosquito breeding.
Make sure screen doors and window screens are in good shape and fit properly. This will keep the mosquitos out of buildings.
Eliminate standing water on any property. That means dump water out of any old cans, tires or birdbaths. A good way to keep water out of tires (because once it is in there it is hard to remove) is to cut them in half.
If there are pools of unmoving water in the area, drain them, particularly old, unkept fountains or swimming pools.
Keep tall weeds and grass cut down short. Also clean out leaf clogged gutters and repair leaking faucets and sprinklers so as not to provide a breeding ground for the insects.
Drain horse and animal troughs and outside watering dishes for domestic animals often. There are also "mosquito dunks" available for putting in troughs. These provide biological, non-toxic control methods and can be used without harm.
As for being outdoors, there are a number of options. Wearing long pants and shirts with long sleeves and applying mosquito repellent that contains DEET to bare skin.
For adults the concentration of DEET should be 30 to 35 percent and for children two through 12 a 10 percent or less solution should be used. Do not apply repellents for children under two.
The mosquitos that carry the disease primarily bite between dusk and dawn, with the height of their attacks at each end of that time period. Nonetheless measures for protection should be taken through the entire nighttime period.
Public entities in the area are also at war with these insects. Since the disease is carried short range by mosquitos, the transfer of the disease across the country appears to be taking place by birds that the mosquitos bite. Many agencies are working to control the mosquito population, and some extra money has been put into Utah's budget to help counties that have had very little or no abatement in the past. Carbon has a very organized abatement plan and department.
In some parts of the state, testing to see if the disease has arrived will still be going on. Birds, horses and humans are considered accidental or dead end hosts to the disease, meaning the either get over it or die and do not pass it along farther. Other animals, such as cattle, goats, domestic dogs and cats, do not seem to incur the disease.
Scientists are presently working on a vaccine for humans, but have not found a formula that works yet. However, there is a vaccine for horses. Horses can be vaccinated at a local veterinarian office. Horses should receive two initial doses, three to six weeks apart. Of all animals, horses are the most susceptible to the disease. Officials also suggest that if possible horses should be kept in during periods of high mosquito activity and that lights should be kept off at night. Last year, just as the disease arrived in the state, the devastating effects to horses could be seen. For example, Emery County had a number of horses get sick from the disease.
So the best way for local residents to deal with the possible occurrence of the disease is for them to take the measures that the health department suggests to keep the possibilities down, both for themselves and others.