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Montrose County Public Health

Posted on: June 5, 2023

With conditions ripe for West Nile virus, a victim and health officials sound out a warning

mosquito west nile virus

From Montrose Press: With conditions ripe for West Nile virus, a victim and health officials sound out a warning

June 2nd, 2023| Katharhynn Heidelberg

Last July, Len Cribbs was active as ever, enjoying the outdoors and golf. First, he began feeling a little off. Then came the lethargy, followed by fever that sent him to the hospital. It would be more than two weeks before he came home, and he’d spend months clawing his way back to as near-normal as he could.

The fatigue persists. So does the dizziness. Most recently, the now-69-year-old Montrose man contends with asthma on top of everything else.

What brought him to this point? It was an insect, so small that it’s hardly noticeable.

Except when it bites.

Last year, Cribbs was one of 38 West Nile virus cases reported to Montrose County Public Health. Although West Nile can present as uncomplicated fever, aches, headache, joint pain or rash, the disease — transmitted to humans by two types of culex mosquitoes — also can have more severe consequences. For Cribbs, it was neuroinvasive spinal meningitis.

“That’s from a mosquito bite, a mosquito infected with West Nile virus,” Cribbs told the Daily Press Wednesday.

Cribbs’ wife, Lorie, insisted on taking him to the hospital when his temperature hit 104 degrees. He said was admitted to the facility in a “life-threatening condition” and spent four days there before being sent to a longer-term care center in Olathe, where he was on an anti-viral IV for the next 14 days. The center arranged for occupational and physical therapy to get Cribbs moving again.

“All I wanted to do was sleep. I probably spent 20 hours a day sleeping at that time. Following the 14 days, I was released home, came home again, and all I did was sleep,” he recounted.

Cribbs also received speech and other therapy in hopes he could be rehabilitated to the point of enjoying his usual activities.

“I would say probably from October to November, I slowly improved. The worst thing from the holdover of the disease was I had pretty much dizziness and fatigue all the time,” Cribbs said.

That persisted, even as he and Lorie went on an RV trip in April, in Utah. He could manage about half a day of activity, followed by half a day of rest at a time.

“Here we are in May and I was back in the hospital again last week, with severe asthma,” said Cribbs, who is now on oxygen. He does not yet know whether the asthma is connected to his West Nile virus, but suspects it is. “There’s just a continual flow of issues that continue from months to years after being infected with West Nile virus,” he said.

West Nile virus is transmitted by the culex tarsalis and culex pipiens mosquitoes, which the insects pick up after biting infected birds.

Meningitis like Cribbs’ is one of the most severe outcomes when the virus strikes humans. For Tara Rhodes, who spoke to the Daily Press about her case last September, it was meningitis and struck her as she was undergoing immunotherapy for melanoma.

For six other county residents last year, West Nile virus meant death.

Highest in the state

“Last year, we were the highest in the state,” said Montrose County Public Health communicable disease specialist Lisa Gallegos on Wednesday.

Montrose County’s 38 cases (with 27 resulting in hospitalizations) contributed to the overall state total of 204 — the latter of which was the most West Nile virus human cases in the nation, according to figures from the Centers for Disease Control and Prevention. More than half — 129 — of Colorado’s cases were listed as neuroinvasive, again, according to the CDC. The state’s death toll was 18, also the highest in the nation, and at six deaths, Montrose County deaths accounted for one-third of Colorado’s fatal cases.

On a five-year average, Delta County has more cases than Montrose, but that wasn’t the case last year, when Delta recorded 18 cases, including eight hospitalizations, Delta County Environmental Health Director Greg Rajnowski said.

Delta also recorded two deaths in 2022; Cedaredge Town Trustee Dick Carbin was one of the two victims.

Delta County uses two mosquito control districts to collect sample mosquito pools and send them to the Colorado Department of Public Health and Environment. This surveillance and reporting is aimed at identifying trends and potential outbreaks.

“We have recently been working to expand our current two districts to involve our Surface Creek area, mainly because of what we have been seeing in human cases,” Rajnowski said. “When you look at the rate of (cases), Montrose last year far exceeded Delta County in terms of deaths and hospitalizations.”

Rajnowski said the hotter and drier the summer is, the more likely a bump in cases, especially if it comes on late after a cold, wet spring — for now, the exact sort of spring the state is experiencing.

“That doesn’t bode well,” he said.

The culex are drawn to stagnant, standing water. Flooding from heavy runoff could be a problem if people do not address water before it becomes a hot spot for breeding: dump out flower pots, water from tires and buckets and ponds that are constantly circulating water, Rajnowski said.

Spraying alone will only kill adult mosquitoes, not larvae in standing water, Rajnowski also said.

“Mosquito control districts are actively looking for standing water and we are providing dunks (with larvicide) and education to the public to help mitigate that as well,” he said.

Although for now, Delta County isn’t seeing culex mosquitoes in its sample traps, it’s getting ready.

“We’re gearing up for June and July, really expecting to see our cases in July. I’m really concerned about Montrose,” Rajnowski said.

“ … Keep your fingers crossed we don’t have a hot, dry June and July.”

Montrose County does not have mosquito control districts to conduct sampling, although Gallegos said there have been talks of establishing one. The county is focused on prevention through public education and has enlisted Cribbs as part of the push.

An ounce of prevention … 

Cribbs urges people to take the risks seriously and to take the simple, recommended precautions.

Avoid being out at dusk and dawn when mosquitoes are most active. Wear long pants and sleeves, with close-toed shoes if you are out at that time. Use a repellent containing DEET, picardin and oil of lemon eucalyptus.

As Rajnowski and also Gallegos stressed, keep standing water drained. Repair torn window screens. Keep doors and windows closed in the evening.

 “I was never really bothered by mosquitoes. Quite frankly, I have to admit I was ignorant of West Nile virus disease and the dangers it possessed,” Cribbs said. “ … Most people just view mosquitoes as pesky little insects and don’t realize the danger they possess. Getting people educated is really important.”

Lorie recounted being shocked at Len's frail appearance when he was released from the hospital. “He thought he was bulletproof before he got sick. He was very active,” she said. After? “He really needed a caregiver for three to four months.”

What Lorie wants to see is the county set up a community task force. “I’ve been kind of the pokey stick to remind people it’s out there. They’re really certainly doing things in their own arenas, but not getting information from one to another,” she said.

Both Cribbses recommend using DEET.

“The one precaution the scientific community seems to agree on is bug spray with DEET in it. There are a lot of things out there. People claim citronella, or home remedies, that are not really backed up by science,” Len said.

“It’s a roll of the dice if you do that (home remedies). You smell good, but you smell good to mosquitoes, too,” Lorie said.

 “The best thing people can do is protect themselves when they go out,” said Gallegos, reiterating that taking care of standing water is one of the most important things people can do to reduce their chances of attracting mosquitoes.

"Mosquitoes are all across the country in several areas," Montrose County Communications Director Katie Yergensen said. "Given the amount of moisture we have right now, we are asking people to be mindful of standing water. That is a breeding area for mosquitoes."

Although people older than 50 are at greatest risk of severe illness due to West Nile virus, younger people shouldn’t think their age confers immunity. “Most people think it’s just older adults. That’s a bad assumption to operate under,” Rajnowski said.

Delta County’s awareness push includes the story of a woman in her 20s who developed viral meningitis when she contracted West Nile virus in 2021.

The virus didn’t spare Montrose County’s younger crowd, either. “We had some young people, too, who got it,” Gallegos said.

Len Cribbs now knows too well how the virus can affect almost any part of the body. He knows what the disease can take away and he knows what it takes to try to get it all back.

 “It certainly changed my life.”

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