News Archive

Health Department Urges Caution When in Close Contact With Bats (July 2010): As many people with sharp eyes can attest, summer evenings are prime time for bat activity. The interesting critters are a part of our summer ecosystem, and from July through early fall the numbers of bats in Larimer County increase as several species reside or migrate through our area.

Three bats captured in Larimer County the week of July 12th were recently confirmed as positive for rabies. As beneficial as bats may be for pollination and pest control, there are some precautions that people need to take to avoid human/bat encounters that could transmit rabies, a deadly disease in humans and pets.

"This summer's numbers (of bats confirmed positive for rabies) have not been unusual," said Dr. Adrienne LeBailly, director of the Larimer County Department of Health and Environment. "When you have an increased population of bats, as we do during the summer, it's not unusual for some to have rabies. These are usually the bats that behave abnormally and allow humans or pets to get near them."

The bats found recently were either handled by a person or found in close contact to people or family pets.

The issue of rabies in bats recurs each summer when the health department receives reports of positive rabies tests in bats that have been collected by the Larimer Humane Society and tested by the CSU veterinary lab or the state health department.

According to LeBailly, most bats do not carry rabies and pose little health risk if not touched by people or pets. However, bats that are visible and approachable during the day, behave abnormally, have trouble flying, or allow a person to handle them are more likely to be infected with rabies. "In Larimer County, a bat that has direct contact with humans or pets has about a 10-15 percent chance of being infected with rabies."

A person or a family pet could come in close enough contact with an infected bat that the bat can pass the infection on through bites or getting bat saliva in small cuts or sores. Bats have very tiny, sharp teeth, and a person can often be bitten without being aware of it.

Each summer a small number of Larimer County residents receive rabies post-exposure treatment for possible contact with rabid bats. These vaccinations are expensive, but will prevent rabies illness from occurring in the event the person was infected. If a bat that may have bitten or scratched a person is tested and found positive for rabies, it is always recommended that rabies vaccinations be started immediately. Rabies can also be carried by dogs, cats, raccoons and skunks after being infected by an animal with rabies. Any infected mammal can transmit the infection to humans through a bite.

"Rabies is a virtually always a fatal disease," said LeBailly. "Waiting for treatment until symptoms appear means it's too late."

Sometimes it is recommended that a person receive preventive treatment for rabies when the actual bat was not caught or tested. "If a person has been bitten or otherwise exposed to bat saliva, but was unable to capture the bat for testing, it's recommended that they too undergo rabies post-exposure treatment as a precaution," LeBailly said. "Better to be safe and prevent any possible rabies infection." She added that testing a bat for rabies not only reveals positive cases, but also reveals if a bat does not carry rabies, thus sparing a person the vaccine treatment series.

The vaccine, once feared because of the required painful multiple shots in the abdomen, is now given in a series of five injections in the upper arm, given over four visits. The first treatment for rabies preventive treatment consists of two injections and is usually given in an emergency room; the three subsequent visits may be done in the ER or in a physician's office. The health department does not administer rabies post-exposure treatment.

There are steps we all can take to help prevent a human/bat rabies exposure:
-- First, never touch a wild bat or any other wild animal. A healthy bat will likely not come near enough to you to be touched, so a bat that is slow, lying on the ground or who lands on a person could be showing signs of illness. If you can touch it, chances are it is sick. If you find a group of baby bats, they too should not be touched.
-- Keep your doors and windows covered with intact screens. Do not leave screenless doors or windows open in the evening.
-- If you have bats in your house, try to find the source of their entrance and seal it.
-- If you find a dead bat, do not pick it up with your hands, even if you're wearing gloves. Use a shovel.
-- Teach your children that they should never touch a bat. If they find one, they should leave it where it is and tell an adult.
-- If you are bitten by a bat or if you suspect you've been exposed to its saliva, try to contain the bat without touching it, and call the Larimer Humane Society.

To report a dead bat or bat encounter, call the Larimer Humane Society at 226-3647, Ext. 5 or the Larimer County Department of Health and Environment at 498-6775.

Keep your pets vaccinated!

Be sure your pets are up to date on their rabies vaccines. Even an indoor cat can get rabies if bitten inside the house. Unvaccinated dogs and cats that are exposed to a rabies positive bat or other animal with rabies will either have to be euthanized or placed under a mandatory 180-day strict quarantine with the first 90 days at a licensed kennel or veterinary clinic. The high bills from boarding and/or the heartbreak of losing a beloved pet to rabies can be prevented simply by keeping your pets current on their vaccinations.
West Nile Virus Season Is Here - Protect Yourself (July 2010): The Larimer County Department of Health and Environment reports the county's first human case of West Nile virus in 2010 has been confirmed.

A 39-year-old resident of LaPorte was confirmed of having West Nile virus. The woman became ill in early June with symptoms consistent with West Nile fever and the results of tests confirmed West Nile virus. The woman was not hospitalized and is recovering at home. A case was also confirmed in Weld County.

"Though we have not yet seen infection in trapped mosquitoes in Larimer County so far this year, the fact that two people have become ill from the virus confirms that the virus is circulating in Northern Colorado," said Dr. Adrienne LeBailly, director of the health department.

"We can't predict how serious of a West Nile season we will have," LeBailly said. "But a few things we know for sure: Culex mosquitoes reproduce rapidly in hot weather, such as we're experiencing this year. Once an infected mosquito bites a person, symptoms of the illness can appear within 3-14 days."

To prevent bites by an infected mosquito, LeBailly recommends the following:

-- Use an effective mosquito repellent when outside during peak mosquito hours between dusk and dawn. Apply it to any exposed skin. Read the label before use. The Centers for Disease Control recommends using repellents containing DEET, Picaridin, Oil of Lemon Eucalyptus or IR3535 which have been shown to be effective when used as directed.
-- Direct a strong fan on the seating area of your deck or patio during mosquito-biting hours. The brisk breeze makes it harder for mosquitoes to fly nearby and land.
-- Eliminate mosquito breeding areas around your home such as containers of standing water.
-- Empty standing water in bird baths, pools, etc., at least weekly, and twice a week when temperatures are over 90 degrees and mosquitoes can grow from eggs to biting adults in only 5 days.
-- Repair all house screens and screen doors. A mosquito needs only a fraction of an inch gap to enter your home.

For information on West Nile virus and mosquito repellents, go to www.larimer.org/health or call 498-6700.
Group B Meningoccal Bacteria Identified (June 2010): The Larimer County Department of Health and Environment has received lab results from the U.S. Centers for Disease Control and Prevention (CDC) which showed that a Fort Collins man who had symptoms of meningococcal meningitis, but who had no confirming lab findings in hospital and commercial lab tests, actually had Group B meningococcal disease.

This strain is different from the Group C meningococcal outbreak involving the recent cases in three Fort Collins hockey players and a CSU student who became ill on Memorial Day weekend. It is believed to be a sporadic case; these occur one to three times per year on average in Larimer County.

The man with Group B meningitis (known as "Patient 4") was admitted to the hospital on June 14, the same day as two of the hockey players, but was treated and released from the hospital three days later and is doing well. This is not a new case.

"It was originally thought this person might have a viral strain of meningitis, since all of his cultures were negative," said Dr. Adrienne LeBailly, director of the Health Department.

"Since then, further testing -- done by the CDC to assess any connection to the outbreak -- found DNA evidence of Group B meningococcal bacteria. Though all five cases of illness were caused by meningococcal bacteria, the Group B strain is unrelated to the other four cases we've seen in Larimer County," said LeBailly.

Because he had clinical symptoms of meningitis, his close contacts were treated with antibiotics soon after he became ill.

"Group B meningococcal bacteria are not covered by the meningococcal vaccine. The vaccine protects against the A, C, Y, and W-135 groups. The bacterial group of a meningococcal infection cannot be distinguished by clinical symptoms; only lab testing can identify it.

The Health Department reports no further cases of meningococcal illness at this time. "This is a good thing," said LeBailly. "It means the quick treatment of close contacts has helped to prevent further spread."

The last meningocococal cases in Fort Collins were admitted to the hospital on June 14. A case related to the hockey game in Fort Collins was admitted to a hospital in Montana on June 17. Because the incubation period from exposure to illness is generally two to 10 days, the further one gets from the last exposure, the less the risk of additional cases.
Second Meningococcal Disease Death Confirmed (June 2010): The Larimer County Department of Health and Environment on Tuesday confirmed the death of a second person from meningococcal disease. The patient had been hospitalized in the intensive care unit at Poudre Valley Hospital in Fort Collins since June 14.

"It is our very sad duty to confirm that the second hockey player from the C Division of the adult hockey league in Fort Collins, who played in a June 9th game, died early Tuesday morning," said Dr. Adrienne LeBailly, director of the Larimer County Department of Health and Environment.

"The individual was a member of one of the teams that played in a game after which three players became seriously ill with meningococcal disease," she added. "This is the second fatality related to that game."

Since Memorial Day, meningococcal disease has been confirmed in four Larimer County residents. Infection with these bacteria can cause either meningitis (an infection of the membranes covering the brain and spinal cord) or sepsis (an infection of the bloodstream). The two hockey players who died had meningococcal sepsis.

Meningococcal disease is a severe infection caused by bacteria known as Neisseria menigitidis. The bacteria are commonly found in the throats of 5 percent to 15 percent of the population. Meningococcal disease is uncommon, and less than 1 percent of persons exposed to the bacteria become ill. However, in some persons serious illness progresses rapidly, and it can lead to death in about 10 percent of those who become ill.

If infection is diagnosed early enough and the right antibiotics are given quickly, a patient can make a complete recovery.

Today the Health Department also announced that results of lab testing done by the Colorado Department of Public Health and Environment (CDPHE) revealed that the bacteria causing the first case of meningococcal disease (in a CSU student who became sick on Memorial Day) and in the hockey players who have died, match each other. Their samples also match the bacteria from a case that occurred in the Denver metro area this past spring.

"This means that these bacteria are all clones from the same source," said LeBailly.

"Even with this information, we will be very unlikely to tie the cases together directly," said LeBailly. "Many people carry these bacteria in their throats but have no symptoms. Less than 1 percent of carriers become ill, so they wouldn't know if they were passing on the bacteria."

LeBailly said that this appears to be a virulent strain that may be new to this area and to which the population may have less immunity.

"This clustering among the hockey players is very unusual. We know we need to continue to focus on the two organizations where cases have occurred in Larimer County -- in the hockey league and among Colorado State University's student population," said LeBailly.

Over the past week, the Health Department offered preventive antibiotics as well as vaccination to family and household members of the ill individuals and everyone in the C division of the hockey league. The department is now expanding prevention efforts by offering vaccinations to all Fort Collins Adult Hockey Association players.

As the Health Department focuses on the hockey players, the university's health center is increasing its efforts to reach students with information about the outbreak and the year-round availability of the vaccine to students through the CSU Health Network.

"Vaccination remains the main way to prevent meningococcal disease," said LeBailly. "This vaccine is recommended for all children reaching middle- to high-school age, for those going into college, as well as for anyone who wants to reduce their risk of meningococcal disease."

Meningococcal vaccine supplies at the Health Department are limited at this time. Call your healthcare provider for meningococcal vaccination information.

For more local information, Larimer County residents can visit www.larimer.org/health or call the info line at (970) 498-6706.

For more information on meningococcal disease, including symptoms, some helpful resources can be found at: www.health.state.mn.us/divs/idepc/diseases/meningococcal and www.cdc.gov/meningitis/index.html.

If you think a person has symptoms that suggest meningitis, contact your doctor immediately, call 911 for an ambulance or go to the nearest hospital emergency department. Early diagnosis and treatment are vital.

Signs and symptoms in older children and adults may include:

-- Fever
-- Headache
-- Loss of appetite
-- Neck stiffness
-- Discomfort when looking at bright lights (photophobia)
-- Nausea and/or vomiting
-- Diarrhea
-- Aching or sore muscles
-- Difficulty walking
-- General malaise
-- Moaning, unintelligible speech
-- Drowsiness
-- Confusion
-- Collapse
-- Rash of red-purple pinprick spots or larger bruises
-- Painful or swollen joints

Signs and symptoms in infants and young children are similar to above, but may also include:

-- Refusing to eat
-- Irritability, fretfulness
-- Grunting or moaning
-- Extreme tiredness or floppiness
-- Turning away from light (photophobia)
-- Convulsions or twitching
-- Dislike of being handled
Additional Meningococcal Illness Confirmed (June 2010): The Larimer County Department of Health and Environment reports that another case of meningococcal disease in a Fort Collins area resident has been confirmed. The affected individual is also associated with the two hockey teams in division C of the adult league that played at EPIC (Edora Pool and Ice Center) on June 9 at 7:15 p.m.

The person had left for a family vacation to Montana on June 12. According to Dr. Adrienne LeBailly, director of the Larimer County Health Department, the individual apparently began to feel ill on Wednesday, June 16. He was taken by his family to a small hospital Thursday evening, where physicians immediately suspected meningococcal sepsis (overwhelming infection of the blood, or "blood poisoning") and was then transferred to a larger hospital by ambulance. He is now in intensive care and in critical condition.

LeBailly noted that both the Health Department and hockey team members had been unable to reach the player who was on vacation to alert him of the possible exposure to meningococcal disease at the June 9 game.

"This is such a tragic situation," LeBailly said. "We will continue to follow up on our investigation and treatment of contacts so that we can try to prevent further meningococcal illness."

LeBailly noted that the Health Department is working closely with hockey league representatives, the Colorado Department of Public Health and Environment and the U.S. Centers for Disease Control (CDC) in responding to the situation.

The Health Department is following up with all household members of cases, and with all hockey players in the C division for preventive antibiotics and vaccination.

Since Memorial Day, there have been four confirmed cases of meningococcal meningitis in Fort Collins residents. Of the four confirmed cases, there has been one death, and two persons remain in critical condition in intensive care. The first confirmed case has been discharged from Poudre Valley Hospital to a Denver-area hospital.

Because three of the four cases are clearly linked to the June 9 hockey game, so far this situation is considered an organizational outbreak, rather than a community outbreak. At this time, preventive efforts will be focused on household members of cases and on the division C teams in the hockey league. However, if further molecular "fingerprinting" shows that these cases are tied to other cases from elsewhere in Colorado or to the CSU student case, preventive efforts may be expanded.

"This is an evolving situation, and recommendations may change as we learn more," said LeBailly.

LeBailly also stressed that the recreational facilities where the games took place are not sources of infection.

"There is no reason to stay away from the ice facilities or the pools," she said. "These bacteria do not survive long on surfaces and are most efficiently spread through direct contact with the saliva of an infected person."

Additional Information

For more information on meningococcal disease, including symptoms, some helpful resources can be found at:

Larimer County Meningitis Info Line: 498-6706
www.larimer.org/health
www.health.state.mn.us/divs/idepc/diseases/meningococcal
www.cdc.gov/meningitis/index.html

If you think a person has symptoms that suggest meningitis, contact your doctor immediately, call 911 for an ambulance or go to the nearest hospital emergency department. Early diagnosis and treatment are vital.

Signs and symptoms in older children and adults may include:

-- Fever
-- Headache
-- Loss of appetite
-- Neck stiffness
-- Discomfort when looking at bright lights (photophobia)
-- Nausea and/or vomiting
-- Diarrhea
-- Aching or sore muscles
-- Difficulty walking
-- General malaise
-- Moaning, unintelligible speech
-- Drowsiness
-- Confusion
-- Collapse
-- Rash of red-purple pinprick spots or larger bruises
-- Painful or swollen joints

Signs and symptoms in infants and young children are similar to above, but may also include:

-- Refusing to eat
-- Irritability, fretfulness
-- Grunting or moaning
-- Extreme tiredness or floppiness
-- Turning away from light (photophobia)
-- Convulsions or twitching
-- Dislike of being handled