Think safe before you clean

Jo Walliser had an unpleasant discovery as she opened a box containing clothes donated to Bridge Street Bargains. Mixed in with the clothing was a dead mouse. Walliser immediately threw the box out and did not touch the garments.

This was a smart precaution.

The threat posed by rodents to both our health and property is significant. Rodents invade an estimated 21 million homes in the U.S. every winter, and an infestation can cause more than just a headache for homeowners. The real concern is these pests can spread diseases and cause serious property damage once inside.

Mice and rodents chewing on wires have been attributed to causing more than one fire. As bad as the property damage can be, the viruses rodents carry can be fatal.

The accumulation of feces from mice and rats can spread bacteria, contaminate food sources and trigger allergic reactions in humans. Once the fecal matter becomes dry, it can be hazardous to those who breathe it in. Rodent droppings can spread diseases like Hanta Pulmonary Syndorome (hanta-virus) which is not often easy to diagnose right away, according to nurse practitioner Cathy Miller, who serves the community of Medicine Bow at the town's clinic.

"The thing that is scary about hanta-virus is that the symptoms can be fairly amorphous, they aren't black and white screaming, 'I am the hanta-virus'," Miller said. "People have to be careful of this virus, because the symptoms can start out pretty mild."

Miller said signs of the hanta-virus can appear the same as the flu which is why it can hard to diagnose at first. Early symptoms of the disease include fatigue, fever and muscle aches, according to the Centers for Disease Control (CDC). People may also experience headaches, dizziness, chills and abdominal problems. The CDC indicates the virus has a mortality rate of 38 percent.

Hanta-virus is a potentially life threatening disease transmitted to humans by rodents, primarily, the white-footed deer mouse, although other types of mice can be carriers. People become infected through exposure or inhalation of infected rodent urine, droppings or saliva. The chances increase when people are near spaces where rodents are actively living, such as barns, sheds and inside walls of residences.

The CDC said in 2018 two cases were reported in Wyoming where both patients lived. Colorado had four cases the same year and one person died. A woman from Saratoga died in 2008 from the virus.

Miller said the hanta-virus is fairly new to the United States coming from North Korea.

"During the Korean War, there was a lot of hand-to-hand combat and soldiers found themselves in the wilderness of Korea," Miller said. "American soldiers found themselves often sleeping on the ground and there were mice who were living in nearby holes in the ground. All of a sudden soldiers started getting headaches, chills, abdominal issues and just universal bad things happening to these soldiers."

Miller said that is how the hanta-virus was discovered.

"It is basically an Asian mouse plague that has moved through the world," Miller said. "But honestly, for all we know, it could have started in America and then died out, but made its way to Asia where it continued to survive. We just don't know where it really came from. We only identified it during the Korean War."

She said it was all the symptoms coming in at the same time during the war which made the medical community take notice.

"It was a new virus to them, even though it is very possible it had been around for a long time," Miller said. "It became known as hanta because that was the area that it was first being reported."

Miller said it took a little time before the hanta-virus became a part of a medical differential.

"A differential is when medical personnel are looking at the signs and symptoms to create a diagnosis," Miller said. "But back in the day when you had the abdominal pain and chills, hanta-virus would not be in the differential and so people died from it. Nowadays, that doesn't happen. The symptoms are in the differential and we will try and eliminate hanta-virus as the cause. They will do blood work to make sure."

There is no cure if a person gets hanta-virus.

"There is no pill you can take for hanta-virus, you have to do supportive care," Miller said. "There is no long term residual ramifications. If you get it and survive, there should be no after-effects. The best thing you can do is just not get it or put yourself in a position to get it."

Miller said because there is no vaccine or cure, the best the medical world can do when the virus gets into a patient's lungs is try to keep the person alive.

"Sometimes they can't save you. People still die from this virus," Miller said. "That is why it is very important to figure it out early."

Another problem with hanta-virus, is it doesn't show signs right after exposure.

"It can take weeks and weeks from when a person was cleaning out a shed before they get sick," Miller said. "You can be cleaning out the shed March 1 and not get sick until mid April. Also, sometimes, a person doesn't even see mouse evidence, so during the differential, the person thinks they haven't been exposed."

Not only are urine and feces of mice the problem, but the virus can be found in the saliva.

"The virus can survive two to three days at normal room temperature," Miller said. "Exposure to sunlight does kill it and increases how quickly it will die. Freezing temps increase how long the virus will survive. That makes sense when you think about how it started in Korea, since much of the country is cold in the winter time."

Miller said what Americans get is called New World Hanta-virus.

"The version that was diagnosed in Korea is called 'Old World Hanta-virus', and the soldiers in Korea got that one," Miller said. "So there are two types, and both can kill."

Since the dry feces of mice, when moved, can trigger the virus to go airborne, Miller not only recommends wearing gloves when cleaning a place that is a possible mouse habitat, but also a mask.

"Actually the mask would be more important than gloves," Miller said. "I understand maybe a rancher isn't going to think about wearing a mask when going around his barn, but a bandana around your mouth and nose works too. You just don't want to breath the virus that is floating around in the air that could get into a nasal cavity or into the lungs. Also opening up a shed or barn to sunlight can help kill the virus."

Miller also suggested a shop-vac to clean instead of a broom which stirs up the air.

"You would have to throw away the filter," Miller said. "Pantries should be treated carefully if mouse droppings can be seen since most pantries are dark and the virus lives longer. Wearing a mask really is very helpful in preventing getting the virus."

Miller said the CDC has been tracking the hanta-virus in the United States since 1993, however the description of the disease's symptoms goes back to 1951.

The hanta-virus is not only disease that can be caught by rodents.

"There are a lot of diseases that you can get from rodents," Miller said. "Some of them are quite dangerous. It is not only the hanta-virus that can be deadly."

Miller said in her opinion, bubonic plague is the most dangerous. The bubonic plague is a highly contagious and often deadly disease notorious for killing one-third of the European population during the Middle Ages. Bubonic plague is usually spread by the bite of an infected rodent flea and can cause fever, headache and painfully swollen lymph nodes. Although there have been years without a death from bubonic plague, in 2015 four people died. There are three types of plagues which all initially come from rodents. They are bubonic, septicemic and pneumonic.

According to the CDC, bubonic plague symptoms include a fever, headache, chills, and weakness and one or more swollen and painful lymph nodes. The bacteria multiply in the lymph node closest to where the bacteria entered the human body. If the patient is not treated with the appropriate antibiotics, the bacteria can spread to other parts of the body.

The CDC indicates septicemic plague patients develop fever, chills, extreme weakness, abdominal pain, shock, and possibly bleeding into the skin and other organs. Skin and other tissues may turn black and die, especially on fingers, toes, and the nose. This type of plague may develop from untreated bubonic plague or come from bites of infected fleas or from handling an infected animal.

People who get pneumonic plague develop fever, headache, weakness, and a rapidly developing pneumonia with shortness of breath, chest pain, cough, and sometimes bloody or watery mucous according to the CDC. Pneumonic plague may develop from inhaling infectious droplets or may develop from untreated bubonic or septicemic plague after the bacteria spread to the lungs. The pneumonia may cause respiratory failure and shock. Pneumonic plague is the most serious form of the disease and is the only type of plague that can be spread from person to person.

"As long as the provider figures out what you have, they can tell a patient what sort of supportive care is required," Miller said. "There isn't a magic pill, so that is why prevention is so important. Just look at mouse droppings with caution. Whether you think they are going to hurt you or not, know rodents carry a lot of diseases."

There is another disease rodents carry but doesn't come from urine or feces.

Rat-bite fever (RBF) is a potentially fatal infectious disease spread by infected rodents or the consumption of food contaminated by rodents. The CDC says symptoms usually begin three to 10 days after contact with the bacteria, but can be delayed as long as three weeks. Within two to four days after fever begins, a rash may appear on the hands and feet. This rash looks like flat, reddened areas with small bumps. One or more joints may then become swollen, red, or painful.

If a medical provider suspects a person has RBF, they will treat the patient with antibiotics. Antibiotics can be highly effective at curing the disease if treatment is started once a person gets sick. Without early diagnosis and appropriate treatment, RBF can cause severe disease and death.

Walliser had every reason to be upset when she came across the dead mouse in the clothing.

"People should never give us any items that they haven't checked throughly," Walliser said. "We truly appreciate the donations and are grateful, but we are all volunteers and don't deserve to get sick because someone can't take the time to make sure what they are giving has been safe from mice. "

Miller agrees with Walliser on taking precautions when there is a chance of exposure to rodents.

"Luckily hanta-virus and most of the other diseases are not spread person-to-person," Miller said. "It is just a person being a dummy when cleaning the shed or wherever and not taking the proper precautions since all it takes is one mouse that has the virus to play all this medical havoc."