Everybody knows you need sunscreen in Colorado, but other dangers lurk out there this summer that could be more serious than a bad case of sunburn.
Mandy Hartman has seen it all. A physician assistant at UCHealth Thornton Urgent Care, and a former microbiologist who worked for the Atlanta-based Centers for Disease Control (CDC), she has lived and worked in Northern Colorado for most of her life.
Hartman has extensive experience with family medicine, urgent care, and pediatrics and is especially interested in infectious disease, travel and wilderness medicine. She has degrees from Colorado State University (in microbiology) and from Philadelphia University (in PA studies). She’s also an adjunctive assistant faculty member in the University of Northern Colorado Nurse Practitioner Program.
Here are some things that might impact your health this summer:
Mosquito-borne illness: About 90 percent of cases of West Nile virus will be found in July and August, “because that’s when people are outside, because the days are longer, incidence rates are the highest in the vector population, and it’s peak mosquito season,” she said.
Although most young and healthy people who are infected “experience no symptoms, or mild ones,” for others it can include fever, stiff neck or joint pain, nausea, vomiting and rash.
Symptoms are lots worse – even fatal – if a patient is elderly, going through chemotherapy or immunocompromised in some state.
Others may never know they got the virus, or not contract it at all.
“We have good antibodies against it, for the most part,” Hartman said. There’s no vaccine for it, “but as a population we are developing a natural immunity to it.”
The best defense is to wear insect repellent (preferably with DEET) and to cover up, especially at dawn and dusk. If you don’t want to wear insect repellent, try lemon oil, she suggested.
“It’s particularly repulsive to them,” she said.
“The only reason mosquitos bite you is because they want to have babies. They need that blood to help them do that,” although she doesn’t think that will incite a lot of empathy for the pesky insects.
The Zika virus is not much of a current concern for active transmission in Colorado, she added.
Tick-borne illness: “We hear a lot about Lyme disease, but this is mostly found in the Northeast, and Rocky Mountain spotted fever, but they are not major transmittable disease in Colorado.”
We don’t see much Lyme disease in Colorado, she said, because our tick, the deer tick “cannot carry Lyme disease because the ticks are too little – literally.
“In Colorado, Colorado tick fever is more common,” she said. “It affects about five people each year.”
Symptoms are flu-like – sore throat, migraine-level headache and fever, with onset usually 3-5 days after they are infected.
To prevent tick bites, wear long pants and sleeves when hiking and walking around grassy areas. Take a shower after being in a tick area, and remove any critters you find on your body. Insect repellent does very little to deter them, she said.
If you do get a tick embedded in your skin, remove it by grasping as close to the mouth parts as possible and pulling straight back.
‘”If any of the embedded tick remains, it may cause a serious infection. “
If you can’t get it all, you may need to visit a physician for removal.
Giardia is probably the most common affliction of campers and hikers who are tempted to drink from those lovely, clear mountain streams.
“Don’t do it!” she said. She had it once herself as a teenager and can highly recommend avoiding it. “It was just awful.”
These small bacteria live in water sources, such as streams, especially where deer are present, Hartman said.
“The main symptom is frothy, foamy diarrhea, but also can include cramping, bloating, fever and dehydration,’’ she said.
Giardia can take a while to show up after it is ingested. “It can come go and get worse and better on its own. You might think you just ate something bad,” Hartman said.
It becomes more active if the host eats a high-fat diet, and it’s especially hard on children. Also, it causes fairly serious dehydration.
To prevent it, “don’t drink from any wild source of water and even test well water if visiting somewhere unfamiliar,” she suggested.
And although boiling water before drinking will kill giardia, it won’t kill some other microbes or viruses that might be lurking out there.
Filtration or iodine are more effective controls. Portable filtration systems – including a filtration straw – and iodine pellets are available for campers and back-country hikers.
“Keep in mind, the incidence rate is likely higher for all of these diseases,” she said, but only proper testing can confirm it. “Only the very sick make it to the doctor.”
Lightning strikes: Not a disease, but lightning strikes kill nearly a dozen Coloradans every year, mostly in the warm months.
“It’s the most dangerous weather element in Colorado, killing at least 10 people a year … mostly golfers and hikers,” Hartman said.
If you see a storm brewing or lightning in the distance, “the best thing to do is to get inside a car or a substantial, fully enclosed building,” she said. In addition, “unplug all electronics and stay away from water and metal. If hiking or golfing, drop your hiking pole or golf club.”
High places are dangerous, too.
“Stay away from the tallest trees and mountain tops, and try to get to lower elevation if you’re hiking,” she added.
According to the Coloradoan newspaper, “Colorado had the third-most lightning-strike fatalities of any state, with 17. Another 15 were injured, according to the National Weather Service.”
If you are with someone who is struck by lightning, Hartman said, “dial 911, and perform CPR if they are unconscious. You need to restart the heart, shock them back alive, and usually that takes paramedics.”
Dehydration: “We are classified as high mountain desert here,” Hartman said. “Dehydration can be an issue, and visitors are especially bothered by it.
“I recently talked to a nephrologist about it,” she added. “And he said to watch your urine” as a tell-tale sign of dehydration. “It should be a light, lemony color.”
The amount of water you need varies a lot, and depends on your activity, heat level, medications, salt intake and body size.
“It’s different for everyone,” she said.
“Your body is always striving for homeostasis,” she said, “which is a delicate balance of potassium, sodium and H2O and other important chemicals. Aim for five 8-ounce glasses of water a day” here in the mountain state. “If you increase your activity or heat level, drink more,” she said, “and also if you take medications, such as blood pressure medicine, that can dehydrate you.”
If you do get dehydrated, a quick cure is to drink an electrolyte solution, such as Pedialyte. You can make one quickly at home by mixing a solution recommended by the CDC: Dissolve 2 tablespoons of sugar and 1 teaspoon of salt in a gallon of water. If you do use a commercial product, Harman said, “avoid grape or red, or any artificial colors, because they can change the colors of stools or vomit to black or red, and that can be frightening!”
Most of these things won’t happen to most people, but it’s good to be prepared and to know the risks, symptoms and treatments.
And, she added, “don’t forget the sunscreen.”
Sunburn isn’t fun, either.