Monogram - Spring Health Matters: Preparedness, Prevention and Protection

This Mono Public Health communication provides updates on a handful of issues of local relevance, focusing on hantavirus risk, new public health vending machines, ticks, measles, adult immunizations, and COVID-19 vaccination during pregnancy.

It’s been an odd respiratory virus season, probably corresponding to the odd weather we’ve had, but currently combined respiratory virus activity (flu, COVID-19 and RSV) is low across the state.

Hantavirus: We remind residents and visitors alike to be careful with indoor rodent problems, specifically mice, due to the risk of hantavirus. Hantavirus pulmonary syndrome is an uncommon infectious disease that begins with flu-like symptoms and progresses  to more severe disease.

Mono County has the highest number of hantavirus cases in the state, and it is potentially deadly. We had three fatal cases last year but fortunately there have not been any cases this year so far. Hantavirus can occur at any time of year but most cases in our area have been seen in the warmer months, spring and summer.

Cleaning mouse-infested indoor spaces that have been closed over the winter is especially risky. We recommend simple precautions including ventilating such spaces before stirring things up, spraying mouse-contaminated areas with disinfectants, and avoiding vacuum cleaning, which increases the chance of inhaling the virus.

The California Department of Public Health, the state health department, will be trapping mice in a few areas of Mammoth this spring to study the rate of hantavirus infection in local deer mice. They will also be doing some genetic profiling in mice that could help identify the potential source of future human infections.

Public Health Vending Machines: Mono County installed our first two free public health vending machines a few months ago at the Mammoth Lakes Library and Latin Market 2 in Chalfant. These machines dispense a large range of free health-related products, including Narcan, COVID-19 and flu tests, external and internal condom kits, N-95 masks (respirators), radon test kits, and pregnancy tests and emergency contraception. We are pleased that people are using them and we would like to hear suggestions for other products that we could try to offer this way.  We hope to gradually install such vending machines in other county communities as resources allow.

Ticks Wanted!  Mono County, specifically Sierra Teemsma in our Environmental Health program, is asking people to submit locally acquired ticks for analysis. Ticks are notorious for carrying diseases and we, in collaboration with the state health department, want to update our understanding of which tick species are present in the County and what diseases they carry. We do not think that deer ticks (Ixodes pacificus) which carry Lyme disease are present in Mono County, but tick populations have been spreading, and it is important to monitor this.  A couple of other tickborne diseases that used to exist in Mono County, Colorado tick fever and Rocky Mountain spotted fever, have not been seen for many years, and ticks will be tested for those pathogens.

Place ticks, dead or alive, in a sealable container or bag and refrigerate or freeze them until pick-up by Sierra can be arranged, or feel free to drop ticks off at county Public Health offices. Sierra can be reached directly at 760-924-1844 or by email steemsma@mono.ca.gov.

*If you’ve just returned from a road trip outside the county, please don’t submit ticks that might be from elsewhere, as it will cause confusion.

Measles: Measles continues to be a bigger global problem than we’re used to, as inadequate childhood vaccination rates allow the most contagious virus in the world to circulate in many regions. There have been more than 1748 cases in the U.S. so far this year, on pace to surpass 2285 cases in 2025, which is more than we’ve seen in decades. There have been 43 measles cases in California so far this year. Utah is currently the epicenter in America, with over 600 cases across the state.

Please consider making sure that you and your children have received recommended measles immunizations, especially if you’ll be traveling internationally or to areas in the USA with active outbreaks, such as Utah. The measles vaccine is both safe and effective. It is recommended that children receive the first dose at 12-15 months of age and a second dose between 4 and 6 years.

There is particular concern about children under 12 months of age and their vulnerability to measles. If you’ll be traveling to a higher risk place (international destinations generally and currently I would include Utah) with a child between 6 and 12 months, talk to your child’s healthcare provider about getting an extra, early, measles shot for protection. Children who get an early dose should still get the regular 12–15-month-old measles immunization for longer protection.

Adult Immunizations: I have been impressed recently by the steady stream of medical articles reporting some unexpected benefits of different immunizations.  Adult vaccinations, including those for influenza, shingles and pneumonia, appear to meaningfully decrease the chance of developing dementia, perhaps by as much as 35% according to one meta-analysis of pooled trials involving large numbers of people.  

Shingles immunization, which is recommended for adults 50 and over, may decrease the chance of dementia by around 20% according to observational studies from at least 4 countries across 3 continents. Observational studies do not prove scientific cause and effect, but the similarity of findings in different parts of the world is striking and suggestive.

We are still learning how COVID-19 immunization affects dementia risk. What we do know is that COVID-19 infection in older adults increases the risk of dementia, especially if the illness is more severe. COVID-19 vaccination is effective in decreasing the severity of illness.

The same vaccines, including COVID-19, also decrease the chances of heart attacks and other “major cardiovascular events”, effects which are most meaningful in people with existing heart problems. The American College of Cardiology now recommends vaccination against flu, COVID-19 and RSV for protection in people with cardiovascular disease.

It is believed that vaccines prevent dementia and heart disease by reducing inflammation and damage to blood vessels that infections can cause.  

COVID-19: COVID-19 immunization has recently, again, been shown to be safe and healthy for pregnancy. To protect us from disease, our immune systems are designed to attack basically anything that is not a natural part of our body. During pregnancy, maternal immune systems are sort of turned down (downregulated), so that the maternal system does not attack the fetus carrying foreign proteins and DNA (dad’s). But this increases the pregnant person’s vulnerability to many infections, including COVID-19. While almost all humans by now have some immunity to COVID-19, severe infections and complications are more likely when someone is pregnant.

COVID-19 vaccines are safe for mother and child, and the benefits are important. Vaccination during pregnancy has been shown to reduce the risk of infection and hospitalization by about 60% and of critical (ICU) illness by 90%, while reducing preterm birth by 20-36%. Young infants are vulnerable to COVID-19, with risks of severe disease like very old people, but infants born to vaccinated mothers have 50-80% less chance of being hospitalized in their first 6 months of life (mothers pass immune protection to unborn babies through the placenta). 

The benefits are clear, and there is no evidence that COVID-19 vaccines harm pregnant people or their babies. That’s why many doctors who care for pregnant patients and children—and who rely on scientific evidence—have been frustrated by last year’s announcement from the Department of Health and Human Services, led by RFK Jr., that vaccination during pregnancy is no longer recommended.

The American College of Obstetrics and Gynecology (ACOG), America’s Ob-Gyns, and other professional societies continue to strongly recommend COVID-19 vaccination during pregnancy.