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2019: Most Pressing Public Health Emerging Issues

2019: Most Pressing Public Health Emerging Issues

Here’s a look at the most pressing Public Health Emerging Issues of 2019, in no particular order.

Stop the Spread

Mesa County Public Health (MCPH) responded to a gastrointestinal illness that impacted a significant portion of our community in 2019, and at a time when people were getting ready to gather for the Thanksgiving holiday. A norovirus-like illness sickened so many students, D51 was forced to close all school buildings and deep clean to stop the spread of illness. While these types of illnesses are very common. The rapid spread and large number of people impacted was unique with this outbreak.  

Viruses like this are around all the time. They typically peak in the winter months when we are all together indoors or other confined spaces. The highly contagious viruses can spread very quickly from person to person as we saw with this outbreak, and the sudden onset of vomiting with this virus made it more widespread than usual.

Our entire community responded to help Stop the Spread. Seeing how quickly this virus spread from one school building to the next, helped folks realize the importance of staying home from work or school when you’re sick. It’s one of the most effective ways to prevent the spread of illness. In addition, MCPH recommended disinfecting techniques for high touch surfaces.  Viruses like norovirus can live on surfaces for weeks, and not all cleaners are effective in killing this specific virus. We were all reading labels and washing our hands. Studies have shown that handwashing can prevent 1 in 3 diarrhea-related sicknesses. If soap and water are not readily available, you can use a hand sanitizer that contains at least 60% alcohol. But whenever possible, wash your hands with soap and water. 

MCPH Emerging Issue: Public Health Response and Recommendations Related to Gastrointestinal Illness Outbreak 

Severe Lung Illness

In the late summer of 2019, a large number of severe lung illnesses began being reported. The Centers for Disease Control and Prevention (CDC) tied the illnesses to the use of e-cigarette, or vaping, products. The CDC calls the investigation into the illnesses complex; there have been cases in nearly every state, with more than 2,500 patients and a wide variety of brands and substances of vaping products. Laboratory data supports findings that vitamin E acetate (an additive) is closely associated with many of the cases, but they caution other substances could be risky, too.

The CDC and FDA recommend people not use THC-containing e-cigarette, or vaping, products, particularly from informal sources like friends, family, or in-person or online sellers.  In addition, the CDC also recommends:

  • Vitamin E acetate should not be added to e-cigarette, or vaping, products. Additionally, people should not add any other substances not intended by the manufacturer to products, including products purchased through retail establishments.
  • While it appears that vitamin E acetate is associated with EVALI, there are many different substances and product sources that are being investigated, and there may be more than one cause. Therefore, the best way for people to ensure that they are not at risk while the investigation continues is to consider refraining from the use of all e-cigarette, or vaping, products.
  • Adults using e-cigarettes or vaping products as an alternative to cigarettes should not go back to smoking; they should weigh all available information and consider utilizing FDA-approved cessation medications.
  • They should contact their healthcare provider if they need help quitting tobacco products, including e-cigarettes.
  • Adults who continue to use an e-cigarette, or vaping, product should carefully monitor themselves for symptoms and see a healthcare provider immediately if they develop symptoms like those reported in this outbreak.

MCPH Emerging Issue: CDC says to stop using e-cigarettes during investigation into severe lung illness

Vaccine-Preventable Measles Makes a Return

Measles is very contagious and can be serious. According to the Centers for Disease Control and Prevention (CDC) an unvaccinated child can get measles when traveling abroad or even in the U.S. 

From January 1 to December 5, 2019, 1,276 cases of measles have been confirmed in 31 states. According to the CDC, 

  • This is the greatest number of cases reported in the U.S. since 1992. More than 75% of the cases this year are linked to recent outbreaks in New York. Measles is more likely to spread and cause outbreaks in U.S. communities where groups of people are unvaccinated.
  • The majority of cases are among people who were not vaccinated against measles.
  • Measles can cause serious complications. From January 1 – December 5, 2019, 124 of the people who got measles this year were hospitalized, and 61 reported having complications, including pneumonia and encephalitis.

Three unvaccinated children were hospitalized in Colorado with measles in 2019.  Public Health officials warned that travelers at the Denver International Airport and a metro hospital might have been exposed to the s a highly contagious respiratory disease caused by a virus.

MCPH Emerging Issue: Possible Measles Exposure in Colorado 

Opioid Use

The Centers for Disease Control ad Prevention (CDC) Director Robert R. Redfield was quoted earlier this year saying, “The opioid epidemic is the public health issue of our time.” According to CDC data, more than 70,000 people died from a drug overdose in 2017. In Mesa County, a large portion (70%) of overdose deaths involve an opioid. 

The opioid crisis has exposed millions of people to other health risks, too. Overdose deaths, Redfield explained, could result from the American public’s lack of understanding of the “true risks” of prescription opioids Redfield said. He said the CDC has taken several steps to combat the issue, including developing prescription drug monitoring programs, drafting clinical guidelines for chronic and acute pain, educating the American public about the risks associated with opioids and creating rapid response teams.

Mesa County is working to combat the issue in our community through the Mesa County Opioid Response Group. You can learn more about the efforts underway in our community on the Healthy Mesa County website.

Learn More: MCPH Opioid Prevention Report

Suicide Prevention 

Suicide is a preventable public health issue that requires comprehensive community-driven strategies. There’s important suicide prevention work happening in our community focused on critical areas such as economic stability, lethal means safety, education and awareness, access to care, and postvention services. Mesa County Public Health (MCPH) collects and analyzes data to understand suicide in Mesa County, based on the data public health recommendations are:

  • Expand amount and variety of support services for attempt and loss survivors.
  • Strengthen economic supports to increase stability in food, housing, and employment.
  • Increase connectedness to enhance social capital.
  • Expand access to suicide care.
  • Maintain educational programming to generate community awareness and reduction of mental health stigma.

The Mesa County Suicide Prevention Council, created in the spring of 2017, is working to reduce suicide deaths and attempts by 20% in the next five years. You can learn more about local resources and the data-driven work being done here

Learn More: Suicide report highlights the need for continued community conversation, collaboration, and connectedness

If you’re struggling, or know someone who needs help,
call the National Suicide Prevention Lifeline
at 1-800-273-TALK or text CO to 741741.

Air Quality

Air quality impacts how you live and breathe.  It can change from day to day, even hour to hour.  Mesa County Public Health is constantly monitoring air quality and in 2019 updated the way we look at air quality to ensure residents in the Grand Valley can enjoy clean air.  We use forecast models, measurement tools and observation to determine if action is needed from our community to continue to enjoy our air and all the outdoor recreation our community desires and deserves. Our team utilizes this local data to inform and educate community members about current air quality conditions. This data, over time, helps shape local policies on clean air.

To monitor air quality we use a measurement system called AQI (air quality index) developed by the Environmental Protection Agency (EPA) to assign a numerical value to the air quality.  This system takes four major air pollutants into account, ground-level ozone, particle pollution, carbon monoxide, and sulfur dioxide. The higher the AQI, the greater the level of air pollution.

You can monitor air quality conditions in real-time using a community-sourced tool called Purple Air.  Check it out here.  

It’s Tick Season: What types of ticks are in Colorado and what diseases do they carry?

It’s Tick Season: What types of ticks are in Colorado and what diseases do they carry?

Tick Troubles

Courtesy: CDPHE

Image from Colorado Department of Public Health & Environment

The wet spring and summer we’ve experienced means an increased chance of finding a tick on your body when you (or your pet) head home from spending time outdoors. We are in the midst of tick season, and while we do not have ticks that carry Lyme disease in Colorado, there are some health hazards you should be aware of when you head into the wilderness.

What is a tick and what types are here?

Ticks are small insects that are part of the arachnid family (same as spiders).  As part of their life cycle, all adult ticks need blood meals, making humans and pets prime targets.  Ticks can transmit diseases through their saliva, so being bit by one can put you at an increased risk for disease.  Ticks carry many diseases and they can change by region.

In Mesa County, we’re most impacted by the Brown Dog tick. Other ticks found in Colorado include the Rocky Mountain wood tick and American dog tick.   You can view a map from the Colorado Department of Public Health and Environment showing regions where the different types of ticks are found. 

What diseases do they carry (in Colorado):

  • Tick-borne relapsing fever is a bacterial infection that can cause recurring bouts of fever, headache, muscle and joint aches, and nausea.  It is usually linked to sleeping in rustic, rodent-infested cabins in the mountains. It’s spread by infected soft ticks.
  • Tularemia is a disease that can infect animals and people.  Symptoms vary depending on how the person was infected, but are typically severe. In most cases, it can be treated successfully with antibiotics. It’s spread by infected dog ticks, wood ticks, and lone star ticks.
  • Rocky Mountain Spotted Fever is a serious bacterial illness, which can be deadly if not treated early with the right antibiotic.bacterial disease spread through the bite of an infected tick.  Many people experience fever, headache, and rash. This disease can be deadly if not treated with the right antibiotic. The name can be misleading as this illness is typically found in the Midwest and Southeastern parts of the United States. It’s spread by infected dog ticks, Rocky Mountain wood ticks, and brown dog ticks.
  • Colorado Tick Fever is a rare, viral disease. It’s spread by Rocky Mountain wood ticks.

Since 2015 there have been 7 cases of Tularemia and 1 case of Spotted Fever reported in Mesa County.

Ways to protect yourself:

Preventing tick bites on both you and your pets is the best protection.Use an EPA-approved repellent that’s effective against ticks–look for a product that contains DEET, IR3535, Picaridin, Oil of Lemon Eucalyptus, or 2-undecanone Treat your clothing and gear with a repellent to protect from tick bites. Pick one with DEET, it’ll serve as protection from mosquitoes, that can transmit West Nile Virus, too.  Avoid contact with ticks by walking in the center of trails and not heading into wooded, brushy areas with high grass.  

When you come in from the outdoors, do a check for ticks on both your clothing and yourself.  

Ticks can be carried on your clothes so tumble dry clothes in a dryer on high heat for 10 minutes to kill ticks. If the clothes require washing first, use hot water if you can.

Image from the Centers for Disease Control and Prevention (CDC)

When you are checking for ticks be sure to look:

  • Under the arms,
  • In, around and behind the ears,
  • Inside belly button,
  • Back of the knees,
  • In and around the hair,
  • Between the legs, and
  • Around the waist

If you find a tick attached to your skin, there’s no need to panic.  The key is to remove it as soon as you can.  There are specialized products on the market, but fine-tipped tweezers work the best.  

Grab the tick as close to the skin’s surface as you can

  • Pull up with steady, even pressure.
  • Don’t twist or jerk the tick.
  • Clean the bite area and your hands with soap and water or rubbing alcohol.
  • Flush the tick down the toilet or put it in a sealed bag. 
Food Safety at Festivals

Food Safety at Festivals

Food Safety at Festivals

Summer has arrived. The smell of fresh cut grass, a BBQ with friends and, of course, those festivals that we wait all year for!  Attending a festival can be a great time, but don’t spoil your fun by getting sick.  Foodborne illness peaks in the summer months. The reasons why are two-fold. First, bacteria multiply more quickly in warmer temperatures. Secondly, preparing food outdoors makes safe food handling more difficult.

To keep bacteria from growing you need to keep food cold or cook it thoroughly. The “danger zone’ for food is between 40 and 140 degrees.

That is when bacteria grow most rapidly. In this range, bacteria can double in as little as 20 minutes. When the temperature outside is in the upper 80s, it doesn’t take long for food to be in this danger zone. A good rule of thumb is never to leave food out of a refrigerator or cooler for more than 2 hours. If the temperature is above 90 degrees, food should not be left out for more than one hour.

One draw to festivals is the numerous types of food and drink you’ll find right at your fingertips, but when vendors travel sometimes the usual safety controls that exist in a commercial kitchen, things like handwashing facilities, large refrigerators, thermometers, and their usual trained staff, can’t come along. Knowing how to protect yourself and what to look for can make sure you can make the best of your visit to the festival, wherever it may be.

If you’re bringing a picnic or food of your own along,  bring a well-insulated cooler with plenty of ice or freezer gel packs. Perishable foods, like summertime favorites macaroni or potato salad, need to stay cool. Here are some tips to pack, transport, and enjoy food safely.

  • Organize cooler contents: Consider a separate container for beverages, that way as people open and close the cooler to grab a drink, the perishable foods won’t be exposed to the warm air and will stay cooler, longer.
  • Clean your produce: Rinse fresh fruit and vegetables under running tap water before putting them in the cooler. This is true even of produce with skins and rinds that you won’t eat.
  • Serve food separately: don’t use the same plate and utensils for cooked food that was used for raw food.

The single most important thing you can do to stay safe and healthy this summer is also fairly simple and cannot be stressed enough. Wash your hands often. Wash your hands with soap and water for at least 20 seconds, don’t forget in-between your fingers, the top of your hands, and up your wrists and arms.

Always wash hands after using the restroom, going on a ride, playing in the water or touching animals. You should also wash your hands after removing dirty clothes or shoes, and don’t forget to wash your hands before eating or drinking.

Bring hand sanitizers or disposable wipes in case there aren’t any places to wash your hands. If possible, washing with soap is best, but sanitizers are a good additional step or one to take if you can’t wash with water.

Our team of inspectors works to ensure food safety. If you do get sick, it’s important to report it, even if you’ve already recovered. You can call the Mesa County Public Health reporting line at (970) 254-4120 or fill out this form on our website.

Colorado Counties Prepare as Risk for Flooding Rises with Record Snowpack

Colorado Counties Prepare as Risk for Flooding Rises with Record Snowpack

Colorado Counties Prepare as Risk for Flooding Rises with Record Snowpack


In Hinsdale County volunteers are being asked to help fill sandbags, as the town of Lake City prepares for possible floods due to snowfall and previous avalanches.  The preparation has been called almost unprecedented, but with snowpack at 60 to 180 percent of the annual average, the county needed to prepare.

In our part of Western Colorado, flooding isn’t imminent, but we’re nearing the date when the rivers usually crest and could spill over their banks.  The National Weather Service tells us that the crest date for the Colorado River can vary significantly from year to year, but it generally reaches it’s peak anywhere from the middle of May to the middle of June.

In our desert climate, water safety and flooding concerns don’t seem as urgent as Wildfire or other disasters, but the reality is Mesa County could experience flooding – and we do in the form of flash floods from time to time.

Flash floods can develop quickly and it doesn’t take a lot of water to create one. As little as 6-inches of rapidly moving water can knock a person down.


If there was significant flooding a unique challenge in Western Colorado is that many homes use on-site wastewater treatment systems, also known as septic systems.  In a flood, these systems can overload and cause backups. If you have a septic system, keep stormwater runoff away from your septic tank and drain field area as much as possible.

Water quality, even to homes that are not on septic systems can also be impacted.  You may notice the water is more ‘murky’ or not as clear. It might also have a smell. Mesa County Public Health’s water quality program provides bacterial testing for drinking water and irrigation water samples from our regional lab.  You can find more information on how to have your water tested here.


The best way to minimize harm and damage to property is to be prepared. Have a 72-hour kit with food, water, and essentials in a waterproof container ready to go. Copy important documents and have them in your kit, too.

Other things that should be in your 72-hour kid are:

  • drinking water
  • non-perishable food
  • first aid
  • blankets
  • chargers for electronic devices
  • flashlight

Download this Emergency Supply List from the Federal Emergency Management Agency (FEMA)  to help you pack that kit.


The Front Range Flood in September of 2013 spread across 200 miles, impacting 17 counties.  At least 8 deaths were reported by the Colorado Office of Emergency Management.  A minimum of 1,750 people and 300 pets had to be rescued by air and on the ground.  

Nearly 19,000 homes were damaged and more than 1,500 were destroyed.


If you encounter flood water while in your vehicle don’t drive or walk through it. The Centers for Disease Control and Prevention estimate that more than half of flood-related drownings occur when a vehicle is driven into hazardous flood water.  Many people underestimate the power this water can carry.  The ‘Turn Around, Don’t Drown campaign is an effort to educate people on the strong currents and hazards rising and fast-moving water can bring.


Colorado Flooding info from the National Weather Service

Staying Safe:  Flood Hazards

Turn Around, Don’t Drown


For more information, visit health.mesacounty.us.

Public Health Emerging Issues – May 24, 2019


  • As the increased amount of snow our state received this winter melts, coupled with a wetter than average spring, Mesa County is at an increased risk for floods.
  • Flash floods can happen in Western Colorado, but floods can develop slowly or very rapidly.
  • Just six inches of rapidly moving water can knock a person down.
  • Many areas of Mesa County use on-site wastewater treatment systems, also known as septic systems.  In a flood, these systems can overload and cause backups.
  • If you have a septic system, keep stormwater runoff away from your septic tank and drain field area as much as possible.
  • Water quality can also be impacted if flooding occurs.  You may notice increased turbidity or murkiness in the water or a possible smell.
  • Mesa County Public Health’s water quality program provides bacterial testing for drinking water and irrigation water samples from our regional lab.  You can find more information on how to have your water tested here.
  • The best way to minimize harm and damage to property is to be prepared.
    • Have a 72-hour kit with food, water, and essentials in a waterproof container ready to go.
    • Copy important documents and have them in your kit, too.

To read more about flooding preparedness and how you can protect your home visit health.mesacounty.us.