21 years after hantavirus

Annie Merriam Berlemann and her 7-year-old daughter enjoy horseback riding together. The 1999 MHS alumnae survived a nearly deadly bout with hantavirus at the beginning of her senior year.
Annie Merriam
MHS Yearbook

MEEKER | Twenty-one years ago, 18-year-old Annie Merriam had a summer job with the Division of Wildlife’s (DOW) youth and natural resources program and was planning for her senior year at Meeker High School. An athlete and musician in the high school band, she was looking forward to volleyball and basketball season and playing the clarinet in the high school marching band.

One day in early August she developed flulike symptoms that quickly became severe.

“I kept getting sicker,” she said in a phone interview. “It got really bad really fast.” Concerned, her parents took her to Pioneers Hospital. Doctors at Pioneers suspected hantavirus and sent her to St. Mary’s Hospital in Grand Junction. As they prepped her for blood tests, one doctor said, “If it’s hantavirus she’ll be dead before the blood work comes back.” St. Mary’s flew her to University Hospital in Albuquerque where she was listed in critical condition.

1998 was a bad year for hantavirus infections in Colorado. A 17-year-old from Teller County died in April of that year, followed by the death of a 38-year-old Durango woman in June. A Wolcott man, 47, contracted the virus in June but survived. According to an Associated Press article, health officials were concerned that cases would increase due to El Nino related moisture that year.

Officials were aware of hantavirus following a 1993 outbreak in the Four Corners region that killed 12 people out of 24 infected. The outbreak resulted in the Center for Disease Control identifying a specific type of hantavirus in the region and its primary carrier: the deer mouse. The 1993 outbreak followed a wet weather year in which rodent populations increased rapidly. The virus is transmitted to humans through the urine, saliva and droppings of infected rodents.

By 1998 the Albuquerque hospital had the most experience of any facility in the nation for treating hantavirus, having cared for more than 30 hantavirus patients in a five year span. They had developed a treatment program called ECMO—extra-corporeal membrane oxygenation. The treatment consisted of a circulating the blood and adding oxygen by means of a machine typically used for premature infants and babies with respiratory problems.

“Either the heart or the lungs stop functioning (with hantavirus),” she explained. The ECMO treatment gives the heart and lungs a chance to rest and heal. Patients can spend a maximum of seven days on the machine.

She had to be paralyzed from the neck down and placed in a medical coma for the duration of the ECMO treatment, which worked for her. After a few days in the intensive care unit, she was transferred back to St. Mary’s and spent two weeks in the hospital rehab before she was allowed to return home right around homecoming.

“The pep band came out and played some Meeker fight songs,” she said of her return to school. At the homecoming game, her classmates had created a “welcome home” sign on the fence around the field. Friends helped her walk to and from classes.

The community rallied around the family, with her father’s co-workers donating vacation time so he could be with her.

“Everybody was really supportive,” she said. “My prognosis was blurry at the beginning,” she said.

Despite a slow and lengthy recovery, she graduated with her class. She missed her senior year of athletics, but managed to play in the band, despite reduced lung capacity that continued to affect her for years. Other lasting effects included nerve damage in one leg.

“I lost two-thirds of my femoral nerve, the one that controls one of the four quadriceps muscles,” she said. Today, her leg gets tired, and she’s aware of the damage, but it hasn’t affected her quality of life.

She went on to college at the University of Southern Colorado and earned a bachelor of science in biology and a master’s degree in applied natural science at Colorado State University-Pueblo.

She met and married her husband, Butch Berlemann, in 2005. They have a seven-year-old daughter and live in Peyton, near Colorado Springs, where she raises honeybees, rides horses, and participates in fox hunting and dressage. She’s part of a hantavirus survivors group on Facebook that provides support for others and said she’s participated in some scientific studies. Antiviral trials to treat hantavirus are underway, but there’s still no cure.

Being active outdoors and living in the country increase the risk of hantavirus exposure.

“I take all the precautions,” Merriam said. That includes masks, gloves and bleach, as well as sunlight. “Ultraviolet is very damaging to this virus. It’s actually pretty fragile for a virus,” she said. “It usually doesn’t survive past 24 hours. It’s a really small window to be exposed.”

While no one can pinpoint when or where she was exposed the virus, she suspects she was infected when she cleaned out a “bad camper trailer.” She remembers spraying all the hard surfaces and wiping them down, but said she vacuumed the carpets and soft surfaces, which is considered a no-no in dealing with potential contamination.

Symptoms of Hantavirus Pulmonary Syndrome usually appear within two-four weeks of infection, but can appear as early as one week or as late as six weeks after infection.

First symptoms are general and flu-like: fever (101° F and above); headache; abdominal, joint, and lower back pain; sometimes nausea and vomiting. However, the primary symptom of this disease is difficulty in breathing, which is caused by fluid build-up in the lungs, and which quickly progresses to an inability to breathe.

Cleaning up after rodents

Ventilate area for at least 30 minutes

Wear latex, rubber or nitrile gloves

Spray droppings with bleach solution or disinfectant and wait

Clean up droppings with paper towels and dispose

Disinfect hard surfaces

Shampoo or steam clean carpets and upholstery

Launder items with detergent and dry on high heat

Expose potentially contaminated materials to open air and sunlight for a week or more

The CDC has specific instructions for cleaning up areas of heavy rodent infestation and vehicle infestation at https://www.cdc.gov/rodents/cleaning/index.html

By NIKI TURNER | editor@ht1885.com