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Colorado Slammed by West Nile Virus But Ignores Prisoners

Loren Gasiorowski, 41, awoke one morning with a big mosquito bite on his forearm and one on his shoulder. Within days he couldn't leave his cell. After being sick for two weeks he couldn't take it any more. He decided to run the gauntlet required for medical access. Once there, he was immediately transferred to the Colorado Department of Corrections (CDOC) main infirmary where he spent eight days on intravenous fluids and oxygen. He didn't fully recover for several weeks. "I've never been this sick, ever," he said. Despite asking many questions to every medical staff available, no clear diagnosis was made; it could have been the flu or maybe pneumonia. No one would discuss West Nile Virus (WNV) and all requests for testing were refused.

With 54 people dead, 2,833 confirmed infected, and an estimated 35,000 untested infections, WNV hit Colorado in 2003 worse than any other state. In contrast, there were only 14 infections and zero deaths in 2002. State agencies jumped to action including the CDOC which instructed staff on necessary precautions and supplied DEET mosquito repellant to all staff working outdoors. For the approximately 19,000 prisoners: Nothing.

WNV is a mosquito-born virus usually hosted by birds bitten by WNV-carrying mosquitoes. The infected birds build up high viral concentrations and pass it on to more mosquitoes. WNV attacks the central nervous system manifesting from flu-like symptoms to meningitis to encephalitis. A few cases exhibit an unexplained lower limb paralysis. For some, especially those over 50 and those with other immune system problems, death may result. In Colorado, 79.9 percent of victims had the flu-like symptoms while 12.5 percent had meningitis and 7.6 percent had encephalitis. About 1 percent had the additional paralysis.

The most effective prevention is to clear standing water, stay inside at dawn and dusk, spray insecticide and wear long-sleeved shirts and pants, and wear repellent containing DEET (N, N-diethyl-meta-toluamide). A human vaccine is three years away. A horse vaccine already exists and at least 30% of unvaccinated horses die.

Colorado attempted to control the spread of WNV by spraying either larvicide's granules containing a bacteria consumed by mosquito larvae, or an insecticide aimed at adult mosquitoes. Some areas installed bat houses because bats eat mosquitoes. On April 1, 2003, Colorado launched its "Fight the Bite" campaign and redoubled its efforts in August when the worst of the mosquito season began (lasting until the first frost). In all, 349,000 wallet cards and 240,000 brochures were distributed along the Front Range (east of the Rocky Mountain Continental Divide). But to the CDOC prisoners: nothing.

CDOC guards working outside were issued DEFT-containing repellent but prisoners on the same crews were not. The CDOC canteen switched from an $8.25 non-DEET (citronella) sunscreen/repellent to a $4.25 per ounce stick but with no mention of DEET by the CDOC or on the product, even thought the stick did contain 28.5% DEET. Prisoners can't be expected to know the chemical name of DEET if not told.

On July 1, 2003, Colorado reduced prisoner pay to 23 cents per week day for unassigned and 60 cents per work day for assigned prisoners. [See PLN, April, 2004] After a 20 percent deduction for restitution it would take nearly half a month's pay for one tiny stick of DEET and only if a prisoner foregoes all other canteen, including hygiene items. With a stick lasting two weeks or less, it would take all the pay an assigned prisoner receives just to protect against the potentially deadly WNV. Unassigned prisoners face the deadly disease unprotected.

After this was exposed in the Denver Post the canteen reduced the price of its stick to $3.40, still requiring nearly two week's pay, and added sheets of DEET for 60 cents per one-use sheetan even harder product to afford in sufficient quantities but now one actually labeled "DEET." By summer's end, when the height of the mosquito season began, some guards were privately providing DEET repellent to their outdoor workers while other guards tried in vain to procure DEET through the CDOC. Many prisoners pleaded for protection from WNV.

For one such prisoner, help never arrived. Manual Gamboa, 36, was assigned as a groundskeeper. He fought mosquitoes daily. "I work outside, I'm attacked all the time," Gamboa said. It finally hit. Gamboa was laid up in his cell for three days before concerned cell house guards finally took him to medical. They started an IV and called a doctor. No one would address the issue of WNV but without testing a nurse practitioner told Gamboa that what he had was "almost like West Nile but its not." Gamboa contacted Walter Gerash, a prominent Colorado attorney featured in the Denver Post's expose of WNV and an outspoken critic of the CDOC's response to the WNV problem. Gerash instructed Gamboa to get tested but the CDOC refused.

Several prisoners interviewed had the same story. All were bitten and suffered flu-like symptoms including headache, nausea, fever, aches and pains, numbness, even mild rashes. Unlike the flu, all were sick for several weeks, not days, and were not contagiouseven in locked down double-bunked conditions no cellmate contracted the illness.

2004 promises to be a bad year again for WNV, according to the Centers for Disease Control and Prevention in Ft. Collins, Colorado. First, the Culex tarsalis mosquito is an effective carrier of WNV and the prevalent species in rural Colorado. Second, the mosquitoes thrive in Colorado's vast flood-irrigated fields and riverine flood plains. Birds in the neighboring trees are infected in large numbers and carry the infection throughout the state. At frost, the mosquitoes hibernate. The late frost and balmy winter weather means more mosquitoes survived the winter to wreak havoc in 2004. Third, birds have not had sufficient time to build immunity. Finally, WNV will now spread across the Continental Divide to the Western Slope where more prisons await.

According to David Lane, another prominent Colorado attorney, the state faces liability if a prisoner is forced to work outside without repellent after the health department puts out a notice to use repellent. The state is exposing a prisoner to a lethal disease "for want of a couple of bucks of insect repellent," reports the Denver Post. Buffy Nelson, whose fiancé is in the Fremont Correctional Facility in Fremont County, the fourth hardest hit county by capita and the county with the most prisons in the state, told the Denver Post that while prisoners owe a debt to society, "they don't owe their lives or their health."

Walter Gerash told the Denver Post that "prisoners in custody have no control" and "as custodians, the state has a duty to treat them humanely and medically." To avoid liability, the CDOC did not test the many prisoners with WNV symptoms lasting for many weeks. Prisoners were told to return to their cells and ride it out. A few were hospitalized in the infirmary when the symptoms became severe but still not tested for WNV. According to Gerash, if the CDOC were sued "a jury would eat `em up faster than a West Nile mosquito."

Sources: The Denver Post, The Rocky Mountain News, Colorado Department of Health website.

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