Marion man dead after rare illness
Four weeks to the day after suffering flu-like symptoms, Marion resident Mike Holub died Friday evening from complications of tularemia at Via Christi Medical Center-St. Francis campus, in Wichita.
He was 58.
The Kansas Department of Transportation worker became ill June 1. He was admitted to St. Luke Hospital in Marion June 5, where he was diagnosed with pneumonia. He was transported the following day to Wichita.
But doctors there diagnosed his ailment as tularemia, also known as "Rabbit Fever," an uncommon disease caused by exposure to ticks.
Kansas state health officials later confirmed the diagnosis. Since then, a second suspected case of tularemia has been reported in Marion County. Citing privacy laws, local health officials declined to reveal the identity of the stricken resident.
It was believed Holub may have inhaled dust caused by an infestation of ticks, possibly passed on to another animal, such as a rabbit.
In Wichita, Holub was sedated and placed on life support during his hospitalization. His wife, Pauline, had said the family was been relieved to know the cause of Mike's illness, but doctors were unable to save him.
The family was told June 12 that Mike probably wouldn't make it through the night, and if he did, he probably wouldn't make it through the next day.
News of Holub's grave condition spread throughout Marion County. Pauline reported he showed some improvement, but cautioned that he was "not out of the woods yet."
But on Thursday, Holub's condition became more grave. Friday he was removed from life support. He died with family members by his side.
Family members said they probably never will know exactly what caused the disease. There also is a possibility that the disease was coupled with another ailment which caused Holub's health to quickly deteriorate. A full obituary is included on Page 2.
Until Holub's diagnosis, Dr. Don Hodson of Marion Family Physicians had never seen any cases of tularemia. So far this summer, he has seen two confirmed cases and one suspected case.
Dr. Randal Claassen of Hillsboro Family Practice Clinic has been practicing in Hillsboro since 1984 and had never seen a case. "It's a very unusual disease," he said.
Tularemia is not only a human disease. Animals can contract it, too.
Veterinarian Jessica Lauren of Animal Health Center of Marion County, said she hasn't seen any cases but Rebecca Irwin of her practice has.
Irwin treated a suspected case of tularemia in a cat about a month ago. It was an outdoor cat and family pet, and exhibited the traditional symptoms.
"The cat was treated and is doing very well," Irwin said.
She said she has seen tick outbreaks in dogs and Lauren said in some cattle. Topical treatments are available to combat the pests in household pets. Tags with pesticides are used in cattle's ears.
What is tularemia and what are the symptoms?
Also known as "rabbit fever," it is a disease caused by a bacteria typically found in animals, especially rodents, rabbits, and hares. It is considered to be a rural disease and has been reported in all U.S. states except Hawaii.
People can become infected through the bite of infected insects, most commonly ticks and deer flies, by handling infected sick or dead animals, by eating or drinking contaminated food or water, or by inhaling airborne bacteria. It is not known to be spread from person to person.
The disease requires treatment as soon as possible with antibiotics and can be fatal if not properly treated.
It takes three to five days before symptoms usually appear but can take up to 14 days.
"Symptoms usually are a sudden onset of fever and chills, headache, and feeling like you were hit by a Mack truck," Hodson said. "The problem is it can have the same symptoms as a common virus," which was the case of Mike Holub.
Other symptoms associated with the bacterial infection are diarrhea, muscle aches, joint pain, dry cough, progressive weakness, skin ulcers, swollen and painful lymph glands, inflamed eyes, sore throat, mouth sores, or pneumonia.
According to the Centers for Disease Control and Prevention, people with pneumonia can develop chest pain, bloody sputum, and respiratory failure.
The mortality rate is low — only one to three percent, but treatment must be sought.
Is there more of a chance of contracting other illnesses from ticks?
"Rocky Mountain Spotted Fever is rare in this part of the state," Hodson said, but then so is tularemia.
Only about 200 human cases of tularemia are reported each year in the U.S. — with Kansas reporting a total of three or four each year.
"I've already seen two confirmed and maybe a third case so far this summer," Hodson said with amazement.
Use caution, don't panic
With the recent case of tularemia being reported, residents need to prepare themselves for going outdoors.
— Use insect repellent that has a minimum of 20 percent DEET. The insecticide premethrin can be applied to camping gear and clothing to deter pests from making human contact.
— Tuck pants in socks and wear long sleeves. Light-colored clothing also is recommended so the dark arachnids can be seen and removed.
Marion County Public Health Administrator Diedre Serene advises parents to check children and pets after being outdoors.
It is always a good idea to check behind ears, along waste bands, and other body crevices.
Dogs and cats are common carriers of ticks. Inspect household pets on a regular basis.
If a tick is found, follow these simple instructions.
— Do not remove with your fingers. Grasp it by the head with fine-tipped curved tweezers and pull slowly, straight out.
— Do not squash the tick. The tick's intestine can be filled with bacteria that can cause illness. By squashing the tick, the bacteria could be spread.
— Do not try to burn or smother it. When the tick is firmly fastened in place, it takes time for the tick to detach itself and depart. No matter how badly the tick may wish to leave quickly, it simply can't.
A burning cigarette may kill the tick but won't make it fall off.
Ticks can live without air for a long period of time, so attempts to smother it allow disease transmission to continue for hours.
— Do not twist out the tick. Ticks aren't threaded. Your best chance of removing the head is pulling straight out with steady traction. Twisting invariably leaves the head behind.
And, finally
The most important thing to remember is it doesn't take a long period of time for a tick to attach itself to a host. It's a good idea to check yourself and family members, including family pets, for the pests.
If flu-like symptoms occur, see a doctor. If they continue or worsen, return to the doctor to make sure it is only the flu.
Antibiotics are normally successful in treating the disease but the sooner they can be administered the better.
