CARD Clinic of Libby reflects

on founding purpose and future work

Submitted by
Center for Asbestos
Related Disease


In honor of National Public Health Week, the Center for Asbestos Related Disease (CARD Clinic) would like to look back
on Libby’s foremost
Public Health threat, the asbestos related disease caused by Libby Amphibole Asbestos.

Over the seventy-year working history of the local vermiculite mine, it is estimated that up to 80,000 people may have been exposed, including mine workers, railroad workers, loggers and mill workers, along with many of the men, women, and children who simply lived in the area over time. At present, approximately 7,500 free screenings have been done at the CARD Clinic. Out of that number, nearly 3,500 have been diagnosed with asbestos related disease. This includes both non-cancerous lung disease as well as asbestos related cancers.

As of 2020, several of the operating units within the EPA Superfund site had been cleaned and partially deleted from the Superfund. On July 1, 2020, the EPA transferred oversight to the Montana Department of Environmental Quality. The
Lincoln County Asbestos Resource Program continues to provide technical assistance to property owners and workers who may encounter residual vermiculite in buildings or the surrounding soil.

Looking forward, screening efforts to
identify asbestos related
disease in individuals who may have been exposed continues and will do so for the foreseeable future as those who were still children when the mine closed enter the 10-40+ year latency period
during which asbestos related disease can
potentially be identified.

The disease process associated with Libby
Amphibole Asbestos
differs from that of the more commonly found and extensively studied
Chrysotile asbestos, with which most medical
providers are at least somewhat familiar.
Education of providers both in Montana and
nationwide remains a
priority. There were over 240 additional processing plants for the vermiculite from Libby and Zonolite was marketed for use as insulation in buildings across the country.

Anyone doing remodeling, demolition, or maintenance in these buildings, including firefighters, can also potentially be exposed.

Research remains a mainstay of the Public Health approach to Libby Amphibole Asbestos, both to better understand the unique characteristics of the diseases associated with it and to develop possible treatment
modalities that can ease the suffering of those

CARD continues to push forward, not only with screening for asbestos related disease and care for those diagnosed, but also with essential outreach and education. We are actively pursuing additional collaborative research opportunities that may one day lead to effective treatments.

CARD has only been able to accomplish what it has over the past twenty years because of the support it has received from the community and we would like to extend our thanks for the many
accomplishments achieved over this period.

This has allowed us to positively address and respond to the public health emergency resulting from asbestos exposure.

At the CARD Clinic, we will continue to support ongoing development of tourism, leisure, and economic opportunities for our community as it emerges into a new period of hope while continuing to provide support for those affected medically by asbestos exposure.

DPHHS confirms first Hantavirus

case of 2021 for State of Montana

Submitted by
Public Health Nurse of Lincoln County


April 9, 2021—Hantivirus case is first one since 2018; Health officials remind Montanans to take precautions to avoid the disease.


DPPHS—The Department of Public Health and Human Services (DPHHS) has confirmed that an adult male from Richland County has been diagnosed with hantavirus infection.

The individual acquired the illness while working out of state where there was an occupational exposure to mice. The individual was hospitalized but is now in the process of recovering at home.

DPHHS and local public health agencies remind Montanans and
visitors to the state to be aware of the risk of hantavirus and to take precautions to avoid exposures to rodents, their droppings and nests. This is
Montana’s first hantavirus case in 2021 and is the state’s 45th case since it was first identified in the state in 1993. Previously, the most recently reported case was in 2018.

“Although hantavirus infection can occur during any month, the risk of exposure is increased in the spring and summer as people are cleaning cabins and sheds, and are spending more time outside which may result in rodent exposures,” said Erika Baldry, epidemiologist for the DPHHS Public Health and Safety Division.

Hantavirus infections are relatively rare in the U.S. and in Montana. Early symptoms of hantavirus include
fatigue, fever and muscle aches with progression to coughing and extreme shortness of breath. Hantavirus
infection can cause severe illness; about 25 percent of Montana’s cases have resulted in death. Supportive medical care is essential to survival and, if diagnosed early, can help
victims through the period of severe
respiratory distress.

Studies have shown that deer mice are the most common host of the virus and are well dispersed throughout Montana. People can become infected with hantavirus when saliva, urine, or droppings from an infected deer mouse are stirred up and inhaled. It is important to avoid activities that raise dust, such as sweeping or vacuuming, if there are signs of rodents in the area.

The best protection against hantavirus is to control rodent populations in the places where people live and work by taking these precautions:

SEAL UP: Prevent mouse entry into homes and sheds by sealing up holes and gaps in walls.

TRAP UP: Use snap traps to eliminate any mice indoors. Individuals can also reduce rodent populations near dwellings by keeping shrubbery near the home well-trimmed and moving woodpiles at least 100 feet from the dwelling and raising them at least one foot off the ground.

CLEAN UP: Carefully clean up areas where mouse droppings are found.

Avoid sweeping or vacuuming
areas with rodent droppings and urine, as the action can stir up dust and
aerosolize the droppings.

If cleaning an area such as a cabin, camper or outbuilding, open windows and doors and air-out the space for 30 minutes prior to cleaning.

Wear rubber or plastic gloves.

Thoroughly spray or soak the area with a disinfectant or a mixture of bleach and water to reduce dust. Let soak for 5 minutes.

Wipe up the droppings with a sponge or paper towel, then clean the entire area with disinfectant or bleach solution.

When cleanup is complete, dispose of sponges and paper towels used to clean, remove and discard gloves and wash hands thoroughly with soap and warm water.

For those who think they have been exposed to hantavirus, monitoring for symptoms is vital. Anyone experiencing symptoms such as fever, muscle aches and shortness of breath after a potential rodent exposure, should see a medical provider immediately.

“Be sure to tell your doctor that you have been around rodents—this will alert your physician to look closely for any rodent-carried disease, such as hantavirus pulmonary syndrome,” Baldry advises.

For more information on hantavirus and prevention of disease, visit the DPHHS website at:



Dear Doc, I missed my appointment for my second shot of the COVID vaccine. Do I have to start over, or can I reschedule the
second shot at a later date?

The Pfizer COVID vaccine is usually scheduled for at least 3 weeks after the first dose; Moderna is at least 4 weeks; Johnson & Johnson’s vaccine is just one shot. It is recommended that, if you miss your appointment for the second dose, you should reschedule as soon as you can.

It is most likely that it will work just as well if you get it late but then your chances of getting infected with COVID are a little higher in between the two doses.

You are considered best protected against getting COVID if it has been two weeks or more since your second shot.


Dear Doc, I get a flu shot every year. Will I need to get a COVID shot every year?

Several types of vaccines for
different diseases give us many years of
protection after their initial series, such as vaccines for measles, mumps and rubella, chicken pox, and Hepatitis B.

The yearly shot for influenza is not just a booster of the same vaccine, it contains vaccine components for several types of influenza virus and most years there is a change in one or two of these components due to the sneaky influenza virus’s ability to change.

One big problem with this pandemic is so many people have been
infected in all countries that variants of the virus that have come up were inevitable. Viral experts know that when so many virus particles are made, the chances are very high there will be variants.

That is why some are saying we may need
another vaccine within a year or two.

However, it is still too soon to say this with
certainty as the current vaccines seem to work well for all the variants going around.

One of the reasons to get vaccinated is to help stop the pandemic as soon as possible so a more dangerous virus variant does not emerge and cause the pandemic to get worse or come back.



It is also the reason that all nations need to get vaccinated. The COVID virus easily spreads from one country to the next.


Dear Doc, are there lingering
effects from having COVID-19?
Who gets them?

Yes, some people have either
persistent symptoms or can have
symptoms come up after the initial
infection, even if the initial infection
is mild. People with persistent or
recurrent symptoms of COVID-19 are often referred to as “long haulers” or
as having post COVID syndrome or
post-acute COVID syndrome.

In children, a rare but serious illness that happens, usually after a minimal or mild infection, is called “Multisystem Inflammatory Syndrome COVID” or

Long haulers syndrome, or post COVID syndrome, commonly causes symptoms such as fatigue, muscle
weakness, insomnia, anxiety or
depression. Loss of taste and smell can persist for weeks or months.

Heart inflammation can also occur that can cause a variety of symptoms including fainting and (rarely) sudden cardiac death.

More than half of hospitalized
COVID-19 patients still have at least one symptom at 6 months after their hospitalization.

If they had significant lung involvement in the hospital, there is a greater chance of persistent shortness of breath and/or need for oxygen even after six months. Long haulers syndrome can also occur in non-hospitalized cases and in any age group.

Dr. Gregory Rice, M.D.

Have a COVID-19

Send your
inquiries to:
Dear Doc
1020 Idaho
Libby, MT