Correction: This story was updated on Nov. 27 to reflect that the statistic for nine U.S. anthrax cases in roughly the past two decades was for humans, not cattle. According to the CDC, anthrax is rare in the U.S., but there are occasional outbreaks in domestic and wild grazing animals.
Joyce Menke is a longtime cattle rancher in Carbon County, near Elk Mountain. In early September, she started feeling not like herself.
“I was tired and running a low grade fever all the time,” she said.
She thought maybe it was a bad cold or the flu. Not to mention she was under a lot of stress – her cattle were dropping dead, left and right.
“This is nothing we have ever seen before,” Joyce remembered thinking.
Then she got a rash on her arm.
“It's got blisters on it and it itches and burns,” Joyce described.
Then she got a call from the state veterinarian about her cattle, “And that's when they told us we [the cattle] had anthrax.”
That’s right – anthrax.
Anthrax is rare in the U.S. However, occasional outbreaks do happen in domestic and wild grazing animals, such as cattle or deer. Centers for Disease Control and Prevention (CDC) data indicate fewer than 10 people were believed to have caught the disease in roughly the past two decades. But by this point, Joyce was wondering if she had it, too.
Joyce, state agencies and public health institutions initially all worked together to diagnose the cattle anthrax outbreak and get her medical attention. But as the situation unfolded, the handling of it all exploded some locals’ mistrust in state services that are supposed to keep the public safe and healthy.
The cattle outbreak: A look back in time.
Let’s rewind to late August at the Menke Ranch. Joyce and her husband did a routine check of their cattle and found?
“Five cows, two bulls and a calf dead,” Joyce said, referring to her detailed notes. “And it was like, ‘Whoa.’”
Each day, more dead cows. Yet the cattle looked healthy otherwise.
“[You] start questioning what the heck have you got?,” said Frances Menke. But, everybody calls him by his nickname: Bug Menke.
Bug has a bushy white beard and camo suspenders. He’s pretty much ranched in this area all 72 years of his life. He’s no stranger to losing cows, but not like this. Everywhere a cow died, there was a black outline on the ground.
“Looked like somebody put oil on the ground, is what it looked like,” Bug remembered.
Back in August, they opened up a carcass to take a look.
“We both go, ‘Oh, wow, this is nothing we have ever seen before,’” Joyce said. “Bloody, black, weird. It had this, I described it as like bloody tapioca pudding.”
Bloody lesions all over the cow’s insides.
“And the liver was mush,” Bug said.
So Joyce took a sample for the state vet lab.
“Well, I tried to scoop this stuff up into the baggie, and it wouldn't go, it would just stick. So, I just reached in the body cavity, grabbed a handful of it and put it in the bag, and wiped my hand in the bag and sealed the bag shut,” Joyce said, reenacting the movements with her hands.
She wasn’t wearing gloves or protection during the necropsy.
A few days later the Menkes got that call from the state: the cows had anthrax. It wasn’t just the Menke’s, cows were dying at two other nearby ranches since about June.
“Nobody really knew nothing. They was reading in a book, is what they were doing,” Bug said about that initial diagnosis phone call with the State Vet, Wyoming Department of Health and state vet lab.
Joyce said she could understand why there was lack of clarity, “because none of them had ever seen anthrax.”
This is not the anthrax that might be coming to mind. The bio-terrorism, white powder that gets sent in the mail.
Rather, this anthrax is all across the U.S. in the soil. Possibly dating back to the big cattle drives of the late 1800s.
Alexandra Brower, director of the state vet lab, said anthrax is deep in the ground where it “just kind of sits and waits quietly.” Possibly for decades.
Brower said there are a lot of unknowns with anthrax. Those who study it don’t know exactly why it re-surfaces. Research shows large weather events – like droughts and floods. In a press release, Wyoming pin-points this as the reason for the Elk Mountain outbreak. But, Brower said once there’s a sick cow, it’s possible flies can transmit it from one animal to the next.
Cattle sick with anthrax are very occasionally reported in a few other states, like the Dakotas, Texas and Colorado.
“But in Wyoming, there hadn't been any really clear cases of it, some say the 50s, some say the 70s, but certainly not for a very, very long time,” Brower said.
So because of that, testing for it wasn’t top of mind. In fact, almost no one at the state vet lab had ever seen a positive case, including Brower.
That’s why it took eight days for the Menkes to almost three months for nearby ranchers to get a diagnosis from Brower’s lab.
“You know, you don't know things until you know them,” Brower said.
She added that the ranchers, local veterinarians and state agencies worked really well to figure it out. For example, the Menke’s let Brower and her team come out and examine dead cows – after hours on Labor Day weekend.
Joyce said Brower’s efforts saved a “bigger catastrophe around here. How many more deaths would occur before? I would not have gone to the doctor.”
The human health scare: Patient Zero?
Remember Joyce’s rash? It kept festering – it's a known symptom of human cutaneous, or skin, anthrax. While it’s treatable and humans rarely die as a result, death can still happen – especially if left untreated.
Joyce said the Wyoming Department of Health recommended she seek medical care. The same night her cattle were diagnosed with anthrax, Joyce rushed to Laramie's Ivinson Memorial Hospital.
She spent almost four hours in the emergency room. Joyce said it felt disorganized and like they were unprepared to treat her.
“It was a calamity of failed healthcare,” she said.
Ivinson said the Department of Health didn’t call to prepare them for Joyce’s visit. They also had never treated a potential anthrax patient in recent history. But they said they still followed protocol – like calling all the state agencies involved once Joyce arrived and running lot’s of tests on her.
Two of the three anthrax tests came back negative. One was not sufficient enough to be tested, according to Ivinson. The Department of Health confirmed there were no positive human cases of anthrax.
But Joyce said she doesn’t believe it. She thinks she had anthrax and that the results were misleading. She thinks the samples weren’t taken properly and were possibly mishandled.
Ivinson said they did everything right on their end. The samples were taken and sent to the Wyoming Department of Health, which then sent them to the CDC and to Montana where they have the proper microbiology machine for testing. The Department of Health said they can’t speak to specific cases, but that, “all samples we received associated with the event were tested at our public health laboratory or the Centers for Disease Control and Prevention without incident.”
According to the CDC, false-negative tests can happen with any test, including anthrax. Ivinson wouldn’t comment if this happened with Joyce.
“Per my expertise, I haven't seen anthrax in the past before,” said Mary Ponce, Ivinson’s chief nursing officer. “I've been a nurse 22 years, and so I haven't seen this before, and so I just can't speak to this.”
Ivinson diagnosed Joyce with ‘exposure’ to anthrax and sent her home with preventative antibiotics.
Ponce added that they gave her anthrax medical guidance that essentially said, “If you start having flu-like symptoms, and those are progressively getting worse, that could be a sign of the anthrax, and you should seek help.”
Over the next few days, Joyce did get sicker. She developed a bad cough and continued to feel exhausted. This time she went to UCHealth Medical Center of the Rockies in Loveland, Colorado. Doctor Dana Saunders was her provider. Saunders said they couldn’t confirm anthrax, but Joyce tested negative for a plethora of other illnesses – like COVID-19 and the flu.
So is it still possible Joyce had anthrax?
“In my mind, yeah,” Saunders said. “I just think the timing of the symptoms that she had – absolutely, I think so.”
Colorado kept Joyce for five days – putting her on IVs and giving her an anthrax vaccine. They also kept her on the antibiotics from the Laramie hospital.
Joyce still doesn’t feel back to normal – mostly fatigue. But she’s healing up back at the ranch now.
“This is my pharmacy, we’re on so many drugs,” Joyce said as she shuffled a couple large yellow bottles of antibiotics off the kitchen table.
Bug’s jokes that Joyce was ‘patient zero’. That’s because they believe Joyce had anthrax, which so few people in the U.S. ever do.
Bug is actually on those antibiotics too.
“It’s a 60-day sentence,” he said. “It’s a mean drug,” Joyce added, saying it’s made her sunburn easier, leading to sun blisters on her lips.
The pills are mostly preventative, especially for Bug. Basically, if someone was around the anthrax cows, they were exposed.
“There's quite a few people around here that are on that cockeyed stuff,” Bug said.
Reflection. Frustration. Mistrust.
Several months after it all, people like the Menke’s are reflecting on how the cattle anthrax and human health scares were handled. Despite the initial collaboration to diagnose the cattle, the Menke’s say they’re frustrated and disillusioned now.
Alexandra Brower, with the state Vet Lab, said that checks out. She thinks that trust was lost in the aftermath of the diagnosis. Essentially, a communication breakdown where state agencies weren’t talking enough with each other to debrief.
“We just drop[ped] the ball as soon as the problem is done over and over again, we're just onto life as usual,” Brower said, even comparing it to fall-outs from COVID-19 and HIV.
She said that communication breakdown means little follow up with those who lived the trauma: the ranchers.
“They feel abandoned because they are abandoned,” she said.
More face-to-face time could validate ranchers’ fears and lingering questions, Brower said.
“Imagine trying to conduct business as you normally do on a ranch that's dependent on the ground, plants and animals, and no one can tell you whether it's okay to run cattle on that property anymore, whether they're safe or not,” Brower said. “I mean, that's really hard.”
Without that validation, Brower said trust is lost. And theories about it all – whether true or not – grow.
“And then that primes people to be, you know, less interested in helping out public health or regulatory services in the future,” Brower said.
The Wyoming Department of Health said they’re available for “communication about health concerns related to the situation,” but that their role is “not to provide primary healthcare to people.”
The Wyoming State Livestock Board said they held a meeting with the Elk Mountain community this fall, but that further investigations into the disease outbreak are difficult “for a bacteria that lives within the soil and occurs sporadically.”
Brower said she has stayed in touch with the Menke’s to try to validate their concerns. But, it’s also not Brower’s job as the head of the state vet lab. She said to keep up the aftermath communication would likely fall on the backs of a state extension service – but it’s not clear who.
One day at a time.
Back at the Menke ranch, Bug points out some cattle in a nearby corral. One orphan survivor came to the fence.
Bug remembered caring for the yearling after his mom died, “I gathered him up and brought him in here and fed him out of a bottle.”
Bug vaccinated all the survivors for anthrax. But they still lost about 30 cows. That’s at least $30,000 from their income. There’s potentially federal money that could help, but they don’t want it.
“We just don't participate,” Joyce said. “We're self-reliant.”
That’s partly because of their mistrust of the government even before, and now, after anthrax?
“Just reinforces it a little more,” Bug chuckled. “That's the best way to put it. How’s that?”
The Menkes still have a lot of questions too. Like, when will Joyce feel back to normal?
And, there’s a pile of dead anthrax cows buried just over the hill. What will that do to the ground or the nearby river? Or to next year’s hay crop? Or their backyard crab apple tree?
