SIOUX CITY | Two weeks ago, Sioux City firefighters responded to a call from homeowners whose carbon monoxide alarm had gone off.

When firefighters arrived, the residents had signs and symptoms of carbon monoxide poisoning. They were administered oxygen and recovered.

That call came just three days after a South Sioux City husband and wife were found dead in their garage, and authorities ruled the cause of their deaths as accidental carbon monoxide poisoning.

Those two calls help show the importance of installing carbon monoxide detectors in homes and businesses and taking other precautions against a gas that's been called "the silent killer," said Sioux City Fire Rescue Capt. Tom Standish.

"You don't smell it. You don't see it. You're just overcome by it," Standish said of the colorless, odorless gas, which he said kills more than 150 people in the United States each year.

Standish said Sioux City Fire Rescue responded to 30 calls for carbon monoxide alarms in 2016, up from 18 in 2015.

"Thirty calls is a lot," Standish said.

In most cases, the alarm was sounding because the batteries needed to be replaced or the alarm was old and outdated. But in the others, an increased level of carbon monoxide was detected. Fortunately, there were no fatalities in Sioux City.

Winter is when the highest risk of carbon monoxide occurs. With the colder temperatures, furnaces, fireplaces and other heaters are running more often, and people are warming up their cars in the garage. Carbon monoxide levels can reach dangerous levels because of leaky appliances. Standish said that even if you have your garage doors open when a vehicle is warming up, carbon monoxide can get into the house.

But carbon monoxide levels can reach dangerous levels at any time of year if a home has natural gas-powered appliances such as stoves and hot water heaters.

Complicating the detection of carbon monoxide is the fact that someone suffering from mild carbon monoxide poisoning exhibits flu-like symptoms: nausea, headaches, fatigue and maybe shortness of breath, said Dr. David Ensz, a family practitioner at Mercy Medical Clinic in South Sioux City.

"A lot of people think they have a little viral syndrome," Ensz said, but without the fever.

Carbon monoxide interrupts the transfer of oxygen from red blood cells to body tissue, which explains the fatigue. Seizures can result in more extreme cases.

Because the symptoms of carbon monoxide poisoning are similar to the flu, Ensz said a couple clues that you may have elevated levels of the gas in your home are if everyone in the house is showing the same signs and if you begin to feel better after you've been out of the house for a while.

The best way to protect against carbon monoxide poisoning, Standish said, is the installation of carbon monoxide detectors in the home. Fire departments across the country continue to educate the public on the importance of the detectors, which can be purchased at just about any home improvement or major department store.

It's a message that appears to be getting through. Standish said one reason for the increased number of carbon monoxide calls in Sioux City is because more people seem to be putting detectors in their homes.

"They're becoming more and more popular. It just takes education," he said.

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