US: Human Plague 2015

[Shiloh]

Source: http://www.cnn.com/2015/08/25/health...015/index.html

CDC reports 11 cases of human plague since April
By Debra Goldschmidt, CNN
Updated 5:52 PM ET, Tue August 25, 2015

(CNN)Since April 1, there have been 11 cases of human plague in the United States, the Centers for Disease Control and Prevention said Thursday. Three of those patients have died. This is according to a new report from the CDC putting doctors on alert that the number of cases this year seems to be higher than usual.

The average number of cases between 2001 and 2012 was seven, with less than one death each year. ..

[Pathfinder]

Human Plague — United States, 2015

Early Release

August 25, 2015 / 64(Early Release);1-2

Natalie Kwit, DVM1,2; Christina Nelson, MD2; Kiersten Kugeler, PhD2; Jeannine Petersen, PhD2; Lydia Plante, MSPH3; Hayley Yaglom, MPH3; Vicki Kramer, PhD4;Benjamin Schwartz, MD5; Jennifer House, DVM6; Leah Colton, PhD6; Amanda Feldpausch, MPH7; Cherie Drenzek, DVM7; Joan Baumbach, MD8; Mark DiMenna, PhD9; Emily Fisher, MD1,10; Emilio Debess, DVM10; Danielle Buttke, DVM11; Matthew Weinburke, MPH11; Christopher Percy, MD12; Martin Schriefer, PhD2; Ken Gage, PhD2; Paul Mead, MD2

Since April 1, 2015, a total of 11 cases of human plague have been reported in residents of six states: Arizona (two), California (one), Colorado (four), Georgia (one), New Mexico (two), and Oregon (one). The two cases in Georgia and California residents have been linked to exposures at or near Yosemite National Park in the southern Sierra Nevada Mountains of California. Nine of the 11 patients were male; median age was 52 years (range = 14–79 years). Three patients aged 16, 52, and 79 years died.

Plague is a rare, life-threatening, flea-borne zoonosis caused by the bacterium Yersinia pestis. During 2001–2012, the annual number of human plague cases reported in the United States ranged from one to 17 (median = three cases) (1). It is unclear why the number of cases in 2015 is higher than usual. Plague circulates among wild rodents and their fleas in rural and semirural areas in the western United States (2). Transmission to humans occurs through the bite of infected fleas, direct contact with infected body fluids or tissues, or inhalation of respiratory droplets from ill persons or animals, including ill domesticated cats and dogs (3). The usual incubation period between exposure and illness onset is 2–6 days.

In humans, plague is characterized by the sudden onset of fever and malaise, which can be accompanied by abdominal pain, nausea, and vomiting. There are three main forms of plague, depending upon the route of infection. Bubonic plague, resulting from the bite of an infected flea, accounts for approximately 80%–85% of cases; patients develop a "bubo," a painful swelling of one or several lymph nodes that progresses during the first few days of illness. Septicemic plague, accounting for approximately 10% of cases, can occur from a flea bite or from direct contact with infectious fluids; infection spreads directly through the bloodstream with no localizing signs. Primary pneumonic plague, occurring in approximately 3% of plague patients, results from aerosol exposure to infective droplets and is characterized by a fulminant primary pneumonia. Secondary pneumonic plague can result from the spread of Y. pestis to the lungs in patients with untreated bubonic or septicemic infection.

The mortality rate for untreated plague has ranged from 66% to 93%; however, in the antibiotic era, mortality has been reduced to approximately 16% (4). Prompt treatment with antimicrobials such as aminoglycosides, fluoroquinolones, or doxycycline greatly improves outcome (4).

Health care providers should consider the diagnosis of plague in any patient with compatible signs or symptoms, residence or travel in the western United States, and recent proximity to rodent habitats or direct contact with rodents or ill domestic animals. Suspicion of plague should prompt 1) collection of blood, bubo aspirate, or sputum samples for Y. pestis diagnostic testing; 2) implementation of isolation and respiratory droplet precautions for patients with respiratory involvement; 3) immediate antibiotic treatment (before laboratory confirmation); and 4) notification of public health officials. Y. pestis–specific testing is available at state health laboratories. Recommendations for diagnostic testing and antibiotic treatment are available athttp://www.cdc.gov/plague/healthcare/clinicians.html. Misidentification of Y. pestis as Pseudomonas luteola and other organisms through the use of automated bacterial identification systems has been reported (5).

Persons engaging in outdoor activities in areas where plague is endemic should wear long pants when possible and use insect repellent on clothing and skin. Persons also should avoid direct contact with ill or dead animals and never feed squirrels, chipmunks, or other rodents. In addition, pet owners should regularly use flea control products on their pets and consult a veterinarian if their pet is ill. Rodent habitat can be reduced around the home by removing brush, clutter, and potential rodent food sources such as garbage or pet food. Additional information on prevention of plague is available athttp://www.cdc.gov/plague/prevention/index.html.

1Epidemic Intelligence Service, CDC; 2Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC; 3Arizona Department of Health Services; 4California Department of Public Health; 5Los Angeles County Department of Public Health, California; 6Colorado Department of Public Health and Environment; 7Georgia Department of Public Health; 8New Mexico Department of Health; 9Albuquerque Environmental Health Department, New Mexico; 10Oregon Health Authority; 11National Park Service; 12Navajo Area Indian Health Service.
Corresponding author: Natalie Kwit, nkwit@cdc.gov, 970-266-3587.

References

1. Adams DA, Jajosky RA, Ajani U, et al. Summary of notifiable diseases—United States, 2012. MMWR Morb Mortal Wkly Rep 2014;61:1–121.
2. CDC. Plague. Atlanta, GA: US Department of Health and Human Services, CDC; 2015. Available at http://www.cdc.gov/plague/.
3. Runfola JK, House J, Miller L, et al. Outbreak of human pneumonic plague with dog-to-human and possible human-to-human transmission—Colorado, June–July 2014. MMWR Morb Mortal Wkly Rep 2015;64:429–34.
4. Kugeler KJ, Staples JE, Hinckley AF, Gage KL, Mead PS. Epidemiology of human plague in the United States, 1900–2012. Emerg Infect Dis 2015;21:16–22.
5. CDC. Notes from the field: two cases of human plague—Oregon, 2010. MMWR Morb Mortal Wkly Rep 2011;60:214.

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http://www.cdc.gov/mmwr/preview/mmwr...=mm64e0825a1_e

[Shiloh]

Source: http://www.kbtx.com/health/headlines...323142021.html

Health Officials: Utah Man In His 70s Dies From Plague
Posted: Thu 4:16 PM, Aug 27, 2015

SALT LAKE CITY, UT Health officials say a Utah man in his 70s has died after contracting the plague earlier this month.

The Centers for Disease Control and Prevention says it is the 12th case reported in the United States this year and fourth fatality.

Dr. Paul Mead, a chief of epidemiology with the CDC, says the Utah case involved a man in his 70s, but he declined to release further details...

[Pathfinder]

Thursday, August 27, 2015

Utah Resident Dies from Plague

(Salt Lake City, UT) – Utah public health officials have confirmed that an elderly resident died from plague earlier this month. This is the first Utah resident to be diagnosed with plague since 2009.

Plague is a rare, life-threatening, flea-borne illness that is maintained in a rodent-flea transmission cycle. Species such as prairie dogs, black footed-ferrets, squirrels, and rabbits are especially susceptible and experience high mortality upon infection. Plague is naturally occurring in Utah, and typically seen in the prairie dog populations each year. Since April 1, 2015, a total of 12 cases of human plague have been reported in residents of seven states: Arizona (two), California (one), Colorado (four), Georgia (one), New Mexico (two), Oregon (one), and Utah (one). The two cases in Georgia and the California resident have been linked to exposures at or near Yosemite National Park. The investigation continues into the circumstances surrounding the Utahn’s illness. The patient may have contracted the disease from a flea, or contact a dead animal. At this time, public health officials believe there was no travel history indicating that the Utah resident traveled anywhere else where plague is common.

Human plague occurs in areas where the bacteria are present in wild rodent populations. The risks are generally highest in rural and semi-rural areas, including campsites and homes that provide food and shelter for various ground squirrels, chipmunks and wood rats, or other areas where you may encounter rodents.

Plague is a very serious illness, but it is treatable with commonly available antibiotics. The earlier a patient seeks marmedical care and receives treatment that is appropriate for plague, the better the chance for a full recovery. Some common symptoms may include fever, headache, chills, and weakness. If you are experiencing symptoms, seek immediate medical attention.

To protect you, your family, and your pets:
•
Reduce rodent habitat around your home, work place, and recreational areas. Remove brush, rock piles, junk, cluttered firewood, and possible rodent food supplies, such as pet and wild animal food. Make your home and outbuildings rodent-proof.
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Always wear gloves if you are handling or skinning wild animals to prevent contact between your skin and potential plague bacteria. Contact your local health department if you have questions about disposal of dead animals.
•
Use repellent if you think you could be exposed to rodent fleas during activities such as camping, hiking, or working outdoors. Products containing DEET can be applied to the skin as well as clothing and products containing permethrin can be applied to clothing (always follow instructions on the label).
•
Keep fleas off of your pets by regularly applying flea control products. Animals that roam freely are more likely to come in contact with plague-infected animals or fleas and could bring them into homes. Keep pets away from wild animals. If your pet becomes sick, seek care from a veterinarian as soon as possible.
•
Do not allow dogs or cats that roam free outside to sleep on your bed.
•
Cook all wild game meat properly to a minimum of 165F inner temperature.
•
Clean and disinfect all knives and equipment used to process wild game.
•
Do not feed raw game meat or inner organs to pets.

Notify your local Utah Division of Wildlife Resources if you see an unusual number of dead prairie dogs, squirrels, or rabbits in any given area. Contact information for local area offices can be found at:http://wildlife.utah.gov/about-us/contact-us.html.

http://udohnews.blogspot.com/2015/08...om-plague.html

[Shiloh]

Source: http://www.freep.com/story/news/heal...igan/72273070/

Bubonic plague case confirmed in Michigan
By Robin Erb, Detroit Free Press 6:48 p.m. EDT September 14, 2015
First ever bubonic plague case confirmed in Michigan
bubonic plague

A Michigan resident has contracted the rare, life-threatening bubonic plague ? the first documented case in Michigan?s public health history, state officials confirmed.

The Marquette County adult is recovering after apparently contracting the flea-borne illness during a trip to Colorado. Officials are reassuring the public there is no cause for alarm, despite the disease's connection to the microorganism that caused the Black Death plague in Europe in the 1300s, killing millions and reshaping history...

[Shiloh]

Human Plague Case Confirmed in Santa Fe County

September 23, 2015 - Zoonotic Diseases - Disease

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The New Mexico Department of Health announced today a laboratory confirmed case of plague in a 73-year-old woman from Santa Fe County. The case was confirmed at the Department of Health?s Scientific Laboratory Division. This is the fourth human case of plague in New Mexico this year and the second in Santa Fe County. The woman was hospitalized and is back home recovering. The other cases in the state occurred in a 52-year-old woman from Santa Fe County, who died from the illness, and in a 65-year-old man and a 59-year-old woman, both from Bernalillo County, who have recovered. ?This is the fourth case of plague in New Mexico with the patient presenting clinical signs of septicemic plague,? said Department of Health Secretary Retta Ward, MPH. ?Though septicemic plague is less common and harder to recognize than the more common form of bubonic plague, health care providers need to consider plague in their diagnosis when the patient has a fever of unknown origin and when the patient is from plague endemic areas of the state.? Septicemic plague accounts for approximately 20-25 percent of New Mexico cases. No detectable swollen lymph node (bubo) is found. Plague is a potentially fatal illness in people that occurs in many parts of New Mexico. It is caused by a bacteria found in rodents, especially ground squirrels, rabbits and pack rats. Most human cases of plague are acquired through the bite of infected fleas. Dogs and cats are also susceptible to plague and are infected either through bites of infected fleas or by eating an animal that has died from the disease. ?Several of our plague cases this year have most likely been exposed to plague-infected rodent fleas brought into the home and bedroom by dogs and cats that are allowed to roam and hunt and aren?t treated with a flea control product,? said Paul Ettestad, state public health veterinarian with the Department of Health. Symptoms of plague in people usually develop two to eight days after exposure. Plague symptoms are sudden fever, chills, headaches, and swelling of the lymph nodes in the neck, armpit, or groin areas. As previously stated, in some cases, infection may progress without swollen lymph nodes making it harder to diagnose. In addition to the four human cases, there have been 8 cases of plague this year in dogs and cats, including pets from Bernalillo, Santa Fe, and Torrance counties. Reduce the risk of plague:

• Use insect repellent on exposed skin and clothing when you go outdoors. The Centers for Disease
• Control and Prevention recommends repellents containing DEET, Picaridin, oil of lemon eucalyptus, or IR3535 for use on skin, and permethrin for use on clothing. Always follow label directions when using insect repellents.
• Keep your pets from roaming and hunting.
• Talk to your veterinarian about using an appropriate flea and tick control product on your pets as not all products are safe for cats, dogs, or your children.
• Clean up areas near the house where rodents could live, such as woodpiles, brush piles, junk and abandoned vehicles.
• Don?t allow children or others to handle sick or dead wildlife.
• Sick pets should be examined promptly by a veterinarian.
• See your health care provider immediately about any unexplained illness involving a sudden and severe fever.
• Put hay, wood, and compost piles as far as possible from your home.

For more information, please visit the Plague section of our website.

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Media Contact

We would be happy to provide additional information about this press release. Simply contact David Morgan at 575-528-5197 (Office) or 575-649-0754 (Mobile) with your questions.

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Versi?n Espa?ola

En un esfuerzo para hacer que nuestros comunicados de prensa m?s accesible, tambi?n tenemos una versi?n espa?ola de este art?culo disponible. Por favor, haga clic en el enlace de abajo para acceder a la traducci?n. Caso de Plaga Humana Confirmado en el Condado de Santa Fe

http://nmhealth.org/news/disease/2015/9/?view=313

[Gert van der Hoek]

Oregon girl, 16, diagnosed with bubonic plague after hunting trip

October 30, 2015

PORTLAND, Ore. — A 16-year-old Crook County girl has been diagnosed with bubonic plague, Oregon health officials confirmed.

The Oregon Health Authority said the girl likely acquired the disease from a flea bite during a hunting trip near Heppner on Oct. 16. She got sick five days later and was admitted to the intensive care unit at a Bend hospital.

No other people in Crook County have been infected with the plague, according to OHA spokesman Jonathan Modie.