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Colorado: 2014 pneumonic plague- 3 more cases identified

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  • Colorado: 2014 pneumonic plague- 3 more cases identified

    Published Date: 2014-07-10 13:31:38
    Subject: PRO/AH/EDR> Plague - USA (02): (CO) pneumonic
    Archive Number: 20140710.2600593

    PLAGUE - USA (02): (COLORADO) PNEUMONIC
    ***************************************
    A ProMED-mail post
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    [1]
    Date: Wed 9 Jul 2014
    Source: 9NEWS, KUSA [edited]



    It's a disease carved into human history, with a deadly reputation. "The plague is basically what's been here for centuries," said 9NEWS Medical Expert Dr. John Torres. "It's what caused the Black Death back in the Middle Ages."

    Even though it doesn't kill people in large numbers like it once did, it is a serious disease. One man from Adams County [Colorado] is in the hospital recovering from a form of plague. The disease is part of the fabric of nature in Colorado now, found in rodents -- mainly prairie dogs. It's transmitted through the fleas they carry.

    "When the prairie dogs actually die, the fleas need somewhere to go. So once there is a prairie dog die-off, the fleas are out looking for somewhere to get a meal from," said Jennifer House of the Colorado Department of Public Health and Environment.

    In the latest case, doctors discovered the owner of a dog contracted plague. Tests later showed the dog, which had died unexpectedly, also had the disease.

    There are 3 types of plague; all can be potentially deadly, if not treated. The 1st is bubonic, which causes lymph nodes to swell. There is also septicemic, which comes about when the plague gets into the bloodstream. Finally, there is pneumonic, which is the kind the patient in Colorado has. Doctors said it can be especially worrisome. "It's a type of pneumonia," Dr. John said. "It can be spread from person to person, and that's what makes it kind of scary and kind of dangerous."

    The Colorado Department of Public Health and Environment said there have been 12 cases of plague in Colorado in the past decade [2004-2014]. The last case of pneumonic plague was in 2004. "In humans, it's actually become fairly rare," House said. "We don't see a lot of cases."

    Still, experts said to protect yourself, insect repellent with DEET helps. They also recommend staying away from wildlife and making sure your pets do as well. The key is to make sure fleas that carry plague don't land on you.

    To treat the plague, doctors give patients specific antimicrobial agents. As for how exactly the latest patient and the dog contracted the plague, the department of health said that was still under investigation.

    [Byline: Maya Rodriguez]

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    ******
    [2]
    Date: 9 Jul 2014
    Source: Colorado Department of Public Health and Environment



    The Colorado Department of Public Health and Environment laboratory yesterday [8 Jul 2014] identified pneumonic plague in a Colorado resident. Investigation revealed the family dog had recently died unexpectedly. The carcass was recovered and tested at the Colorado State University Veterinarian Diagnostic Laboratory, where tests were positive for plague.

    Tri-County Health Department officials and the Colorado Department of Public Health and Environment are working together to investigate the source of exposure and to identify those who may have been exposed through close contact with the individual. Any individuals exposed will be recommended for antibiotic treatment.

    The patient and the dog may have been exposed in eastern Adams County. Plague is spread from fleas on rodents, most commonly prairie dogs. People walking in open spaces and trails should avoid contact with rodents.

    Dr. Jennifer House, public health veterinarian at the Colorado Department of Public Health and Environment, encourages people take the following precautions to prevent plague exposure:

    - Do not directly handle any dead rodents.
    - Keep pets away from wildlife, especially dead rodents.
    - Don't let dogs or cats hunt prairie dogs or other rodents.
    - Don't allow pets to roam freely.
    - Treat all pets for fleas according to a veterinarian's advice.
    - Do not feed prairie dogs or other rodents - this attracts them to your property, brings them in close contact with other rodents and increases the risk of disease transmission.
    - Be aware of rodent populations in your area and report sudden die-offs or multiple dead animals to your local health department.

    Contact your physician if you develop a high fever and other plague symptoms following a fleabite or direct contact with dead rodents. Symptoms of plague include a sudden onset of high fever, muscle pain, malaise, nausea and vomiting, or a general feeling of being ill. Individuals with bubonic plague will develop a large, swollen, painful lymph node in the area of a flea bite, usually in the groin or armpit. If untreated, the disease can enter the bloodstream or lungs, which are severe, life-threatening complications. Individuals with pneumonic plagues (the lung form) develop fever, headache, weakness, shortness of breath, chest pain, cough which can lead to respiratory failure. Pneumonic plague is the most serious form of the disease and is the only form of plague that can be spread from person to person (by infectious droplets from coughing). Although human cases occur infrequently, plague is severe and potentially life-threatening if not detected and quickly treated with common antibiotics.

    Plague often is identified when there is an unusual die-off of prairie dogs in an area. When an infected animal dies, the fleas leave the carcass to find another host, thus spreading the disease. Most human plague cases occur when humans are bitten by infected fleas. Less commonly, people are infected by direct contact with blood or tissues from an infected animal or from pets that become infected and transmit the disease. Since 1957, Colorado has identified 60 cases of human plague, 9 (15 percent) of which were fatal.

    Additional information on plague can be found at: http://www.cdc.gov/plague

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    [Most cases of _Yersinia pestis_ infections in the USA are reported from the 4 Corners area of the USA where the states of Colorado, Utah, Arizona, and New Mexico come together.

    As outlined by the CDC (Centers for Disease Control and Prevention) and quoted in ProMED-mail post 20120601.1153277: "Death from bubonic plague occurs after the bacterium _Yersinia pestis_ escapes from the infected bubo into the bloodstream (septicemic plague), causing the manifestations of the sepsis syndrome. Disseminated intravascular coagulation (DIC) with subsequent cutaneous hemorrhage may well have been what was called the 'Black Death' in the Middle Ages. The bacterium can spread to the lungs, causing a secondary plague pneumonia (secondary to the bacteremia), or to the meninges, causing a plague meningitis. Both of these events have a high case fatality rate, and the secondary plague pneumonia is the way the infection spreads (by aerosol) from person to person.

    "The typical sign of the most common form of human plague is a swollen and very tender lymph gland, accompanied by pain. The swollen gland is called a 'bubo.' Bubonic plague should be suspected when a person develops a swollen gland, fever, chills, headache, and extreme exhaustion, and has a history of possible exposure to infected rodents, rabbits, or fleas. A person usually becomes ill with bubonic plague 2 to 6 days after being infected.

    "When bubonic plague is left untreated, plague bacteria invade the bloodstream. As the plague bacteria multiply in the bloodstream, they spread rapidly throughout the body and cause a severe and often fatal condition. Infection of the lungs with the plague bacterium causes the pneumonic form of plague, a severe respiratory illness. The infected person may experience high fever, chills, cough, and breathing difficulty and may expel bloody sputum. If plague patients are not given specific antibiotic therapy, the disease can progress rapidly to death. About 14 per cent (1 in 7) of all plague cases in the United States are fatal."

    Adams County is the 5th most populous of the 64 counties of the US state of Colorado. As of the 2010 census, the population was 441 603. The county seat is Brighton. The county is named for Alva Adams, Governor of the State of Colorado.

    Adams County is part of the Denver-Aurora-Lakewood, CO Metropolitan Area and can be found on a map at http://en.wikipedia.org/wiki/File:Ma...ams_County.svg. - Mod.LL

  • #2
    Re: Colorado: 2014 pneumonic plague- 3 more cases identified

    Source: http://www.denverpost.com/news/ci_26...ified-colorado

    ore cases of plague identified in Colorado
    By Anthony Cotton
    The Denver Post
    Posted: 07/18/2014 10:41:22 AM MDT2 Comments | Updated: about 4 hours ago

    ...Officials said the newest cases are related to an incident about eight days ago, in which the owner of a dog who had died had also contracted the illness...

    ...The three latest patients all had contact with the same dog, with two of the three contracting pneumonic plague, as did the initial patient. Dr. Jennifer House, the department's public health veterinarian,said the fourth case did not reach that level.

    House added that the three latest patients were treated with antibiotics and had recovered; the initial patient is still hospitalized...

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