Wednesday, July 18, 2012

Case of Bubonic Plague in Oregon

Here is a general interest story that we found….interesting. A man in Oregon contracted bubonic plague after trying to take a rat out of a stray cat’s mouth. Near death, he spent a month on life support. Now, he will need to have his hands and toes removed. (picture below gives meaning to the Black Death).

As you know, the bubonic plague or Black Death has had a large impact on the history of mankind. Through a series of major pandemics (6th to 7th century in the Mediterranean, 1300 to 1650 in Europe, and 19th and early 20th century in Asia and ports around the world), the plague wiped out some 200 million people (close to a third of Europe in the dark ages). The responsible organism, Yersinia pestis, is spread by fleas carried on rats. The disease was mostly eradicated by improved sanitary practices. While considered an ancient disease, there are still cases that pop up from time to time. There have been a reported 11 cases in the US since 1976, most all cases were in western US. (People living and working in areas with natural environment where there is a higher prevalence of woodrats).

Yersinia pestis, a gram negative organism, is one of the most pathogenic organisms known. It can infect through lesions in the skin (such as a flea bite) where it infects the lymphnodes and then invades other organs where it causes massive tissue destruction. Gangrene often sets in on the dead tissue. It can also spread through inhalation of infective respiratory particles (pneumonia). Disease is initially characterized by development of one or more inflamed, swollen lymph nodes (buboes), and then chills and fever, lethargy and confusion. Historically, the fatality rate was greater than 50%, but now with antibiotics, it is now about 5%. But still, who wants to be this guy.

Plague infects Oregon man who tried to get rodent from stray cat
An Oregon man who was bitten by a stray cat has contracted the plague — the fifth case of the disease in Oregon since 1995.
Nigel Duara and Steven Duboist
The Associated Press

PORTLAND — Health officials have confirmed an Oregon man has the plague after he was bitten while trying to take a dead rodent from the mouth of a stray cat.

The unidentified Prineville, Ore., man was in critical condition on Friday. He is suffering from a blood-borne version of the disease, not the bubonic plague, which wiped out at least one-third of Europe in the 14th century. The bubonic plague affects the lymph nodes.

There is an average of seven human plague cases in the U.S. each year. A map maintained by the Centers for Disease Control and Prevention shows most cases since the 1970s have been in the West, primarily the southwest.

The last reported case of plague in Washington state occurred in 1984 when an animal trapper in Yakima became infected while skinning a bobcat. In 2010, a Washington laboratory technician was treated to prevent plague infection after working with a specimen from one of the two reported cases in Oregon at the time.

The plague bacteria cycles through rodent populations without killing them off; in urban areas, it's transmitted back and forth from rats to fleas. There's even a name for it, the "enzootic cycle."

The bacteria thrive in forests, semiarid areas and grasslands, which plague-carrying rodents from wood rats to rock squirrels call home.

Once a coin flip with death, the plague is now easier to handle for humans in the U.S. The national mortality rate stood at 66 percent before World War II, but advances in antibiotics dropped that rate to its present 16 percent.

Central Oregon health officials don't blame the cat.

"The reality is that, in rural areas, part of the role of cats is to keep the rodent population controlled around our homes and barns" said Karen Yeargain of the Crook County Health Department.

 The Prineville man, who is in his 50s, remained in critical condition Friday at a Bend hospital. His illness marks the fifth case of plague in Oregon since 1995.

State public health veterinarian Dr. Emilio DeBess said the man was infected when he was bitten by the stray his family befriended. The cat died and its body is being sent to the CDC for testing.

DeBess has collected blood samples from two dogs and another cat that lives with the man's family. DeBess also collected blood samples from neighbors' pets and from animals in the local shelter to determine whether the area has a plague problem.

More than a dozen people who were in contact with the sick man have been notified and are receiving preventive antibiotics.


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