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Biological Health Threat – Zoonotic Disease Outbreak [Plague, Tularemia]: New Mexico

2016/06/16

PLAGUE, TULAREMIA – USA (NEW MEXICO): ALERT
********************
Published Date: 2016-06-15 14:41:39
Subject: PRO/AH/EDR> Plague, tularemia – USA (NM) alert
Archive Number: 20160615.4289092

Date: Monday, 13 June 2016
Source: Albuquerque Journal [edited]

The New Mexico Department of Health has confirmed 10 cases of plague and 19 cases of tularemia in dogs and cats – “higher than average” this year – in multiple counties.

Plague-positive pets have been reported in Los Alamos, Rio Arriba, Sandoval, Santa Fe, Taos and Torrance counties; while pet positive tests for tularemia have been reported in Bernalillo, Los Alamos, Sandoval and Santa Fe counties.

Plague and tularemia are bacterial diseases of rodents and rabbits. Human contraction of plague is generally from flea bites, while human contraction of tularemia is from deer fly bites, Department of Health veterinarian Dr. Paul Ettestad said Mon [14 Jun 2016]. These illnesses also can be transmitted by direct contact with infected animals, including pets.

Ettestad said the contraction rate of both plague and tularemia this year “is higher than average, but not on a record pace.” In New Mexico, plague and tularemia are more prevalent in the spring and early summer.

“We are seeing recent die-offs of rabbits in several areas of New Mexico from both plague and tularemia,” Ettestad said. “People can be exposed to plague when pets bring infected fleas back into the home, by caring for a sick pet without proper precautions, or by contact with rodents or fleas outdoors. Exposure to tularemia can occur from bites from deer flies or handling infected animals or pets which have been exposed,” he said.

Symptoms of plague and tularemia in humans are similar and include sudden onset of fever, chills, headache, weakness, swollen lymph nodes and possible infection at the bite site, Ettestad said. Likewise, he noted, signs of plague and tularemia in cats and dogs are similar, and include fever, lethargy, loss of appetite and possible swelling in the lymph node under the jaw.

The only sure way to distinguish the difference between these is through laboratory testing, he said. With prompt diagnosis and appropriate antibiotic treatment, the fatality rate in people and pets can be greatly reduced. According to statistics compiled by the Department of Health for 2015, 4 people in New Mexico contracted plague, with 1 fatality in Santa Fe County, and 8 cases of tularemia were confirmed, with no fatalities. There were also 63 confirmed cases of tularemia in dogs and cats in 2015, and 18 confirmed pet plague cases.

[Byline: Rick Nathanson]

Communicated by:
ProMED-mail
<promed@promedmail.org>

[Fleas and ticks are the guilty party in spreading these diseases to other animals, including our pets and us. Protecting our pets and ourselves from fleas and ticks is primary. Flea and tick collars around your ankles when hiking these areas can be helpful. For pets there are generally once-a-month treatments available that work very well.

Plague is primarily a disease of wild rodents. It is caused by the bacterium _Yersinia pestis_, which is mainly spread by the bites of infectious fleas. The bacterium is not native to North America. When it was introduced, it became established in some rodent populations, with some species being particularly susceptible. Free-ranging carnivores, including feral cats, are particularly exposed to plague as they prey on its reservoir.

Tularemia is a bacterial septicemia that affects, aside from people, more than 250 species of wild and domestic mammals, birds, reptiles and fish. It is listed as a category A bioterrorism agent because of the potential for fatality, airborne dissemination, and societal disruption if released. The causative bacterium, _Francisella tularensis_, is a nonspore-forming, Gram-negative coccobacillus antigenically related to _Brucella_ spp.

Tularemia can be transmitted by aerosol, direct contact, ingestion, or arthropods. Inhalation of aerosolized organisms (in the laboratory or as an airborne agent in an act of bioterrorism) can produce a pneumonic form. Direct contact with, or ingestion of, infected carcasses of wild animals (such as cottontail rabbit) can produce the ulceroglandular, oculoglandular, oropharyngeal (local lesion with regional lymphadenitis), or typhoidal form. Immersion in or ingestion of contaminated water can result in infection in aquatic animals. Ticks can maintain infection transstadially [pathogen remains with the vector from one life stage (“stadium”) to the next] and transovarially [transmission of a pathogen from an organism (as a tick) to its offspring by infection of eggs in its ovary], making them efficient reservoirs and vectors.

The commonest source of infection for people and herbivores is the bite of an infected tick, but people who prepare or eat improperly cooked wild game are also at increased risk. Dogs, cats, and other carnivores may acquire infection from ingestion of an infected carcass. Case reports have implicated cats as a source of infection in people. – Mod.TG

A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/233.]

See Also

Plague, animal – USA (03): (ID) ground squirrel, domestic cat, susp 20160604.4265294
Plague, animal – USA (02): (WY) feline 20160423.4178118
Plague, animal – USA: (NM) pets 20160117.3944780

2015

Plague, animal – USA (14): (CA) squirrel 20150907.3629694
Plague, animal – USA (13): (CA) squirrel 20150819.3588477
Plague, animal – USA (12): (CO) feline 20150802.3552460
Plague, animal – USA (11): (CO) squirrel 20150727.3540232
Plague, animal – USA (10): (UT) sylvatic, prairie dog, alert 20150715.3513063
Plague, animal – USA (09): (CO) mule deer, prairie dog 20150628.3470704
Plague – USA (02): (CO) fatality 20150623.3458401
Plague, animal – USA (08): (ID) vole, susp. 20150617.3443480
Plague, animal – USA (07): (ID) canine 20150608.3417597
Plague, animal – USA (06): (NE) prairie dog, spread 20150601.3400360
Plague, animal – USA (05): (ID) ground squirrel, alert 20150529.3394344
Plague, animal – USA (04): (NM) feline, canine 20150517.3368466
Plague, animal – USA (03): (AZ) feline, warning 20150511.3354008
Plague – USA: (CO) pneumonic, canine source, poss. human-to-human spread, 2014 20150501.3335475
Plague, animal – USA (02): (AZ) prairie dogs, fleas 20150406.3280037
Plague, animal – USA: (NM) multiple animals 20150116.3097674

2014

Plague – USA (06): (CO) septicemic 20140908.2757605
Plague, animal – USA (07): (CO) prairie dog, rabbit 20140825.2720056
Plague, animal – USA (06): comment 20140807.2666637
Plague, animal – USA (05): (CA) squirrel 20140804.2656788
Plague – USA (04): (NM) 20140803.2656232
Plague – USA (03): (CO) cluster from canine exposure 20140719.2621418
Plague, animal – USA: (NM) zoo 20140729.2643587
Plague – USA (02): (CO) pneumonic 20140710.2600593
Plague – USA: (NM) pneumonic 20140425.2430602
and other items in the archives

Tularemia – USA: (MN,AK) feline, canine, lagomorph 20160529.4252246

2015
—-
Tularemia – USA (18) 20151205.3842058
Tularemia – USA (17): (WY, NE) 20150925.3670429
Tularemia – USA (16): (AZ) rabbits 20150830.3612365
Tularemia – USA (15): (CO) rabbits 20150828.3608721
Tularemia – USA (14): (WY) fatality 20150825.3599260
Tularemia – USA (13): (NM, WY, AZ) human, animal 20150819.3580618
Tularemia – USA (12): (AK) hare, human 20150818.3586385
Tularemia – USA (11): (WY) rabbit 20150802.3553047
Tularemia – USA (10): (CO, SD) 20150801.3548673
Tularemia – USA (09): (CO) muskrat, alert 20150728.3542178
Tularemia – USA (08): (ND): human, animal 20150726.3537551
Tularemia – USA (07): (NM) 20150715.3510564
Tularemia – USA (06): (CO) rabbit, alert 20150703.3482641
Tularemia – USA (05): (AK) susp. 20150702.3480207
Tularemia – USA (04): (CO) rabbit, dog 20150702.3479571
Tularemia – USA (03): (CO) 20150626.3467769
Tularemia – USA (02): (CO) 20150603.3403896
Tularemia – USA: (CO) 20150522.3379806

2014
—-
Tularemia – USA (09): (CO) humans, beavers 20141206.3014671
Tularemia – USA (08): (CO) hunter warning 20141003.2829512
Tularemia – USA (07): (CO) 20140923.2798680
Tularemia – USA (06): (CO) 20140918.2783744
Tularemia – USA (05): (CO) 20140912.2763100
Tularemia – USA (04): (IL, CO) fatal 20140813.2684686
Tularemia – USA (03): (CA) feline 20140711.2602339
Tularemia – USA (02): (NM) 20140711.2601188
Tularemia – USA: (CO) rabbit 20140705.2589884

2013
—-
Tularemia – USA (08): 2001-2010 20131130.2083934
Tularemia – USA (07): (MA) 20130905.1926007
Tularemia – USA (06): (CO) rabbit 20130818.1886594
Tularemia – USA (05): (AK) snowshoe hare 20130702.1802498
And others in the archives.
………………………………………….tg/ao/ml

Source:
A ProMED-mail post
ProMED-mail is a program of the International Society for Infectious Diseases


Category A – Priority Pathogens

Plague is a Category A Bioterrorism agent. Category A Bioterrorism organisms/biological agents are high-priority pathogens posing a risk to national security, can be easily transmitted and disseminated, result in high mortality, have potential major public health impact, may cause public panic, or require special action for public health preparedness. — Centers for Disease Control and Prevention

Category A Biological warfare agents

These high-priority agents pose a risk to national security, can be easily transmitted and disseminated, result in high mortality, have potential major public health impact, may cause public panic, or require special action for public health preparedness.

Tularemia

Tularemia, or rabbit fever,[9] has a very low fatality rate if treated, but can severely incapacitate. The disease is caused by the Francisella tularensis bacterium, and can be contracted through contact with the fur, inhalation, ingestion of contaminated water or insect bites. Francisella tularensis is very infectious. A small number (10–50 or so organisms) can cause disease. If F. tularensis were used as a weapon, the bacteria would likely be made airborne for exposure by inhalation. People who inhale an infectious aerosol would generally experience severe respiratory illness, including life-threatening pneumonia and systemic infection, if they are not treated. The bacteria that cause tularemia occur widely in nature and could be isolated and grown in quantity in a laboratory, although manufacturing an effective aerosol weapon would require considerable sophistication.[10]

Anthrax

Anthrax is a non-contagious disease caused by the spore-forming bacterium Bacillus anthracis. An anthrax vaccine does exist but requires many injections for stable use. When discovered early anthrax can be cured by administering antibiotics (such as ciprofloxacin).[11] Its first modern incidence in biological warfare were when Scandinavian “freedom fighters” supplied by the German General Staff used anthrax with unknown results against the Imperial Russian Army in Finland in 1916.[12] In 1993, the Aum Shinrikyo used anthrax in an unsuccessful attempt in Tokyo with zero fatalities.[8] Anthrax was used in a series of attacks on the offices of several United States Senators in late 2001. The anthrax was in a powder form and it was delivered by the mail.[13] Anthrax is one of the few biological agents that federal employees have been vaccinated for. The strain used in the 2001 anthrax attack was identical to the strain used by the USAMRIID.[14]

Smallpox

[15] Smallpox is a highly contagious virus. It is transmitted easily through the atmosphere and has a high mortality rate (20–40%). Smallpox was eradicated in the world in the 1970s, thanks to a worldwide vaccination program.[16] However, some virus samples are still available in Russian and American laboratories. Some believe that after the collapse of the Soviet Union, cultures of smallpox have become available in other countries. Although people born pre-1970 will have been vaccinated for smallpox under the WHO program, the effectiveness of vaccination is limited since the vaccine provides high level of immunity for only 3 to 5 years. Revaccination’s protection lasts longer.[17] As a biological weapon smallpox is dangerous because of the highly contagious nature of both the infected and their pox. Also, the infrequency with which vaccines are administered among the general population since the eradication of the disease would leave most people unprotected in the event of an outbreak. Smallpox occurs only in humans, and has no external hosts or vectors.

Botulinum toxin

[18] The neurotoxin [19] Botulinum is one of the deadliest toxins known, and is produced by the bacterium Clostridium botulinum. Botulism causes death by respiratory failure and paralysis.[20] Furthermore, the toxin is readily available worldwide due to its cosmetic applications in injections.

Bubonic plague

[21] Plague is a disease caused by the Yersinia pestis bacterium. Rodents are the normal host of plague, and the disease is transmitted to humans by flea bites and occasionally by aerosol in the form of pneumonic plague.[22] The disease has a history of use in biological warfare dating back many centuries, and is considered a threat due to its ease of culture and ability to remain in circulation among local rodents for a long period of time. The weaponized threat comes mainly in the form of pneumonic plague (infection by inhalation)[23] It was the disease that caused the Black Death in Medieval Europe.

Viral hemorrhagic fevers

[24] This includes hemorrhagic fevers caused by members of the family Filoviridae (Marburg virus and Ebola virus), and by the family Arenaviridae (for example Lassa virus and Machupo virus). Ebola virus disease has fatality rates ranging from 50–90%. No cure currently exists, although vaccines are in development. The Soviet Union investigated the use of filoviruses for biological warfare, and the Aum Shinrikyo group unsuccessfully attempted to obtain cultures of Ebola virus. Death from Ebola virus disease is commonly due to multiple organ failure and hypovolemic shock. Marburg virus was first discovered in Marburg, Germany. No treatments currently exist aside from supportive care. The arenaviruses have a somewhat reduced case-fatality rate compared to disease caused by filoviruses, but are more widely distributed, chiefly in central Africa and South America.

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