Biological Health Threat – Plague (Yersinia Pestis) Human Infection: New Mexico
PLAGUE – USA (03): (NEW MEXICO)
Published Date: 2016-06-18 09:33:51
Subject: PRO/AH/EDR> Plague – USA (03): (NM)
Archive Number: 20160618.4295323
Date: Friday, 17 June 2016
Source: New Mexico Department of Health [edited]
The New Mexico Department of Health [NMDH] has confirmed a case of plague in a 16-year-old boy from Rio Arriba County who is currently hospitalized. Confirmatory testing was conducted at the Scientific Laboratory Division. This is the 1st human case of plague in New Mexico and in the USA in 2016.
“We will conduct an environmental investigation at the teen’s home to look for ongoing risk and to ensure the health of the immediate family and neighbors,” said Department of Health Secretary Designate Lynn Gallagher. “Staff will go door-to-door to neighbors near the patient’s home to inform them about plague found in the area and educate them on reducing their risk.”
Plague is a bacterial disease of rodents and is generally transmitted to humans through the bites of infected fleas, but can also be transmitted by direct contact with infected animals, including rodents, wildlife and pets.
“Late spring and summer are when we see most cases of plague, though they can occur throughout the year in New Mexico,” said Dr Paul Ettestad, public health veterinarian for the Department of Health. “Sick or dead rodents and rabbits are being reported from many areas in the state so it is very important to take precautions to avoid rodents and their fleas which can expose you to plague. Pets that are allowed to roam and hunt can bring plague-infected fleas from dead rodents back into the home, putting you and your children at risk.”
To prevent plague, the Department of Health recommends:
– avoid sick or dead rodents and rabbits, and their nests and burrows;
– keep your pets from roaming and hunting;
– talk to your veterinarian about using an appropriate flea 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;
– sick pets should be examined promptly by a veterinarian;
– see your doctor about any unexplained illness involving a sudden and severe fever;
– put hay, wood, and compost piles as far as possible from your home; and
– don’t leave your pet’s food and water where rodents can get to it.
Symptoms of plague in humans include sudden onset of fever, chills, headache, and weakness. In most cases there is a painful swelling of the lymph node in the groin, armpit, or neck areas. Plague symptoms in cats and dogs are fever, lethargy, and loss of appetite. There may be a swelling in the lymph node under the jaw. Prompt diagnosis and appropriate antibiotic treatment can greatly reduce the risk of death. Physicians who suspect a patient may have plague should promptly report it to the Department of Health.
In New Mexico, there were 4 human plague cases in 2015 with one death.
Paul Ettestad DVM
Public Health Veterinarian
New Mexico Department of Health
[ProMED-mail thanks Dr Ettestad for this post. The manifestations of _Yersinia pestis_ in this case are not stated in the NMDH report.
2015 was a “banner year” for _Y. pestis_ infections in the USA with 15 cases and 4 deaths. In recent decades, an average of 7 human plague cases have been reported each year (range: 1-17 cases per year) with 0-2 deaths.
The following was extracted from Prentice MB, Rahalison L: Plague. Lancet. 2007; 369(9568): 1196-207, with the citations removed:
“Some plague cases (10-25 percent) present with primary septicemia (hypotension, shock) without lymph nodes being obviously affected and these patients have higher mortality than those with bubonic plague. The term septicemic plague can be confusing, since most patients with buboes have detectable bacteremia at some stage and can also have high-density bacteremia with systemic signs of sepsis. Debate about whether septicemic plague is always secondary to frank or subclinical bubonic or pneumonic disease continues, but work in mice lends support to the existence of a syndrome of septicemic disease without histological changes in lymph nodes in a few animals infected by flea bites.”
The state of New Mexico can be located on the HealthMap/ProMED-mail interactive map at http://healthmap.org/promed/p/17672. Rio Arriba County can be seen on the map at http://geology.com/county-map/new-mexico-county-map.gif. – Mod.LL]
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