1/31. Cases of cat-associated human plague in the Western US, 1977-1998. Exposure to cats infected with yersinia pestis is a recently recognized risk for human plague in the US. Twenty-three cases of cat-associated human plague (5 of which were fatal) occurred in 8 western states from 1977 through 1998, which represent 7.7% of the total 297 cases reported in that period. Bites, scratches, or other contact with infectious materials while handling infected cats resulted in 17 cases of bubonic plague, 1 case of primary septicemic plague, and 5 cases of primary pneumonic plague. The 5 fatal cases were associated with misdiagnosis or delays in seeking treatment, which resulted in overwhelming infection and various manifestations of the systemic inflammatory response syndrome. Unlike infections acquired by flea bites, the occurrence of cat-associated human plague did not increase significantly during summer months. plague epizootics in rodents also were observed less frequently at exposure sites for cases of cat-associated human plague than at exposure sites for other cases. The risk of cat-associated human plague is likely to increase as residential development continues in areas where plague foci exist in the western US. Enhanced awareness is needed for prompt diagnosis and treatment. ( info) |
2/31. plague and the gallium scan: Case report. inflammation in the right axillary lymph nodes and the meninges was detected by 67Gacitrate scans in an 11-year-old boy with yersinia pestis infection. This case provides another example of 67Ga localizing to areas of infection, indicating potential utility in future cases of bubonic plague. ( info) |
| The transmission of bubonic plague from the kitten of a domestic cat to a man by means of a bite on a finger is described. The human case was complicated by the development of a secondary meningitis, followed, after specific therapy, by protracted recovery. The kitten showed swollen lymph nodes of the head and neck, frothing at the mouth and nostrils, and signs of an acute infectious disease which had a fatal termination. yersinia pestis was isolated on about the 8th day from the cerebrospinal fluid of the man. The foster mother of the kitten exhibited signs of spinal and cerebral meningitis but recovered following treatment; her serum contained plague antibody levels of 1:512 and 1:1024 on the 22nd and 34th days respectively after the first evidence of illness. Three litter mates of the kitten also died. The outbreak occurred on a farm in the Graaff-Reinet district of the eastern Cape Province, which is situated about 160 km from the nearest known natural plague focus. ( info) |
| On November 1, 2002, a married couple traveled from Santa Fe County, new mexico, to new york city (NYC), where they both became ill with fever and unilateral inguinal adenopathy; bubonic plague (yersinia pestis) was diagnosed subsequently. This report summarizes the clinical and public health investigation of these cases and underscores the importance of rapid diagnosis and communication among health-care providers, public health agencies, and the public when patients seek medical attention for an illness that might be caused by an agent of terrorism. ( info) |
| On August 26, 1992, a 31-year-old male resident of Tucson, arizona, died of an illness subsequently diagnosed as primary pneumonic plague. This is the 10th case of plague reported in the united states in 1992, the first pneumonic plague case this year, and the first plague fatality reported since 1987 (CDC, unpublished data). This report summarizes the investigation of this case by county, state, and federal public health officials in arizona and colorado. ( info) |
| From January 1 through October 15, 1992, 11 human plague cases, including one described recently (1), have been reported in the united states. This report summarizes the epidemiologic information on these cases and provides recommendations for control of plague. ( info) |
7/31. Limited infection upon human exposure to a recombinant raccoon pox vaccine vector. A laboratory accident resulted in human exposure to a recombinant raccoon poxvirus (RCN) developed as a vaccine vector for antigens of yersinia pestis for protection of wild rodents (and other animals) against plague. Within 9 days, the patient developed a small blister that healed within 4 weeks. Raccoon poxvirus was cultured from the lesion, and the patient developed antibody to plague antigen (F1) and RCN. This is the first documented case of human exposure to RCN. ( info) |
8/31. Bubonic plague. A 19-year-old man, recently returned from a 10-day military exercise in central california, had acute onset of shaking chills, headache, and bilateral inguinal adenopathy after having been bitten by insects on his lower extremities. He had exquisitely tender inguinal and femoral nodes bilaterally. Needle aspirate from an inguinal node grew yersinia pestis. The patient was treated with streptomycin and chloramphenicol and did well. ( info) |
| In November 2002, a couple from new mexico traveled to New York where both had fever and unilateral inguinal adenopathy. The husband was in septic shock when he sought medical care and was admitted to an intensive care unit, where he developed ischemic necrosis of his feet which later required bilateral amputation. yersinia pestis was grown from his blood. Immunohistochemical assays using anti-Y pestis antibodies demonstrated multiple bacteria and granular antigens in and around vessels of the ischemic amputation tissues obtained 20 days after initiation of antibiotics; however, no evidence of Y pestis was present in viable tissues. Immunohistochemical evidence of Y pestis inside vessels of gangrenous feet in this patient underscores the importance of adequate excision of necrotic or partially necrotic tissues because antibiotics cannot be effectively delivered to necrotic and poorly perfused tissues. ( info) |
| We investigated a cluster of 5 plague cases; the patients included 4 with severe pharyngitis and submandibular lymphadenitis. These 4 case-patients had eaten raw camel liver. yersinia pestis was isolated from bone marrow of the camel and from jirds (Meriones libycus) and fleas (xenopsylla cheopis) captured at the camel corral. ( info) |