Issue: October 2015
September 03, 2015
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Reason for surge in plague cases remains unknown

Issue: October 2015
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A recent report in MMWR, detailing the 12 cases of human plague reported this year, noted that the reason behind the surge remains unclear.

Perspective from

“Plague is a rare, life-threatening, flea-borne zoonosis caused by the bacterium Yersinia pestis,” researcher Natalie Kwit, DVM, an epidemic intelligence service officer at the CDC, and colleagues wrote. “During 2001-2012, the annual number of human plague cases reported in the United States ranged from one to 17 (median = three cases). It is unclear why the number of cases in 2015 is higher than usual.”

From April 1 through Aug. 27, there have been 12 reported cases of plague from seven states. Plague has been consolidated in the western U.S., with four patients residing in Colorado, two in Arizona, two in New Mexico, one in California, one in Oregon and one most recently in Utah. Georgia is the only Eastern state to report a plague-infected resident, although that case has been linked to an exposure near Yosemite National Park in California.

Of the cases reported this year, four, all males, were fatal. They include a child and three adults aged 52 years and older. Six other cases involved boys and men.

Map of plague by state

Figure 1. 2015 cases of plague by state.

Source:MMWR

 

The CDC researchers said by using antibiotics, mortality associated with plague has declined from 66% (1900-1941) to 16% (1942-2012). Doctors in plague endemic areas are advised to consider the illness as a diagnosis in patients displaying symptoms of sudden onset of fever and malaise, with accompanying abdominal pain, nausea and vomiting. The CDC requires that all suspicions of plague be reported immediately to health officials.

“Persons engaging in outdoor activities in areas where plague is endemic should wear long pants when possible and use insect repellent on clothing and skin,” Kwit and colleagues wrote. “Persons also should avoid direct contact with ill or dead animals and never feed squirrels, chipmunks or other rodents.” – by David Costill

Reference:

Utah Department of Health Press Release.

Disclosure: The researchers report no relevant financial disclosures.