Oregon Man Critical With Bubonic Plague

Posted: June 17, 2012 in medicine and health

A man in his fifties is in critical condition in an eastern Oregon hospital with bubonic (‘black death’) plague. The man was trying to remove a dead mouse from the mouth of a stray cat, when the cat bit him. A few days later, he developed a high fever and other classic symptoms of the disease. There are about 11 cases of the disease in the US each year. Source.

About 1000-2500 cases of the infectious disease are reported globally each year, according to the CDC.. The plague is usually the result of a flea bite, but in this case, the stray cat was a carrier.

Plague is rare in the US. From CDC:

Plague is endemic in rural areas in central and southern Africa, central Asia and the Indian subcontinent, the northeastern part of South America, and parts of the southwestern United States. Although rare, urban outbreaks of plague have been reported in Mahajanga, Madagascar. All ages are at risk for infection; however, risk to travelers is largely restricted to rural endemic areas. Only 1 case associated with international travel has been reported in the United States in the past 2 decades.

Model of bubonic plague bacteria - Smithsonian Museum of Natural History - 2012-05-17
Image by dctim1, creative commons, flickr.

Plague is caused by the bacterium Yersinia pestis.

There are three types of plague, with the following clinical presentations:

-Bubonic (more than 80%)—rapid onset of fever; painful, swollen, and tender lymph nodes, usually inguinal, axillary, or cervical

-Pneumonic—high fever, overwhelming pneumonia, cough, bloody sputum, chills

-Septicemic—fever, prostration, hemorrhagic or thrombotic phenomena, progressing to acral gangrene

Source.

In the United States, all cases of the plague are reported to the CDC, and CDC recommendations are followed. First-line therapy is IV antibiotics.

The name bubonic comes from the resultant bubo, or swollen lymph node draining the infected site. The symptoms occur 6-10 days after exposure, and without treatment the bacteria can enter the lungs, causing the form of plague listed above, pneumonic plague. Pneumonic plague is one of the most deadly diseases known; a patient can die within 24 hours of onset. Source- World Health Organization.

In the middle ages in Europe, the plague killed one-third of the population, and remains one of the worst disasters in Europe’s history. The plague is also estimated to have killed 25 million people in the sixth century during the Byzantine Empire. Source- wiki.

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