Thursday, June 14, 2018

PRO/AH/EDR> Plague - USA (02): (ID)

PLAGUE - USA (02): (IDAHO)
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Date: Tue 12 Jun 2018
Source: Idaho Central District Health Department [edited]
<http://www.cdhd.idaho.gov/pdfs/News/2018/06-12-18-human-plague-case.pdf>


Plague was confirmed this week in an Elmore county child. The child is
recovering after receiving antimicrobial treatment. "Plague is spread
to humans through a bite from an infected flea. People can decrease
their risk by treating their pets for fleas and avoiding contact with
wildlife," said Sarah Correll, DVM, Central District Health Department
epidemiologist. "Wear insect repellant, long pants, and socks when
visiting plague affected areas."

It is not known whether the child was exposed to plague in Idaho or
during a recent trip to Oregon. Plague has historically been found in
wildlife in both states. Since 1990, 8 human cases were confirmed in
Oregon and 2 were confirmed in Idaho.

Plague in humans is rare, but occurs naturally in some rodent
populations, including ground squirrels in Idaho. Fleas spread the
disease between animals. The disease can also be transmitted to humans
by direct contact with infected animals or their fleas.
Person-to-person transmission is extremely rare and this case was not
a risk to others.

Symptoms of plague usually occur within 2 to 6 days of exposure and
include sudden onset of fever, chills, headache, and weakness. In most
cases, there is also a painful swelling of the lymph node [called a
bubo - Mod.LL] in the groin, armpit, or neck. Plague signs in cats and
dogs include fever, lethargy and loss of appetite. There may be a
swelling in the lymph nodes under the jaw of pets. Prompt diagnosis
and appropriate antibiotic treatment can greatly reduce the risk of
death in people and pets.

Plague was identified in 2015 and 2016 in ground squirrels in both
Elmore and south Ada counties. However, this season [2018], no ground
squirrel die offs or unusual behavior has been reported by state
wildlife officials.

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[The manifestations of _Yersinia pestis_ infection in this case are
not stated in the report but it is likely to have been bubonic plague.
Of late, 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 per cent) 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."

Elmore county, Idaho which was named after the Ida Elmore mines,
producer of silver and gold in the 1860s is located south of Boise and
in the southwestern part of the state. Its location can be found on a
map at: <https://en.wikipedia.org/wiki/Elmore_County,_Idaho>. -
Mod.LL

HealthMap/ProMED-mail map of Idaho, United States:
<http://healthmap.org/promed/p/3482>]

[See Also:
Plague - USA: (NM) canine http://promedmail.org/post/20180331.5721677
2017
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Plague - USA (14): (CA) bear, exposure
http://promedmail.org/post/20171213.5501299
Plague - USA (13): (AZ) bubonic, infected fleas, alert
http://promedmail.org/post/20170815.5251542
Plague - USA (12): (NM) bubonic, squirrel, alert
http://promedmail.org/post/20170811.5244152
Plague - USA (11): (AZ) bubonic, prairie dog, die-off
http://promedmail.org/post/20170807.5233248
Plague - USA (10): (AZ,TX) bubonic, prairie dogs, fleas
http://promedmail.org/post/20170723.5197563
Plague - USA (09): (TX) prairie dog, alert
http://promedmail.org/post/20170704.5150405
Plague - USA (08): (NM) http://promedmail.org/post/20170626.5132081
Plague - USA (07): (CO) feline
http://promedmail.org/post/20170615.5108564
Plague - USA (06): (NM) http://promedmail.org/post/20170606.5087671
Plague - USA (05): (CO) feline, bubonic, alert: corr
http://promedmail.org/post/20170506.5017288
Plague - USA (05): (CO) feline, bubonic, alert
http://promedmail.org/post/20170505.5014699
Plague - USA (04): (NM) feral cat, alert
http://promedmail.org/post/20170419.4980169
Plague - USA (03): (NM) feline, canine
http://promedmail.org/post/20170412.4965194
Plague - USA (02): (CO) prairie dog, alert
http://promedmail.org/post/20170318.4910519
Plague - USA: (NM) canine http://promedmail.org/post/20170211.4832639
2016
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Plague, animal - USA (06): (ID) cat recovering, ground squirrel
http://promedmail.org/post/20160616.4290356
Plague, animal - USA (05): (ID) domestic cat, ground squirrel
http://promedmail.org/post/20160615.4287888
Plague, animal - USA (03): (ID) ground squirrel, domestic cat, susp
http://promedmail.org/post/20160604.4265294
2015
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Plague, animal - USA (08): (ID) vole, susp.
http://promedmail.org/post/20150617.3443480
Plague, animal - USA (07): (ID) canine
http://promedmail.org/post/20150608.3417597]
.................................................jh/ll/mj/jh
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