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A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases
Date: Thu 4 Jun 2009
Source: C-Health, Associated Press (AP) report [edited]
New Mexico boy dies of plague, sister recovering
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An 8-year-old New Mexico boy has died and his 10-year-old sister was
hospitalized after both contracted bubonic plague, the 1st recorded
human plague cases in the USA so far in 2009. New Mexico health
officials did not immediately say Thursday [4 Jun 2009] how the
brother and sister contracted the infectious disease, but they are
conducting an investigation at the family's residence to determine if
there is any risk to other people.
Plague is generally transmitted to humans through the bites of
infected fleas, but also can be transmitted by direct contact with
infected animals, including rodents, rabbits, and pets.
The Health Department, citing privacy concerns, would not release the
name of the siblings or give a location for their home, other than
saying it was in Santa Fe County. Spokeswoman Deborah Busemeyer said
the boy died in the last couple of days but she declined to be more
specific.
Fleas collected from the area are being sent to the CDC for testing.
Health workers also canvassed the neighborhood to tell other
residents that plague had been confirmed in the area.
The CDC says an average of 10 to 15 persons contract the plague each
year in the USA. Modern antibiotics are an effective treatment.
[Byline: Susan Montoya Bryan]
--
Communicated by:
Edward McSweegan, PhD
National Institute of Allergy and Infectious Diseases
Bethesda, MD
USA
[Photo of inguinal buboes at
Mod.JW]
[It is probable, but not clearly stated that the siblings were
co-primary cases; that is, they both acquired the infection from flea
bites.
As outlined by the CDC (Centers for Disease Control and Prevention) at
"Death from bubonic plague occurs after the bacterium _Yersinia
pestis_ escapes from the infected bubo into the bloodstream
(septicemic plague) causing the manifestations of the sepsis
syndrome. Disseminated intravascular coagulation (DIC) with
subsequent cutaneous hemorrhage may well have been what was called
the "Black Death" in the Middle Ages. The bacterium can spread to the
lungs, causing a secondary plague pneumonia (secondary to the
bacteremia), or to the meninges, causing a plague meningitis. Both of
these events have a high case fatality rate and the secondary plague
pneumonia is the way the infection spreads (by aerosol) from person
to person.
"The typical sign of the most common form of human plague is a
swollen and very tender lymph gland, accompanied by pain. The swollen
gland is called a "bubo." Bubonic plague should be suspected when a
person develops a swollen gland, fever, chills, headache, and extreme
exhaustion, and has a history of possible exposure to infected
rodents, rabbits, or fleas. A person usually becomes ill with bubonic
plague 2 to 6 days after being infected.
"When bubonic plague is left untreated, plague bacteria invade the
bloodstream. As the plague bacteria multiply in the bloodstream, they
spread rapidly throughout the body and cause a severe and often fatal
condition. Infection of the lungs with the plague bacterium causes
the pneumonic form of plague, a severe respiratory illness. The
infected person may experience high fever, chills, cough, and
breathing difficulty and may expel bloody sputum. If plague patients
are not given specific antibiotic therapy, the disease can progress
rapidly to death. About 14 per cent (1 in 7) of all plague cases in
the United States are fatal."
Cases of plague in feral animals and therefore in humans are unusual
in a calendar year, although the disease may occur at any time.
ProMED-mail has posted a case of human plague from New Mexico in
January 2000 (Plague, bubonic, human - USA (New Mexico)
20000127.0138). However, in the past 4 years, 1st cases posted in the
USA were May 2004, May 2005, February 2006, April 2007, and January
2008.
The southwestern state of New Mexico can be located on the
HealthMap/ProMED-mail interactive map of the US at
A map of the state of New Mexico showing the location of Santa Fe
county mentioned in the posting can be found at
[see also:
Plague, rabbit - USA (NM) 20090415.1435
2008
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Plague, human, feline - USA (NM): early season cases 20080127.0340
2007
----
Plague, bubonic, human - USA (NM) 20070929.3218
Plague, feline - USA (NM) 20070914.3055
Plague, human, septicemic - USA (NM) 20070612.1914
Plague, human, fatal - USA (NM) 20070608.1875
Plague, human, secondary pneumonic - USA (NM) 20070607.1846
Plague, septicemic - USA (NM) 20070504.1447
2006
----
Plague, bubonic, human - USA (NM)(02) 20060724.2034
Plague, bubonic, human - USA (NM) 20060717.1960
Plague, human - USA (NM) 20060601.1526
Plague, human, fatal - USA (NM) 20060528.1500
2005
----
Plague, human - USA (NM)(02) 20050726.2163
Plague, human - USA (NM) 20050725.2157
2004
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Plague, cats - USA (NM) 20040502.1213]
........................................ll/mj/jw
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