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Published Date: 2011-09-20 10:09:31
Subject: PRO/AH/EDR> Plague - USA (04): (OR), septicemic
Archive Number: 20110920.2855

PLAGUE - USA (04): (OREGON), SEPTICEMIC
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International Society for Infectious Diseases
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Date: Mon 19 Sep 2011
Source: The News Tribune [edited]
http://www.thenewstribune.com/2011/09/17/1830741/umatilla-man-has-plague.html

Umatilla County, Oregon, health officials confirmed Friday [16 Sep
2011] that a local man was hospitalized with septicemic plague. The
man is believed to have been infected while hunting in Lake County,
Oregon. He is receiving treatment for the disease.

"Plague is spread to humans through a bite from an infected flea,"
said Genni Lehnert-Beers, Umatilla County public health administrator.
"Plague is serious but it is treatable with antibiotics if caught
early."

Only 3 human cases of plague have been diagnosed in Oregon since 1995,
including 2 in Lake County in 2010. All 3 people recovered.

Lehnert-Beers recommends that people stay away from flea-infested
areas and learn to recognize plague symptoms. Plague can be cured with
antimicrobials, but early treatment is essential. Untreated plague can
be fatal. Lehnert-Beers also recommends taking precautions against
fleas and flea bites, including using flea treatment on pets, wearing
insect repellent, tucking pant cuffs into socks when in areas heavily
occupied by rodents and avoiding contact with wildlife.

[Byline: Michelle Dupler]

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[Most cases of _Yersinia pestis_ infections in the USA are reported
from the Four Corners area of the USA where the states of Colorado,
Utah, Arizona and New Mexico come together.

As outlined by the CDC (Centers for Disease Control and Prevention) at
http://www.cdc.gov/ncidod/dvbid/plague/diagnosis.htm:
"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."
- Mod.LL]

[The interactive HealthMap/ProMED map for the state of Oregon is
available at: http://healthmap.org/r/1fWb - CopyEd.EJP]

See Also