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Archive Number 20090611.2153
Published Date 11-JUN-2009
Subject PRO/AH/EDR> Plague, fatal - USA (02): (NM) risk, prevention

PLAGUE, FATAL - USA (02): (NEW MEXICO) RISK, PREVENTION
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International Society for Infectious Diseases
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Date: Wed 10 Jun 2009
From: Paul Ettestad <Paul.Ettestad@state.nm.us>


The 3rd human case of plague (_Yersinia pestis_) from New Mexico in 
2009 has been confirmed and only 1 week after the 1st 2 cases. All 3 
cases were most likely exposed via fleabite due to their clinical 
presentations of bubonic plague. Though we will never know the exact 
exposure, one of the risk factors in the 1st 2 cases was that the 
family dog was allowed to roam and hunt and then sleep in bed with 
the children. No flea control products were used on the dog.

This type of risk has been seen in other human cases in past years 
and serves as a reminder to emphasize flea control product use on 
pets, even in dry areas. These are not the typical dog and cat fleas, 
but plague-infected rodent fleas from various animal species (prairie 
dogs, rock squirrels, wood rats, etc) that may be involved in a 
plague outbreak. The rodent fleas will transiently move to other 
animals (dogs, cats, etc) from their preferred rodent host when it 
dies, and can be brought into the home by pets that are allowed to 
roam and hunt.

North-central New Mexico is having a cooler and wetter late spring 
which allows infected fleas to survive longer and to move to the 
burrow entrances after their host rodent has died from plague without 
being prone to desiccation in the usual hot and dry environment. This 
increases the risk that people and pets walking near the burrow 
entrances may have infected fleas jump onto them to try and take a blood meal.

--
Paul Ettestad DVM, MS
State Public Health Veterinarian
Epidemiology and Response Division
New Mexico Department of Health
USA

[ProMED-mail thanks Dr Ettestad for his first-hand information and 
the inclusion of the news release from the State Department of 
Health, dated 10 Jun 2009:

State confirms 3rd human plague case from Santa Fe County
Animal cases also confirmed in Taos and Santa Fe Counties
----------------------------------------------------------------------
The New Mexico Department of Health confirmed today [10 Jun 2009] a 
3rd case of bubonic plague in Santa Fe County so far in 2009. A 
56-year-old man was hospitalized and is back home recovering. The 
Department of Health is conducting an environmental investigation at 
the man's residence to determine if there is any ongoing risk to people.

The Department also confirmed a plague case in a dog from north of 
the city of Taos and a cat case from the Arroyo Hondo area southeast 
of the city of Santa Fe. Earlier this month [June 2009] the 
Department reported a fatal case in an 8-year-old Santa Fe County boy 
and a case in his 10-year-old sister who recovered. There have been a 
total of 3 human cases in New Mexico, all in Santa Fe County, so far in 2009.

To prevent cases of plague, the Department of Health recommends
- Avoid sick or dead rodents.
- Teach children not to play near rodent nests or burrows.
- Treat pets regularly with an effective flea control product.
- Clean up areas near the house where rodents could live.
- Keep pets from roaming and hunting.
- Sick pets should be examined promptly by a veterinarian.

Symptoms in cats and dogs are similar to humans. Fever, lethargy, not 
eating, and swollen lymph nodes (usually in the neck area) are the 
most common signs.

There was one human case of plague in 2008 in an Eddy County man. 
There were 5 human cases of plague in Bernalillo, San Juan, Santa Fe, 
and Torrance counties in 2007 with a fatality. 8 human plague cases 
occurred in New Mexico in 2006 with 3 fatalities."

The southwestern state of New Mexico can be located on the 
HealthMap/ProMED-mail interactive map of the US at
<http://healthmap.org/r/00bF>.
A map of the state of New Mexico showing the location of Santa Fe and 
the other counties mentioned in the posting can be found at
<http://quickfacts.census.gov/qfd/maps/new_mexico_map.html>. - Mod.LL]

[see also:
Plague, fatal - USA: (NM) bubonic 20090605.2080
Plague, rabbit - USA (NM) 20090415.1435
2008
----
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
----
Plague, cats - USA (NM) 20040502.1213]
...................................ll/mj/dk

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